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HCPCS C1062 · Level II · C code

C1062: Intravertebral body fracture augmentation with implant (e.g., metal, polymer), HCPCS Level II C code

Compiled from CMS files by the QuickIntell RCM Editorial Team · Data effective · Method: reference methodology · Report a data correction

Data currency: HCPCS Level II file: October 2026 (effective October 1, 2026); NCCI MUE tables: 2026 Q4 (effective October 1, 2026); NCCI PTP edits: v323r0 (2026 Q4) (effective October 1, 2026); OPPS Addendum B: October 2026 (effective October 1, 2026). Next CMS release: January 1, 2027 (quarterly update).

Key facts for C1062

Medicare payment
none in these files
no PFS, DMEPOS, CLFS, OPPS or ASC amount; pricing indicator 53
Coverage code
D
special coverage instructions apply
Practitioner MUE
3
MAI 3
OPPS status
SI N
Items and Services packaged into APC rates
NCCI PTP pairs
2
2 hospital outpatient
LCDs and articles
0 / 0

TL;DR

C1062 is a Level II code from the C section (hospital outpatient prospective payment system, temporary codes), in use since 2021: "Intravertebral body fracture augmentation with implant (e.g., metal, polymer)". None of the October 2026 PFS, DMEPOS, CLFS, OPPS or ASC files lists a national amount for C1062; its HCPCS pricing indicator is 53 (statute). Its 2026 Q4 MUEs per date of service: practitioner 3 (MAI 3, Nature of Service/Procedure); hospital outpatient 3 (MAI 3, Nature of Service/Procedure). In the NCCI PTP files v323r0 C1062 appears in 0 practitioner pairs as column 2 and 2 as column 1, and in 0 hospital outpatient pairs as column 2 and 2 as column 1. No current LCD or billing article lists C1062; its HCPCS coverage code is D (special coverage instructions apply). OPPS status indicator N: Items and Services packaged into APC rates. HCPCS record: BETOS D1A (medical/surgical supplies); pricing indicator 53; type of service 9 (other medical items or services), F (ambulatory surgical center). Nearby codes: C1600, C1601, C1602, C1603.

C1062 descriptor and code status

The October 2026 HCPCS Level II file describes C1062 as “Intravertebral body fracture augmentation with implant (e.g., metal, polymer)”. It sits in the C section (hospital outpatient prospective payment system, temporary codes), listed with the other C codes.

HCPCS file attributes of C1062
FieldValue
Short descriptorIntravertebral fx aug impl
Added to HCPCS2021-01-01
Last actionN (no maintenance), effective 2024-01-01
Coverage codeD: special coverage instructions apply
Pricing indicator53: statute
BETOS categoryD1A: medical/surgical supplies
Type of service9: other medical items or services; F: ambulatory surgical center
Statute1833(T)

Medicare payment for C1062

None of the October 2026 PFS, DMEPOS, CLFS, OPPS or ASC files lists a national amount for C1062; its HCPCS pricing indicator is 53 (statute). The amounts below are national figures from the October 2026 CMS files; the contractor applies the locality, rural or state adjustment and the beneficiary's cost sharing.

Hospital outpatient (OPPS Addendum B)

Status indicator N (Items and Services packaged into APC rates), with no separate OPPS payment rate.

Ambulatory surgical center (Addendum BB)

Payment indicator N1 (Packaged service/item; no separate payment made).

Medically Unlikely Edits for C1062

Its 2026 Q4 MUEs per date of service: practitioner 3 (MAI 3, Nature of Service/Procedure); hospital outpatient 3 (MAI 3, Nature of Service/Procedure). The practitioner MUE is a date-of-service clinical edit: units above the limit deny but can be paid on appeal with documentation.

MUE values for C1062 by setting
SettingMUE (units/DOS)MAICMS rationale
Practitioner services33 Date of Service Edit: ClinicalNature of Service/Procedure
Facility outpatient hospital33 Date of Service Edit: ClinicalNature of Service/Procedure

The MUE lookup for C1062 shows every setting next to any other code on the same claim.

