CPT 47381 Open Liver Cryoablation Reimbursement

CPT code 47381 denotes open cryosurgical ablation of one or more liver tumors, a surgical ablative technique performed through an open abdominal approach. Nationally, this code captures complex operative management of hepatic neoplasms where cryoablation is selected for tumor destruction, often in settings where percutaneous or laparoscopic techniques are not suitable. The code matters for hospitals and surgical teams because it reflects a resource-intensive inpatient or operating-room procedure with implications for perioperative care, anesthesia, and post-procedural monitoring.

Key payers addressed in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context and typical sites of service, plus benchmarking elements relevant to reimbursement and utilization where available. The publication outlines common billing considerations, associated modifiers, and potential policy or coverage influence on coding and payment. It also highlights areas where data was not available in the input and notes where readers should consult payer-specific policies for coverage criteria and documentation requirements.

This summary is intended for revenue cycle leaders, surgical coders, and policy analysts seeking a national-level briefing on the clinical and billing identity of CPT code 47381 and what to expect when this procedure is billed across major payers.

Billing Code Overview

CPT code 47381 describes open cryosurgical ablation of one or more liver tumors. The procedure involves surgically exposing the liver through an open approach and applying cryotherapy to ablate hepatic tumor tissue by freezing.

Service type: Ablative surgical procedure (open cryoablation)

Typical site of service: Hospital operating room or inpatient surgical setting

Clinical Context

A 62-year-old patient with a history of colorectal cancer presents with one or more metastatic hepatic lesions identified on imaging (contrast-enhanced CT or MRI). The multidisciplinary tumor board recommends surgical management because lesions are accessible via laparotomy and the patient is an appropriate operative candidate. In the operating room under general anesthesia, the surgical team performs an open hepatic cryoablation: after laparotomy and mobilization of the liver, intraoperative ultrasound localizes the tumors, cryoprobes are placed into each lesion, and freeze–thaw cycles are performed to achieve tumor necrosis. Hemostasis is confirmed, and the abdomen is closed. Typical perioperative workflow includes preoperative imaging and labs, anesthesia evaluation, intraoperative ultrasound guidance, placement of cryotherapy probes through the open incision, intraoperative pathology consultation if needed, and postoperative monitoring on a surgical ward or step-down unit. This procedure is coded with 47381 for open cryosurgical ablation of one or more liver tumors and is typically performed in an inpatient hospital setting or an ambulatory surgery center when admission is not required. Common clinical indications include primary hepatocellular carcinoma not amenable to resection, solitary or limited liver metastases (for example from colorectal primaries), and palliative control of symptomatic hepatic tumors.

Coding Specifications

Modifier	Description	When to Use
`22`

Taxonomy Code	Specialty	Notes
`207L00000X`	General Surgery	Most common specialty performing open hepatic cryoablation for liver tumors.
`2080P0208X`	Surgical Oncology	Frequently performs open liver-directed tumor ablation as part of cancer-directed surgery.
`2086S0115X`	Interventional Radiology	While cryoablation is often percutaneous under radiologic guidance, IR may be involved intraoperatively for localization or percutaneous approaches; included for multidisciplinary care.
`207RH0000X`	Hepatobiliary Surgery	Specialized general surgeons focusing on complex liver procedures and ablations.
`208000000X`	Thoracic Surgery	May be involved when lesions extend to diaphragmatic or adjacent thoracic structures or when combined procedures are required.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`C78.7`	Secondary malignant neoplasm of liver and intrahepatic bile duct	Represents metastatic liver lesions (common indication for hepatic cryoablation).
`C22.0`	Liver cell carcinoma	Primary hepatocellular carcinoma may be treated with cryoablation when resection is not possible.
`C22.9`	Malignant neoplasm of liver, unspecified	Used when the specific hepatic malignancy type is unspecified but hepatic tumor ablation is indicated.
`K76.89`	Other specified diseases of liver	May be used for certain benign or non-specific hepatic lesions when ablation is indicated for symptom control (limited use).
`R19.7`	Hepatomegaly, unspecified	Describes enlarged liver which can be associated with hepatic tumors and may be documented in preoperative assessment; not a primary indication but relevant to clinical context.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`76942`	Ultrasonic guidance for needle placement (eg, for biopsy, aspiration, injection, or ablation)	Often used intraoperatively or preoperatively for localization and guiding probe placement for liver lesion targeting.
`47120`	Hepatectomy, partial; lobectomy	May be performed instead of or in combination with `47381` when resection is feasible; represents an alternative definitive surgical treatment.
`49799`	Unlisted procedure, abdomen, peritoneum and omentum	Occasionally reported for novel or unlisted adjunct intra-abdominal procedures performed during the same operative session.
`76937`	Guidance for ablation probe placement (CT or ultrasound); percutaneous	Used when ablation probe placement is performed percutaneously with image guidance during the same episode of care; relates to non-open approaches complementary to cryoablation.
`49422`	Peritoneal drainage, open (separate procedure)	May be billed if intra-abdominal drainage is performed in the same operative setting for management of fluid collections or ascites.

OpenPayer

Summary & Overview

CPT 47381: Open Cryosurgical Ablation of Liver Tumors