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HCPCS C7550 · Level II · C code

C7550: Cystourethroscopy, 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 C7550

Medicare payment
$1,723.02
ASC rate, PI G2
Coverage code
C
carrier judgment, so the Medicare contractor decides coverage
Practitioner MUE
1
MAI 2
OPPS status
SI E1
Non-allowed item or service
NCCI PTP pairs
0
practitioner file
LCDs and articles
0 / 0

TL;DR

C7550 is a Level II code from the C section (hospital outpatient prospective payment system, temporary codes), in use since 2023: "Cystourethroscopy, with biopsy(ies) with adjunctive blue light cystoscopy with fluorescent imaging agent". Ambulatory surgical centers are paid $1,723.02 for C7550 (payment indicator G2, October 2026 Addendum AA). MUE limits for C7550: practitioner 1 (MAI 2, Code Descriptor / CPT Instruction); hospital outpatient 1 (MAI 2, Code Descriptor / CPT Instruction). No current LCD or billing article lists C7550; its HCPCS coverage code is C (carrier judgment, so the Medicare contractor decides coverage). OPPS status indicator E1: Non-allowed item or service. HCPCS record: BETOS P8E (endoscopy - cystoscopy); pricing indicator 11; type of service 2 (surgery). 4 other active codes open with "Cystourethroscopy"; related codes: C9739, C9740, C9761, C8014.

C7550 descriptor and code status

The October 2026 HCPCS Level II file describes C7550 as “Cystourethroscopy, with biopsy(ies) with adjunctive blue light cystoscopy with fluorescent imaging agent”. It sits in the C section (hospital outpatient prospective payment system, temporary codes), listed with the other C codes.

HCPCS file attributes of C7550
FieldValue
Short descriptorCysto w/ bx(s) w/ blue light
Added to HCPCS2023-01-01
Last actionN (no maintenance), effective 2023-01-01
Coverage codeC: carrier judgment, so the Medicare contractor decides coverage
Pricing indicator11: physician fee schedule, priced with national RVUs
BETOS categoryP8E: endoscopy - cystoscopy
Type of service2: surgery

Medicare payment for C7550

Ambulatory surgical centers are paid $1,723.02 for C7550 (payment indicator G2, October 2026 Addendum AA). 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 E1 (Non-allowed item or service), with no separate OPPS payment rate.

Ambulatory surgical center (Addendum AA)

Payment indicator G2 (Non office-based surgical procedure added in CY 2008 or later; payment based on OPPS relative payment weight), national rate $1,723.02 at a payment weight of 30.5923. The multiple-procedure discount applies when it is billed with another ASC procedure.

Medically Unlikely Edits for C7550

MUE limits for C7550: practitioner 1 (MAI 2, Code Descriptor / CPT Instruction); hospital outpatient 1 (MAI 2, Code Descriptor / CPT Instruction). 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 C7550 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 C7550 shows every setting next to any other code on the same claim.

NCCI edits and add-on rules

No active practitioner PTP pair lists C7550 in v323r0.

C7550 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 C7550 against a second code to see whether the pair bundles and whether a modifier can separate the services.

Medicare coverage policies for C7550

No current LCD or billing and coding article lists C7550. The HCPCS coverage code C means carrier judgment, so the Medicare contractor decides coverage, and any National Coverage Determination for the service still applies.

Denials to expect on C7550

CARC 50 · N115

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

CARC 151 · N362

units of C7550 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 C7550 claims

QuickCode supports qualified coder review of units, modifiers and NCCI pairs for C7550 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 C7550

What does HCPCS code C7550 describe?

"Cystourethroscopy, with biopsy(ies) with adjunctive blue light cystoscopy with fluorescent imaging agent" (short descriptor "Cysto w/ bx(s) w/ blue light"), in the C section (hospital outpatient prospective payment system, temporary codes). Added 2023-01-01.

Is C7550 a CPT code?

No: CMS maintains C7550 in HCPCS Level II, while the AMA maintains CPT. It goes in the same procedure-code field.

What does Medicare pay for C7550?

Ambulatory surgical centers are paid $1,723.02 for C7550 (payment indicator G2, October 2026 Addendum AA).

How many units of C7550 can be billed per day?

MUE limits for C7550: practitioner 1 (MAI 2, Code Descriptor / CPT Instruction); hospital outpatient 1 (MAI 2, Code Descriptor / CPT Instruction). 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 C7550?

No current LCD or billing article lists C7550; its HCPCS coverage code is C (carrier judgment, so the Medicare contractor decides coverage).

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.