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CPT 76965: Ultrasound-Guided Interstitial Brachytherapy Placement

CPT code 76965 denotes ultrasound-guided placement of an interstitial radioelement for brachytherapy, a targeted radiation technique used to destroy tumors. This procedure is a key component of localized cancer care, enabling precise implantation of radioactive material while minimizing exposure to surrounding tissues. Nationally, use of image-guided brachytherapy affects surgical oncology workflows, hospital outpatient capacity, and radiation oncology service lines.

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 types of operational and coding considerations that shape payment and delivery for this service. The publication presents benchmarking information where available, summarizes relevant policy and coding considerations, and highlights implications for billing workflows and facility planning.

This material is intended to inform revenue cycle teams, clinical coding staff, and health policy analysts about the clinical purpose of CPT code 76965, common service environments, and the payer landscape nationally. Data not available in the input will be noted as such in the detailed sections.

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Billing Code Overview

CPT code 76965 describes the placement of an interstitial radioelement using ultrasonic guidance. The procedure involves inserting a radioactive element into the interstitial space of tissue with the clinical goal of destroying tumor cells through localized radiation.

Service type: Image-guided interstitial brachytherapy placement
Typical site of service: Hospital outpatient department, ambulatory surgery center, or other procedural setting where ultrasound guidance and brachytherapy implants are performed

Data not available in the input.

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CPT 76965: Ultrasound-Guided Interstitial Brachytherapy Placement

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Billing Code Overview

Service type: Image-guided interstitial brachytherapy placement
Typical site of service: Hospital outpatient department, ambulatory surgery center, or other procedural setting where ultrasound guidance and brachytherapy implants are performed

Data not available in the input.

Clinical & Coding Specifications

Clinical Context

A typical patient is an adult with a localized malignant tumor (for example, a recurrent head and neck squamous cell carcinoma or a small soft-tissue or prostate tumor) for which brachytherapy is indicated. The patient presents to an outpatient surgical or interventional radiology suite after multidisciplinary tumor board review where imaging and pathology confirmed a target amenable to interstitial radioactive seed placement. Pre-procedure planning includes review of prior cross-sectional imaging (CT or MRI), informed consent, review of coagulation status, and administration of local or monitored anesthesia care. In the procedure, the interventionalist uses real-time ultrasonic guidance to place radioactive seeds or sources into the interstitial space of the tumor to deliver a therapeutic radiation dose. Immediate post-placement imaging (ultrasound or CT) confirms positioning and dosimetry. The patient is recovered in the PACU or same-day observation area and discharged with radiation safety instructions and follow-up arranged with radiation oncology for dose verification and surveillance.

Coding Specifications

Modifier	Description	When to Use
`26`	Professional component	Use when billing only the physician professional component separate from technical services.
`50`	Bilateral procedure	Use if identical interstitial placements are performed bilaterally in anatomic paired organs.
`51`	Multiple procedures	Use when this service is one of multiple distinct procedures during the same encounter.
`52`	Reduced services	Use when the procedure is partially reduced or not fully performed.
`53`	Discontinued procedure	Use when the procedure is started but terminated due to extenuating circumstances.
`58`	Staged or related procedure by same physician during postoperative period	Use when this placement is part of a planned staged treatment.
`59`	Distinct procedural service	Use when the ultrasonic-guided placement is distinct from other services performed at the same session.
`76`	Repeat procedure by same physician	Use when the same physician repeats the procedure later the same day.
`78`	Unplanned return to OR for related procedure during postoperative period	Use if an unplanned return is required for complications related to the placement.
`80`	Assistant surgeon required	Use when an assistant surgeon participates and billing requires indicating assistant services.
`62`	Two surgeons	Use when two surgeons of different specialties share the operative procedure.
`22`	Increased procedural service	Use when work required is substantially greater than typically required.
`23`	Unusual anesthesia	Use when general anesthesia is required for an otherwise local/regional procedure.
`TC`	Technical component	Use when billing only the technical component (facility or equipment) separate from the physician.

