HCPCS code C9604 — Perc d-e cor revasc t cabg s. Status: Active. Effective Jan 1, 2026. Source: CMS HCPCS Level II.

C9604

Active

Perc d-e cor revasc t cabg s

Percutaneous transluminal revascularization of or through coronary artery bypass graft (internal mammary, free arterial, venous), any combination of drug-eluting intracoronary stent, atherectomy and angioplasty, including distal protection when performed; single vessel

Category: Outpatient PPS
Section: C-codes: Outpatient PPS
Effective: Jan 1, 2026
Code type: alphanumeric
OPPS Status: J1 — Hospital Part B services paid through a comprehensive APC (C-APC)
OPPS APC: 5193

MUE — Medically Unlikely Edits

Maximum units of C9604 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 2
Practitioner Services 2

Source: CMS Medicare NCCI Medically Unlikely Edits

NCCI Edits

The following codes cannot be billed together with C9604 without appropriate documentation.

Column 2 Code Modifier
G0269 Modifier may bypass edit
G0471 Modifier may bypass edit

Source: CMS National Correct Coding Initiative (NCCI)

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 2026-Q1
    Perc d-e cor revasc t cabg s