© Copyright 2025 American Medical Association. All rights reserved.
Intraoperative hyperthermic intraperitoneal chemotherapy (HIPEC) is a specialized procedure designed to deliver heated chemotherapy directly into the abdominal cavity during surgery. This technique is primarily utilized after the surgical removal of cancerous tumors from the abdomen, with the goal of targeting any residual cancer cells that may remain. The procedure involves the application of heated chemotherapy agents, which are circulated through the peritoneal cavity, allowing for a concentrated and localized treatment. The heating of the chemotherapy drugs enhances their effectiveness by increasing their penetration into the cancer cells and improving their cytotoxic effects. This method minimizes systemic exposure, as the chemotherapy is confined to the abdominal area, reducing potential side effects associated with traditional chemotherapy administration. The procedure may necessitate the creation of additional small incisions, particularly when performed using minimally invasive techniques, to facilitate the placement of catheters that connect to a perfusion machine. This machine is responsible for heating the chemotherapy solution to temperatures between 41-43 degrees Celsius (106-109 degrees Fahrenheit) before it is infused into the abdominal cavity. The infusion typically lasts for one to two hours, after which the solution is drained, and the abdomen is rinsed with saline before closing the incisions. This targeted approach aims to improve treatment outcomes for patients with abdominal cancers by effectively addressing localized disease while minimizing the impact on the rest of the body.
© Copyright 2025 Coding Ahead. All rights reserved.
The intraoperative hyperthermic intraperitoneal chemotherapy (HIPEC) procedure is indicated for patients undergoing surgical treatment for abdominal cancers. The specific indications include:
The intraoperative HIPEC procedure involves several critical steps to ensure effective delivery of chemotherapy. These steps include:
Post-procedure care following HIPEC involves monitoring the patient for any immediate complications related to the surgery and chemotherapy. Patients may experience abdominal discomfort, and healthcare providers will assess for signs of infection or other adverse effects. Recovery typically includes a hospital stay for observation, during which vital signs and overall health are closely monitored. Patients may also receive supportive care to manage any side effects from the chemotherapy. Follow-up appointments are essential to evaluate the effectiveness of the treatment and to monitor for any recurrence of cancer. The healthcare team will provide specific instructions regarding activity levels, dietary modifications, and any necessary medications to aid in recovery.
| Short Descr | NTRAOP HIPEC PX EA ADD 30MIN | Medium Descr | INTRAOPERATIVE HIPEC PX EACH ADDL 30 MINUTES | Long Descr | Intraoperative hyperthermic intraperitoneal chemotherapy (HIPEC) procedure, including separate incision(s) and closure, when performed; each additional 30 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 | 2 |
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. | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | 76 | Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | 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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