Taxonomy Code	Specialty	Notes
`208D00000X`	Radiation Oncology	Radiation oncologists coordinate dosimetry and follow-up.
`2084P0800X`	Diagnostic Radiology	Interventional radiologists perform image-guided seed placement.
`2086S0124X`	Surgical Oncology	Surgical oncologists perform operative interstitial brachytherapy.
`207Q00000X`	Urology	Urologists perform prostate interstitial seed placement.
`207L00000X`	Otolaryngology (ENT)	ENT surgeons perform head and neck tumor brachytherapy.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`C61`	Malignant neoplasm of prostate	Prostate cancer is commonly treated with interstitial radioactive seed implantation (brachytherapy).
`C32.9`	Malignant neoplasm of larynx, unspecified	Selected head and neck cancers may be managed with interstitial brachytherapy.
`C41.9`	Malignant neoplasm of bone and articular cartilage, unspecified	Superficial or accessible bone tumors may be treated with interstitial radioactive element placement.
`C50.9`	Malignant neoplasm of breast, unspecified	Recurrent or localized breast tumors in selected cases may receive interstitial brachytherapy.
`C00.9`	Malignant neoplasm of lip, unspecified	Small mucosal or cutaneous head and neck tumors are potential indications for interstitial brachytherapy.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`76930`	Ultrasonic guidance for needle placement (e.g., biopsy, aspiration, injection, localization device), imaging supervision and interpretation	Often used when real-time ultrasound guidance is billed for needle or catheter placement associated with interstitial seed insertion.
`77295`	Therapeutic radiology simulation-aided field setting	May be used in the brachytherapy planning process for dosimetry and treatment setup.
`77778`	Brachytherapy physics consultation and review	Used for physics planning, dosimetry calculations, and quality assurance related to interstitial radioactive element placement.
`57455`	Colposcopy of the cervix including biopsy(s) and endocervical curettage (when applicable for gynecologic interstitial brachytherapy planning)	Performed when gynecologic evaluation or biopsy is necessary before gynecologic brachytherapy.
`51720`	Implantation of a temporary intraluminal device (e.g., urethral) for radionuclide insertion (example for prostate-related procedures)	Performed in select genitourinary brachytherapy workflows when adjunctive devices are placed.

CPT 76932: Ultrasound Guidance Imaging for Endomyocardial Biopsy

CPT-76936-ULTRASOUND-GUIDED-PSEUDOANEURYSM-COMPRESSION-REPAIR

CPT 76936: Ultrasound-Guided Pseudoaneurysm/AV Fistula Compression Repair

CPT-76937-ULTRASOUND-GUIDANCE-VASCULAR-ACCESS

CPT 76937: Ultrasound Guidance for Vascular Access Procedures

CPT-76940-ULTRASOUND-GUIDANCE-PARENCHYMAL-ABLATION-MONITORING

CPT 76940: Ultrasound Guidance for Parenchymal Tissue Ablation

CPT-76941-ULTRASOUND-GUIDANCE-INTRAUTERINE-FETAL-TRANSFUSION-CORDOCENTESIS

CPT 76941: Ultrasound Guidance for Intrauterine Fetal Transfusion/Cordocentesis

CPT-76942-ULTRASOUND-GUIDANCE-NEEDLE-PLACEMENT

CPT 76942: Ultrasonography Guidance for Needle Placement

CPT-76945-ULTRASOUND-GUIDANCE-CHORIONIC-VILLUS-SAMPLING-SUPERVISION

CPT 76945: Ultrasound Guidance and Imaging for Chorionic Villus Sampling

CPT-76946-ULTRASOUND-GUIDANCE-AMNIOCENTESIS-SUPERVISION-INTERPRETATION

CPT 76946: Ultrasound Guidance Imaging for Amniocentesis

CPT-76948-ULTRASOUND-SUPERVISION-INTERPRETATION-OVA-ASPIRATION

CPT 76948: Imaging Supervision and Interpretation for Ultrasound-Guided Ova Aspiration

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
`26`	Professional component	Use when billing only the physician professional component separate from technical services.
`50`	Bilateral procedure	Use if identical interstitial placements are performed bilaterally in anatomic paired organs.
`51`	Multiple procedures	Use when this service is one of multiple distinct procedures during the same encounter.
`52`	Reduced services	Use when the procedure is partially reduced or not fully performed.
`53`	Discontinued procedure	Use when the procedure is started but terminated due to extenuating circumstances.
`58`	Staged or related procedure by same physician during postoperative period	Use when this placement is part of a planned staged treatment.
`59`	Distinct procedural service	Use when the ultrasonic-guided placement is distinct from other services performed at the same session.
`76`	Repeat procedure by same physician	Use when the same physician repeats the procedure later the same day.
`78`	Unplanned return to OR for related procedure during postoperative period	Use if an unplanned return is required for complications related to the placement.
`80`	Assistant surgeon required	Use when an assistant surgeon participates and billing requires indicating assistant services.
`62`	Two surgeons	Use when two surgeons of different specialties share the operative procedure.
`22`	Increased procedural service	Use when work required is substantially greater than typically required.
`23`	Unusual anesthesia	Use when general anesthesia is required for an otherwise local/regional procedure.
`TC`	Technical component	Use when billing only the technical component (facility or equipment) separate from the physician.

