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    v1.0.30
    OpenPayerBilling CodesTherapeutic Nuclear Medicine ProceduresCPT cpt-79403-radiolabeled-monoclonal-antibody-infusion
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    CPT 79403: Intravenous Radiolabeled Monoclonal Antibody Infusion

    Medicare pays $108 on average nationally for this procedure.

    CPT code 79403 describes infusion of radiolabeled monoclonal antibodies delivered directly into the venous bloodstream for therapeutic purposes; service type: systemic radiopharmaceutical therapy via intravenous infusion; typical site of service: hospital outpatient infusion center or specialized outpatient nuclear medicine/oncology infusion suite.

    For related coverage guidance, see recent payer policy updates: Vafseo (vadadustat) for anemia in CKD on dialysis, Metabolic Disorders - Cysteamine (Oral) Products for Individual and Family Plans, Kerendia (finerenone) — Coverage Criteria.

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    Table of contents

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    Clinical & Coding Specifications

    Clinical Context

    A typical patient is a 62-year-old with metastatic colorectal carcinoma who presents for systemic radiolabeled monoclonal antibody infusion to target circulating or metastatic tumor cells. The patient has completed prior staging and interdisciplinary tumor board review confirming suitability for radiolabeled antibody therapy. On the day of service the patient arrives to an outpatient oncology infusion center or hospital outpatient infusion suite. Pre-infusion steps include verification of identity, review of recent labs (complete blood count, renal and hepatic function), assessment for active infections or pregnancy, informed consent, and confirmation of appropriate radiopharmaceutical dose prepared by nuclear pharmacy and radiopharmacist. Vascular access is established via a peripheral IV or implanted central venous access device. The nuclear medicine physician or authorized oncology specialist performs time-out procedures, confirms radiolabel and activity, and supervises administration while nursing monitors vital signs, radiation safety protocols, and infusion pump function. Post-infusion observation for immediate hypersensitivity or infusion-related adverse events occurs in the same infusion setting; radiation safety and patient discharge instructions are provided, including precautions for bodily fluids and follow-up imaging or laboratory surveillance scheduled by the treating team. Typical sites of service are an outpatient hospital infusion center, freestanding oncology infusion clinic, or ambulatory nuclear medicine department.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    96365Intravenous infusion, therapeutic, prophylactic, or diagnostic; initial, up to 1 hourMay be used for documenting the actual infusion time for adjunctive intravenous medications given during the radiolabeled antibody visit (e.g., premedication or hydration).
    96413Chemotherapy administration, IV infusion technique; each additional hourUsed when additional monitored infusion time is billed for concurrent chemotherapeutic or biologic infusions administered during the same encounter.
    36415Collection of venous blood by venipuncturePerformed for pre-infusion laboratory testing (CBC, chemistries) documented as part of the treatment visit.
    77012Fluoroscopic guidance for vascular access; radiological supervision and interpretationMay be performed if image-guided central catheter placement is required prior to infusion.
    A9513Sodium iodide I-131 therapeutic, per millicurie (CMS-assigned HCPCS)Example of a radiotherapeutic product code used for billing radiopharmaceuticals; relates to the radiolabeled agent component of therapy.

    Related Modifiers

    5 rows

    ModifierDescriptionWhen to Use
    25CPT modifier 25 indicates that on the same day as another procedure or service, the same physician or other qualified health care professional provided a significant, separately identifiable…- When to apply: Use modifier 25 only on an E/M code to indicate the same provider delivered a significant, separately identifiable E/M service on the same day as another procedure or service — i.e.,…
    66Modifier 66 (Surgical Team) is used when three or more surgeons act as primary surgeons on a single, highly complex procedure. The AMA defines it for use when a surgical team — often composed of…- Use modifier 66 when three or more surgeons act as primary surgeons working collaboratively as a surgical team on a single, highly complex or difficult procedure (for example organ…
    2PModifier -2P is a Category II performance‑measure exclusion appended to a CPT Category II (quality) code when the provider did not perform the measured action because of patient‑related reasons (for…- Use modifier 2P only with CPT Category II (performance‑measure) codes when a patient‑specific reason prevented performance of the measured action (for example, patient refusal, economic or social…
    99Modifier 99 is a placeholder modifier used when more modifiers apply to a single procedure than the claim form or electronic field allows. The AMA classifies it under Provider Services and Ambulatory…- Use CPT modifier -99 when more modifiers apply to a single procedure line than the claim form or payer field allows (CMS/Noridian: when more than four modifiers are needed); append modifier 99 on…
    77Modifier 77 indicates that a previously performed procedure or service was legitimately repeated by a different physician or other qualified health care professional. The AMA’s CPT definition…- Use modifier 77 when a basic procedure or service already performed is repeated by a different physician or other qualified health care professional (for example, a second provider independently…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    207RH0000X
    363A00000X
    364SI0800X
    222Q00000X
    364SP0200X
    122300000X
    163WC1400X
    208C00000X

    Related Payer Policy Updates

    Specialty: Nephrology1 / 2

    10 rows

    PolicyPayerEffective Date
    Vafseo (vadadustat) for anemia in CKD on dialysisCigna2026-08-15
    Metabolic Disorders - Cysteamine (Oral) Products for Individual and Family PlansCigna2026-08-15
    Kerendia (finerenone) — Coverage CriteriaBlue Cross Blue Shield - Iowa2026-08-05
    Voyxact (sibeprenlimab-szsl) — Prior authorization / medical necessity for primary IgA nephropathyColorado Rocky Mountain Health Plans2026-08-01
    Oxlumo (lumasiran) and Rivfloza (nedosiran) — Coverage Criteria (Ohio)Colorado Rocky Mountain Health Plans2026-08-01
    Korsuva (difelikefalin) — Medical Benefit Drug Coverage Criteria (Ohio)Colorado Rocky Mountain Health Plans2026-08-01
    Complement Inhibitors - EmpaveliCigna2026-08-01
    Tolvaptan (Jynarque)Cigna2026-08-01
    Nephrology - Filspari (sparsentan) coverageCigna2026-08-01
    Rivfloza (nedosiran) prior authorization for PH1UnitedHealthcare2026-08-01

    Related Codes

    CPT-79005-ORAL-RADIOPHARMACEUTICAL-THERAPY

    CPT 79005: Oral Radiopharmaceutical Therapy

    CPT-79101-RADIOPHARMACEUTICAL-INTRAVENOUS-THERAPY

    CPT 79101: Intravenous Radiopharmaceutical Therapy

    CPT-79200-INTRACAVITARY-RADIOPHARMACEUTICAL-ADMINISTRATION

    CPT 79200: Intracavitary Radiopharmaceutical Administration

    CPT-79300-INTERSTITIAL-BRACHYTHERAPY-IMPLANTATION

    CPT 79300: Brachytherapy Radioactive Seed/Wire Implantation

    CPT-79440-RADIOPHARMACEUTICAL-INJECTION-FOR-SYNOVIAL-INFLAMMATION

    CPT 79440: Therapeutic Radioactive Joint Injection

    CPT-79445-TRANSARTERIAL-RADIOEMBOLIZATION-INTRA-ARTERIAL-RADIOACTIVE-INJECTION

    CPT 79445: Transarterial Radioembolization (Intra-arterial Embolization)

    CPT-79999-RADIOPHARMACEUTICAL-THERAPY-UNLISTED-PROCEDURE

    CPT 79999: Radiopharmaceutical Therapy, Unlisted Procedure

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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