NCCI edits and add-on rules

In the practitioner PTP file v323r0, C1062 is the column-2 (bundled) code in 0 active pairs and the column-1 code in 2 (100% modifier-allowed); 3 earlier pairs have been deleted.

Column-2 codes bundled into C1062 (practitioner)
Column-2 codePairs
0200T (CPT; descriptor licensed by AMA)1
0201T (CPT; descriptor licensed by AMA)1

In the hospital outpatient PTP file v323r0, C1062 is the column-2 (bundled) code in 0 active pairs and the column-1 code in 2 (100% modifier-allowed); 3 earlier pairs have been deleted.

Column-2 codes bundled into C1062 (hospital outpatient)
Column-2 codePairs
0200T (CPT; descriptor licensed by AMA)1
0201T (CPT; descriptor licensed by AMA)1

C1062 is neither an add-on code nor a designated primary code in the 2026 Q4 NCCI add-on edit file.

Pair counts show exposure, not the answer for one claim. Check C1062 against a second code to see whether the pair bundles and whether a modifier can separate the services.

Medicare coverage policies for C1062

No current LCD or billing and coding article lists C1062. The HCPCS coverage code D means special coverage instructions apply, and any National Coverage Determination for the service still applies.

Denials to expect on C1062

CARC 50 · N115

the service is not reasonable and necessary for the diagnosis on the claim

CARC 151 · N362

units of C1062 exceed the practitioner MUE of 3 per date of service

CARC 4

the modifier reported is inconsistent with the code

CARC 16

the claim lacks information needed to adjudicate the line, such as an order, NPI or required modifier

Where QuickIntell fits for C1062 claims

QuickCode supports qualified coder review of units, modifiers and NCCI pairs for C1062 before the claim leaves, and QuickRCM carries claim readiness and the denial follow-up when an edit or coverage policy is missed.

See QuickCode for coder reviewSee QuickRCM for denial follow-upBook a meeting

Frequently asked questions: HCPCS C1062

What does HCPCS code C1062 describe?

"Intravertebral body fracture augmentation with implant (e.g., metal, polymer)" (short descriptor "Intravertebral fx aug impl"), in the C section (hospital outpatient prospective payment system, temporary codes). Added 2021-01-01; last action N (no maintenance) effective 2024-01-01.

Is C1062 a CPT code?

No. C1062 is a CMS HCPCS Level II code; CPT codes are the AMA's five-character set.

What does Medicare pay for C1062?

None of the October 2026 PFS, DMEPOS, CLFS, OPPS or ASC files lists a national amount for C1062; its HCPCS pricing indicator is 53 (statute).

How many units of C1062 can be billed per day?

Its 2026 Q4 MUEs per date of service: practitioner 3 (MAI 3, Nature of Service/Procedure); hospital outpatient 3 (MAI 3, Nature of Service/Procedure). For the practitioner MUE (MAI 3), units above 3 deny for the day but can be paid on appeal with documentation; denials arrive as CARC 151.

Does Medicare cover C1062?

No current LCD or billing article lists C1062; its HCPCS coverage code is D (special coverage instructions apply).

Sources

Every figure on this page is taken from the CMS publications below, as released by the Centers for Medicare & Medicaid Services. Projection built 2026-10-10. Verify against the primary file before billing or contracting decisions. The reference methodology explains how each figure is computed from these files.

Disclaimer

This page is an operational reference compiled from CMS publications: the HCPCS Level II file, the physician, DMEPOS and clinical laboratory fee schedules, OPPS and ASC addenda, NCCI MUE, PTP and add-on edit tables and the Medicare Coverage Database. Amounts are Medicare national figures before locality and state adjustment; Medicaid and commercial payers set their own. CPT codes are shown as numbers only; CPT descriptors are copyright AMA. Nothing here is legal, clinical or billing advice.

Found a figure that does not match the CMS file? Report a data correction with the CMS file and the value you expected; the request reaches the editorial team through the contact form.