C9797 HCPCS code: Vascular embolization or occlusion procedure with use of a pressure-generating catheter (e.g., one-way valve, intermittently occluding), inclusive of all radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance necessary to complete the intervention; for tumors, organ ischemia, or infarction
C9797 is the HCPCS Level II code for vascular embolization or occlusion procedure with use of a pressure-generating catheter (e.g., one-way valve, intermittently occluding), inclusive of all radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance necessary to complete the intervention; for tumors, organ ischemia, or infarction. In 2024 Medicare paid an average of $7,245.70 per service for C9797 across 19 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. In 2024, about 2 clinicians billed Medicare for C9797 for 14 beneficiaries.
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 | P1G |
| Added | 2024-01-01 |
| Last action effective | 2024-01-01 |
Who bills C9797 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 2 |
| Medicare beneficiaries | 14 |
| States with claims | 1 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for C9797, 2024–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2024 | 19 | 14 | $9,094.09 | $7,245.70 |
States with the most C9797 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Arkansas | 18 | $7,226.34 |
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 C9797
- 2024-01-01: C9797 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 C9797?
C9797 is the HCPCS Level II code for vascular embolization or occlusion procedure with use of a pressure-generating catheter (e.g., one-way valve, intermittently occluding), inclusive of all radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance necessary to complete the intervention; for tumors, organ ischemia, or infarction. Short descriptor: "Vasc emb/occ w/prs cath".
How much does Medicare pay for C9797?
In 2024, the average Medicare payment was $7,245.70 per service (average allowed $9,094.09).
Does Medicare cover C9797?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
How many units of C9797 can be billed per day?
1 on outpatient hospital claims; 1 on practitioner claims (NCCI medically unlikely edits).
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Building a device that would bill under a code like this? Caduvo matches a device description to HCPCS/CPT codes, Medicare coverage and payment, and the FDA pathway in one report.
Next steps
- Run a reimbursement report for a device billed under C9797
- Watch C9797 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for C9797
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.