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Intraoperative hyperthermic intraperitoneal chemotherapy (HIPEC) is a specialized procedure that involves the administration of heated chemotherapy directly into the peritoneal cavity during surgery. This technique is primarily utilized after the surgical excision of malignant tumors located in the abdominal region. The objective of HIPEC is to eliminate any residual cancer cells that may remain after the tumor has been removed, thereby reducing the risk of recurrence. The chemotherapy agents used in this procedure are heated to temperatures between 41-43 degrees Celsius (106-109 degrees Fahrenheit), which enhances their effectiveness by allowing deeper penetration into the cancerous tissues. The procedure is characterized by the use of separate incisions for the insertion of catheters that facilitate the delivery and circulation of the heated chemotherapy solution throughout the abdominal cavity. This localized treatment approach minimizes systemic exposure to the chemotherapy drugs, thereby reducing potential side effects associated with traditional chemotherapy methods. The entire process typically lasts for about 60 minutes, during which the heated solution is circulated, and upon completion, it is drained from the abdomen, followed by rinsing with saline and closure of the incisions.
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The intraoperative hyperthermic intraperitoneal chemotherapy (HIPEC) procedure is indicated for patients who have undergone surgical resection of abdominal tumors, particularly in cases where there is a high risk of residual cancer cells remaining in the peritoneal cavity. The following conditions may warrant the use of HIPEC:
The intraoperative hyperthermic intraperitoneal chemotherapy (HIPEC) procedure involves several critical steps to ensure effective delivery of the chemotherapy agents. The following outlines the procedural steps:
Following the intraoperative hyperthermic intraperitoneal chemotherapy (HIPEC) procedure, patients are typically monitored in a recovery area for any immediate post-operative complications. Expected recovery may vary based on individual patient factors and the extent of the initial surgery. Patients may experience some discomfort or pain at the incision sites, which can be managed with appropriate pain relief medications. It is essential for healthcare providers to monitor for signs of infection or other complications during the recovery period. Follow-up appointments will be necessary to assess the patient's overall recovery and to determine the effectiveness of the HIPEC treatment in conjunction with the primary surgical intervention.
| Short Descr | INTRAOP HIPEC PX 1ST 60 MIN | Medium Descr | INTRAOPERATIVE HIPEC PX FIRST 60 MINUTES | Long Descr | Intraoperative hyperthermic intraperitoneal chemotherapy (HIPEC) procedure, including separate incision(s) and closure, when performed; first 60 minutes (List separately in addition to code for primary procedure) | Status Code | Active Code | Global Days | ZZZ - Code Related to Another Service | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 0 - No payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 2 - Payment restriction for assistants at surgery does not apply to this procedure... | Co-Surgeons (62) | 1 - Co-surgeons could be paid, though supporting documentation is required... | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Items and Services Packaged into APC Rates | Type of Service (TOS) | 1 - Medical Care | Berenson-Eggers TOS (BETOS) | none | MUE | 1 |
This is an add-on code that must be used in conjunction with one of these primary codes.
| 38100 | MPFS Status: Active Code APC C CPT Assistant Article Illustration for Code Splenectomy; total (separate procedure) | 38101 | MPFS Status: Active Code APC C Illustration for Code Splenectomy; partial (separate procedure) | 38102 | Addon Code MPFS Status: Active Code APC C CPT Assistant Article Illustration for Code Splenectomy; total, en bloc for extensive disease, in conjunction with other procedure (List in addition to code for primary procedure) | 38120 | MPFS Status: Active Code APC J1 CPT Assistant Article Illustration for Code Laparoscopy, surgical, splenectomy | 43611 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Illustration for Code Excision, local; malignant tumor of stomach | 43620 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Illustration for Code Gastrectomy, total; with esophagoenterostomy | 43621 | MPFS Status: Active Code APC C Physician Quality Reporting Illustration for Code Gastrectomy, total; with Roux-en-Y reconstruction | 43622 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Illustration for Code Gastrectomy, total; with formation of intestinal pouch, any type | 43631 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Illustration for Code Gastrectomy, partial, distal; with gastroduodenostomy | 43632 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Illustration for Code Gastrectomy, partial, distal; with gastrojejunostomy | 43633 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Illustration for Code Gastrectomy, partial, distal; with Roux-en-Y reconstruction | 43634 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Illustration for Code Gastrectomy, partial, distal; with formation of intestinal pouch | 44010 | MPFS Status: Active Code APC C Physician Quality Reporting Illustration for Code Duodenotomy, for exploration, biopsy(s), or