Summary & Overview
CPT 0338T: Percutaneous Renal Artery Radiofrequency Therapy
CPT code 0338T represents a percutaneous, catheter-based procedure that delivers radiofrequency energy to the endoluminal surface of the renal artery on one side. This emerging endovascular intervention is used in select clinical scenarios where targeted thermal modification of the renal artery is indicated. The code captures a specialized image-guided arterial procedure and is relevant for hospitals, ambulatory surgical centers, interventional radiology groups, and vascular specialists.
Key payers covered in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a national perspective on clinical context, coding definitions, and payer coverage considerations for this procedure. The publication summarizes how the service is billed, the typical settings where it is performed, and what to expect from major payers in terms of coverage presence. It also provides benchmarks and policy updates where available, and places the procedure in clinical context for referring clinicians and billing professionals.
This summary is intended to orient clinical, coding, and revenue-cycle stakeholders to the procedure and its billing classification, helping readers locate more detailed benchmarks, payer policy language, and related coding guidance in the full publication.
Billing Code Overview
CPT code 0338T describes a procedure in which the physician uses a percutaneous approach to deliver radiofrequency energy to the endoluminal surface of the renal artery on one side of the body. This procedure is a catheter-based, image-guided arterial intervention performed to modify the renal artery lining using thermal energy.
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Service type: Percutaneous renal artery radiofrequency ablation/intervention
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Typical site of service: Hospital outpatient department or ambulatory surgical center; procedure is performed in an interventional radiology or endovascular suite
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Clinical & Coding Specifications
Clinical Context
A typical patient is a 55–70 year-old adult with treatment-resistant, medication-refractory hypertension attributed to renal sympathetic overactivity or anatomically appropriate renovascular hypertension. The patient has undergone history and physical examination, ambulatory or office blood pressure monitoring, medication review, renal artery imaging (CT angiography or duplex ultrasound) confirming suitable renal artery anatomy (non-atherosclerotic focal disease or anatomy amenable to catheter access), and cardiovascular risk assessment. The clinical workflow: pre-procedure evaluation by an interventional cardiologist, interventional radiologist, or endovascular specialist; informed consent; percutaneous arterial access (commonly femoral or radial) in an outpatient catheterization lab or hybrid operating room; intra-procedural angiography to confirm renal artery anatomy; delivery of radiofrequency energy via an endoluminal catheter to the renal artery lumen on one side (0338T) with physiologic and hemodynamic monitoring; hemostasis and post-procedure observation for several hours to overnight depending on institutional protocols and patient comorbidities; discharge with follow-up blood pressure monitoring and medication adjustment as needed. Typical site of service is an outpatient ambulatory surgical center or hospital-based catheterization lab/procedural suite.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when work or complexity is substantially greater than usual for 0338T and documented justification is present. |
51 | Multiple procedures | Use when 0338T is billed on the same date with other distinct procedures and payer requires the multiple-procedure modifier. |
52 | Reduced services | Use when the renal denervation procedure is partially reduced or not completed as planned. |
53 | Discontinued procedure | Use when the procedure is terminated before completion for reasons unrelated to patient improvement (e.g., severe anatomic difficulty, complication). |
54 | Surgical care only | Use when another clinician provides pre- and post-operative care and the billing clinician provides only the intra-procedural services. |
55 | Postoperative management only | Use when billing clinician provides only postoperative care for the procedure performed by another surgeon. |
56 | Preoperative management only | Use when billing clinician provides only preoperative evaluation for the procedure performed by another surgeon. |
62 | Two surgeons | Use when two surgeons of different specialties work together as primary surgeons performing distinct surgical responsibilities during 0338T. |
66 | Surgical team | Use when a surgical team or primary-surgeon/team approach is used for a complex case involving 0338T. |
78 | Unplanned return to OR | Use when a patient returns to the operating/procedure room for related care for a complication of 0338T during the global period. |
80 | Assistant surgeon | Use when an assistant surgeon performs part of the procedure and documentation supports assistant role. |
81 | Minimum assistant surgeon | Use when a minimal assistant surgeon contribution is billed for 0338T. |
82 | Assistant surgeon (when qualified resident not available) | Use when an assistant surgeon is required but a qualified resident is not available. |
AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | Use when an advanced practice clinician assists during the procedure per payer policy. |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
| 208000000X | Cardiology | Interventional cardiologists commonly perform renal artery interventions and catheter-based renal denervation. |
| 208600000X | Vascular Surgery | Vascular surgeons perform endovascular renal artery procedures and manage access and arterial complications. |
| 207RG0300X | Interventional Radiology | Interventional radiologists perform image-guided percutaneous renal denervation procedures. |
| 363L00000X | Nephrology | Nephrologists may be involved in patient selection and long-term blood pressure/renal function follow-up. |
| 207P00000X | Diagnostic Radiology | Diagnostic radiologists provide vascular imaging interpretation for pre-procedure planning. |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
I10 | Essential (primary) hypertension | Most common indication when hypertension is poorly controlled on multi-drug therapy and renal denervation is considered. |
I15.0 | Renovascular hypertension due to renal artery stenosis | Secondary hypertension from renal artery disease may be anatomic reason to evaluate renal arteries prior to or instead of denervation. |
I12.0 | Hypertensive chronic kidney disease with stage 1 through stage 4 CKD, or unspecified CKD | CKD often coexists with difficult-to-control hypertension and is relevant to risk/benefit assessment. |
I13.0 | Hypertensive heart and chronic kidney disease with heart failure and stage 1 through stage 4 CKD, or unspecified CKD | Patients with combined cardiac and renal disease may be candidates for specialized blood pressure interventions. |
N28.9 | Disorder of kidney and ureter, unspecified | Used when kidney-specific concerns are present but not otherwise specified during pre-procedure evaluation. |
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Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
36215 | Selective catheter placement, arterial system; each first-order abdominal, pelvic, or lower extremity branch, within a vascular family | Used for selective catheterization of the renal artery during angiography before 0338T. |
36011 | Arterial catheterization or cannulation for sampling, monitoring or transfusion (separate procedure) | May be used for arterial access management or monitoring during the procedure when billed separately. |
75898 | Angiography, catheter-based, radiological supervision and interpretation, therapeutic intervention within the same vessel performed at time of diagnostic angiographic exam (List separately in addition to codes for primary procedure) | Used to report angiographic imaging and guidance during endovascular renal denervation. |
51720 | Measurement of post-void residual urine; non-instrumental (bladder scan) | Ancillary assessment sometimes used peri-procedurally in patients with autonomic concerns (not routine; included here as possible ancillary code). |
99214 | Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity | Commonly used for pre-procedure evaluation and post-procedure follow-up visits related to 0338T. |
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