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HCPCS C8903 · Level II · C code

C8903: Magnetic resonance imaging with contrast, breast; unilateral, 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 C8903

Medicare payment
$179.20
OPPS rate, SI Q3
Coverage code
D
special coverage instructions apply
Facility outpatient MUE
1
MAI 3
OPPS status
SI Q3
Codes that may be paid through a composite APC
NCCI PTP pairs
25
22 hospital outpatient
LCDs and articles
2 / 2

TL;DR

CMS describes HCPCS C8903, added in 2001, as "Magnetic resonance imaging with contrast, breast; unilateral". Hospital outpatient departments are paid $179.20 for C8903 under status indicator Q3, APC 5571 (Level 1 Imaging with Contrast), minimum unadjusted copayment $35.84 (October 2026 Addendum B). Its 2026 Q4 MUEs per date of service: practitioner 1 (MAI 3, Code Descriptor / CPT Instruction); hospital outpatient 1 (MAI 3, Code Descriptor / CPT Instruction). C8903 is a primary code for 1 add-on code (C8937). In the NCCI PTP files v323r0 C8903 appears in 2 practitioner pairs as column 2 and 23 as column 1 (most often with C8906, C8908), and in 4 hospital outpatient pairs as column 2 and 18 as column 1. 2 active LCDs and 2 billing and coding articles list C8903 across 7 states: L33585 (Breast Imaging: Breast Echography (Sonography)/Breast MRI/Ductography), L33950 (Breast Imaging Mammography/Breast Echography (Sonography)/Breast MRI/Ductography), A52849, A56448. HCPCS record: BETOS I2D (advanced imaging - MRI/MRA: other); pricing indicator 53; type of service 4 (diagnostic radiology). 1 other active code opens with "Magnetic resonance imaging with contrast"; related codes: C8906, C8908, C8924, C8928.

C8903 descriptor and code status

The October 2026 HCPCS Level II file describes C8903 as “Magnetic resonance imaging with contrast, breast; unilateral”. It sits in the C section (hospital outpatient prospective payment system, temporary codes), listed with the other C codes.

HCPCS file attributes of C8903
FieldValue
Short descriptorMri w/cont, breast, uni
Added to HCPCS2001-10-01
Last actionN (no maintenance), effective 2001-10-01
Coverage codeD: special coverage instructions apply
Pricing indicator53: statute
BETOS categoryI2D: advanced imaging - MRI/MRA: other
Type of service4: diagnostic radiology
Statute1833(t)(2)

Medicare payment for C8903

Hospital outpatient departments are paid $179.20 for C8903 under status indicator Q3, APC 5571 (Level 1 Imaging with Contrast), minimum unadjusted copayment $35.84 (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 Q3 (Codes that may be paid through a composite APC), APC 5571 (Level 1 Imaging with Contrast), national unadjusted payment $179.20 with a minimum unadjusted copayment of $35.84.

Ambulatory surgical center (Addendum BB)

Payment indicator Z2 (Radiology or diagnostic service paid separately when provided integral to a surgical procedure on ASC list; payment based on OPPS relative payment weight), national rate $97.27 at a payment weight of 1.7270.

Medically Unlikely Edits for C8903

Its 2026 Q4 MUEs per date of service: practitioner 1 (MAI 3, Code Descriptor / CPT Instruction); hospital outpatient 1 (MAI 3, Code Descriptor / CPT Instruction). The facility outpatient MUE is a date-of-service clinical edit: units above the limit deny but can be paid on appeal with documentation.

MUE values for C8903 by setting
SettingMUE (units/DOS)MAICMS rationale
Practitioner services13 Date of Service Edit: ClinicalCode Descriptor / CPT Instruction
Facility outpatient hospital13 Date of Service Edit: ClinicalCode Descriptor / CPT Instruction

The MUE lookup for C8903 shows every setting next to any other code on the same claim.

NCCI edits and add-on rules

In the practitioner PTP file v323r0, C8903 is the column-2 (bundled) code in 2 active pairs, 100% of which allow a modifier and the column-1 code in 23 (70% modifier-allowed); 13 earlier pairs have been deleted. CMS's most frequent rationale for the bundled pairs: HCPCS/CPT procedure code definition.

