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HCPCS C1825 · Level II · C code

C1825: Generator, neurostimulator (implantable), 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 C1825

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
1
MAI 2
OPPS status
SI N
Items and Services packaged into APC rates
NCCI PTP pairs
0
0 hospital outpatient
LCDs and articles
0 / 0

TL;DR

CMS describes HCPCS C1825, added in 2021, as "Generator, neurostimulator (implantable), non-rechargeable with carotid sinus baroreceptor stimulation lead(s)". None of the October 2026 PFS, DMEPOS, CLFS, OPPS or ASC files lists a national amount for C1825; its HCPCS pricing indicator is 53 (statute). CMS caps C1825 at practitioner 1 (MAI 2, Code Descriptor / CPT Instruction); hospital outpatient 1 (MAI 2, Code Descriptor / CPT Instruction) units per day in the 2026 Q4 MUE tables. C1825 appears in no active LCD or billing and coding article, so coverage follows HCPCS coverage code D (special coverage instructions apply) and any NCD. 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). 7 other active codes open with "Generator"; related codes: C1820, C1767, C1824, C1826.

C1825 descriptor and code status

The October 2026 HCPCS Level II file describes C1825 as “Generator, neurostimulator (implantable), non-rechargeable with carotid sinus baroreceptor stimulation lead(s)”. It sits in the C section (hospital outpatient prospective payment system, temporary codes), listed with the other C codes.

HCPCS file attributes of C1825
FieldValue
Short descriptorGen, neuro, carot sinus baro
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 C1825

None of the October 2026 PFS, DMEPOS, CLFS, OPPS or ASC files lists a national amount for C1825; 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 C1825

CMS caps C1825 at practitioner 1 (MAI 2, Code Descriptor / CPT Instruction); hospital outpatient 1 (MAI 2, Code Descriptor / CPT Instruction) units per day in the 2026 Q4 MUE tables. The practitioner MUE is a date-of-service policy edit: units above the limit deny even when split across lines, and appeals rarely succeed.

MUE values for C1825 by setting
SettingMUE (units/DOS)MAICMS rationale
Practitioner services12 Date of Service Edit: PolicyCode Descriptor / CPT Instruction
Facility outpatient hospital12 Date of Service Edit: PolicyCode Descriptor / CPT Instruction

The MUE lookup for C1825 shows every setting next to any other code on the same claim.

NCCI edits and add-on rules

No active practitioner PTP pair lists C1825 in v323r0.

C1825 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 C1825 against a second code to see whether the pair bundles and whether a modifier can separate the services.

Medicare coverage policies for C1825

No current LCD or billing and coding article lists C1825. The HCPCS coverage code D means special coverage instructions apply, and any National Coverage Determination for the service still applies.

Denials to expect on C1825

CARC 50 · N115

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

CARC 151 · N362

units of C1825 exceed the practitioner MUE of 1 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 C1825 claims

QuickCode supports qualified coder review of units, modifiers and NCCI pairs for C1825 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 C1825

What does HCPCS code C1825 describe?

"Generator, neurostimulator (implantable), non-rechargeable with carotid sinus baroreceptor stimulation lead(s)" (short descriptor "Gen, neuro, carot sinus baro"), 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 C1825 a CPT code?

It is not. C1825 belongs to the C section (hospital outpatient prospective payment system, temporary codes) of HCPCS Level II, the CMS code set, not to AMA CPT.

What does Medicare pay for C1825?

None of the October 2026 PFS, DMEPOS, CLFS, OPPS or ASC files lists a national amount for C1825; its HCPCS pricing indicator is 53 (statute).

How many units of C1825 can be billed per day?

CMS caps C1825 at practitioner 1 (MAI 2, Code Descriptor / CPT Instruction); hospital outpatient 1 (MAI 2, Code Descriptor / CPT Instruction) units per day in the 2026 Q4 MUE tables. For the practitioner MUE (MAI 2), units above 1 deny for the whole day as a policy limit; denials arrive as CARC 151.

Does Medicare cover C1825?

C1825 appears in no active LCD or billing and coding article, so coverage follows HCPCS coverage code D (special coverage instructions apply) and any NCD.

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.