C8937 HCPCS code: Computer-aided detection, including computer algorithm analysis of breast mri image data for lesion detection/characterization, pharmacokinetic analysis, with further physician review for interpretation (list separately in addition to code for primary procedure)
C8937 is the HCPCS Level II code for computer-aided detection, including computer algorithm analysis of breast mri image data for lesion detection/characterization, pharmacokinetic analysis, with further physician review for interpretation (list separately in addition to code for primary procedure). 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.
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 | I2D |
| Added | 2019-01-01 |
| Last action effective | 2019-01-01 |
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 C8937
- 2019-01-01: C8937 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 C8937?
C8937 is the HCPCS Level II code for computer-aided detection, including computer algorithm analysis of breast mri image data for lesion detection/characterization, pharmacokinetic analysis, with further physician review for interpretation (list separately in addition to code for primary procedure). Short descriptor: "Cad breast mri".
Does Medicare cover C8937?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
How many units of C8937 can be billed per day?
2 on outpatient hospital claims; 2 on practitioner claims (NCCI medically unlikely edits).
Related C89 codes
- C8900 — Magnetic resonance angiography with contrast, abdomen
- C8901 — Magnetic resonance angiography without contrast, abdomen
- C8902 — Magnetic resonance angiography without contrast followed by with contrast, abdomen
- C8903 — Magnetic resonance imaging with contrast, breast; unilateral
- C8904 — Magnetic resonance imaging without contrast, breast; unilateral
- C8905 — Magnetic resonance imaging without contrast followed by with contrast, breast; unilateral
- C8906 — Magnetic resonance imaging with contrast, breast; bilateral
- C8907 — Magnetic resonance imaging without contrast, breast; bilateral
- C8908 — Magnetic resonance imaging without contrast followed by with contrast, breast; bilateral
- C8909 — Magnetic resonance angiography with contrast, chest (excluding myocardium)
- C8910 — Magnetic resonance angiography without contrast, chest (excluding myocardium)
- C8911 — Magnetic resonance angiography without contrast followed by with contrast, chest (excluding myocardium)
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Next steps
- Run a reimbursement report for a device billed under C8937
- Watch C8937 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for C8937
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.