C1604 HCPCS code: Graft, transmural transvenous arterial bypass (implantable), with all delivery system components
C1604 is the HCPCS Level II code for graft, transmural transvenous arterial bypass (implantable), with all delivery system components. Its Medicare coverage code is D (Special coverage instructions apply): Medicare covers it when its national or local coverage criteria are met. The NCCI unit limit is 1 per day on outpatient hospital claims.
Code details
| Field | Value |
|---|---|
| Section | C codes — Outpatient PPS (hospital outpatient temporary codes) |
| Coverage code | D — Special coverage instructions apply |
| Pricing indicator | 53 |
| BETOS category | D1A — Medical/surgical supplies |
| Added | 2024-01-01 |
| Last action effective | 2024-01-01 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 1 | Nature of Equipment |
| practitioner claims | 1 | Nature of Equipment |
What changed for C1604
- 2024-01-01: C1604 added to HCPCS Level II
- Next scheduled CMS quarterly update (HCPCS and DMEPOS fee schedule): 2027-01-01
Frequently asked questions
What is HCPCS code C1604?
C1604 is the HCPCS Level II code for graft, transmural transvenous arterial bypass (implantable), with all delivery system components. Short descriptor: "Grft, trnsmurl/trnsvens byps".
Does Medicare cover C1604?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
How many units of C1604 can be billed per day?
1 on outpatient hospital claims; 1 on practitioner claims (NCCI medically unlikely edits).
Related C16 codes
- C1600 — Catheter, transluminal intravascular lesion preparation device, bladed, sheathed (insertable)
- C1601 — Endoscope, single-use (i.e. disposable), pulmonary, imaging/illumination device (insertable)
- C1602 — Orthopedic/device/drug matrix/absorbable bone void filler, antimicrobial-eluting (implantable)
- C1603 — Retrieval device, insertable, laser (used to retrieve intravascular inferior vena cava filter)
- C1605 — Pacemaker, leadless, dual chamber (right atrial and right ventricular implantable components), rate-responsive, including all necessary components for implantation
- C1606 — Adapter, single-use (i.e. disposable), for attaching ultrasound system to upper gastrointestinal endoscope
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Next steps
- Run a reimbursement report for a device billed under C1604
- Watch C1604 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for C1604
Sources: CMS HCPCS Level II release October 2025; CMS DMEPOS fee schedule; CMS NCCI MUE tables; CMS Medicare utilization (physician and DME supplier files); CMS Medicare Coverage Database articles. Fees are Medicare allowables, not commercial rates. Not billing or legal advice.