C8005 Transbronchial PEF Ablation HCPCS Reimbursement | OpenPayer

Summary & Overview

HCPCS C8005: Transbronchial PEF Ablation with Image-Guided Navigation and EBUS

HCPCS Level II code C8005 represents a highly specialized bronchoscopic service: non-thermal transbronchial ablation of pulmonary lesions using pulsed electric field (PEF) energy combined with advanced image guidance and endobronchial ultrasound (EBUS)-guided sampling. The code captures a bundled, multidisciplinary procedure that includes CT acquisition(s) with 3D rendering, computer-assisted image-guided navigation, fluoroscopic and/or ultrasound guidance when used, and diagnostic sampling of lung and mediastinal/hilar lymph node stations alongside therapeutic interventions. Nationally, this code matters because it documents an emerging, technology-driven approach to thoracic tumor management and diagnostic staging that can affect payment policy, hospital service line planning, and adoption of image-guided bronchoscopic platforms.

Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will learn what the code covers clinically and procedurally, typical sites of service, and which major payers are relevant to coverage and billing discussions. The publication also provides benchmarks, notes on policy and coding updates where available, and clinical context for how the integrated diagnostic and therapeutic elements are captured under a single HCPCS Level II code. Data not available in the input for associated taxonomies, ICD-10 diagnoses, and related codes.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareC8005HCPCS Level IIbronchoscopypulsed electric fieldimage-guided navigationendobronchial ultrasoundthoracic interventionablationdiagnostic sampling

Billing Code Overview

HCPCS Level II code C8005 describes a complex bronchoscopic procedure involving non-thermal transbronchial ablation of lesion(s) using pulsed electric field (PEF) energy. The service includes guidance with fluoroscopy and/or ultrasound when performed, computer-assisted image-guided navigation with computed tomography acquisition(s) and 3D rendering, and endobronchial ultrasound (EBUS) guided transtracheal and/or transbronchial sampling (e.g., aspiration(s)/biopsy(ies)) of the lungs and all mediastinal and/or hilar lymph node stations or structures, plus any therapeutic interventions performed.

Service Type: Advanced interventional bronchoscopic procedure combining ablation, image-guidance, and diagnostic sampling

Typical Site of Service: Hospital outpatient departments, ambulatory surgery centers, or specialized bronchoscopy suites

Data not available in the input for associated taxonomies, ICD-10 diagnoses, and related codes.

Clinical & Coding Specifications

Clinical Context

A 64-year-old current/former smoker with a 40-pack-year history presents with a 2.5 cm centrally located pulmonary mass near the bronchus and suspicious ipsilateral mediastinal lymphadenopathy on chest CT. The multidisciplinary thoracic team plans a bronchoscopic diagnostic and therapeutic session: image-guided bronchoscopy using computed tomography acquisition with 3D rendering and computer-assisted navigation to target the lesion; endobronchial ultrasound (EBUS) for transbronchial and transtracheal sampling of mediastinal and hilar lymph nodes; non-thermal pulsed electric field (PEF) ablation of the endobronchial/peribronchial tumor; and concurrent therapeutic interventions as indicated (e.g., suction, biopsy, hemostasis). The procedure is performed in an operating room or procedure suite with fluoroscopic and ultrasound guidance under moderate sedation or general anesthesia, with peri-procedural airway management, pathology processing of biopsies, and post-procedure recovery and imaging as clinically indicated.

Coding Specifications

Modifier	Description	When to Use
`00`	Default/No modifier	When no specific modifier applies to the service.
`22`	Increased procedural services

