C1839 HCPCS code: Iris prosthesis
C1839 is the HCPCS Level II code for iris prosthesis. In 2023 Medicare paid an average of $6,258.61 per service for C1839 across 25 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. Medicare volume rose 14% from 2022 to 2023 (22 to 25 services). In 2023, about 4 clinicians billed Medicare for C1839 for 25 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 C1839 (2023)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 4 |
| Medicare beneficiaries | 25 |
| States with claims | 1 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for C1839, 2022–2023
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 22 | 21 | $7,980.60 | $6,371.95 |
| 2023 | 25 | 25 | $7,855.19 | $6,258.61 |
States with the most C1839 services (2023)
| State | Services | Avg. paid |
|---|---|---|
| Ohio | 22 | $6,176.49 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 2 | Anatomic Consideration |
| practitioner claims | 2 | Anatomic Consideration |
What changed for C1839
- 2020-01-01: C1839 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 C1839?
C1839 is the HCPCS Level II code for iris prosthesis. Short descriptor: "Iris prosthesis".
How much does Medicare pay for C1839?
In 2023, the average Medicare payment was $6,258.61 per service (average allowed $7,855.19).
Does Medicare cover C1839?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
How many units of C1839 can be billed per day?
2 on outpatient hospital claims; 2 on practitioner claims (NCCI medically unlikely edits).
Related C18 codes
- C1813 — Prosthesis, penile, inflatable
- C1814 — Retinal tamponade device, silicone oil
- C1815 — Prosthesis, urinary sphincter (implantable)
- C1816 — Receiver and/or transmitter, neurostimulator (implantable)
- C1817 — Septal defect implant system, intracardiac
- C1818 — Integrated keratoprosthesis
- C1819 — Surgical tissue localization and excision device (implantable)
- C1820 — Generator, neurostimulator (implantable), with rechargeable battery and charging system
- C1821 — Interspinous process distraction device (implantable)
- C1822 — Generator, neurostimulator (implantable), high frequency, with rechargeable battery and charging system
- C1823 — Generator, neurostimulator (implantable), non-rechargeable, with transvenous sensing and stimulation leads
- C1824 — Generator, cardiac contractility modulation (implantable)
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 C1839
- Watch C1839 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for C1839
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.