foreign body removal | 44015 | Addon Code MPFS Status: Active Code APC C CPT Assistant Article Illustration for Code Tube or needle catheter jejunostomy for enteral alimentation, intraoperative, any method (List separately in addition to primary procedure) | 44110 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Illustration for Code Excision of 1 or more lesions of small or large intestine not requiring anastomosis, exteriorization, or fistulization; single enterotomy | 44111 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Illustration for Code Excision of 1 or more lesions of small or large intestine not requiring anastomosis, exteriorization, or fistulization; multiple enterotomies | 44120 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Illustration for Code Enterectomy, resection of small intestine; single resection and anastomosis | 44121 | Addon Code MPFS Status: Active Code APC C CPT Assistant Article Illustration for Code Enterectomy, resection of small intestine; each additional resection and anastomosis (List separately in addition to code for primary procedure) | 44125 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Illustration for Code Enterectomy, resection of small intestine; with enterostomy | 44130 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Illustration for Code Enteroenterostomy, anastomosis of intestine, with or without cutaneous enterostomy (separate procedure) | 44139 | Addon Code MPFS Status: Active Code APC C CPT Assistant Article Illustration for Code Mobilization (take-down) of splenic flexure performed in conjunction with partial colectomy (List separately in addition to primary procedure) | 44140 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Colectomy, partial; with anastomosis | 44141 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Illustration for Code Colectomy, partial; with skin level cecostomy or colostomy | 44143 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Illustration for Code Colectomy, partial; with end colostomy and closure of distal segment (Hartmann type procedure) | 44144 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Illustration for Code Colectomy, partial; with resection, with colostomy or ileostomy and creation of mucofistula | 44145 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Illustration for Code Colectomy, partial; with coloproctostomy (low pelvic anastomosis) | 44146 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Illustration for Code Colectomy, partial; with coloproctostomy (low pelvic anastomosis), with colostomy | 44147 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Illustration for Code Colectomy, partial; abdominal and transanal approach | 44150 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Illustration for Code Colectomy, total, abdominal, without proctectomy; with ileostomy or ileoproctostomy | 44151 | MPFS Status: Active Code APC C Physician Quality Reporting Illustration for Code Colectomy, total, abdominal, without proctectomy; with continent ileostomy | 44155 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Illustration for Code Colectomy, total, abdominal, with proctectomy; with ileostomy | 44156 | MPFS Status: Active Code APC C Physician Quality Reporting Illustration for Code Colectomy, total, abdominal, with proctectomy; with continent ileostomy | 44157 | MPFS Status: Active Code APC C Physician Quality Reporting Illustration for Code Colectomy, total, abdominal, with proctectomy; with ileoanal anastomosis, includes loop ileostomy, and rectal mucosectomy, when performed | 44158 | MPFS Status: Active Code APC C Physician Quality Reporting Illustration for Code Colectomy, total, abdominal, with proctectomy; with ileoanal anastomosis, creation of ileal reservoir (S or J), includes loop ileostomy, and rectal mucosectomy, when performed | 44160 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Illustration for Code Colectomy, partial, with removal of terminal ileum with ileocolostomy | 44202 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Illustration for Code Laparoscopy, surgical; enterectomy, resection of small intestine, single resection and anastomosis | 44203 | Addon Code MPFS Status: Active Code APC C CPT Assistant Article Illustration for Code Laparoscopy, surgical; each additional small intestine resection and anastomosis (List separately in addition to code for primary procedure) | 44204 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Illustration for Code Laparoscopy, surgical; colectomy, partial, with anastomosis | 44207 | MPFS Status: Active Code APC C Physician Quality Reporting Illustration for Code Laparoscopy, surgical; colectomy, partial, with anastomosis, with coloproctostomy (low pelvic anastomosis) | 44213 | Addon Code MPFS Status: Active Code APC C CPT Assistant Article Illustration for Code Laparoscopy, surgical, mobilization (take-down) of splenic flexure performed in conjunction with partial colectomy (List separately in addition to primary procedure) | 44227 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Illustration for Code Laparoscopy, surgical, closure of enterostomy, large or small intestine, with resection and anastomosis | 47001 | Addon Code MPFS Status: Active Code APC N ASC N1 CPT Assistant Article Illustration for Code Biopsy of liver, needle; when done for indicated purpose at time of other major procedure (List separately in addition to code for primary procedure) | 47100 