Summary & Overview
HCPCS Level II C7501: Stereotactic Percutaneous Breast Biopsy with Localization Device
HCPCS Level II code C7501 represents stereotactic-guided percutaneous breast biopsies that include placement of a breast localization device (such as a clip or metallic pellet) and imaging of the biopsy specimen when performed. This code captures a common image-guided intervention used in diagnostic breast care and preoperative planning for lesions identified on mammography or tomosynthesis. Nationally, accurate coding for these procedures matters for consistent claim submission, care coordination between radiology and surgery, and monitoring utilization of minimally invasive breast diagnostics.
Key payers typically involved in coverage and reimbursement considerations include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers can expect a concise review of how this code is used in clinical workflows, where the service is typically delivered (hospital outpatient departments, ambulatory surgical centers, radiology suites), and common billing themes tied to localization device placement and specimen imaging. The publication will cover benchmarking and payment context, relevant policy updates affecting outpatient image-guided breast biopsy services, and clinical context that explains when stereotactic guidance and localization devices are used. Data not available in the input will be noted as such where applicable.
Billing Code Overview
HCPCS Level II code C7501 describes percutaneous breast biopsy performed using stereotactic guidance with placement of a breast localization device (e.g., clip or metallic pellet) when performed, and imaging of the biopsy specimen when performed. The code covers procedures on unilateral and bilateral lesions; for a single lesion biopsy, use the appropriate single-lesion code.
Service Type: Image-guided percutaneous breast biopsy with localization device placement and specimen imaging
Typical Site of Service: Hospital outpatient department, ambulatory surgical center, or radiology suite
Clinical & Coding Specifications
Clinical Context
A 52-year-old woman presents after screening mammography identified a suspicious calcification cluster in the left breast. Diagnostic mammography and targeted ultrasound confirm a focal area corresponding to the mammographic abnormality. The breast surgeon and radiologist review imaging and recommend a percutaneous stereotactic core biopsy with placement of a localization clip because the lesion is best targeted with stereotactic guidance and may require future surgical excision if malignant. On the day of service the patient is consented, positioned prone on a stereotactic table or seated at a dedicated stereotactic unit, and the lesion is localized using stereotactic mammographic imaging. Local anesthesia is administered, multiple core samples are obtained using a biopsy device, a permanent localization device (clip) is placed at the biopsy site, and specimen radiographs are obtained to confirm retrieval of calcifications. The radiologist documents laterality, the number of cores, placement of the marker, immediate complications (if any), and communicates results to the referring surgeon. Typical site of service: outpatient radiology department or ambulatory surgical center; hospital outpatient department when concomitant services or observation are needed. Service type: image-guided percutaneous breast biopsy with placement of localization device and specimen imaging as indicated, unilateral or bilateral per reporting instructions.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services |