Summary & Overview
HCPCS C2634: Iodine-125 High-Activity Brachytherapy Source
HCPCS Level II code C2634 designates a high-activity, non-stranded iodine-125 brachytherapy source (greater than 1.01 mCi, NIST) billed per source. Brachytherapy sources like these are central to targeted radiation oncology treatments for certain cancers, offering highly localized dosing that can reduce exposure to surrounding healthy tissue. Nationally, accurate coding for these devices affects facility billing, device reimbursement, and tracking of high-cost implantable oncology supplies.
Key payers addressed in this analysis include Aetna, Blue Cross Blue Shield, Cigna, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical context for C2634, how the code is used in procedural billing lines, and typical sites of service where these sources are supplied and implanted. The publication summarizes benchmark considerations, common billing modifiers used with HCPCS Level II codes, and policy updates that commonly influence coverage and payment for radioactive brachytherapy sources.
This resource is aimed at billing professionals, radiation oncology administrators, and policy analysts seeking a national-level briefing on coding, clinical use, and payer considerations related to HCPCS Level II code C2634.
Billing Code Overview
HCPCS Level II code C2634 describes a brachytherapy source, non-stranded, high activity, iodine-125, greater than 1.01 mCi (NIST), per source. This item represents an individual sealed radioactive source used in brachytherapy procedures where iodine-125 seeds are implanted temporarily or permanently to deliver localized radiation.
Service Type: Brachytherapy radioactive source supply and implant
Typical Site of Service: Hospital outpatient departments, ambulatory surgery centers, and radiation oncology clinics
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A 68-year-old male with clinically localized prostate cancer is evaluated for definitive brachytherapy. After multidisciplinary review, the radiation oncology team schedules an intraoperative permanent seed implantation using high-activity non-stranded iodine-125 sources (C2634) to achieve the prescribed dose to the prostate while minimizing dose to the urethra and rectum. On the day of service the patient presents to an outpatient radiation oncology procedural suite or an operating room within a hospital, undergoes general or spinal anesthesia, transrectal ultrasound (TRUS) planning to map gland volume and needle trajectories, and real-time seed placement using ultrasound and/or intraoperative fluoroscopy. The billing for each high-activity, non-stranded iodine-125 source is reported per source using C2634. Typical clinical workflow steps: pre-procedure consent and treatment planning, anesthesia and patient positioning, intraoperative imaging and real-time dosimetry, transperineal needle insertion and seed deposition, postimplant imaging (CT or MRI) for verification, and routine postprocedure follow-up for urinary and sexual function monitoring.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery |