C9136 HCPCS code: Injection, factor viii, fc fusion protein, (recombinant), per i.u.
C9136 is the HCPCS Level II code for injection, factor viii, fc fusion protein, (recombinant), per i.u.. CMS terminated C9136 on 2015-03-31; do not bill it for later dates of service. Its Medicare coverage code is D (Special coverage instructions apply): Medicare covers it when its national or local coverage criteria are met.
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 | O1E — Other drugs |
| Added | 2015-01-01 |
| Last action effective | 2015-04-01 |
| Terminated | 2015-03-31 |
What changed for C9136
- 2015-01-01: C9136 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 C9136?
C9136 is the HCPCS Level II code for injection, factor viii, fc fusion protein, (recombinant), per i.u.. Short descriptor: "Factor viii (eloctate)".
Does Medicare cover C9136?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
Related C91 codes
- C9101 — Injection, oliceridine, 0.1 mg
- C9113 — Injection, pantoprazole sodium, per vial
- C9121 — Injection, argatroban, per 5 mg
- C9122 — Mometasone furoate sinus implant, 10 micrograms (sinuva)
- C9132 — Prothrombin complex concentrate (human), kcentra, per i.u. of factor ix activity
- C9133 — Factor ix (antihemophilic factor, recombinant), rixubis, per i.u.
- C9134 — Factor xiii (antihemophilic factor, recombinant), tretten, per 10 i.u.
- C9135 — Factor ix (antihemophilic factor, recombinant), alprolix, per i.u.
- C9137 — Injection, factor viii (antihemophilic factor, recombinant) pegylated, 1 i.u.
- C9138 — Injection, factor viii (antihemophilic factor, recombinant) (nuwiq), 1 i.u.
- C9139 — Injection, factor ix, albumin fusion protein (recombinant), idelvion, 1 i.u.
- C9140 — Injection, factor viii (antihemophilic factor, recombinant) (afstyla), 1 i.u.
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Next steps
- Run a reimbursement report for a device billed under C9136
- Watch C9136 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for C9136
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.