Summary & Overview

CPT 0950T: Transrectal HIFU Ablation of Benign Prostate Tissue

CPT code 0950T represents transrectal high intensity–focused ultrasound (HIFU) ablation of benign prostate tissue under ultrasound guidance. The code captures a minimally invasive, image-guided prostate procedure increasingly considered as an alternative to other surgical and device-based benign prostatic hyperplasia (BPH) treatments. Nationally, adoption of HIFU has implications for procedural pathways, outpatient capacity, and payer coverage policies as technology-driven, tissue-preserving options expand.

Key payers in this overview include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a grounded summary of what the code denotes clinically, typical sites of service, and which major payers are relevant to coverage and reimbursement conversations. The publication also outlines the kinds of benchmarks and policy updates readers can expect: utilization and reimbursement benchmarking, common modifiers and billing considerations, and the clinical context for use in patients with benign prostate conditions.

This summary is written for a national audience seeking concise policy and billing context for CPT code 0950T, including stakeholders involved in coding, billing strategy, coverage policy, and clinical program planning.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare0950TCPTHIFUprostate-ablationbenign-prostatic-hyperplasiaimage-guided-procedureoutpatient-procedures

Billing Code Overview

CPT code 0950T describes a high intensity–focused ultrasound (HIFU) procedure performed transrectally to ablate benign prostate tissue under ultrasound guidance. The service is a minimally invasive thermal ablation therapy delivered via a device inserted through the rectum while real-time ultrasound imaging guides targeting and monitoring of tissue destruction.

Service type: Image-guided transrectal HIFU prostate ablation

Typical site of service: Outpatient ambulatory surgery center or hospital outpatient department, with possible performance in other outpatient procedural settings depending on facility capability and payer rules.

Clinical & Coding Specifications

Clinical Context

A typical patient is a man in his 60s to 70s with symptomatic benign prostatic hyperplasia (BPH) who has persistent lower urinary tract symptoms (urinary frequency, nocturia, weak stream, incomplete emptying) despite medical therapy (alpha-blockers and/or 5-alpha-reductase inhibitors) or who desires a minimally invasive alternative to transurethral resection. The procedure is performed in an outpatient ambulatory surgery center or hospital outpatient department. Pre-procedure evaluation includes urologic history, physical exam with digital rectal exam, prostate-specific antigen testing, urinalysis to exclude infection, and transrectal ultrasound or MRI to assess prostate volume and anatomy. On the day of service the patient receives appropriate anesthesia (conscious sedation, regional block, or general anesthesia per anesthesiology and patient comorbidity). Under ultrasound guidance, a high intensity–focused ultrasound (HIFU) device is inserted transrectally; targeted sonication destroys localized benign prostate tissue. Intra-procedural ultrasound imaging is used to monitor treatment area and avoid adjacent structures. Post-procedure monitoring includes voiding trial, pain management, and instructions regarding urinary catheter use if placed. Follow-up visits assess symptom improvement, urinary flow, post-void residual, and PSA trends. Typical site of service: outpatient ambulatory surgery center or hospital outpatient department. Service type: minimally invasive image-guided prostate ablation procedure using transrectal HIFU.

Coding Specifications

Modifier	Description	When to Use
`22`

Taxonomy Code	Specialty	Notes
`2080S0001X`	Urology	Urologists commonly perform transrectal HIFU ablation for BPH.
`207L00000X`	Interventional Radiology	Interventional radiologists may be involved when image-guidance expertise is required.
`2084P0800X`	Radiation Oncology	Radiation oncologists are less commonly involved but may have HIFU programmatic oversight in some centers.
`364S00000X`	Anesthesiology	Anesthesiologists or CRNAs provide procedural sedation or general anesthesia for HIFU cases.
`261QM0800X`	Family Medicine	In some outpatient programs primary care or family medicine physicians coordinate pre- and post-procedure care.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`N40.0`	Enlarged prostate with lower urinary tract symptoms	Primary indication for transrectal HIFU ablation to relieve obstructive BPH symptoms.
`N40.1`	Nodular prostate without lower urinary tract symptoms	May be considered when nodularity causes progressive changes or as part of evaluation leading to treatment decision.
`R33.9`	Retention of urine, unspecified	Acute or chronic urinary retention can be an indication for procedural intervention when refractory to medical therapy.
`R39.15`	Urgency of urination	Symptom commonly reported by patients with BPH considered when selecting HIFU therapy.
`N13.8`	Other obstructive and reflux uropathy	Relevant when bladder outlet obstruction from BPH leads to upper urinary tract effects and requires definitive therapy.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`52000`	Cystourethroscopy, with or without irrigation and with or without diagnostic procedures; diagnostic, with or without collection of specimen(s) by brushing or washing	Performed preoperatively or intraoperatively to evaluate the urethra and bladder, or postoperatively if hematuria or retention occurs.
`51701`	Insertion of temporary indwelling urethral catheter; simple (e.g., straight catheterization)	May be used intraoperatively or postoperatively for bladder drainage or voiding trial.
`76942`	Ultrasonic guidance for needle placement (eg, biopsy, aspiration, injection, localization device), imaging supervision and interpretation	Used for ultrasound guidance and documentation when imaging guidance is billed separately according to payer policy.
`52332`	Cystoscopy, with manipulation of ureteral orifice, including dilation and/or stent placement	Performed if ureteral compromise or need for stent placement arises from procedure-related issues.
`99499`	Unlisted evaluation and management service	Used for reporting unusual pre- or post-procedure evaluation services not described by another code when necessary (use per payer rules).