Fiducial Marker Coding

* Medicare National Average Rates are indicated

**Package indicates that CMS has included the reimbursement for this procedure/device in the primary procedure

***By report reimbursement requires submission of additional patient data for payment to be determined by CMS

Implanted Markers
HCPCS	Description	Hospital Outpatient Value*	Physician Office Value*
A4648	Implantable Tissue Marker, each	Packaged	COST

Implant Procedure
HCPCS	Description	Hospital Outpatient Value*	Physician Office Value*
55876	Placement of interstitial device(s) for radiation therapy guidance (eg, fiducial markers, dosimeter), percutaneous, prostate, single or multiple	$927.34	$140.01
C9728 or 19499	Placement of interstitial device(s) for radiation therapy/surgery guidance (e.g., fiducial markers, dosimeter), for other than the following sites (any approach): abdomen, pelvis, prostate, retroperitoneum, thorax, single or multiple	$927.34	By Report***
31626	Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with placement of fiducial markers, single or multiple	$699.05	$422.55
41019	Placement of needles, catheters, or other device(s) into the head and/or neck region (percutaneous, transoral, or transnasal) for subsequent interstitial radioelement application	$1682.70	$472.35
32553	Placement of interstitial device(s) for radiation therapy guidance (eg, fiducial markers, dosimeter), percutaneous, intra-thoracic, single or multiple	$927.34	$581.32
49411	Placement of interstitial device(s) for radiation therapy guidance (eg, fiducial markers, dosimeter), percutaneous, intra-abdominal, intra-pelvic (except prostate), and/or retroperitoneum, single or multiple	$927.34	$504.32

Image Guidance
HCPCS	Description	Hospital Outpatient Value*	Physician Office Value*
76942	Ultrasound guidance for needle placement (e.g., biopsy, aspiration, injection, localization device), imaging supervision and interpretation	Packaged	$181.87
77012	CT guidance for needle placement (e.g., biopsy, aspiration, injection, localization device), radiological supervision and interpretation	Packaged	$170.32
77021	MR guidance for needle placement (e.g., biopsy, needle aspiration, injection of localization device), radiological supervision and interpretation	Packaged	$417.50
77031	Stereotactic localization guidance for breast biopsy or needle placement (e.g., wire localization or for injection, each lesion, supervision and interpretation	Packaged	$168.88

APPROPRIATE CODING IS DETERMINED BY LOCAL POLICY
BE AWARE OF CODING BASED UPON PLACE OF SERVICE

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Procedure coding should be based upon medical necessity and procedures and supplies provided to the patient. Coding and reimbursement Information is provided for educational purposes and does not assure coverage of the specific item or service in a given case. RadiaDyne and The Pinnacle Health Group make no guarantee of coverage or reimbursement of fees. Contact your local Medicare Fiscal Intermediary, Carrier or CMS for specific information as payment rates listed are subject to change and will vary by payer and region. To the extent that you submit cost information to Medicare, Medicaid or any other reimbursement program to support claims for services or items, you are obligated to accurately report the actual price paid for such items, including any subsequent adjustments. CPT five-digit numeric codes, descriptions, and numeric modifiers only are Copyright AMA. All rights reserved.

It is great that I can use Gold Anchor without local anesthesia. I also find it useful to give each marker a recognizable shape when using several markers for the same patient.

We are using Gold Anchors to achieve a more reliable localization over time for our gynecology patients.

Fiducial Marker Coding

* Medicare National Average Rates are indicated

**Package indicates that CMS has included the reimbursement for this procedure/device in the primary procedure

***By report reimbursement requires submission of additional patient data for payment to be determined by CMS

Implanted Markers

Implant Procedure

Image Guidance

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Physician Testimonial Enrique Castellanos, M.D., Ph.D.

Physician Testimonial Catharina Beskow, M.D., Ph.D.