HCPCS code C7565 — Rpr aa hrn < 3 rdc w/ rmvl. Status: Active. Effective Jan 1, 2025. Source: CMS HCPCS Level II.

C7565

Active

Rpr aa hrn < 3 rdc w/ rmvl

Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (i.e., open, laparoscopic, robotic), recurrent, including implantation of mesh or other prosthesis when performed, total length of defect(s) less than 3 cm, reducible with removal of total or near total non-infected mesh or other prosthesis at the time of initial or recurrent anterior abdominal hernia repair or parastomal hernia repair

Category: Outpatient PPS
Section: C-codes: Outpatient PPS
Effective: Jan 1, 2025
Code type: alphanumeric
OPPS Status: E1 — Items / services not paid by Medicare

MUE — Medically Unlikely Edits

Maximum units of C7565 Medicare will pay for one beneficiary on one date of service. Claims exceeding the MUE are denied or returned for review.

Service Type Max Units / Day
Outpatient Hospital 1
Practitioner Services 1

Source: CMS Medicare NCCI Medically Unlikely Edits

Change History

Quarterly changes published by CMS. Revisions may affect the code description, coverage, or rate — review each quarter's changes before submitting claims.

  • New Code 2025-Q1
    Rpr aa hrn < 3 rdc w/ rmvl