C1734 HCPCS code: Orthopedic/device/drug matrix for opposing bone-to-bone or soft tissue-to bone (implantable)
C1734 is the HCPCS Level II code for orthopedic/device/drug matrix for opposing bone-to-bone or soft tissue-to bone (implantable). In 2023 Medicare paid an average of $1,781.21 per service for C1734 across 48 services. 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 2 per day on outpatient hospital claims. In 2023, about 15 clinicians billed Medicare for C1734 for 43 beneficiaries.
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 | 2020-01-01 |
| Last action effective | 2023-01-01 |
Who bills C1734 (2023)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 15 |
| Medicare beneficiaries | 43 |
| States with claims | 1 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for C1734, 2022–2023
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 48 | 48 | $2,645.24 | $2,111.57 |
| 2023 | 48 | 43 | $2,235.60 | $1,781.21 |
States with the most C1734 services (2023)
| State | Services | Avg. paid |
|---|---|---|
| Missouri | 13 | $1,714.23 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 2 | Nature of Service/Procedure |
| practitioner claims | 2 | Nature of Service/Procedure |
What changed for C1734
- 2020-01-01: C1734 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 C1734?
C1734 is the HCPCS Level II code for orthopedic/device/drug matrix for opposing bone-to-bone or soft tissue-to bone (implantable). Short descriptor: "Orth/devic/drug bn/bn,tis/bn".
How much does Medicare pay for C1734?
In 2023, the average Medicare payment was $1,781.21 per service (average allowed $2,235.60).
Does Medicare cover C1734?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
How many units of C1734 can be billed per day?
2 on outpatient hospital claims; 2 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)
- C1726 — Catheter, balloon dilatation, non-vascular
- C1727 — Catheter, balloon tissue dissector, non-vascular (insertable)
Building a device that would bill under a code like this? Caduvo matches a device description to HCPCS/CPT codes, Medicare coverage and payment, and the FDA pathway in one report.
Next steps
- Run a reimbursement report for a device billed under C1734
- Watch C1734 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for C1734
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.