Taxonomy Code	Specialty	Notes
`208D00000X`	Radiation Oncology	Radiation oncologists coordinate dosimetry and follow-up.
`2084P0800X`	Diagnostic Radiology	Interventional radiologists perform image-guided seed placement.
`2086S0124X`	Surgical Oncology	Surgical oncologists perform operative interstitial brachytherapy.
`207Q00000X`	Urology	Urologists perform prostate interstitial seed placement.
`207L00000X`	Otolaryngology (ENT)	ENT surgeons perform head and neck tumor brachytherapy.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`C61`	Malignant neoplasm of prostate	Prostate cancer is commonly treated with interstitial radioactive seed implantation (brachytherapy).
`C32.9`	Malignant neoplasm of larynx, unspecified	Selected head and neck cancers may be managed with interstitial brachytherapy.
`C41.9`	Malignant neoplasm of bone and articular cartilage, unspecified	Superficial or accessible bone tumors may be treated with interstitial radioactive element placement.
`C50.9`	Malignant neoplasm of breast, unspecified	Recurrent or localized breast tumors in selected cases may receive interstitial brachytherapy.
`C00.9`	Malignant neoplasm of lip, unspecified	Small mucosal or cutaneous head and neck tumors are potential indications for interstitial brachytherapy.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`76930`	Ultrasonic guidance for needle placement (e.g., biopsy, aspiration, injection, localization device), imaging supervision and interpretation	Often used when real-time ultrasound guidance is billed for needle or catheter placement associated with interstitial seed insertion.
`77295`	Therapeutic radiology simulation-aided field setting	May be used in the brachytherapy planning process for dosimetry and treatment setup.
`77778`	Brachytherapy physics consultation and review	Used for physics planning, dosimetry calculations, and quality assurance related to interstitial radioactive element placement.
`57455`	Colposcopy of the cervix including biopsy(s) and endocervical curettage (when applicable for gynecologic interstitial brachytherapy planning)	Performed when gynecologic evaluation or biopsy is necessary before gynecologic brachytherapy.
`51720`	Implantation of a temporary intraluminal device (e.g., urethral) for radionuclide insertion (example for prostate-related procedures)	Performed in select genitourinary brachytherapy workflows when adjunctive devices are placed.

CPT 76932: Ultrasound Guidance Imaging for Endomyocardial Biopsy

CPT-76936-ULTRASOUND-GUIDED-PSEUDOANEURYSM-COMPRESSION-REPAIR

CPT 76936: Ultrasound-Guided Pseudoaneurysm/AV Fistula Compression Repair

CPT-76937-ULTRASOUND-GUIDANCE-VASCULAR-ACCESS

CPT 76937: Ultrasound Guidance for Vascular Access Procedures

CPT-76940-ULTRASOUND-GUIDANCE-PARENCHYMAL-ABLATION-MONITORING

CPT 76940: Ultrasound Guidance for Parenchymal Tissue Ablation

CPT-76941-ULTRASOUND-GUIDANCE-INTRAUTERINE-FETAL-TRANSFUSION-CORDOCENTESIS

CPT 76941: Ultrasound Guidance for Intrauterine Fetal Transfusion/Cordocentesis

CPT-76942-ULTRASOUND-GUIDANCE-NEEDLE-PLACEMENT

CPT 76942: Ultrasonography Guidance for Needle Placement

CPT-76945-ULTRASOUND-GUIDANCE-CHORIONIC-VILLUS-SAMPLING-SUPERVISION

CPT 76945: Ultrasound Guidance and Imaging for Chorionic Villus Sampling

CPT-76946-ULTRASOUND-GUIDANCE-AMNIOCENTESIS-SUPERVISION-INTERPRETATION

CPT 76946: Ultrasound Guidance Imaging for Amniocentesis

CPT-76948-ULTRASOUND-SUPERVISION-INTERPRETATION-OVA-ASPIRATION

CPT 76948: Imaging Supervision and Interpretation for Ultrasound-Guided Ova Aspiration

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 76965: Ultrasound-Guided Interstitial Brachytherapy Placement

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Billing Code Overview

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CPT 76965: Ultrasound-Guided Interstitial Brachytherapy Placement

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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