C2596 HCPCS code: Probe, image-guided, robotic, waterjet ablation
C2596 is the HCPCS Level II code for probe, image-guided, robotic, waterjet ablation. 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 | 2020-01-01 |
| Last action effective | 2023-01-01 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 1 | Nature of Service/Procedure |
| practitioner claims | 1 | Nature of Service/Procedure |
Medicare policy articles for this code
- A56797: Billing and Coding: Fluid Jet System Treatment for LUTs/BPH (Wellpoint Federal (MAC - Part A, MAC - Part B))
- A57926: Billing and Coding: Fluid Jet System in the Treatment of Benign Prostatic Hyperplasia (BPH) (CGS Administrators, LLC (MAC - Part A, MAC - Part B))
- A58008: Billing and Coding: Transurethral Waterjet Ablation of the Prostate (Palmetto GBA (MAC - Part A, MAC - Part B))
- A58209: Billing and Coding: Transurethral Waterjet Ablation of the Prostate (WPS Insurance Corporation (MAC - Part A, MAC - Part B))
- A58227: Billing and Coding: Transurethral Waterjet Ablation of the Prostate (Noridian Healthcare Solutions, LLC (MAC - Part A, MAC - Part B))
- A58243: Billing and Coding: Transurethral Waterjet Ablation of the Prostate (Novitas Solutions, Inc. (MAC - Part A, MAC - Part B))
- A58264: Billing and Coding: Transurethral Waterjet Ablation of the Prostate (First Coast Service Options, Inc. (MAC - Part A, MAC - Part B))
Covered diagnoses (1 ICD-10-CM codes)
The diagnoses most often listed as covered in the policy articles above:
| ICD-10-CM | Diagnosis | Articles listing it |
|---|---|---|
| N40.1 | Benign prostatic hyperplasia with lower urinary tract symptoms | 7 |
What changed for C2596
- 2020-01-01: C2596 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 C2596?
C2596 is the HCPCS Level II code for probe, image-guided, robotic, waterjet ablation. Short descriptor: "Probe, robotic, water-jet".
Does Medicare cover C2596?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
Which diagnoses support coverage for C2596?
Medicare policy articles that cite C2596 list 1 covered ICD-10-CM diagnosis codes across 7 articles. The most cited include N40.1 (Benign prostatic hyperplasia with lower urinary tract symptoms). A listed diagnosis is necessary but not sufficient; the policy's other criteria still apply.
How many units of C2596 can be billed per day?
1 on outpatient hospital claims; 1 on practitioner claims (NCCI medically unlikely edits).
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Next steps
- Run a reimbursement report for a device billed under C2596
- Watch C2596 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for C2596
Sources: CMS HCPCS Level II release October 2026; 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.