HCPCS G0340: Robotic Linear Accelerator Fractionated Stereotactic Radiosurgery - OpenPayer

Summary & Overview

HCPCS G0340: Robotic Linear Accelerator Fractionated Stereotactic Radiosurgery

HCPCS Level II code G0340 denotes image-guided, robotic linear accelerator-based stereotactic radiosurgery delivered as fractionated therapy, covering the second through fifth sessions of a treatment course with a maximum of five sessions per course. This code captures procedures that use robotic linac platforms with collimator changes and custom plugging to target lesions precisely across multiple fractions. Nationally, accurate coding for fractionated stereotactic radiosurgery supports appropriate payment, care coordination, and tracking of advanced radiation oncology services.

Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical service and billing context, including how the code fits into multi-session stereotactic radiosurgery regimens. The publication presents benchmarking and policy-relevant context for payers and providers, explains common billing considerations, and highlights where additional documentation or session-level reporting may be expected. Data not provided in the input—such as specific reimbursement rates, associated taxonomies, and ICD-10 diagnosis mappings—is noted as unavailable. The content is designed for national audiences seeking clarity on service description, site of service, and payer coverage patterns for advanced, image-guided fractionated stereotactic radiosurgery.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareG0340HCPCS Level IIstereotactic radiosurgeryradiation oncologyrobotic linacfractionated treatmentimage-guided therapysession-based billing

Billing Code Overview

HCPCS Level II code G0340 describes image-guided, robotic linear accelerator-based stereotactic radiosurgery delivered with features such as collimator changes and custom plugging. The code covers fractionated treatment for all lesions, billed per session for the second through fifth sessions of a course, with a maximum of five sessions per course of treatment.

Service type: Robotic linear accelerator-based stereotactic radiosurgery (fractionated)

Typical site of service: Hospital outpatient department or freestanding radiation oncology center

Clinical & Coding Specifications

Clinical Context

A 62-year-old patient with a 3.2 cm metastatic lesion in the right parietal lobe of the brain from non-small cell lung cancer presents for fractionated stereotactic radiosurgery (SRS) using an image-guided robotic linear accelerator. The care pathway begins with consultation by a radiation oncologist and neurosurgeon, diagnostic contrast-enhanced MRI for target delineation, and immobilization planning (thermoplastic mask). A simulation CT fused with MRI defines the gross tumor volume (GTV), clinical target volume (CTV) as appropriate, and planning target volume (PTV). The medical physics team generates a high-precision plan incorporating collimator changes and custom plugging to conform dose and spare adjacent normal tissue. The patient receives fractionated treatment delivered over 3–5 sessions; this code (G0340) represents the second through fifth sessions in a course that uses an image-guided robotic linear accelerator platform. Each treatment session is image-guided (positional verification via cone-beam CT or stereoscopic X-ray), with on-table verification, potential re-planning if anatomy changes, and physician review of setup. Typical documentation includes indication, simulation and planning notes, immobilization description, image guidance records, fraction number (e.g., session 2 of 4), device and accessory usage (collimator changes, custom plugging), and total dose/fractionation. Billing uses G0340 for sessions two through five; the first session would be billed with the initial session code, and subsequent sessions up to five total use G0340 as specified.

