CPT 0945T: Intraoperative Fluorescence Imaging During Partial Mastectomy

CPT code 0945T indicates an intraoperative, add-on service in which computer-aided fluorescence imaging is used during a partial mastectomy to detect residual tumor tissue. As an adjunct to surgical excision, this technology can inform immediate resection decisions and potentially reduce the need for reoperation. Nationally, the code represents a targeted surgical imaging procedure relevant to breast-conserving surgery and related quality-of-care considerations.

Key payers included in this coverage discussion are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise national perspective on what the code represents, payer coverage context, and the clinical setting in which the service is provided.

This publication outlines the clinical purpose of the code, typical sites of service, and which major payers are considered in coverage discussions. It also highlights the types of benchmarks and policy updates readers can expect: utilization patterns for intraoperative imaging add-on services, common billing practices for add-on surgical imaging, and payer-specific coverage language or coding guidance where available. Clinical context clarifies how the imaging is used during partial mastectomy procedures and why the service may affect surgical decision-making. Data not available in the input will be noted explicitly where applicable.

Billing Code Overview

CPT code 0945T describes an add-on intraoperative imaging service performed during a partial mastectomy. The provider uses computer-aided fluorescence imaging at the surgical site to assess for any remaining abnormal (tumor) tissue, helping ensure removal of residual tumor during the procedure.

Service type: Intraoperative adjunctive imaging service (add-on to a partial mastectomy)
Typical site of service: Operative/surgical setting (inpatient or outpatient operating room or ambulatory surgical center)

Data not available in the input.

Clinical Context

A typical patient is a woman diagnosed with early-stage invasive breast carcinoma or ductal carcinoma in situ (DCIS) presenting for a breast-conserving surgery (partial mastectomy/lumpectomy). Preoperative workup includes imaging (mammography, ultrasound, often MRI) and core needle biopsy confirming malignancy. Intraoperatively, after excision of the targeted lesion with appropriate margins, the surgeon requests the add-on computer-aided fluorescence imaging service to assess the surgical bed for residual tumor tissue. The imaging system uses a fluorescent agent and real-time computer-assisted analysis to highlight areas of abnormal uptake that may represent residual tumor. If residual tissue is identified, the surgeon performs additional targeted excision to achieve clear margins. Typical workflow: preoperative planning and informed consent for partial mastectomy with possible intraoperative imaging; induction of anesthesia; partial mastectomy performed; application of fluorescence agent (if not pre-injected) and activation of imaging; interpretation of imaging results by the operating surgeon; additional resection as indicated; specimen sent to pathology for margin assessment. Typical site of service: hospital operating room or ambulatory surgical center during a partial mastectomy procedure.

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services	When work required is substantially greater than typical for partial mastectomy with add-on imaging (document increased complexity).

Taxonomy Code	Specialty	Notes
207Q00000X	Surgical Oncology	Surgeons who perform breast-conserving cancer surgery and intraoperative margin assessment.
207P00000X	General Surgery	General surgeons who perform partial mastectomy/lumpectomy procedures.
207RC0000X	Plastic and Reconstructive Surgery	Oncoplastic surgeons providing reconstruction or reshaping at time of lumpectomy.
207XS0101X	Breast Surgery	Providers with a focused breast surgery specialty performing targeted excisions and intraoperative imaging.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`C50.911`	Malignant neoplasm of unspecified site of right female breast	Representative invasive breast cancer diagnosis prompting partial mastectomy with intraoperative margin assessment.
`C50.912`	Malignant neoplasm of unspecified site of left female breast	Same clinical indication for left-sided disease.
`D05.90`	Unspecified carcinoma in situ of breast	DCIS often managed with breast-conserving surgery and intraoperative tools to ensure clear margins.
`C50.919`	Malignant neoplasm of unspecified site of breast, unspecified laterality	General breast cancer code applicable when laterality not specified but surgery and imaging indicated.
`N63`	Unspecified lump in breast	May be an indication for excision and intraoperative assessment if malignancy suspected on pathology.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`19301`	Partial mastectomy, lumpectomy, or excision of breast lesion; single lesion	This is the primary procedure during which the add-on fluorescence imaging (`0945T`) is performed to assess margins.
`88305`	Level IV surgical pathology, gross and microscopic examination	Pathology code used for histologic analysis of excised breast tissue and margin assessment after intraoperative imaging-guided resection.
`77046`	Magnetic resonance imaging, breast, without and with contrast material, bilateral	Preoperative breast MRI often used in surgical planning for partial mastectomy when multifocal disease is a concern.
`19318`	Reduction mammoplasty (when performed concurrently for symmetry)	May be performed by plastic surgeons for oncoplastic reconstruction in conjunction with lumpectomy and intraoperative imaging.
`99152`	Anesthesia for procedures on patient of age 5 years or older, moderate sedation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service	Example of anesthesia/sedation services that support the operative setting where intraoperative imaging is used.

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Summary & Overview