C9727 HCPCS code: Insertion of implants into the soft palate; minimum of three implants
C9727 is the HCPCS Level II code for insertion of implants into the soft palate; minimum of three implants. 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 | P6D |
| Added | 2006-10-01 |
| Last action effective | 2006-10-01 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 1 | Code Descriptor / CPT Instruction |
| practitioner claims | 1 | Code Descriptor / CPT Instruction |
Medicare policy articles for this code
- A56905: Billing and Coding: Surgical Treatment of Obstructive Sleep Apnea (OSA) (WPS Insurance Corporation (MAC - Part A, MAC - Part B))
Covered diagnoses (4 ICD-10-CM codes)
The diagnoses most often listed as covered in the policy articles above:
| ICD-10-CM | Diagnosis | Articles listing it |
|---|---|---|
| G47.30 | Sleep apnea, unspecified | 1 |
| G47.33 | Obstructive sleep apnea (adult) (pediatric) | 1 |
| K14.8 | Other diseases of tongue | 1 |
| Q38.2 | Macroglossia | 1 |
What changed for C9727
- 2006-10-01: C9727 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 C9727?
C9727 is the HCPCS Level II code for insertion of implants into the soft palate; minimum of three implants. Short descriptor: "Insert palate implants".
Does Medicare cover C9727?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
Which diagnoses support coverage for C9727?
Medicare policy articles that cite C9727 list 4 covered ICD-10-CM diagnosis codes across 1 article. The most cited include G47.30 (Sleep apnea, unspecified), G47.33 (Obstructive sleep apnea (adult) (pediatric)), K14.8 (Other diseases of tongue). A listed diagnosis is necessary but not sufficient; the policy's other criteria still apply.
How many units of C9727 can be billed per day?
1 on outpatient hospital claims; 1 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
- C9726 — Placement and removal (if performed) of applicator into breast for intraoperative radiation therapy, add-on to primary breast procedure
- 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 C9727
- Watch C9727 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for C9727
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.