Summary & Overview

CPT 0874T: Removal of Peritoneal Ascites Pump System

CPT code 0874T represents the surgical removal (explantation) of a peritoneal ascites pump system, including the pump, the peritoneal catheter, and the bladder catheter. This code captures a distinct device removal service that can follow device malfunction, infection, patient recovery, or therapy discontinuation. Nationally, accurate coding for device explantation affects facility billing, device registries, and quality measurement for patients with refractory ascites who have received implanted pump therapy.

Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Coverage policies for device explantation services vary by payer and often depend on documented clinical indications, prior authorization status at implantation, and post-implant complications. Reimbursement and site-of-service rules differ across commercial plans and Medicare, making correct procedural coding and accompanying documentation important for claims processing.

Readers will find a concise overview of the clinical scope of the service, typical sites of care, and the role of CPT code 0874T in billing workflows. The publication outlines benchmarking considerations and policy context relevant to device explantation services, and it highlights where additional payer-specific policy lookup is needed. Data not available in the input is noted where applicable.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare0874TCPTperitoneal-ascites-pumpdevice-explantationsurgical-removalambulatory-surgeryhospital-proceduresbilling-coding

Billing Code Overview

CPT code 0874T describes the removal of a peritoneal ascites pump system, including removal of the pump device, the peritoneal catheter (tube), and the bladder catheter. This procedure is a device explantation service performed by a qualified provider.

Service type: Surgical device removal (explantation) of a peritoneal ascites pump system
Typical site of service: Hospital operating room or ambulatory surgical center, depending on clinical status and facility capabilities

Clinical & Coding Specifications

Clinical Context

A 62-year-old patient with refractory malignant ascites previously had an implanted peritoneal ascites pump system to manage recurrent fluid accumulation. Over time the pump failed, became infected, or the underlying disease progressed such that continued implantation is no longer indicated. The patient is scheduled for removal of the peritoneal ascites pump system in the operating room under monitored anesthesia care or general anesthesia. The surgical workflow includes preoperative consent and assessment, verification of device model and prior operative reports, sterile preparation, incision/exposure over the pump pocket, dissection to free and remove the pump, removal of the peritoneal catheter from the peritoneal cavity, removal of the bladder catheter portion if present, hemostasis, irrigation, layered closure of the pocket and skin, and dressing application. Intraoperative documentation includes device serial numbers, catheter lengths removed, extent of adhesions, any concurrent procedures, and the condition of surrounding tissues. Typical sites of service are the hospital inpatient or outpatient surgery center; documentation should support whether the service is inpatient or outpatient and any medically necessary observation or admission.

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services	When work required is substantially greater than typical for `0874T` and documentation supports specific reasons (extensive adhesions, difficult explantation).
`26`	Professional component	If a reporting split between professional and facility components applies (rare for device removal) and the professional component is separately billable.
`51`	Multiple procedures	When `0874T` is billed on the same date as unrelated additional surgical procedures performed at the same session.
`52`	Reduced services	When the procedure is partially reduced or not completed and documentation supports the reason.
`53`	Discontinued procedure	When the removal is started but discontinued for patient safety reasons intraoperatively.
`54`	Surgical care only	When the surgeon bills only the surgical portion and another provider bills pre/postoperative care.
`55`	Postoperative management only	When billing only postoperative management related to `0874T`.
`56`	Preoperative management only	When billing only preoperative evaluation related to `0874T`.
`62`	Two surgeons	When two surgeons of different specialties perform distinct portions of the explantation requiring documentation of separate work.
`66`	Surgical team	When a surgical team approach is used for complex removal requiring multiple surgeons.
`73`	Discontinued outpatient hospital/ambulatory surgery before anesthesia	When the outpatient removal is cancelled after patient is prepared but before anesthesia.
`78`	Return to OR for related procedure during global period	When a related operative intervention for a complication of the removal is performed during the global period.
`80`	Assistant surgeon	When an assistant surgeon performs a substantive operative role, per payer rules.
`81`	Minimum assistant surgeon	When a minimal assistant role is performed and allowed by payer policy.
`82`	Assistant surgeon (when qualified resident not available)	When no qualified resident is available and an assistant surgeon is required.
`AS`	Ambulatory surgery center facility	When the service is furnished in an ambulatory surgery center; used to identify ASC as facility.

Taxonomy Code	Specialty	Notes
`208C00000X`	General Surgery	Most common specialty performing abdominal device removal and catheter explantation.
`207L00000X`	Colon & Rectal Surgery	May perform explantation when extensive intra-abdominal adhesiolysis or bowel involvement exists.
`2080P0206X`	Surgical Oncology	In cases of malignant ascites where oncologic surgeons manage device removal and related tumor considerations.
`208K00000X`	Urology	Involved when bladder catheter components or bladder repair is required during explantation.
`207P00000X`	Gastroenterology	May be involved for peritoneal access assessment or endoscopic evaluation when indicated.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`K65.9`	Peritonitis, unspecified	Peritoneal infection can necessitate removal of an implanted ascites pump due to contamination or sepsis risk.
`R18.8`	Other ascites	Indicates presence of ascites managed by the pump and relevant to explantation decisions.
`T85.79XA`	Infection and inflammatory reaction due to other internal prosthetic device, implant and graft, initial encounter	Used when the pump or catheters become infected and require removal.
`T82.7XXA`	Mechanical complication of other vascular device, implant and graft, initial encounter	Applied when the device malfunctions leading to explantation; specific code choice depends on device type.
`C78.7`	Secondary malignant neoplasm of liver and intrahepatic bile duct	Malignant ascites from intra-abdominal metastases may lead to palliative device removal when ineffective or complicated.
`Z45.2`	Encounter for adjustment and management of implanted device	Relevant in the broader care cycle; may precede decision to remove if adjustments fail.
`Z98.890`	Other specified postprocedural states	Denotes prior implant status in the problem list and supports history of device placement.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`0874T`	Removal of peritoneal ascites pump system, including pump, peritoneal catheter, and bladder catheter	Primary code describing complete explantation of an implanted peritoneal ascites pump and associated catheters.
`49905`	Removal of implanted subcutaneous infusion port; without central venous catheter removal	May be performed if a separate subcutaneous pump or port is present and requires removal in the same operative session.
`44120`	Enterolysis (lysis of adhesions), small bowel; may involve lysis of adhesions to facilitate catheter removal	Performed when dense intra-abdominal adhesions prevent safe catheter extraction and require adhesiolysis.
`49000`	Unlisted procedure, abdomen, peritoneum and omentum	Used when an unusual abdominal or peritoneal procedure related to device removal has no specific CPT code.
`11982`	Removal of implanted material (e.g., pump or reservoir) through same incision, simple; initial removal	Alternate removal code for certain pump systems in non-T code settings or when payer requires conventional CPT coding.