Coding Specifications

Modifier	Description	When to Use

HCPCS G8914: ASC Discharge with Hospital Transfer or Admission

HCPCS-G8465-PROSTATE-CANCER-HIGH-VERY-HIGH-RECURRENCE-RISK

HCPCS G8465: High or Very High Risk of Prostate Cancer Recurrence

HCPCS-G8933-SUICIDE-RISK-NOT-ASSESSED-INITIAL-EVALUATION

HCPCS G8933: Suicide Risk Not Assessed at Initial Evaluation

HCPCS-G9539-PLACEMENT-WITH-INTENT-FOR-POTENTIAL-REMOVAL

HCPCS G9539: Intent for Potential Removal at Time of Placement

HCPCS-G8877-BREAST-CANCER-NO-PREOP-MINIMALLY-INVASIVE-BIOPSY-ATTEMPT

HCPCS G8877: No Preoperative Minimally Invasive Breast Biopsy Attempt

HCPCS-G9941-BACK-PAIN-VAS-PRE-AND-POSTOPERATIVE-ASSESSMENT

HCPCS G9941: Back Pain VAS Preoperative and Postoperative Assessment

HCPCS-G0921-DOCUMENTATION-PATIENT-REFUSAL-ASSESSMENT

HCPCS G0921: Documentation of Patient Refusal or Inability to Assess

HCPCS-G9946-BACK-PAIN-VASSCORE-NOT-MEASURED-1YR-POSTOP

HCPCS G9946: Back Pain VAS/Numeric Score Not Measured at 1-Year Postop

HCPCS-G8499-RHEUMATOID-ARTHRITIS-QUALITY-MEASURES-COMPLETE

HCPCS G8499: Rheumatoid Arthritis Quality Measures Completed

HCPCS-G9007-COORDINATED-CARE-TEAM-CONFERENCE

HCPCS G9007: Coordinated Care Fee for Scheduled Team Conference

Showing 1–10 of 1996

Taxonomy Code	Specialty	Notes
`2084P0800X`	Radiation Oncology	Primary specialty responsible for planning and delivery of SRS.
`2086S0102X`	Radiation Therapist	Clinical staff delivering image-guided treatments and performing setup and immobilization.
`2085R0201X`	Radiation Physicist	Responsible for treatment planning, machine QA, and dosimetry.
`208000000X`	Neurological Surgery	Neurosurgeon frequently collaborates for target definition or surgical management when applicable.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`C79.31`	Secondary malignant neoplasm of brain	Common indication for stereotactic radiosurgery to treat brain metastases with high-dose, focal radiation.
`C71.9`	Malignant neoplasm of brain, unspecified	Primary brain tumors or unspecified intracranial malignancies treated with stereotactic radiosurgery.
`D33.3`	Benign neoplasm of brain, supratentorial	Select benign intracranial tumors (e.g., meningioma) that may be managed with fractionated SRS.
`D43.0`	Neoplasm of uncertain behavior of brain, supratentorial	Lesions of uncertain malignant potential evaluated and sometimes treated with stereotactic radiosurgery.
`G45.9`	Transient cerebral ischemic attack, unspecified	Occasionally included as a comorbidity in planning; not an indication for SRS but relevant to treatment risk assessment.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`77301`	Special medical radiation physics consultation, treatment planning, dosimetry computation, and brachytherapy devices (simple or complex)	Often billed for complex treatment planning and dosimetry associated with stereotactic plans.
`77295`	Simulation of radiation treatment, complex, includes respiratory motion management if performed	Used for simulation and immobilization prior to SRS when complex simulation is required.
`77435`	Radiation treatment management, 5 treatments	Used to report management of the course of radiation therapy over a 5-fraction schedule; billed by the physician for treatment planning and management.
`96440`	Injection of contrast for imaging guidance (if applicable)	Used when intravenous contrast is administered for imaging required for localization or fusion during planning.

`26`	Professional component	Use when only the physician interpretation/planning component is billed separate from technical services.
`53`	Discontinued procedure	Use when a treatment session is started but discontinued prior to planned delivery for patient safety or intolerance.
`59`	Distinct procedural service	Use to indicate a distinct procedure or service that is separate from other services on the same day when clinically appropriate.
`62`	Two surgeons	Use when two surgeons of different specialties share responsibility for the procedure (rare for radiosurgery; applicable if surgical team involvement documented).
`78`	Return to operating/procedure room for related procedure during global period	Use if patient requires an immediate repeat procedural intervention related to the radiosurgery during the global period.
`80`	Assistant surgeon	Use when an assistant surgeon provides substantive assisting services during a procedure that supports billing rules.
`81`	Minimum assistant surgeon	Use when minimal assistant surgeon services are provided; applicable only if assistant participation is documented and allowed.
`52`	Reduced services	Use when the service is provided at less than full description (e.g., abbreviated treatment delivered).
`22`	Increased procedural services	Use when work required to provide the service is substantially greater than typically required and well documented.
`59`	Distinct procedural service	Use to indicate a distinct procedural service not ordinarily reported together; (listed again for emphasis in day-of-event bundling scenarios).

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