C1726 HCPCS code: Catheter, balloon dilatation, non-vascular
C1726 is the HCPCS Level II code for catheter, balloon dilatation, non-vascular. 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 5 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 | 2001-04-01 |
| Last action effective | 2004-01-01 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 5 | Clinical: Data |
| practitioner claims | 5 | Clinical: CMS Workgroup |
What changed for C1726
- 2001-04-01: C1726 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 C1726?
C1726 is the HCPCS Level II code for catheter, balloon dilatation, non-vascular. Short descriptor: "Cath, bal dil, non-vascular".
Does Medicare cover C1726?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
How many units of C1726 can be billed per day?
5 on outpatient hospital claims; 5 on practitioner claims (NCCI medically unlikely edits).
Related C17 codes
- C1713 — Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable)
- C1714 — Catheter, transluminal atherectomy, directional
- C1715 — Brachytherapy needle
- C1716 — Brachytherapy source, non-stranded, gold-198, per source
- C1717 — Brachytherapy source, non-stranded, high dose rate iridium-192, per source
- C1719 — Brachytherapy source, non-stranded, non-high dose rate iridium-192, per source
- C1721 — Cardioverter-defibrillator, dual chamber (implantable)
- C1722 — Cardioverter-defibrillator, single chamber (implantable)
- C1724 — Catheter, transluminal atherectomy, rotational
- C1725 — Catheter, transluminal angioplasty, non-laser (may include guidance, infusion/perfusion capability)
- C1727 — Catheter, balloon tissue dissector, non-vascular (insertable)
- C1728 — Catheter, brachytherapy seed administration
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Next steps
- Run a reimbursement report for a device billed under C1726
- Watch C1726 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for C1726
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.