CPT 0664T: Deceased Donor Uterus Procurement and Preservation

CPT code 0664T represents deceased donor uterus procurement and preservation, a specialized surgical service that harvests a donor uterus and preserves it on ice and in cold preservation solution for transplantation. The code codifies an increasingly relevant step in the expansion of uterine transplant programs and organ donation services, supporting clinical pathways for fertility restoration in select recipients.

Key payers referenced in a national analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of clinical context for uterus procurement, expected sites of service (operating room/surgical procurement facilities), common billing modifiers associated with complex surgical and transplant services, and guidance on where to find additional coding and policy references. The publication outlines typical reimbursement considerations and payer coverage patterns without offering clinical recommendations.

The article provides benchmarks and policy context relevant to hospital transplant programs and billing teams, summarizes common administrative and documentation elements tied to organ procurement coding, and notes areas where payers may require prior authorization or specific documentation. Data not available in the input is identified where applicable, and readers are directed to payer policy manuals and transplant billing guides for operational details and updates.

Billing Code Overview

CPT code 0664T describes a surgical procurement procedure in which a provider harvests a uterus from a deceased donor and preserves the organ on ice and in cold preservation solution for later transplantation into a recipient. This procedure is a donor organ procurement service specifically focused on uterus retrieval and immediate cold preservation.

Service type: Deceased donor uterus procurement and organ preservation
Typical site of service: Operating room or surgical procurement facility where organ retrieval and cold preservation are performed

Clinical Context

A deceased-donor uterine procurement is performed when a uterus is recovered from a brain-dead or circulatory-death donor for subsequent transplantation into an eligible recipient. The procedure is conducted in an operating room under general anesthesia by a surgical team that typically includes a transplant surgeon, gynecologic surgeon, anesthesiologist, and surgical assistants. After standard donor evaluation and consent, the donor is taken to the OR where a midline laparotomy provides exposure. The provider dissects and mobilizes the uterus with its vascular pedicles (usually utero-ovarian or internal iliac arterial and venous branches as indicated), divides supporting ligaments, and ensures adequate vascular length for back-table preparation. The uterus is flushed with cold preservation solution, removed en bloc or as indicated, placed on ice, and transferred in sterile cold storage media for transport to the recipient center. Documentation includes donor identification, time of cross-clamp, details of vascular pedicles and ureteral preservation, preservation solution used, ischemia time, and chain-of-custody transfer notes. Typical site of service is an acute care hospital operating room. Typical patient scenario: a brain-dead female organ donor meeting donor suitability criteria undergoes multi-organ procurement in which the uterus is harvested, preserved on ice, and shipped to a recipient center for planned transplant evaluation and implantation.

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services

Taxonomy Code	Specialty	Notes
`2080P0002X`	General Surgery	Transplant and abdominal organ procurement expertise; commonly leads multiorgan recovery teams.
`2084P0800X`	Obstetrics & Gynecology	Gynecologic surgeons provide uterine-specific dissection, vascular control, and back-table preparation.
`2084P0805X`	Female Pelvic Medicine & Reconstructive Surgery	Complex pelvic dissection skills for challenging anatomy during uterine harvest.
`208800000X`	Transplant Surgeon	Specialized in organ procurement coordination and multiorgan donor management.
`207L00000X`	Anesthesiology	Provides intraoperative anesthesia care for the donor during procurement procedures.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`Z52.4`	Organ donor	This code identifies a patient as an organ donor and is directly relevant to any deceased-donor organ procurement, including uterus harvest.
`Z48.23`	Encounter for removal of organ or tissue donor site dressing	Used for donor-related surgical follow-up and procurement site care documentation.
`Z99.89`	Dependence on other enabling machines and devices, not elsewhere classified	May be used when donors were on life support at time of procurement; documents support care context.
`R96.0`	Instantaneous death (sudden cardiac arrest)	May be applicable in circulatory death donors when relevant to documentation of cause and timing.
`R99`	Ill-defined and unknown cause of mortality	May be used in deceased donors where final cause of death is pending or non-specific at time of procurement.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`76937`	Ultrasound guidance for vascular access requiring ultrasound, first vessel	May be used preoperatively for donor vascular access placement during donor management.
`33945`	Heart procurement (donor)	Example of another organ procurement code that may be performed during the same multiorgan donor operation; often billed separately.
`50320`	Kidney procurement from deceased donor for subsequent transplantation	Common concurrent organ procurement during the same donor operation; billed per organ-specific procurement codes.
`01990`	Anesthesia for donor procurement of multiple organs, or for organ procurement for transplant (list separately in anesthesia coding)	Reflects anesthesia services complex to multiorgan procurement procedures (use appropriate anesthesia coding rules).
`66999`	Unlisted procedure, anterior segment of eye (placeholder for specialty-specific unlisted techniques)	Rarely used when a specific procurement technique lacks a direct CPT descriptor; coding must be justified with documentation.

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Summary & Overview