Summary & Overview
HCPCS C1819: Implantable Surgical Tissue Localization and Excision Device
HCPCS Level II code C1819 represents an implantable surgical tissue localization and excision device used to mark and guide the removal of target tissue during surgical procedures. Such devices support precise localization for excision, potentially improving surgical accuracy and workflow. Nationally, coding and coverage for implantable localization systems are important for hospital billing, device reimbursement, and perioperative planning.
Key payers considered in national coverage discussions include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of clinical context for device use, common settings where the device is implanted and used (hospital outpatient departments, ambulatory surgical centers, and inpatient operating rooms), and a summary of payer coverage landscape. The publication examines billing considerations tied to HCPCS Level II code C1819, outlines common modifiers and billing practices where available, and highlights implications for surgical service lines and device supply chains.
This summary provides clinicians, coding professionals, and revenue cycle staff with concise context on the code’s purpose, typical sites of service, and payer relevance to support accurate charge capture and administrative planning. Data not available in the input is noted where applicable.
Billing Code Overview
HCPCS Level II code C1819 describes an implantable surgical tissue localization and excision device. This device is used to localize target tissue intraoperatively and facilitate surgical excision, typically as an implanted marker or localization system.
Service Type: Surgical implantable device procedure
Typical Site of Service: Hospital outpatient department or ambulatory surgical center, and may also be used in inpatient surgical settings when an implantable localization device is placed and used to guide tissue excision.
Clinical & Coding Specifications
Clinical Context
A 52-year-old female with a suspicious, nonpalpable breast lesion identified on screening mammography and breast MRI is scheduled for localization and excision. Preoperative localization is performed by interventional radiology using an implantable surgical tissue localization device (C1819) placed under ultrasound or stereotactic guidance to mark the lesion site. On the day of surgery, the breast surgeon uses intraoperative guidance from the implantable marker to perform a targeted excisional biopsy or lumpectomy with margin assessment. Typical workflow: preoperative imaging and biopsy confirmation of atypia or malignancy; consent and scheduling; radiology places the implantable localization device; operative team documents removal of the device and excised specimen; pathology processes the specimen; postoperative follow-up and adjuvant planning as needed.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when work required to place or remove the implantable localization device is substantially greater than usual and supporting documentation justifies additional reimbursement. |
50 |