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Summary & Overview

CPT 0874T: Removal of Peritoneal Ascites Pump System

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare0874TCPTperitoneal-ascites-pumpdevice-explantationsurgical-removalambulatory-surgeryhospital-proceduresbilling-coding

Billing Code Overview

Service type: Surgical device removal (explantation) of a peritoneal ascites pump system
Typical site of service: Hospital operating room or ambulatory surgical center, depending on clinical status and facility capabilities

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services	When work required is substantially greater than typical for `0874T` and documentation supports specific reasons (extensive adhesions, difficult explantation).
`26`	Professional component	If a reporting split between professional and facility components applies (rare for device removal) and the professional component is separately billable.
`51`	Multiple procedures	When `0874T` is billed on the same date as unrelated additional surgical procedures performed at the same session.
`52`	Reduced services	When the procedure is partially reduced or not completed and documentation supports the reason.
`53`	Discontinued procedure	When the removal is started but discontinued for patient safety reasons intraoperatively.
`54`	Surgical care only	When the surgeon bills only the surgical portion and another provider bills pre/postoperative care.
`55`	Postoperative management only	When billing only postoperative management related to `0874T`.
`56`	Preoperative management only	When billing only preoperative evaluation related to `0874T`.
`62`	Two surgeons	When two surgeons of different specialties perform distinct portions of the explantation requiring documentation of separate work.
`66`	Surgical team	When a surgical team approach is used for complex removal requiring multiple surgeons.
`73`	Discontinued outpatient hospital/ambulatory surgery before anesthesia	When the outpatient removal is cancelled after patient is prepared but before anesthesia.
`78`	Return to OR for related procedure during global period	When a related operative intervention for a complication of the removal is performed during the global period.
`80`	Assistant surgeon	When an assistant surgeon performs a substantive operative role, per payer rules.
`81`	Minimum assistant surgeon	When a minimal assistant role is performed and allowed by payer policy.
`82`	Assistant surgeon (when qualified resident not available)	When no qualified resident is available and an assistant surgeon is required.
`AS`	Ambulatory surgery center facility	When the service is furnished in an ambulatory surgery center; used to identify ASC as facility.

Taxonomy Code	Specialty	Notes
`208C00000X`	General Surgery	Most common specialty performing abdominal device removal and catheter explantation.
`207L00000X`	Colon & Rectal Surgery	May perform explantation when extensive intra-abdominal adhesiolysis or bowel involvement exists.
`2080P0206X`	Surgical Oncology	In cases of malignant ascites where oncologic surgeons manage device removal and related tumor considerations.
`208K00000X`	Urology	Involved when bladder catheter components or bladder repair is required during explantation.
`207P00000X`	Gastroenterology	May be involved for peritoneal access assessment or endoscopic evaluation when indicated.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`K65.9`	Peritonitis, unspecified	Peritoneal infection can necessitate removal of an implanted ascites pump due to contamination or sepsis risk.
`R18.8`	Other ascites	Indicates presence of ascites managed by the pump and relevant to explantation decisions.
`T85.79XA`	Infection and inflammatory reaction due to other internal prosthetic device, implant and graft, initial encounter	Used when the pump or catheters become infected and require removal.
`T82.7XXA`	Mechanical complication of other vascular device, implant and graft, initial encounter	Applied when the device malfunctions leading to explantation; specific code choice depends on device type.
`C78.7`	Secondary malignant neoplasm of liver and intrahepatic bile duct	Malignant ascites from intra-abdominal metastases may lead to palliative device removal when ineffective or complicated.
`Z45.2`	Encounter for adjustment and management of implanted device	Relevant in the broader care cycle; may precede decision to remove if adjustments fail.
`Z98.890`	Other specified postprocedural states	Denotes prior implant status in the problem list and supports history of device placement.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`0874T`	Removal of peritoneal ascites pump system, including pump, peritoneal catheter, and bladder catheter	Primary code describing complete explantation of an implanted peritoneal ascites pump and associated catheters.
`49905`	Removal of implanted subcutaneous infusion port; without central venous catheter removal	May be performed if a separate subcutaneous pump or port is present and requires removal in the same operative session.
`44120`	Enterolysis (lysis of adhesions), small bowel; may involve lysis of adhesions to facilitate catheter removal	Performed when dense intra-abdominal adhesions prevent safe catheter extraction and require adhesiolysis.
`49000`	Unlisted procedure, abdomen, peritoneum and omentum	Used when an unusual abdominal or peritoneal procedure related to device removal has no specific CPT code.
`11982`	Removal of implanted material (e.g., pump or reservoir) through same incision, simple; initial removal	Alternate removal code for certain pump systems in non-T code settings or when payer requires conventional CPT coding.