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CPT 49411: Abdominal Fiducial or Dosimeter Placement for Radiation Guidance

CPT code 49411 covers the placement of fiducial markers or a dosimeter within the abdominal cavity adjacent to a known tumor site to guide and measure radiation therapy. This procedure supports accurate targeting for external-beam radiotherapy and can improve treatment precision for abdominal soft-tissue malignancies. Nationally, the code is relevant to radiation oncology, interventional radiology, and surgical teams involved in multidisciplinary cancer care.

Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical indications, the typical procedural setting, and payer coverage patterns where available. The publication outlines benchmarks for utilization and reimbursement trends, summarizes policy and coding updates affecting the code, and provides clinical context for when fiducial or dosimeter placement is used in abdominal radiation planning.

The content is intended for administrators, coders, and clinical leaders seeking a national perspective on coding, coverage, and the clinical role of abdominal fiducial/dosimeter placement in radiation therapy. Data not available in the input is noted where relevant in detailed sections.

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Billing Code Overview

CPT code 49411 describes the placement of one or more small metal markers or fiducial devices within the abdominal cavity adjacent to a previously identified tumor site to guide radiation therapy, or the placement of a dosimeter to measure radiation delivered to targeted soft tissue. This procedure is intended to assist precise localization and dosimetric assessment during external-beam radiation treatment planning and delivery.

Service type: Image-guided localization and dosimetry support for targeted radiation therapy
Typical site of service: Hospital outpatient department or ambulatory surgical center, often performed in an operating room, interventional radiology suite, or similar procedural setting

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CPT 49411: Abdominal Fiducial or Dosimeter Placement for Radiation Guidance

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Billing Code Overview

Service type: Image-guided localization and dosimetry support for targeted radiation therapy
Typical site of service: Hospital outpatient department or ambulatory surgical center, often performed in an operating room, interventional radiology suite, or similar procedural setting

Clinical & Coding Specifications

Clinical Context

A typical patient is an adult with a localized intra-abdominal or pelvic soft-tissue tumor (for example, a hepatic metastasis, pancreatic tumor, or pelvic sarcoma) who is scheduled to receive image-guided external beam radiation or stereotactic body radiation therapy. The patient has completed diagnostic imaging (CT and/or MRI) and multidisciplinary tumor board review confirming the tumor target. On the day of the procedure the interventional radiologist or surgical oncologist places one or more small metal fiducial markers or a dosimeter into the abdominal cavity adjacent to the previously identified tumor using image guidance (ultrasound, CT, or fluoroscopy) under conscious sedation or general anesthesia as clinically indicated. Post-placement imaging (intra-procedural or immediate post-procedure radiograph/CT) documents marker position relative to the target to allow radiation oncology to fuse planning scans and track tumor motion during treatment. The workflow includes pre-procedure consent and assessment, sterile placement of markers, confirmation imaging, recovery monitoring, and transmission of marker coordinates/images to the radiation oncology planning team for treatment simulation and delivery.

Coding Specifications

Modifier	Description	When to Use
`11`	Normal, active postoperative care	When reporting the code during the global period for an unrelated service requiring separate evaluation and management (rare for this procedure).
`22`	Increased procedural services	When the placement required substantially greater resources or operative time than usual (extensive adhesiolysis, prolonged procedure time).
`52`	Reduced services	If the fiducial placement was attempted but not completed as planned and a reduced service was performed.
`53`	Discontinued procedure	If the procedure was started but terminated due to patient instability or unexpected findings before marker placement.
`59`	Distinct procedural service	When another procedure on a different site or distinct session is performed the same day and bundling rules would otherwise apply.
`62`	Two surgeons	When two surgeons work together as primary surgeons performing shared technical components of placement.
`63`	Procedure performed on infants less than 4 kg	If patient weight criteria apply (rare for adult abdominal cases).
`76`	Repeat procedure by same physician	When the same physician performs an unplanned repeat fiducial placement the same day.
`78`	Unplanned return to operating/procedure room by same physician following initial procedure for a related procedure during the global period	For re-entry to correct marker migration or complication requiring return to procedure room.
`79`	Unrelated procedure or service by the same physician during the postoperative period	If an unrelated procedure is performed during the global period.

Taxonomy Code	Specialty	Notes
`208000000X`	Diagnostic Radiology	Interventional radiologists commonly place fiducials under image guidance.
`208600000X`	Radiation Oncology	Radiation oncologists coordinate marker use for treatment planning and may place markers in select settings.
`207L00000X`	Surgical Oncology	Surgical oncologists place fiducials during minimally invasive or open procedures when involved in tumor management.
`363LP0200X`	Pain Medicine / Interventional Pain	In some centers interventional pain specialists with image-guided skills perform marker placement for abdominal/pelvic targets.
`207R00000X`	General Surgery	General surgeons perform placements during operative or laparoscopic interventions when part of surgical care.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`C78.7`	Secondary malignant neoplasm of liver and intrahepatic bile duct	Common metastatic site targeted for focal radiation guided by fiducials.
`C25.9`	Malignant neoplasm of pancreas, unspecified	Pancreatic tumors may require fiducials to account for respiratory motion during stereotactic radiation.
`C49.9`	Malignant neoplasm of connective and soft tissue, unspecified	Pelvic or abdominal soft-tissue sarcomas frequently require marker placement for precise targeting.
`C56.9`	Malignant neoplasm of ovary, unspecified	Pelvic gynecologic tumors may use fiducials when radiation is part of local control strategy.
`C16.9`	Malignant neoplasm of stomach, unspecified	Gastric tumors adjacent to critical structures may need fiducials for conformal radiotherapy.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`49411`	Placement of abdominal fiducial(s) or dosimeter to guide radiation therapy	Primary procedure to place markers/dosimeter adjacent to a known tumor for radiotherapy guidance.
`NAV`	Data not available in the input.	Data not available in the input.
`32701`	Data not available in the input.	Data not available in the input.

