2025 CPT code 49411
(Active) Effective Date: N/A Revision Date: N/A Surgery - Surgical Procedures on the Digestive System Surgery Feed
Percutaneous placement of interstitial device(s) for radiation therapy guidance (e.g., fiducial markers, dosimeter) in the intra-abdominal, intra-pelvic (except prostate), and/or retroperitoneal regions.
Modifiers may be applicable depending on the circumstances of the procedure.Consult the CPT guidelines and NCCI edits for appropriate modifier use.
Medical necessity for 49411 is established by the need for precise radiation therapy targeting.This is typically indicated in cases of cancer where accurate localization of the tumor is crucial for optimal treatment efficacy and minimizing damage to surrounding healthy tissues. Documentation must support the clinical indication for radiation therapy and the need for fiducial markers or dosimeter.
The physician is responsible for patient preparation, anesthesia (nerve block), percutaneous needle insertion, image guidance using appropriate imaging modality, placement of fiducial markers or dosimeter, and hemostasis. Post-procedural care and monitoring are also the physician's responsibility.
In simple words: The doctor places small metal markers or a measuring device near a tumor to help guide radiation treatment. This is done through the skin using imaging (like X-rays or ultrasound) to ensure accurate placement. The markers help the radiation target the tumor precisely.
This CPT code encompasses the percutaneous placement of one or more small metal markers (fiducial markers) or a dosimeter within the intra-abdominal, intra-pelvic (excluding the prostate), or retroperitoneal regions.The procedure uses imaging guidance (CT, fluoroscopy, ultrasound, or MRI) to precisely position these devices adjacent to a previously identified tumor site to facilitate radiation therapy. The provider inserts a needle under nerve block anesthesia, utilizes the chosen imaging modality for guidance, and places the fiducials in the target interstitial space. Hemostasis is achieved using pressure after placement.The supply of the devices is billed separately.This code should not be used for prostate radiation therapy (use CPT code 55876 instead).
Example 1: A 65-year-old female patient diagnosed with colon cancer is scheduled for radiation therapy.The physician performs a percutaneous placement of fiducial markers under CT guidance to accurately target the tumor during radiation treatments., A 72-year-old male patient with a retroperitoneal sarcoma undergoes a percutaneous placement of a dosimeter to measure radiation dosage during treatment.Ultrasound guidance is used for the procedure., A 50-year-old female patient with ovarian cancer requires fiducial markers placed for radiation therapy. The physician uses fluoroscopy to guide the percutaneous placement of multiple markers in the pelvic cavity.
Detailed medical history, including diagnosis, imaging studies demonstrating tumor location, operative report including the number and type of devices placed, type of imaging guidance used, and post-procedure notes verifying accurate placement and absence of complications.Consent form should also be documented.
** The supply of fiducial markers and dosimeters are billed separately.If imaging guidance is used, the appropriate imaging guidance codes should also be reported. The procedure can be performed on various anatomical sites (intra-abdominal, intra-pelvic, retroperitoneal), but the prostate is excluded. Always refer to the most up-to-date CPT and NCCI guidelines.
- Revenue Code: P7B (ONCOLOGY - OTHER)
- RVU: Information not available.RVUs vary based on geographic location, facility type, and other factors. Consult your local payer's fee schedule for accurate RVU values.
- Global Days: Information not available.The global surgical period is not explicitly defined for this code.Refer to your payer's guidelines for potential bundling considerations.
- Payment Status: Active
- Modifier TC rule: A Technical Component (TC) modifier is not typically applied to this code, as it represents the professional component of the procedure.
- Fee Schedule: Information not available.Historical fee schedule data varies significantly based on location and payer.
- Specialties:Radiation Oncology, Surgical Oncology, Gastroenterology
- Place of Service:Office, Outpatient Hospital, Ambulatory Surgical Center