0816T Opn insj/replacement ins pattern subcutaneous
Also known as: insulin pump placement, pump implant
Open surgical insertion or replacement of insulin pump system with subcutaneous placement. Implantation of programmable infusion pump beneath the skin.
In Plain Language
Surgically placing a small medication pump under the skin; Insulin pump surgery
Clinical Context
Used for initial surgical implantation or revision of subcutaneous insulin infusion systems in patients with diabetes requiring intensive insulin therapy.
RVU Information
CPT 0816T does not have a physician work RVU assigned by CMS. Category III codes for emerging technology do not receive RVU assignments. Reimbursement is negotiated with individual payers.
Billing & Documentation
Category III codes are temporary codes for emerging technology, services, and procedures. They are not assigned RVU values by CMS. Coverage and reimbursement vary by payer — check with individual insurers before billing. These codes sunset after 5 years if not converted to Category I.
Specialties
Frequently Asked Questions
What is CPT code 0816T?
CPT 0816T (Opn insj/replacement ins pattern subcutaneous) is a Category III code. Open surgical insertion or replacement of insulin pump system with subcutaneous placement. Implantation of programmable infusion pump beneath the skin.
Is 0816T a permanent CPT code?
No — 0816T is a Category III temporary code for emerging technology. It may be converted to a permanent Category I code if widely adopted. Category III codes expire after 5 years without renewal.
When is CPT 0816T used?
Used for initial surgical implantation or revision of subcutaneous insulin infusion systems in patients with diabetes requiring intensive insulin therapy.
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CPT® is a registered trademark of the American Medical Association. Data sourced from CMS Physician Fee Schedule RVU26A. Descriptions, synonyms, and clinical context are original content by RVU Edge.