C9726 HCPCS code: Placement and removal (if performed) of applicator into breast for intraoperative radiation therapy, add-on to primary breast procedure
C9726 is the HCPCS Level II code for placement and removal (if performed) of applicator into breast for intraoperative radiation therapy, add-on to primary breast 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 | P7A |
| Added | 2006-01-01 |
| Last action effective | 2014-01-01 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 2 | Anatomic Consideration |
| practitioner claims | 2 | Clinical: CMS Workgroup |
Medicare policy articles for this code
- A56684: Billing and Coding: Intraoperative Radiation Therapy (Palmetto GBA (MAC - Part A, MAC - Part B))
Covered diagnoses (58 ICD-10-CM codes)
The diagnoses most often listed as covered in the policy articles above:
| ICD-10-CM | Diagnosis | Articles listing it |
|---|---|---|
| C18.0 | Malignant neoplasm of cecum | 1 |
| C18.1 | Malignant neoplasm of appendix | 1 |
| C18.2 | Malignant neoplasm of ascending colon | 1 |
| C18.3 | Malignant neoplasm of hepatic flexure | 1 |
| C18.4 | Malignant neoplasm of transverse colon | 1 |
| C18.5 | Malignant neoplasm of splenic flexure | 1 |
| C18.6 | Malignant neoplasm of descending colon | 1 |
| C18.7 | Malignant neoplasm of sigmoid colon | 1 |
| C18.8 | Malignant neoplasm of overlapping sites of colon | 1 |
| C18.9 | Malignant neoplasm of colon, unspecified | 1 |
Showing 10 of 58. The full list, non-covered diagnoses and CSV export are in Caduvo.
What changed for C9726
- 2006-01-01: C9726 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 C9726?
C9726 is the HCPCS Level II code for placement and removal (if performed) of applicator into breast for intraoperative radiation therapy, add-on to primary breast procedure. Short descriptor: "Rxt breast appl place/remov".
Does Medicare cover C9726?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
Which diagnoses support coverage for C9726?
Medicare policy articles that cite C9726 list 58 covered ICD-10-CM diagnosis codes across 1 article. The most cited include C18.0 (Malignant neoplasm of cecum), C18.1 (Malignant neoplasm of appendix), C18.2 (Malignant neoplasm of ascending colon). A listed diagnosis is necessary but not sufficient; the policy's other criteria still apply.
How many units of C9726 can be billed per day?
2 on outpatient hospital claims; 2 on practitioner claims (NCCI medically unlikely edits).
Related C97 codes
- C9724 — Endoscopic full-thickness plication of the stomach using endoscopic plication system (eps); includes endoscopy
- C9725 — Placement of endorectal intracavitary applicator for high intensity brachytherapy
- C9727 — Insertion of implants into the soft palate; minimum of three implants
- C9728 — Placement of interstitial device(s) for radiation therapy/surgery guidance (e.g., fiducial markers, dosimeter), for other than the following sites (any approach): abdomen, pelvis, prostate, retroperitoneum, thorax, single or multiple
- C9733 — Non-ophthalmic fluorescent vascular angiography
- C9734 — Focused ultrasound ablation/therapeutic intervention, other than uterine leiomyomata, with magnetic resonance (mr) guidance
- C9735 — Anoscopy; with directed submucosal injection(s), any substance
- C9737 — Laparoscopy, surgical, esophageal sphincter augmentation with device (e.g., magnetic band)
- C9738 — Adjunctive blue light cystoscopy with fluorescent imaging agent (list separately in addition to code for primary procedure)
- C9739 — Cystourethroscopy, with insertion of transprostatic implant; 1 to 3 implants
- C9740 — Cystourethroscopy, with insertion of transprostatic implant; 4 or more implants
- C9741 — Right heart catheterization with implantation of wireless pressure sensor in the pulmonary artery, including any type of measurement, angiography, imaging supervision, interpretation, and report
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Next steps
- Run a reimbursement report for a device billed under C9726
- Watch C9726 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for C9726
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.