2025 CPT code 96548
(Active) Effective Date: N/A Injection and Infusion Services - Chemotherapy administration Medicine Feed
Intraoperative hyperthermic intraperitoneal chemotherapy (HIPEC) procedure, including separate incision(s) and closure, when performed; each additional 30 minutes (List separately in addition to code for primary procedure)
Modifiers may be applicable in certain situations. For example, modifier 52 may be used to indicate reduced services if the procedure is discontinued prematurely. Modifier 73 may be appended when the HIPEC component of the procedure is discontinued after it has begun, along with appropriate reporting of primary procedure and modifier.
Medical necessity for HIPEC must be supported by documentation that establishes the diagnosis and the appropriateness of this treatment modality for the patient's specific condition.
The physician or other qualified healthcare professional is responsible for all aspects of the HIPEC procedure, including selecting the chemotherapy agent, ensuring proper equipment setup, making incisions for catheter placement, supervising the perfusion and agitation of the heated chemotherapy agent, irrigating and closing the surgical site, and documenting the procedure.
In simple words: This code covers the additional 30-minute increments of a specialized heated chemotherapy treatment delivered directly into the abdomen during an operation.It's used for each half-hour beyond the first hour of this treatment.This code is in addition to the codes for the main surgery.It covers setting up and delivering the heated chemotherapy, monitoring the patient, and cleaning the area afterwards.
This add-on code describes each additional 30 minutes of intraoperative hyperthermic intraperitoneal chemotherapy (HIPEC) beyond the initial 60 minutes. HIPEC involves the perfusion of a heated chemotherapy agent into the abdominal cavity through catheters during an operation, which is considered the primary procedure.The HIPEC procedure includes chemotherapy agent selection, confirmation of perfusion equipment settings for chemotherapy agent delivery, additional incision(s) for catheter and temperature probe placement, perfusion supervision and manual agitation of the heated chemotherapy agent in the abdominal cavity during chemotherapy agent dwell time, irrigation of the chemotherapy agent, closure of wounds related to HIPEC, and documentation of the chemotherapy agent and HIPEC procedure in the medical record.This code does not include the typical preoperative, intraoperative, and postoperative work related to the primary procedure.
Example 1: A patient undergoes a cytoreductive surgery (e.g., 44204) for peritoneal carcinomatosis followed by HIPEC. The HIPEC procedure lasts 90 minutes. 96547 is reported for the first 60 minutes and 96548 is reported once for the additional 30 minutes., A patient with appendiceal cancer undergoes a right hemicolectomy (44204) with HIPEC. The HIPEC procedure lasts for 120 minutes. 96547 is billed for the initial 60 minutes and 96548 is billed twice for the additional 60 minutes., A patient undergoes an omentectomy (e.g. 49255) and peritonectomy with HIPEC. The HIPEC portion lasts for 150 minutes. 96547 is reported once, and 96548 is reported three times.
Documentation should include details of the primary surgical procedure, the type and dosage of chemotherapy agent used, the duration of the HIPEC procedure, temperature monitoring information, any complications encountered, and a detailed operative report specific to the HIPEC portion of the procedure.
- Global Days: This code is an add-on code and does not have its own global period.It is included in the global period of the primary procedure.
- Payment Status: Active
- Specialties:Surgical Oncology, Gynecologic Oncology, General Surgery
- Place of Service:Inpatient Hospital, Ambulatory Surgical Center