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Illustration for Code Biopsy of liver, wedge | 48140 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Illustration for Code Pancreatectomy, distal subtotal, with or without splenectomy; without pancreaticojejunostomy | 48145 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Illustration for Code Pancreatectomy, distal subtotal, with or without splenectomy; with pancreaticojejunostomy | 48152 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Illustration for Code Pancreatectomy, proximal subtotal with total duodenectomy, partial gastrectomy, choledochoenterostomy and gastrojejunostomy (Whipple-type procedure); without pancreatojejunostomy | 48155 | MPFS Status: Active Code APC C Physician Quality Reporting Illustration for Code Pancreatectomy, total | 49000 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Illustration for Code Exploratory laparotomy, exploratory celiotomy with or without biopsy(s) (separate procedure) | 49010 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Exploration, retroperitoneal area with or without biopsy(s) (separate procedure) | 49320 | MPFS Status: Active Code APC J1 ASC A2 Physician Quality Reporting CPT Assistant Article Illustration for Code Laparoscopy, abdomen, peritoneum, and omentum, diagnostic, with or without collection of specimen(s) by brushing or washing (separate procedure) | 58200 | Female Edit MPFS Status: Active Code APC C Physician Quality Reporting PUB 100 CPT Assistant Article Illustration for Code Total abdominal hysterectomy, including partial vaginectomy, with para-aortic and pelvic lymph node sampling, with or without removal of tube(s), with or without removal of ovary(s) | 58210 | Female Edit MPFS Status: Active Code APC C Physician Quality Reporting PUB 100 CPT Assistant Article Illustration for Code Radical abdominal hysterectomy, with bilateral total pelvic lymphadenectomy and para-aortic lymph node sampling (biopsy), with or without removal of tube(s), with or without removal of ovary(s) | 58575 | Female Edit MPFS Status: Active Code APC C Laparoscopy, surgical, total hysterectomy for resection of malignancy (tumor debulking), with omentectomy including salpingo-oophorectomy, unilateral or bilateral, when performed | 58940 | Female Edit MPFS Status: Active Code APC C PUB 100 CPT Assistant Article Illustration for Code Oophorectomy, partial or total, unilateral or bilateral; | 58943 | Female Edit MPFS Status: Active Code APC C PUB 100 CPT Assistant Article Illustration for Code Oophorectomy, partial or total, unilateral or bilateral; for ovarian, tubal or primary peritoneal malignancy, with para-aortic and pelvic lymph node biopsies, peritoneal washings, peritoneal biopsies, diaphragmatic assessments, with or without salpingectomy(s), with or without omentectomy | 58950 | Female Edit MPFS Status: Active Code APC C Illustration for Code Resection (initial) of ovarian, tubal or primary peritoneal malignancy with bilateral salpingo-oophorectomy and omentectomy; | 58951 | Female Edit MPFS Status: Active Code APC C Physician Quality Reporting PUB 100 CPT Assistant Article Resection (initial) of ovarian, tubal or primary peritoneal malignancy with bilateral salpingo-oophorectomy and omentectomy; with total abdominal hysterectomy, pelvic and limited para-aortic lymphadenectomy | 58952 | Female Edit MPFS Status: Active Code APC C CPT Assistant Article Resection (initial) of ovarian, tubal or primary peritoneal malignancy with bilateral salpingo-oophorectomy and omentectomy; with radical dissection for debulking (ie, radical excision or destruction, intra-abdominal or retroperitoneal tumors) | 58953 | Female Edit MPFS Status: Active Code APC C Physician Quality Reporting PUB 100 CPT Assistant Article Bilateral salpingo-oophorectomy with omentectomy, total abdominal hysterectomy and radical dissection for debulking; | 58954 | Female Edit MPFS Status: Active Code APC C Physician Quality Reporting PUB 100 CPT Assistant Article Bilateral salpingo-oophorectomy with omentectomy, total abdominal hysterectomy and radical dissection for debulking; with pelvic lymphadenectomy and limited para-aortic lymphadenectomy | 58956 | Female Edit MPFS Status: Active Code APC C Physician Quality Reporting PUB 100 Illustration for Code Bilateral salpingo-oophorectomy with total omentectomy, total abdominal hysterectomy for malignancy | 58958 | Changed Code for 2025 Female Edit MPFS Status: Active Code APC C Illustration for Code Resection (tumor debulking) of recurrent ovarian, tubal, primary peritoneal, uterine malignancy (intra-abdominal, retroperitoneal tumors), with omentectomy, if performed, with pelvic lymphadenectomy and limited para-aortic lymphadenectomy | 58960 | Female Edit MPFS Status: Active Code APC C CPT Assistant Article Illustration for Code Laparotomy, for staging or restaging of ovarian, tubal, or primary peritoneal malignancy (second look), with or without omentectomy, peritoneal washing, biopsy of abdominal and pelvic peritoneum, diaphragmatic assessment with pelvic and limited para-aortic lymphadenectomy |
| 58 | Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78. | GC | This service has been performed in part by a resident under the direction of a teaching physician | Q1 | Routine clinical service provided in a clinical research study that is in an approved clinical research study |
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| 2024-01-01 | Added | Code Added. |
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