Summary & Overview

HCPCS C1717: HDR Brachytherapy Iridium-192 Source

HCPCS Level II code C1717 denotes a non-stranded, high dose rate iridium-192 brachytherapy source billed per source. These radioactive sources are central to HDR brachytherapy treatments used across oncology to deliver localized, high-dose radiation with rapid dose falloff, reducing exposure to surrounding healthy tissue. Nationally, accurate coding for brachytherapy sources matters for clinical documentation, radiation safety compliance, and consistent payment processing for institutional and physician services.

Key payers covered in this overview include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of the code's clinical role, typical sites of service such as hospital outpatient departments and radiation oncology clinics, and the kinds of materials and supply charges this code represents. The publication summarizes common billing considerations, typical modifiers that may appear on claims (provided in the input), and related administrative issues affecting reimbursement and claim adjudication.

This summary provides benchmarks and policy context relevant to facility billing for HDR brachytherapy supplies, highlights areas where coding clarity supports compliance, and outlines the clinical context for use of C1717. Data not available in the input is noted where applicable in the full publication.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareC1717HCPCS Level IIbrachytherapyiridium-192high-dose-rateradiation-oncologymedical-suppliesprocedure-supply

Billing Code Overview

HCPCS Level II code C1717 represents a brachytherapy source, non-stranded, high dose rate iridium-192, per source. This item is a disposable radioactive source used in high-dose-rate (HDR) brachytherapy procedures, in which a high-activity Ir-192 source is temporarily placed within or next to a tumor to deliver concentrated radiation.

Service type: Brachytherapy source supply for HDR brachytherapy procedures

Typical site of service: Hospital outpatient departments, radiation oncology clinics, and ambulatory surgery centers where HDR brachytherapy is performed

Clinical & Coding Specifications

Clinical Context

A typical patient is an adult undergoing high-dose-rate (HDR) brachytherapy for a localized malignancy such as gynecologic (cervical or endometrial) cancer, prostate cancer, or selected head and neck or soft-tissue tumors. The patient is evaluated by a radiation oncologist and multidisciplinary team; imaging (MRI/CT) and clinical exam determine target volumes. On the day of treatment the patient is brought to the radiation oncology suite or operating room; applicable anesthesia or sedation may be provided. Interstitial or intracavitary applicators are placed and connected to a remote afterloader. Individual C1717 sources (non-stranded, Iridium-192) are loaded into the afterloader per treatment plan; each source is billed per source as indicated. Post-treatment, applicators are removed and the patient is observed for immediate complications before discharge or transfer to inpatient care.

Key workflow steps:

Referral and consultation with radiation oncology.
Simulation and treatment planning with CT/MRI and brachytherapy planning software.
Applicator placement under anesthesia or sedation in procedure area or operating room.
Source loading with C1717 Ir-192 high-dose-rate non-stranded sources into the afterloader for planned dwell positions and times.
Delivery of HDR fractions per protocol, source removal, and post-procedure monitoring.

Typical site of service: outpatient radiation oncology department, specialized brachytherapy suite, or operating room when combined with surgical procedures.

Typical patient scenario: a 62-year-old female with locally advanced cervical cancer receives external beam radiotherapy followed by HDR intracavitary brachytherapy; during each HDR fraction the treatment team loads multiple non-stranded Iridium-192 sources into the afterloader according to the planned dwell pattern and documents the number of sources used for billing per source.

Coding Specifications

Modifier	Description	When to Use
`00`	Procedure code exempt from modifier reporting	Rarely used; applied per payer rules when no modifier is required
`22`	Increased procedural services	When work, time, or technical difficulty for applicator placement or source loading is substantially greater than usual
`23`	Unusual anesthesia	When general anesthesia is medically necessary for a normally non‑anesthetized procedure (per payer guidance)
`51`	Multiple procedures	When brachytherapy is billed along with additional distinct procedures during the same session (check payer bundling)
`52`	Reduced services	When fewer sources or a shortened treatment is delivered compared with standard planned service
`53`	Discontinued procedure	If applicator placement or source loading is begun but aborted for patient safety before completion
`54`	Surgical care only	If a separate surgeon provides applicator placement and another provider manages postoperative radiation
`55`	Postoperative care only	When only postoperative management is billed separately from the procedure
`56`	Preoperative care only	For billing pre-procedure evaluation separated from the brachytherapy service
`59`	Distinct procedural service	When a clearly distinct service (e.g., separate diagnostic procedure) is performed on the same day unrelated to brachytherapy
`62`	Two surgeons	When two surgeons with different specialties share performance of the surgical component (applicator placement)
`76`	Repeat procedure by same physician	For repeat HDR fraction or repeat source placement during the same course billed separately
`XE`	Separate encounter	When a distinct encounter for a separately identifiable service occurs on a different date/time
`QK`	Anesthesia qualifying circumstances — medically required; CRNA	When a CRNA furnishes anesthesia under qualifying circumstances

Taxonomy Code	Specialty	Notes
`207RX0200X`	Radiation Oncology	Primary specialty that plans and delivers HDR brachytherapy
`207L00000X`	Radiology — Diagnostic	Performs imaging (CT/MRI) essential for treatment planning
`208600000X`	General Surgery	May perform applicator placement in combined surgical cases
`390200000X`	Anesthesiology	Provides anesthesia or sedation for applicator placement or complex procedures
`363L00000X`	Medical Physics	Medical physicists perform source calibration, treatment planning QA, and afterloader commissioning

ICD-10 Code	Description	Clinical Relevance
`C53.9`	Malignant neoplasm of cervix uteri, unspecified	Common indication for intracavitary HDR brachytherapy using Ir-192 sources
`C61`	Malignant neoplasm of prostate	Indication for interstitial HDR brachytherapy with transperineal needle placement and Ir-192 sources
`C54.1`	Malignant neoplasm of endometrium	Pelvic malignancy that may be treated with HDR vaginal cuff brachytherapy
`C77.0`	Secondary and unspecified malignant neoplasm of lymph nodes of head, face and neck	Brachytherapy used for select head and neck nodal disease
`C44.9`	Malignant neoplasm of skin, unspecified	Superficial tumor sites sometimes treated with surface or interstitial brachytherapy

CPT Code	Description	Relationship to This Procedure
`51720`	Irrigation and insertion of ureteral catheter(s)	Performed when urinary catheterization or stenting is required during pelvic brachytherapy procedures
`59025`	Fetal nonstress test (if applicable in pregnant patients)	Not typically used for oncology HDR; included here only if pregnancy monitoring is required (rare)
`55875`	Transperineal placement of needles or catheters into prostate for interstitial radiation therapy including imaging guidance	Used for placement of interstitial applicators in prostate HDR brachytherapy prior to source loading
`77261`	Therapeutic radiology treatment planning; complex	Reflects complicated HDR brachytherapy planning services performed by dosimetry/physicist and physician
`77336`	Continuing medical physics consultation, supervision and interpretation for brachytherapy procedures	Medical physics support and remote afterloader QA associated with HDR source use

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