CPT 49412: Fiducial Marker or Dosimeter Placement During Open Abdominal/Pelvic Surgery

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Jul 29, 2026.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Modifier	Description	When to Use
`11`	Normal, active postoperative care	When reporting the code during the global period for an unrelated service requiring separate evaluation and management (rare for this procedure).
`22`	Increased procedural services	When the placement required substantially greater resources or operative time than usual (extensive adhesiolysis, prolonged procedure time).
`52`	Reduced services	If the fiducial placement was attempted but not completed as planned and a reduced service was performed.
`53`	Discontinued procedure	If the procedure was started but terminated due to patient instability or unexpected findings before marker placement.
`59`	Distinct procedural service	When another procedure on a different site or distinct session is performed the same day and bundling rules would otherwise apply.
`62`	Two surgeons	When two surgeons work together as primary surgeons performing shared technical components of placement.
`63`	Procedure performed on infants less than 4 kg	If patient weight criteria apply (rare for adult abdominal cases).
`76`	Repeat procedure by same physician	When the same physician performs an unplanned repeat fiducial placement the same day.
`78`	Unplanned return to operating/procedure room by same physician following initial procedure for a related procedure during the global period	For re-entry to correct marker migration or complication requiring return to procedure room.
`79`	Unrelated procedure or service by the same physician during the postoperative period	If an unrelated procedure is performed during the global period.

Taxonomy Code	Specialty	Notes
`208000000X`	Diagnostic Radiology	Interventional radiologists commonly place fiducials under image guidance.
`208600000X`	Radiation Oncology	Radiation oncologists coordinate marker use for treatment planning and may place markers in select settings.
`207L00000X`	Surgical Oncology	Surgical oncologists place fiducials during minimally invasive or open procedures when involved in tumor management.
`363LP0200X`	Pain Medicine / Interventional Pain	In some centers interventional pain specialists with image-guided skills perform marker placement for abdominal/pelvic targets.
`207R00000X`	General Surgery	General surgeons perform placements during operative or laparoscopic interventions when part of surgical care.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`C78.7`	Secondary malignant neoplasm of liver and intrahepatic bile duct	Common metastatic site targeted for focal radiation guided by fiducials.
`C25.9`	Malignant neoplasm of pancreas, unspecified	Pancreatic tumors may require fiducials to account for respiratory motion during stereotactic radiation.
`C49.9`	Malignant neoplasm of connective and soft tissue, unspecified	Pelvic or abdominal soft-tissue sarcomas frequently require marker placement for precise targeting.
`C56.9`	Malignant neoplasm of ovary, unspecified	Pelvic gynecologic tumors may use fiducials when radiation is part of local control strategy.
`C16.9`	Malignant neoplasm of stomach, unspecified	Gastric tumors adjacent to critical structures may need fiducials for conformal radiotherapy.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`49411`	Placement of abdominal fiducial(s) or dosimeter to guide radiation therapy	Primary procedure to place markers/dosimeter adjacent to a known tumor for radiotherapy guidance.
`NAV`	Data not available in the input.	Data not available in the input.
`32701`	Data not available in the input.	Data not available in the input.

CPT 49412: Fiducial Marker or Dosimeter Placement During Open Abdominal/Pelvic Surgery

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Jul 29, 2026.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

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CPT 49411: Abdominal Fiducial or Dosimeter Placement for Radiation Guidance

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Billing Code Overview

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CPT 49411: Abdominal Fiducial or Dosimeter Placement for Radiation Guidance

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Billing Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References

CPT 49411: Abdominal Fiducial or Dosimeter Placement for Radiation Guidance

Sign up for cpt 49411 policy alerts

Billing Code Overview

CPT 49411: Abdominal Fiducial or Dosimeter Placement for Radiation Guidance

Sign up for cpt 49411 policy alerts

Billing Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

What procedure is described by CPT 49411 and what is its clinical purpose?

Where is CPT 49411 usually performed and which specialties commonly provide it?

Which CPT modifiers are relevant to reporting CPT 49411 and when are they used?

What diagnoses are commonly associated with the use of CPT 49411?

Which payers are referenced for CPT 49411 and does the page provide reimbursement rates or coverage criteria?

References

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

What procedure is described by CPT 49411 and what is its clinical purpose?

Where is CPT 49411 usually performed and which specialties commonly provide it?

Which CPT modifiers are relevant to reporting CPT 49411 and when are they used?

What diagnoses are commonly associated with the use of CPT 49411?

Which payers are referenced for CPT 49411 and does the page provide reimbursement rates or coverage criteria?

References