Summary & Overview
HCPCS C2635: Palladium-103 High-Activity Brachytherapy Source
HCPCS Level II code C2635 denotes a high-activity, non-stranded palladium-103 brachytherapy source (greater than 2.2 mCi, per source). These radioactive seeds are used in intraoperative or implant-based radiation therapies to deliver targeted dose to tumors while limiting exposure to surrounding healthy tissue. Nationally, payment and coverage for brachytherapy supplies like C2635 affect radiation oncology service lines, capital planning for oncology clinics, and cost considerations for procedures such as prostate brachytherapy and other localized tumor treatments.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise review of clinical context for palladium-103 high-activity sources, typical sites of service (hospital outpatient departments, ambulatory surgery centers, and radiation oncology clinics), and what to expect in payer coverage patterns. The publication outlines benchmark considerations, common billing modifiers and coding practice notes, and policy updates that influence reimbursement and claim adjudication. Where specific data points were not provided in the source input, the report indicates that those items are not available. This summary provides clinicians, billing professionals, and administrators a national-level primer on the use and billing considerations for HCPCS Level II code C2635.
Billing Code Overview
HCPCS Level II code C2635 describes a brachytherapy source, non-stranded, high activity, palladium-103, greater than 2.2 mCi (NIST), per source. This item is a radioactive seed used in brachytherapy procedures where high-activity, non-stranded palladium-103 sources are implanted to deliver localized radiation to target tissues.
Service type: Brachytherapy radioactive source supply
Typical site of service: Hospital outpatient department, ambulatory surgery center, or specialized radiation oncology clinic
Data not available in the input for associated taxonomies, ICD-10 diagnoses, or related procedure codes.
Clinical & Coding Specifications
Clinical Context
A typical patient is a 65-year-old man with clinically localized prostate cancer electing definitive low-dose-rate (LDR) brachytherapy using permanent seed implantation. After staging with prostate biopsy and multiparametric prostate MRI, the radiation oncologist and urologist plan a brachytherapy implant using palladium-103 seeds with individual source activity greater than 2.2 mCi (NIST) per source (HCPCS C2635). On the day of service the patient undergoes preprocedural anesthesia evaluation, placement in the operating or procedure suite (typically an ambulatory surgery center or hospital-based operating room), transrectal ultrasound (TRUS)–guided template mapping, and transperineal placement of non‑stranded high‑activity seeds under fluoroscopic/ultrasound guidance. Intraoperative dosimetry confirms target coverage; postoperative imaging (CT or MRI) is obtained for dosimetric verification. Typical care team includes a radiation oncologist (brachytherapy subspecialist), urologist (if performing implant or assisting), medical physicist for source calibration and dosimetry, and procedural nursing/anesthesia staff. Follow-up includes urinary and sexual function assessment and PSA surveillance at regular intervals.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component |