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    v1.0.28
    OpenPayerBilling CodesOutpatient PPSHCPCS hcpcs-c2640-palladium-103-brachytherapy-source-stranded
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    HCPCS C2640: Brachytherapy Source, Palladium-103, Stranded

    HCPCS Level II code C2640 describes a brachytherapy source, stranded, palladium-103, billed per source, used in radiation oncology for permanent or temporary implant procedures; the service type is brachytherapy implant source supply and the typical site of service is an outpatient hospital, ambulatory surgery center, or radiation oncology clinic where implantation and radiation treatment planning occur.

    For related coverage guidance, see recent payer policy updates: Cardiac Computed Tomography (CCT)/Coronary Computed Tomographic Angiography (CCTA), Cardiovascular Disease Risk Assessment, Biomarkers for Myocardial Infarction and Chronic Heart Failure.

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    Clinical & Coding Specifications

    Clinical Context

    A typical patient is an adult male diagnosed with localized prostate cancer being treated with low-dose-rate (LDR) brachytherapy using stranded palladium-103 sources. The patient presents to a hospital outpatient radiation oncology brachytherapy suite or an ambulatory surgical center. Pre-procedure workflow includes consultation with a radiation oncologist, staging workup (PSA, prostate biopsy report, pelvic MRI or transrectal ultrasound for planning), informed consent, and pre-anesthesia evaluation if sedation or general anesthesia is planned. On the day of service the patient undergoes transperineal implantation of C2640 palladium-103 stranded seeds under ultrasound guidance with sterile technique. The radiation oncologist and brachytherapy physicist perform treatment planning intraoperatively and verify seed placement and dosimetry. Post-implant imaging (post-operative CT or MRI) is obtained for dose verification. Typical post-procedure care includes short-term analgesia, voiding observation, discharge instructions, and scheduled follow-up for PSA monitoring and toxicity assessment.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    55875Transperineal placement of needles and/or catheters into prostate for interstitial radioelement application, single or multiple needle direction (separate procedure)Often used to report the needle placement step for transperineal seed implantation prior to placing C2640 sources
    77778Interstitial radiation source administration, complex (includes imaging and guidance)Reports complex image-guided interstitial source administration when appropriate adjunct imaging and dosimetric services are provided with C2640
    51715Insertion of temporary transurethral catheter, simple (e.g., straight catheterization)Commonly performed perioperatively for urinary drainage during or after prostate brachytherapy procedures
    76942Ultrasonic guidance for needle placement (e.g., biopsy, aspiration, injection), imaging supervision and interpretationUsed to report ultrasound guidance during seed placement and real-time needle guidance
    77290Therapeutic radiology simulation-aided field setup or isodose planning, complexRepresents planning and dosimetry activities that support accurate placement and dosing of C2640 sources

    Related Modifiers

    9 rows

    ModifierDescriptionWhen to Use
    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…
    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…
    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…

    Related Provider Taxonomies

    8 rows

    Taxonomy CodeSpecialtyNotes
    207RR0500XRheumatology PhysicianAn internist who treats diseases of joints, muscle, bones and tendons. This specialist diagnoses and treats arthritis, back pain, muscle strains, comm…
    208100000XPhysical Medicine & Rehabilitation PhysicianPhysical medicine and rehabilitation, also referred to as rehabilitation medicine, is the medical specialty concerned with diagnosing, evaluating, and…
    364SH1100XHolistic Clinical Nurse SpecialistPhysician Assistants & Advanced Practice Nursing Providers · Clinical Nurse Specialist
    111NP0017XPediatric ChiropractorThe Pediatric Chiropractor is a chiropractor with specialized, advanced training and certification in the evaluation, care and management of health an…
    152WL0500XLow Vision Rehabilitation OptometristOptometrists who specialize in low-vision care having training to assess visual function, prescribe low-vision devices, develop treatment plans, and r…
    247ZC0005XClinical Laboratory Director (Non-physician)An individual who is state-licensed as a clinical laboratory director and meets the qualifications in the Clinical Laboratory Improvement Amendments o…
    320800000XMental Illness Community Based Residential Treatment FacilityA home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illnes…
    146E00000XCommunity ParamedicA Community Paramedic is trained in responding to a scene and arranging appointments and transportation to alternate destinations through established …

    Related Payer Policy Updates

    Specialty: Cardiology1 / 3

    6 rows

    PolicyPayerEffective Date
    Cardiac Computed Tomography (CCT)/Coronary Computed Tomographic Angiography (CCTA)univerahealthcare2026-10-15
    Cardiovascular Disease Risk AssessmentOscar Health2026-10-01
    Biomarkers for Myocardial Infarction and Chronic Heart FailureOscar Health2026-10-01
    Multiple Procedure Payment Reduction for Diagnostic Cardiovascular ProceduresBlue Cross Blue Shield - Maine2026-10-01
    Cardiovascular Disease Risk Assessmentblue cross blue shield - louisiana2026-09-15
    Cardiovascular Disease Risk AssessmentBlue Cross Blue Shield - New Mexico2026-09-04

    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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