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Landau et al. Art Int Surg. 2025;5:24-35 https://dx.doi.org/10.20517/ais.2024.78 Page 30

Table 2. Reported accuracy and efficiency of CPT code assignment
AI method(s) employed (ML/NLP) Specificity Sensitivity ROC values Accuracy
Bing AI [13,15] 33.3% (endovascular) 46.7% (simple), 20% (complex) N/A 40%
[13,15]
ChatGPT 4.0 20% (simple), 40% (complex) 33.3% (simple), 40% (complex) N/A 25%
[13,15]
ChatGPT 3.5 26.7% (simple), 0% (complex) 20% (simple), 60% (complex) N/A 20%
[13,16]
RF 74%-92% 74%-82% N/A 74%-84%
[16]
NN N/A N/A N/A 39%-54%
SVM [10] 0.918-1.00 0.594-0.897 0.422-0.967 0.650-0.884
[10,16]
LR 0.937-0.955 0.594-0.873 0.445-0.983 0.644-0.965
NB [10] 0.571-0.981 0.594-0.806 0.513-0.981 0.636-0.973
[18,21]
GBT 92%-93% 65%-67% 0.89-0.90 N/A
DT [14] 0.940-0.971 0.594-0.970 0.441-0.984 0.636-0.973
[14]
RF + CWR Improved by 8% Improved by 8% N/A 82%-84%
Text mining (ICD-9-CM, CPT codes) [10,13,18,19] 93%-100% 40%-100% 0.76-0.99 0.98
[13,15]
TF-IDF 74%-100% 74%-100% N/A 74%-76%
[20]
BiLSTM 80% 80% 80% 98%
CPT: Current procedural terminology; AI: artificial intelligence; ML: machine learning; NLP: natural language processing; ROC: receiver operating
curve; RF: random forest; NN: neural network; SVM: support vector machine; LR: logistic regression; NB: Naïve Bayes; GBT: gradient boosted
trees; DT: decision tree; CWR: class weight recalculation; ICD-9-CM: International Classification of Diseases, Ninth Revision, Clinical
Modification, TF-IDF: term frequency-inverse document frequency; BiLSTM: bidirectional long short-term memory.

Figure 2. Key advantages (green) and disadvantages (red) derived from the literature represented as presence (absolute count) in
selected sources. Key advantages and disadvantages were defined as points biased toward the benefits or drawbacks of integration of
AI, ML, or NLP, respectively. AI: Artificial intelligence; ML: machine learning; NLP: natural language processing.

We identified a severe sparsity of articles evaluating plastic surgery-specific AI-driven CPT code
assignment, including an absence of codes commonly used in several subspecialties, such as cosmetics, hand
surgery, or gender-affirming surgery. Of the 11 studies included, only four directly reported investigating
CPT codes that overlapped with plastic surgery. The corresponding CPT codes included 30520, which may
be used in the context of craniofacial surgery, 69990 for operation of a microscope used in microsurgery,
20932 for autografting, and 20930 for morselized allograft material and osteoinductive materials, applicable