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    v1.0.30
    OpenPayerBilling CodesOutpatient PPSHCPCS hcpcs-c2634-iodine-125-brachytherapy-source-high-activity
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    HCPCS Level II C2634: Brachytherapy Iodine-125 High-Activity Source

    HCPCS Level II code C2634 represents a high-activity iodine-125 brachytherapy source (non-stranded) billed per source for use in brachytherapy procedures; the service involves placement of radioactive seeds for localized radiation therapy and the typical site of service is an operating room or radiation oncology procedure suite where interstitial or intracavitary radioactive seed implantation is performed.

    For related coverage guidance, see recent payer policy updates: Percutaneous Left Atrial Appendage Closure Devices for Stroke Prevention in Atrial Fibrillation, Percutaneous Left Atrial Appendage Closure Devices for Stroke Prevention in Atrial Fibrillation, Percutaneous Left Atrial Appendage Closure Devices for Stroke Prevention in Atrial Fibrillation.

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    Table of contents

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    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.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    55873Brachytherapy, insertion of radioactive source into prostate, interstitial (separate procedure)Primary procedure code used for reporting the brachytherapy implantation service; C2634 is billed per-source in addition to the professional/surgical CPT code
    77014Computed tomography guidance for localization and targeting during procedures (e.g., dosimetry verification)Used when CT guidance or postimplant CT is performed for seed localization and dosimetric planning
    76937Ultrasound guidance for needle placement (e.g., prostate)Used for intraoperative transrectal ultrasound guidance of needle placement and seed deposition
    77295Radiation physics consultation and treatment planning for brachytherapy (complex)Used for detailed dosimetry, treatment planning, and physicist calculations associated with high-activity seed implants
    54300Implantation of radioactive material into prostate, interstitial (separate procedure—diagnostic or therapeutic)Occasionally used in specific payer contexts for reporting prostate seed implant procedures alongside planning codes

    Related Modifiers

    12 rows

    ModifierDescriptionWhen to Use
    26Modifier 26 (Professional Component) identifies and bills only the professional portion of a split service — the physician’s interpretation, report, and medical judgment — when the technical…- Use CPT Modifier -26 when you are billing only the professional component (PC) of a split‑bill eligible service—i.e., you performed the physician interpretation, medical judgment and prepared a…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    80CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…
    81Modifier -81 indicates a physician served as a minimal assistant surgeon for part—not all—of an operative procedure. Use when a physician’s assisting role is limited and does not represent full…- Use CPT modifier -81 when a physician acts as a minimum assistant surgeon who assists during only part (a limited portion) of an operative procedure; append -81 to the primary surgical CPT code to…
    82Modifier 82 is appended to a surgical CPT code to indicate that an attending physician acted as an assistant because a qualified resident surgeon was unavailable. In teaching hospitals it documents…- When to use: Append modifier 82 in teaching-hospital settings to indicate a physician served as an assistant surgeon because a qualified resident surgeon was unavailable (includes situations where…
    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…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    22Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
    23Modifier -23 (Unusual Anesthesia) is used on anesthesia service CPT codes when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia…- Use modifier -23 only on anesthesia CPT codes (00100–01999) when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia because of…

    Showing 1–10 of 12

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    208000000X
    207P00000X
    363A00000X
    207PT0002X
    163WA2000X
    341800000X
    1223D0001X
    224Y00000X

    Related ICD-10-CM Codes

    26 rows

    ICD-10-CM CodeDescription
    C20Malignant neoplasm of rectum
    C25.9Malignant neoplasm of pancreas, unspecified
    C32.9Malignant neoplasm of larynx, unspecified
    C34.90Malignant neoplasm of unspecified part of unspecified bronchus or lung
    C44.91Basal cell carcinoma of skin, unspecified
    C50.919Malignant neoplasm of unspecified site of unspecified female breast
    C53.9Malignant neoplasm of cervix uteri, unspecified
    C61Malignant neoplasm of prostate
    C62.11Malignant neoplasm of descended right testis
    C64.9Malignant neoplasm of unspecified kidney, except renal pelvis

    Showing 1–10 of 26

    Related Payer Policy Updates

    Specialty: Cardiology1 / 3

    10 rows

    PolicyPayerEffective Date
    Percutaneous Left Atrial Appendage Closure Devices for Stroke Prevention in Atrial Fibrillationpremerabluecrossofwashington2027-02-05
    Percutaneous Left Atrial Appendage Closure Devices for Stroke Prevention in Atrial Fibrillationpremerabluecrossofwashington2027-02-05
    Percutaneous Left Atrial Appendage Closure Devices for Stroke Prevention in Atrial Fibrillationpremerabluecrossofwashington2027-02-05
    Percutaneous Left Atrial Appendage Closure - Medical PolicyHealth-New-England2027-02-01
    Transcatheter Mitral Valve Repair Medical PolicyHealth-New-England2027-02-01
    Cardiac Electrophysiological (EP) Studies and Cardiac Ablation of Abnormal Electrical RhythmsCigna2027-01-15
    Outpatient Cardiology Procedures for EviCore Arrangement (for Oxford Only)Colorado Rocky Mountain Health Plans2026-11-01
    Biomarkers for Myocardial Infarction and Chronic Heart Failure Reimbursement PolicyHealthfirst2026-11-01
    Percutaneous Left Atrial Appendage Closure Devices for Stroke Prevention in Atrial Fibrillationpremerabluecrossofwashington2026-11-01
    Percutaneous Left Atrial Appendage Closure Devices for Stroke Prevention in Atrial Fibrillationpremerabluecrossofwashington2026-11-01

    Related Codes

    HCPCS-C1713-IMPLANTABLE-ANCHOR-SCREW-BONE-FIXATION

    HCPCS C1713: Anchor/Screw for Bone or Soft Tissue Fixation (Implantable)

    HCPCS-C1714-TRANSLUMINAL-DIRECTIONAL-ATHERECTOMY-CATHETER

    HCPCS C1714: Catheter, transluminal atherectomy, directional

    HCPCS-C1715-BRACHYTHERAPY-NEEDLE

    HCPCS C1715: Brachytherapy Needle

    HCPCS-C1716-BRACHYTHERAPY-GOLD-198-SOURCE

    HCPCS C1716: Brachytherapy Source, Gold-198, Per Source

    HCPCS-C1717-HDR-BRACHYTHERAPY-IRIDIUM-192-SOURCE

    HCPCS C1717: HDR Iridium-192 Brachytherapy Source, Per Source

    HCPCS-C1719-BRACHYTHERAPY-IRIDIUM-192-SOURCE-NON-STRANDED

    HCPCS C1719: Brachytherapy Source, Iridium-192, Non-Stranded

    HCPCS-C1721-IMPLANTABLE-DUAL-CHAMBER-CARDIOVERTER-DEFIBRILLATOR

    HCPCS C1721: Cardioverter-Defibrillator, Dual Chamber (Implantable)

    HCPCS-C1724-ROTATIONAL-TRANSLUMINAL-ATHERECTOMY-CATHETER

    HCPCS Level II C1724: Rotational Transluminal Atherectomy Catheter

    HCPCS-C1725-TRANSLUMINAL-ANGIOPLASTY-CATHETER-NON-LASER

    HCPCS Level II C1725: Transluminal Angioplasty Catheter, Non-Laser

    HCPCS-C1726-NON-VASCULAR-BALLOON-DILATATION-CATHETER

    HCPCS C1726: Catheter, Balloon Dilatation, Non-Vascular

    Showing 1–10 of 603

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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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