Column-1 codes most often paired with C8903 (practitioner)
Column-1 codePairs
C8906 Mri w/cont, breast, bi1
C8908 Mri w/o fol w/cont, breast,1
Column-2 codes bundled into C8903 (practitioner)
Column-2 codePairs
0708T (CPT; descriptor licensed by AMA)1
0709T (CPT; descriptor licensed by AMA)1
36000 (CPT; descriptor licensed by AMA)1
36410 (CPT; descriptor licensed by AMA)1
36591 (CPT; descriptor licensed by AMA)1
36592 (CPT; descriptor licensed by AMA)1
76000 (CPT; descriptor licensed by AMA)1
76942 (CPT; descriptor licensed by AMA)1

In the hospital outpatient PTP file v323r0, C8903 is the column-2 (bundled) code in 4 active pairs, 50% of which allow a modifier and the column-1 code in 18 (89% modifier-allowed); 12 earlier pairs have been deleted. CMS's most frequent rationale for the bundled pairs: Mutually exclusive procedures.

Column-1 codes most often paired with C8903 (hospital outpatient)
Column-1 codePairs
77046 (CPT; descriptor licensed by AMA)1
77047 (CPT; descriptor licensed by AMA)1
C8906 Mri w/cont, breast, bi1
C8908 Mri w/o fol w/cont, breast,1
Column-2 codes bundled into C8903 (hospital outpatient)
Column-2 codePairs
0708T (CPT; descriptor licensed by AMA)1
0709T (CPT; descriptor licensed by AMA)1
36000 (CPT; descriptor licensed by AMA)1
36410 (CPT; descriptor licensed by AMA)1
76000 (CPT; descriptor licensed by AMA)1
76942 (CPT; descriptor licensed by AMA)1
76998 (CPT; descriptor licensed by AMA)1
77001 (CPT; descriptor licensed by AMA)1

C8903 is a designated primary code for 1 add-on code (C8937).

Pair counts show exposure, not the answer for one claim. Check C8903 against a second code to see whether the pair bundles and whether a modifier can separate the services.

Medicare coverage policies for C8903

2 active Local Coverage Determinations and 2 billing and coding articles list C8903. 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 C8903
ArticleTitleContractor(s)Related LCD
A52849Billing and Coding: Breast Imaging: Breast Echography (Sonography)/Breast MRI/DuctographyWellpoint FederalL33585
A56448Billing and Coding: Breast Imaging Mammography/Breast Echography (Sonography)/Breast MRI/DuctographyCGS Administrators, LLCL33950

Denials to expect on C8903

CARC 50 · N115

the diagnosis or documentation does not meet the LCD or billing article that lists C8903

CARC 151 · N362

units of C8903 exceed the facility outpatient 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 C8903 claims

QuickCode supports qualified coder review of units, modifiers and NCCI pairs for C8903 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 C8903

What does HCPCS code C8903 describe?

"Magnetic resonance imaging with contrast, breast; unilateral" (short descriptor "Mri w/cont, breast, uni"), in the C section (hospital outpatient prospective payment system, temporary codes). Added 2001-10-01.

Is C8903 a CPT code?

No. C8903 is a CMS HCPCS Level II code; CPT codes are the AMA's five-character set.

What does Medicare pay for C8903?

Hospital outpatient departments are paid $179.20 for C8903 under status indicator Q3, APC 5571 (Level 1 Imaging with Contrast), minimum unadjusted copayment $35.84 (October 2026 Addendum B).

Is C8903 an add-on code?

C8903 is a primary code for 1 add-on code (C8937).

How many units of C8903 can be billed per day?

Its 2026 Q4 MUEs per date of service: practitioner 1 (MAI 3, Code Descriptor / CPT Instruction); hospital outpatient 1 (MAI 3, Code Descriptor / CPT Instruction). For the facility outpatient MUE (MAI 3), units above 1 deny for the day but can be paid on appeal with documentation; denials arrive as CARC 151.

Does Medicare cover C8903?

Coverage code D (special coverage instructions apply). 2 active LCDs and 2 billing and coding articles list C8903 across 7 states: L33585 (Breast Imaging: Breast Echography (Sonography)/Breast MRI/Ductography), L33950 (Breast Imaging Mammography/Breast Echography (Sonography)/Breast MRI/Ductography), A52849, A56448.

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.