HCPCS code C9901 — Endo defect closure gi tract. Status: Active. Effective Jan 1, 2026. Source: CMS HCPCS Level II.

C9901

Active

Endo defect closure gi tract

Endoscopic defect closure within the entire gastrointestinal tract, including upper endoscopy (including diagnostic, if performed) or colonoscopy (including diagnostic, if performed), with all system and tissue anchoring components

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: 5362

MUE — Medically Unlikely Edits

Maximum units of C9901 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

NCCI Edits

The following codes cannot be billed together with C9901 without appropriate documentation.

Column 2 Code Modifier
G0463 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
    Endo defect closure gi tract