Key facts for C8008
- Medicare payment
- $11,384.04
- OPPS rate, SI J1
- Coverage code
- C
- carrier judgment, so the Medicare contractor decides coverage
- MUE
- none published
- no MUE in the 2026 Q4 tables
- NCCI PTP pairs
- 0
- practitioner file
- LCDs and articles
- 5 / 3
TL;DR
HCPCS Level II C8008 reads "Revision or replacement of hypoglossal nerve neurostimulator array including connection to existing pulse generator" in the October 2026 file; it dates from 2026. Hospital outpatient departments are paid $11,384.04 for C8008 under status indicator J1, APC 5463 (Level 3 Neurostimulator and Related Procedures), minimum unadjusted copayment $2,276.81 (October 2026 Addendum B). 5 active LCDs and 3 billing and coding articles list C8008 across 14 states: L35490 (Category III Codes), L36839 (Polysomnography and Other Sleep Studies), A57944, A57948. HCPCS record: BETOS P1G (major procedure - other); pricing indicator 11; type of service 2 (surgery). Nearby codes: C8007, C8004, C8003, C8000.
C8008 descriptor and code status
The October 2026 HCPCS Level II file describes C8008 as “Revision or replacement of hypoglossal nerve neurostimulator array including connection to existing pulse generator”. It sits in the C section (hospital outpatient prospective payment system, temporary codes), listed with the other C codes.
| Field | Value |
|---|---|
| Short descriptor | Rv/rpl hpgls ns inc cnt pg |
| Added to HCPCS | 2026-01-01 |
| Last action | N (no maintenance), effective 2026-01-01 |
| Coverage code | C: carrier judgment, so the Medicare contractor decides coverage |
| Pricing indicator | 11: physician fee schedule, priced with national RVUs |
| BETOS category | P1G: major procedure - other |
| Type of service | 2: surgery |
Medicare payment for C8008
Hospital outpatient departments are paid $11,384.04 for C8008 under status indicator J1, APC 5463 (Level 3 Neurostimulator and Related Procedures), minimum unadjusted copayment $2,276.81 (October 2026 Addendum B). 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 J1 (Hospital Part B services paid through a comprehensive APC), APC 5463 (Level 3 Neurostimulator and Related Procedures), national unadjusted payment $11,384.04 with a minimum unadjusted copayment of $2,276.81.
Ambulatory surgical center (Addendum AA)
Payment indicator J8 (Device-intensive procedure; paid at adjusted rate), national rate $7,477.20 at a payment weight of 132.7581. The multiple-procedure discount applies when it is billed with another ASC procedure.
Medically Unlikely Edits for C8008
CMS publishes no MUE for C8008 in the 2026 Q4 practitioner, facility or DME supplier tables. Some MUE values are confidential and applied without publication, so unit limits can still deny; document the quantity furnished on every claim.
The MUE lookup for C8008 shows every setting next to any other code on the same claim.
NCCI edits and add-on rules
No active practitioner PTP pair lists C8008 in v323r0.
C8008 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 C8008 against a second code to see whether the pair bundles and whether a modifier can separate the services.
Medicare coverage policies for C8008
5 active Local Coverage Determinations and 3 billing and coding articles list C8008. Each applies only in its contractor's jurisdiction, and the article carries the diagnosis codes that support the item or service.
- Category III Codes, LCD L35490 · Wisconsin Physicians Service Insurance Corporation
- Polysomnography and Other Sleep Studies (L36839) · Wisconsin Physicians Service Insurance Corporation
- LCD L38276: Hypoglossal Nerve Stimulation for Obstructive Sleep Apnea · Palmetto GBA
- Hypoglossal Nerve Stimulation for the Treatment of Obstructive Sleep Apnea, LCD L38528 · Wisconsin Physicians Service Insurance Corporation
- L38310 Hypoglossal Nerve Stimulation for the Treatment of Obstructive Sleep Apnea · Noridian Healthcare Solutions, LLC
| Article | Title | Contractor(s) | Related LCD |
|---|---|---|---|
| A57944 | Billing and Coding: Hypoglossal Nerve Stimulation for Treatment of Obstructive Sleep Apnea | Wisconsin Physicians Service Insurance Corporation | L35490, L36839, L38527, L38528, L39246 |
| A57948 | Billing and Coding: Hypoglossal Nerve Stimulation for the Treatment of Obstructive Sleep Apnea | Noridian Healthcare Solutions, LLC | L38310 |
| A58075 | Billing and Coding: Hypoglossal Nerve Stimulation for Obstructive Sleep Apnea | Palmetto GBA | L38276 |
Denials to expect on C8008
the diagnosis or documentation does not meet the LCD or billing article that lists C8008
the modifier reported is inconsistent with the code
the claim lacks information needed to adjudicate the line, such as an order, NPI or required modifier
Where QuickIntell fits for C8008 claims
QuickCode supports qualified coder review of units, modifiers and NCCI pairs for C8008 before the claim leaves, and QuickRCM carries claim readiness and the denial follow-up when an edit or coverage policy is missed.
Frequently asked questions: HCPCS C8008
What does HCPCS code C8008 describe?
"Revision or replacement of hypoglossal nerve neurostimulator array including connection to existing pulse generator" (short descriptor "Rv/rpl hpgls ns inc cnt pg"), in the C section (hospital outpatient prospective payment system, temporary codes). Added 2026-01-01.
Is C8008 a CPT code?
No: CMS maintains C8008 in HCPCS Level II, while the AMA maintains CPT. It goes in the same procedure-code field.
What does Medicare pay for C8008?
Hospital outpatient departments are paid $11,384.04 for C8008 under status indicator J1, APC 5463 (Level 3 Neurostimulator and Related Procedures), minimum unadjusted copayment $2,276.81 (October 2026 Addendum B).
Does Medicare cover C8008?
Coverage code C (carrier judgment, so the Medicare contractor decides coverage). 5 active LCDs and 3 billing and coding articles list C8008 across 14 states: L35490 (Category III Codes), L36839 (Polysomnography and Other Sleep Studies), A57944, A57948.
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.
- HCPCS Level II alpha-numeric file, October 2026Version October 2026 · effective 2026-10-01 · file HCPC2026_OCT_ANWEB_09232026.txtSHA-256 c25240c63108756d…
- OPPS Addendum B, October 2026Version October 2026 · effective 2026-10-01 · file 508-compliant-version-2026_October_Web_Addendum_B.09.28.26.csvSHA-256 6ad7393a318bf1b9…
- Integrated Outpatient Code Editor v27.3 data tables: status and payment indicatorsVersion I/OCE v27.3 (October 2026) · effective 2026-10-01 · file Data_Status_Indicator.txtSHA-256 78f119ef0a435351…
- ASC Addendum AA (covered surgical procedures), October 2026Version October 2026 · effective 2026-10-01 · file Oct 2026 ASC AA.txtSHA-256 bc3479589b7b1f23…
- NCCI PTP edits, practitioner, v323r0 (four files)Version v323r0 (2026 Q4) · effective 2026-10-01 · file ccipra-v323r0-f1.TXTSHA-256 7793c0b6686c1e22…
- Medicare Coverage Database, current Billing and Coding Articles exportVersion MCD release 2026-10-08 · effective 2026-10-04 · file article.csvSHA-256 5e95c4a8ac3664be…
- Medicare Coverage Database, current LCD exportVersion MCD release 2026-10-08 · effective 2026-10-04 · file lcd.csvSHA-256 9aee1bd7f14056b0…
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.