HCPCS C1886: Catheter for Extravascular Tissue Ablation, Insertable

HCPCS-C9784-ENDOSCOPIC-SLEEVE-GASTROPLASTY

HCPCS C9784: Endoscopic Sleeve Gastroplasty with EGD

HCPCS-C9756-INTRAOPERATIVE-ICG-LYMPHATIC-MAPPING

HCPCS C9756: Intraoperative ICG Near-Infrared Lymphatic Mapping

HCPCS-C1831-PERSONALIZED-INTERBODY-CAGE-SPINAL-FUSION

HCPCS C1831: Personalized Interbody Cage for Spinal Fusion

HCPCS-LEVEL-II-C9081-IDECABTAGENE-VICLEUCEL-AUTOLOGOUS-CAR-T-THERAPY

HCPCS Level II C9081: Idecabtagene vicleucel, Autologous Anti-BCMA CAR-T

HCPCS-C9085-INJECTION-AVALGLUCOSIDASE-ALFA-4MG

HCPCS C9085: Injection, avalglucosidase alfa-ngpt, 4 mg

HCPCS-C8923-TRANSTHORACIC-ECHOCARDIOGRAPHY-CONTRAST-COMPLETE-2D

HCPCS C8923: Transthoracic Echocardiography with Contrast, Complete

HCPCS-C1752-SHORT-TERM-HEMODIALYSIS-PERITONEAL-CATHETER

HCPCS C1752: Short-Term Hemodialysis/Peritoneal Catheter

HCPCS-C7542-ERCP-WITH-BIOPSY-ENDOSCOPIC-CANNULATION-OF-PAPILLA

HCPCS C7542: ERCP with Biopsy and Endoscopic Cannulation of Papilla

HCPCS-C9101-OLICERIDINE-INJECTION-0-1-MG

HCPCS C9101: Injection, oliceridine, 0.1 mg

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Taxonomy Code	Specialty	Notes
`207RC0000X`	Pulmonary Disease (Pulmonology)	Primary specialty performing diagnostic bronchoscopy, EBUS, and PEF ablation.
`207LP2900X`	Thoracic Surgery	Thoracic surgeons perform complex airway procedures and may collaborate for therapeutic interventions.
`363L00000X`	Interventional Pulmonology	Focused specialty for advanced bronchoscopic navigation, EBUS staging, and bronchoscopic ablation.
`207K00000X`	Critical Care Medicine	Provides peri-procedural care for medically complex patients and anesthesia coordination.
`364S00000X`	Anesthesiology	Provides sedation or general anesthesia for airway procedures when required.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`C34.10`	Malignant neoplasm of upper lobe, right bronchus or lung	Central lung mass requiring bronchoscopic biopsy, staging, and possible PEF ablation.
`C34.90`	Malignant neoplasm of unspecified part of unspecified bronchus or lung	Used when exact lung site unspecified during diagnostic workup prior to final staging.
`R91.8`	Other nonspecific abnormal findings of lung field	Incidental or indeterminate pulmonary nodule prompting navigational bronchoscopy and sampling.
`J98.4`	Other disorders of lung, not elsewhere classified	Airway lesions or benign tumors potentially treated with bronchoscopic ablation.
`J95.9`	Postprocedural respiratory complication, unspecified	Possible complication code used if post-bronchoscopy respiratory events occur.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`31622`	Bronchoscopy, rigid or flexible, including fluoroscopic guidance, diagnostic, with bronchial or transbronchial biopsy(s), when performed	May be used for diagnostic bronchoscopic biopsy procedures performed alongside navigation and EBUS sampling when reporting per CPT definitions.
`32607`	Thoracotomy or thoracoscopy with pulmonary wedge resection, single lobe; for comparison of advanced interventions	Codes like this are not directly reported with bronchoscopic ablation but represent alternative surgical management options in the treatment pathway.
`32405`	Thoracentesis, diagnostic; with imaging guidance	Represents ancillary pleural diagnostic procedures sometimes performed in the same episode of care in thoracic disease evaluation.
`76536`	Ultrasound, chest (eg, pleural, mediastinal), real-time with image documentation	Ultrasound imaging is commonly performed with EBUS guidance for transbronchial/transtracheal sampling and may be reported separately when billing rules permit.
`76377`	3D rendering with interpretation and reporting of CT, MRI, PET/CT studies for image-guided procedures	CT acquisition with 3D rendering and computer-assisted image-guided navigation described in the HCPCS code is related to this CPT code for advanced 3D imaging processing.
`31652`	Bronchoscopy with endobronchial ultrasound (EBUS) guided transbronchial needle aspiration (TBNA) of the right and/or left peribronchial and/or peritracheal lymph nodes	Directly corresponds to the EBUS-guided nodal sampling component performed during the procedure.

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