Summary & Overview
CPT 20982: Percutaneous Radiofrequency Ablation of Metastatic Bone Tumor
CPT code 20982 represents percutaneous radiofrequency ablation (RFA) of metastatic bone tumors, a minimally invasive interventional oncology treatment that destroys bone lesions and adjacent affected soft tissue using thermal energy. Nationally, this code is significant as RFA offers palliative pain relief, local tumor control, and a treatment option for patients not suited to surgery. Payers evaluate coverage for 20982 based on clinical indications, documented imaging guidance, and facility/provider settings.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context, typical sites of service, and the service type associated with the code. The publication outlines national benchmarking considerations, common billing modifiers and documentation elements (listed separately), and policy themes that influence coverage decisions and reimbursement consistency across payers.
This summary equips clinicians, coders, and policy analysts with a clear statement of what CPT code 20982 is used for, why it matters in cancer care and interventional radiology, and what areas of billing and policy typically affect its use. Data not available in the input will be flagged in relevant sections.
Billing Code Overview
CPT code 20982 describes percutaneous radiofrequency ablation of one or more metastatic bone tumors, including destruction of adjacent soft tissue affected by the tumor. The procedure uses radiofrequency thermal energy applied through the skin and may be performed with or without imaging guidance to localize and monitor treatment.
Service type: Image-guided percutaneous tumor ablation / interventional oncology procedure
Typical site of service: Hospital outpatient department or ambulatory surgical center; may also be performed in specialized interventional radiology suites
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A 62-year-old patient with a history of metastatic renal cell carcinoma presents with a painful, expanding lytic lesion in the proximal femur confirmed by prior imaging. The interventional radiology team evaluates the patient for percutaneous tumor ablation to provide local tumor control and palliation of pain. Pre-procedure workflow includes review of oncologic history, coagulation status, and current medications (anticoagulants held per institutional protocol), informed consent explaining goals and risks, and cross-sectional imaging (CT or MRI) to define tumor extent and relationship to neurovascular structures. On the day of the procedure the patient receives conscious sedation or general anesthesia in a procedure suite or interventional radiology operating room. Under sterile technique, the operator uses CT or fluoroscopic guidance to place a percutaneous probe into the metastatic bone lesion and adjacent involved soft tissue. Radiofrequency energy is applied to ablate tumor tissue while monitoring probe position with imaging; multiple overlapping ablations may be performed for larger lesions. Hemostasis and soft-tissue assessment are confirmed with post‑procedure imaging; the patient is observed for recovery and discharged same day or admitted for pain control based on clinical status. Follow-up imaging and oncology coordination occur to assess local control and plan systemic therapy continuation.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when billing only the physician professional component separate from technical facility resources for imaging guidance or interpretation. |
50 | Bilateral procedure | Use when identical ablation procedures are performed on anatomically bilateral sites during the same operative session. |
51 | Multiple procedures | Use when 20982 is reported in the same session with other distinct procedure codes; check payer rules for multiple-procedure payment adjustments. |
52 | Reduced services | Use when the procedure is partially reduced or not completed for clinical reasons (e.g., inaccessible lesion despite attempt). |
53 | Discontinued procedure | Use when the procedure is started but terminated due to extenuating circumstances or patient safety concerns. |
59 | Distinct procedural service | Use to indicate a separate and distinct procedure performed at a different anatomic site or session when bundling rules might otherwise apply. |
62 | Two surgeons | Use when two surgeons work together as primary surgeons on the same procedure. |
66 | Surgical team | Use when a team of surgeons performs the procedure per payer or facility requirements. |
76 | Repeat procedure by same physician | Use when the same physician repeats 20982 for the same lesion during the postoperative period (if clinically warranted). |
77 | Repeat procedure by another physician | Use when a different physician repeats the procedure for the same lesion during the postoperative period. |
78 | Unplanned return to the operating/procedure room | Use when the patient returns for a related procedure during the global period for complications. |
79 | Unrelated procedure or service by the same physician during the global period | Use when an unrelated procedure is performed during the global period. |
LT | Left side | Use to designate the left anatomic side when laterality reporting is required by payer. |
RT | Right side | Use to designate the right anatomic side when laterality reporting is required by payer. |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
| 207RC0000X | Interventional Radiology | Most commonly performs percutaneous radiofrequency ablation for bone metastases under imaging guidance. |
| 2085P0200X | Orthopedic Oncology | May perform percutaneous or open ablation procedures in collaboration for skeletal tumor management and stabilization. |
| 2084P0800X | Radiation Oncology | Involved in multidisciplinary planning for local control; may coordinate with ablation for palliation. |
| 207L00000X | Diagnostic Radiology | Procedural guidance and imaging interpretation support; some diagnostic radiologists perform interventional oncologic procedures. |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
C79.51 | Secondary malignant neoplasm of bone | Direct indication for percutaneous radiofrequency ablation of metastatic bone lesions. |
C79.52 | Secondary malignant neoplasm of bone marrow | Indicates marrow involvement often associated with painful lesions targeted by ablation. |
C79.49 | Secondary malignant neoplasm of other specified sites | Used when bone metastasis is specified under other regional sites associated with ablation. |
M84.50XA | Pathologic fracture, unspecified site, initial encounter | Pathologic fractures through metastatic lesions may prompt stabilization and ablation for local control and pain relief. |
M84.51XA | Pathologic fracture, shoulder region, initial encounter | Region-specific pathologic fracture related to metastatic disease that may be treated with ablation adjunctively. |
M84.56XA | Pathologic fracture, pelvic region, initial encounter | Pelvic metastatic lesions causing fracture or pain are commonly treated with image-guided ablation and adjunct stabilization. |
R52 | Pain, unspecified | Symptom code used when pain from a metastatic bone lesion is an indication for palliative ablation. |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
77012 | Computed tomography guidance for needle placement (eg, biopsy, aspiration, localization device), radiological supervision and interpretation | Used when CT guidance is employed to localize the probe for 20982; typically billed in conjunction per payer rules. |
77002 | Fluoroscopic guidance for needle placement (eg, biopsy, aspiration, localization device) | Used when fluoroscopic guidance is used to position ablation probes during 20982. |
76942 | Ultrasonic guidance for needle placement (e.g., biopsy, aspiration, injection, localization device), imaging supervision and interpretation | Used when ultrasound is used to assist probe placement for superficial lesions or soft-tissue components adjacent to bone. |
20680 | Removal of deep implant; e.g., tunneled catheter, implant, or foreign body | Used when removal of previously placed hardware or cement is required to access the lesion before ablation. |
20983 | Percutaneous image-guided high-energy ablative procedure, cryoablation, for soft tissue lesions | Related ablative modality; may be selected instead of 20982 when cryoablation is the chosen energy source. |
11042 | Debridement, subcutaneous tissue (includes epidermis and dermis, first stage of closure) | May be used for wound care or debridement related to access site complications following 20982. |