C9781 HCPCS code: Arthroscopy, shoulder, surgical; with implantation of subacromial spacer (e.g., balloon), includes debridement (e.g., limited or extensive), subacromial decompression, acromioplasty, and biceps tenodesis when performed
C9781 is the HCPCS Level II code for arthroscopy, shoulder, surgical; with implantation of subacromial spacer (e.g., balloon), includes debridement (e.g., limited or extensive), subacromial decompression, acromioplasty, and biceps tenodesis when performed. In 2024 Medicare paid an average of $8,216.17 per service for C9781 across 403 services. 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. Medicare volume rose 776% from 2022 to 2024 (46 to 403 services). In 2024, about 133 clinicians billed Medicare for C9781 for 400 beneficiaries; California, Texas, Florida accounted for 53% of services.
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 | P8A |
| Added | 2022-04-01 |
| Last action effective | 2022-04-01 |
Who bills C9781 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 133 |
| Medicare beneficiaries | 400 |
| States with claims | 14 |
| Share of services in top 3 states (California, Texas, Florida) | 53% |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for C9781, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 46 | 45 | $4,136.69 | $3,301.01 |
| 2023 | 282 | 280 | $8,189.80 | $6,527.22 |
| 2024 | 403 | 400 | $10,315.84 | $8,216.17 |
States with the most C9781 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| California | 133 | $9,653.32 |
| Texas | 27 | $7,260.16 |
| New York | 20 | $8,222.37 |
| Florida | 20 | $6,730.37 |
| Massachusetts | 19 | $8,054.50 |
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 |
What changed for C9781
- 2022-04-01: C9781 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 C9781?
C9781 is the HCPCS Level II code for arthroscopy, shoulder, surgical; with implantation of subacromial spacer (e.g., balloon), includes debridement (e.g., limited or extensive), subacromial decompression, acromioplasty, and biceps tenodesis when performed. Short descriptor: "Arthro/shoul surg; w/spacer".
How much does Medicare pay for C9781?
In 2024, the average Medicare payment was $8,216.17 per service (average allowed $10,315.84).
Does Medicare cover C9781?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
How many units of C9781 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
- 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
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Next steps
- Run a reimbursement report for a device billed under C9781
- Watch C9781 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for C9781
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.