Skip to main content
HCPCS C1897 · Level II · C code

C1897: Lead, neurostimulator test kit (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); Medicare Coverage Database LCD export: MCD release October 8, 2026 (effective October 4, 2026). Next CMS release: January 1, 2027 (quarterly update) for the HCPCS Level II file and NCCI MUE tables and NCCI PTP edits and OPPS Addendum B; weekly, every Thursday for the Medicare Coverage Database LCD export.

Key facts for C1897

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
2
MAI 3
OPPS status
SI N
Items and Services packaged into APC rates
NCCI PTP pairs
0
practitioner file
LCDs and articles
1 / 3

TL;DR

C1897 is a Level II code from the C section (hospital outpatient prospective payment system, temporary codes), in use since 2001: "Lead, neurostimulator test kit (implantable)". None of the October 2026 PFS, DMEPOS, CLFS, OPPS or ASC files lists a national amount for C1897; its HCPCS pricing indicator is 53 (statute). CMS caps C1897 at practitioner 2 (MAI 3, Clinical: CMS Workgroup); hospital outpatient 2 (MAI 3, Clinical: Data) units per day in the 2026 Q4 MUE tables. 1 active LCD and 3 billing and coding articles list C1897 across 12 states: L39543 (Sacral Nerve Stimulation for the Treatment of Urinary and Fecal Incontinence), A53359, A55835. 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), S (surgical dressings or other medical supplies). 8 other active codes open with "Lead"; related codes: C1778, C1896, C1898, C1895.

C1897 descriptor and code status

The October 2026 HCPCS Level II file describes C1897 as “Lead, neurostimulator test kit (implantable)”. It sits in the C section (hospital outpatient prospective payment system, temporary codes), listed with the other C codes.

HCPCS file attributes of C1897
FieldValue
Short descriptorLead, neurostim test kit
Added to HCPCS2001-04-01
Last actionN (no maintenance), effective 2004-01-01
Coverage codeD: special coverage instructions apply
Pricing indicator53: statute
BETOS categoryD1A: medical/surgical supplies
Type of service9: other medical items or services; S: surgical dressings or other medical supplies
Statute1833(T)

Medicare payment for C1897

None of the October 2026 PFS, DMEPOS, CLFS, OPPS or ASC files lists a national amount for C1897; 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 C1897

CMS caps C1897 at practitioner 2 (MAI 3, Clinical: CMS Workgroup); hospital outpatient 2 (MAI 3, Clinical: Data) units per day in the 2026 Q4 MUE tables. 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 C1897 by setting
SettingMUE (units/DOS)MAICMS rationale
Practitioner services23 Date of Service Edit: ClinicalClinical: CMS Workgroup
Facility outpatient hospital23 Date of Service Edit: ClinicalClinical: Data

The MUE lookup for C1897 shows every setting next to any other code on the same claim.

NCCI edits and add-on rules

No active practitioner PTP pair lists C1897 in v323r0.

C1897 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 C1897 against a second code to see whether the pair bundles and whether a modifier can separate the services.

Medicare coverage policies for C1897

1 active Local Coverage Determination and 3 billing and coding articles list C1897. Each applies only in its contractor's jurisdiction, and the article carries the diagnosis codes that support the item or service.

Billing and Coding Articles listing C1897
ArticleTitleContractor(s)Related LCD
A53359Billing and Coding: Sacral Nerve Stimulation for Urinary and Fecal IncontinenceNoridian Healthcare Solutions, LLC—
A55835Billing and Coding: Sacral Nerve Stimulation for Urinary and Fecal IncontinenceCGS Administrators, LLC—
A59332Billing and Coding: Sacral Nerve Stimulation for the Treatment of Urinary and Fecal IncontinencePalmetto GBAL39543

Denials to expect on C1897

CARC 50 · N115

the diagnosis or documentation does not meet the LCD or billing article that lists C1897

CARC 151 · N362

units of C1897 exceed the practitioner MUE of 2 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 C1897 claims

QuickCode supports qualified coder review of units, modifiers and NCCI pairs for C1897 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 C1897

What does HCPCS code C1897 describe?

"Lead, neurostimulator test kit (implantable)" (short descriptor "Lead, neurostim test kit"), in the C section (hospital outpatient prospective payment system, temporary codes). Added 2001-04-01; last action N (no maintenance) effective 2004-01-01.

Is C1897 a CPT code?

It is not. C1897 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 C1897?

None of the October 2026 PFS, DMEPOS, CLFS, OPPS or ASC files lists a national amount for C1897; its HCPCS pricing indicator is 53 (statute).

How many units of C1897 can be billed per day?

CMS caps C1897 at practitioner 2 (MAI 3, Clinical: CMS Workgroup); hospital outpatient 2 (MAI 3, Clinical: Data) units per day in the 2026 Q4 MUE tables. For the practitioner MUE (MAI 3), units above 2 deny for the day but can be paid on appeal with documentation; denials arrive as CARC 151.

Does Medicare cover C1897?

Coverage code D (special coverage instructions apply). 1 active LCD and 3 billing and coding articles list C1897 across 12 states: L39543 (Sacral Nerve Stimulation for the Treatment of Urinary and Fecal Incontinence), A53359, A55835.

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.