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    v1.0.28
    OpenPayerBilling CodesMedical And Surgical SuppliesHCPCS hcpcs-a4648-implantable-tissue-marker
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    HCPCS Level II A4648: Tissue Marker, Implantable, Each

    HCPCS Level II code A4648 describes an implantable tissue marker provided per device for use in surgical or interventional procedures to mark tissue (for example, breast tumor localization) and is typically billed when a single implantable marker is placed; service type: device placement/implantable medical device supply; typical site of service: outpatient surgical center or hospital outpatient department.

    For related coverage guidance, see recent payer policy updates: Salivary Hormone Testing, Parathyroid Hormone, Phosphorus, Calcium, and Magnesium Testing, Bone Turnover Markers Testing.

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    Clinical & Coding Specifications

    Clinical Context

    A patient undergoing breast-conserving surgery for a confirmed or suspected breast malignancy receives an implantable tissue marker (A4648) placed intraoperatively or during an image-guided percutaneous biopsy. Typical patients are adult women or men with a focal breast lesion identified on mammography, ultrasound, or MRI who require localization for future surgical excision or to mark the biopsy site for radiation planning. The clinical workflow: pre-procedure imaging identifies the target lesion; if a core needle biopsy is performed, an interventional radiologist or breast surgeon implants the tissue marker at the biopsy site immediately after tissue sampling. Alternatively, during lumpectomy, the surgeon may place a tissue marker to delineate margins for adjuvant radiation. Documentation includes indication (e.g., suspicious mass), informed consent, device type and quantity (A4648 — each marker), implantation site (laterality and quadrant), imaging confirmation of marker position, and any immediate complications. The marker facilitates later localization with imaging or wire/seed guidance and supports radiation therapy targeting and follow-up imaging correlation.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    19083Image-guided (ultrasound or stereotactic) placement of breast marker/clip, single lesionCommonly performed at the time of percutaneous core needle biopsy to mark the biopsy site for future localization
    19120Biopsy, breast, with placement of localization device (e.g., clip), percutaneous, including imaging guidance when performed; first lesionPerformed when a biopsy and marker placement are done as a combined service
    38500Biopsy or excision of lymph node(s); open, superficialMay be performed later if lymph node staging is required; markers may assist correlation
    19281Placement of interstitial needles/implants for radiation therapy, breast; initial placementPerformed in radiation planning workflows where tissue markers guide target delineation
    77012CT guidance for needle placementImaging guidance code used when CT is used to confirm marker placement or assist percutaneous placement

    Related Modifiers

    6 rows

    ModifierDescriptionWhen to Use
    59Modifier 59 indicates a distinct procedural service when two procedures that are not normally billed together are clinically and procedurally separate. The CPT definition (as reiterated by CMS)…- Use modifier -59 to report a distinct procedural service when documentation supports that the procedure reported is not normally billed together with another service on the same day because of a…
    51Modifier –51 (Multiple Procedures) is used when the same provider performs multiple procedures in the same session to identify secondary, non‑exempt procedures and indicate payment reduction logic…- Use modifier -51 when the same provider performs multiple distinct procedures during the same patient encounter: report the highest‑valued procedure first (no modifier) and append -51 to…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    76Modifier -76, Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional, is appended when the same provider performs an identical, medically necessary procedure or…- Use modifier -76 when the same physician or other qualified health care professional performs an identical procedure or service a second (or subsequent) time on the same date of service and the…
    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…
    50Modifier –50 (Bilateral Procedure) is appended to a CPT code when an identical procedure is performed on paired anatomical structures during the same operative session. The AMA states to add…- Use modifier -50 when the same CPT surgical, diagnostic, or radiology procedure is performed on paired anatomical structures (both sides of the body) during the same operative/session by the same…

    Related Provider Taxonomies

    8 rows

    Taxonomy CodeSpecialtyNotes
    207Q00000XFamily Medicine PhysicianFamily Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadt…
    207V00000XObstetrics & Gynecology PhysicianAn obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproducti…
    207X00000XOrthopaedic Surgery PhysicianAn orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated…
    2084P0800XPsychiatry PhysicianA Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, …
    208000000XPediatrics PhysicianA pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectru…
    1041C0700XClinical Social WorkerA social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of p…
    2082S0105XSurgery of the Hand (Plastic Surgery) PhysicianA plastic surgeon with additional training in the investigation, preservation, and restoration by medical, surgical and rehabilitative means of all st…
    376G00000XNursing Home AdministratorAn individual, often licensed by the state, who is responsible for the management of a nursing home.

    Related Payer Policy Updates

    Specialty: Endocrinology1 / 3

    10 rows

    PolicyPayerEffective Date
    Salivary Hormone TestingOscar Health2026-10-01
    Parathyroid Hormone, Phosphorus, Calcium, and Magnesium TestingOscar Health2026-10-01
    Bone Turnover Markers TestingOscar Health2026-10-01
    Testosterone — Coverage Criteria for Measurement and MonitoringOscar Health2026-10-01
    Diabetes Mellitus Testing — Coverage CriteriaOscar Health2026-10-01
    Thyroid Disease TestingOscar Health2026-10-01
    Thyroid Disease Testingblue cross blue shield - louisiana2026-09-15
    Thyroid Disease TestingBlue Cross Blue Shield - New Mexico2026-09-04
    Parathyroid Hormone, Phosphorous, Calcium and Magnesium TestingBlue Cross Blue Shield - New Mexico2026-09-04
    Testosterone laboratory testing and managementPremera Bluecross2026-09-04

    Related Codes

    HCPCS-A4206-STERILE-SYRINGE-1CC-NEEDLE

    HCPCS A4206: Syringe with Needle, 1 cc or Less, Sterile

    HCPCS-A4207-STERILE-2CC-SYRINGE-WITH-NEEDLE

    HCPCS Level II A4207: Syringe with Needle, Sterile 2 cc

    HCPCS-A4208-STERILE-3CC-SYRINGE-WITH-NEEDLE

    HCPCS Level II A4208: Syringe with Needle, Sterile 3 cc

    HCPCS-A4209-STERILE-SYRINGE-WITH-NEEDLE-5CC-OR-GREATER

    HCPCS Level II A4209: Syringe with Needle, Sterile 5 cc or Greater

    HCPCS-A4210-NEEDLE-FREE-INJECTION-DEVICE

    HCPCS Level II A4210: Needle-free Injection Device, Each

    HCPCS-A4211-SUPPLIES-SELF-ADMINISTERED-INJECTIONS

    HCPCS Level II A4211: Supplies for Self-Administered Injections

    HCPCS-A4212-NON-CORING-NEEDLE-STYLET-CATHETER-ACCESS-SUPPLY

    HCPCS Level II A4212: Non-coring Needle or Stylet with/without Catheter

    HCPCS-A4213-STERILE-SYRINGE-20CC-OR-GREATER

    HCPCS Level II A4213: Syringe, Sterile, 20 cc or Greater, Each

    HCPCS-A4215-STERILE-NEEDLE-SINGLE-EACH

    HCPCS Level II A4215: Needle, Sterile, Any Size

    HCPCS-A4216-STERILE-DILUENT-FLUSH-10ML

    HCPCS Level II A4216: Sterile Diluent/Flush, 10 ml

    Showing 1–10 of 633

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    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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