Key facts for C8921
- Medicare payment
- $800.90
- OPPS rate, SI S
- Coverage code
- D
- special coverage instructions apply
- Facility outpatient MUE
- 1
- MAI 3
- NCCI PTP pairs
- 296
- 293 hospital outpatient
- LCDs and articles
- 2 / 2
TL;DR
HCPCS Level II C8921 reads "Transthoracic echocardiography with contrast, or without contrast followed by with contrast, for congenital cardiac anomalies; complete" in the October 2026 file; it dates from 2008. Hospital outpatient departments are paid $800.90 for C8921 under status indicator S, APC 5573 (Level 3 Imaging with Contrast), minimum unadjusted copayment $160.18 (October 2026 Addendum B). Its 2026 Q4 MUEs per date of service: practitioner 1 (MAI 3, Nature of Service/Procedure); hospital outpatient 1 (MAI 3, Nature of Service/Procedure). C8921 is a primary code for 4 add-on codes (93320, 93321, 93325, 93356). In the NCCI PTP files v323r0 C8921 appears in 274 practitioner pairs as column 2 and 22 as column 1 (most often with 00100, 00102, 00103), and in 274 hospital outpatient pairs as column 2 and 19 as column 1. 2 active LCDs and 2 billing and coding articles list C8921 across 7 states: L33577 (Transthoracic Echocardiography (TTE)), L34338 (Transthoracic Echocardiography (TTE)), A56781, A57306. HCPCS record: BETOS I3C (ultrasound - heart); pricing indicator 53; type of service 4 (diagnostic radiology). 5 other active codes open with "Transthoracic echocardiography with contrast"; related codes: C8924, C8928, C8929, C8922.
C8921 descriptor and code status
The October 2026 HCPCS Level II file describes C8921 as “Transthoracic echocardiography with contrast, or without contrast followed by with contrast, for congenital cardiac anomalies; complete”. It sits in the C section (hospital outpatient prospective payment system, temporary codes), listed with the other C codes.
| Field | Value |
|---|---|
| Short descriptor | Tte w or w/o fol w/cont, com |
| Added to HCPCS | 2008-01-01 |
| Last action | N (no maintenance), effective 2008-01-01 |
| Coverage code | D: special coverage instructions apply |
| Pricing indicator | 53: statute |
| BETOS category | I3C: ultrasound - heart |
| Type of service | 4: diagnostic radiology |
| Statute | 1833(t)(2) |
Medicare payment for C8921
Hospital outpatient departments are paid $800.90 for C8921 under status indicator S, APC 5573 (Level 3 Imaging with Contrast), minimum unadjusted copayment $160.18 (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 S (Procedure or service, not discounted when multiple), APC 5573 (Level 3 Imaging with Contrast), national unadjusted payment $800.90 with a minimum unadjusted copayment of $160.18.
Medically Unlikely Edits for C8921
Its 2026 Q4 MUEs per date of service: practitioner 1 (MAI 3, Nature of Service/Procedure); hospital outpatient 1 (MAI 3, Nature of Service/Procedure). The facility outpatient MUE is a date-of-service clinical edit: units above the limit deny but can be paid on appeal with documentation.
| Setting | MUE (units/DOS) | MAI | CMS rationale |
|---|---|---|---|
| Practitioner services | 1 | 3 Date of Service Edit: Clinical | Nature of Service/Procedure |
| Facility outpatient hospital | 1 | 3 Date of Service Edit: Clinical | Nature of Service/Procedure |
The MUE lookup for C8921 shows every setting next to any other code on the same claim.
NCCI edits and add-on rules
In the practitioner PTP file v323r0, C8921 is the column-2 (bundled) code in 274 active pairs, 99% of which allow a modifier and the column-1 code in 22 (82% modifier-allowed); 17 earlier pairs have been deleted. CMS's most frequent rationale for the bundled pairs: Standard preparation/monitoring services for anesthesia.
| Column-1 code | Pairs |
|---|---|
| 00100 (CPT; descriptor licensed by AMA) | 1 |
| 00102 (CPT; descriptor licensed by AMA) | 1 |
| 00103 (CPT; descriptor licensed by AMA) | 1 |
| 00104 (CPT; descriptor licensed by AMA) | 1 |
| 00120 (CPT; descriptor licensed by AMA) | 1 |
| 00124 (CPT; descriptor licensed by AMA) | 1 |
| 00126 (CPT; descriptor licensed by AMA) | 1 |
| 00140 (CPT; descriptor licensed by AMA) | 1 |
| Column-2 code | Pairs |
|---|---|
| 0708T (CPT; descriptor licensed by AMA) | 1 |
| 0709T (CPT; descriptor licensed by AMA) | 1 |
| 36000 (CPT; descriptor licensed by AMA) | 1 |
| 36005 (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 |
| 76998 (CPT; descriptor licensed by AMA) | 1 |
In the hospital outpatient PTP file v323r0, C8921 is the column-2 (bundled) code in 274 active pairs, 99% of which allow a modifier and the column-1 code in 19 (95% modifier-allowed); 17 earlier pairs have been deleted. CMS's most frequent rationale for the bundled pairs: Standard preparation/monitoring services for anesthesia.
| Column-1 code | Pairs |
|---|---|
| 00100 (CPT; descriptor licensed by AMA) | 1 |
| 00102 (CPT; descriptor licensed by AMA) | 1 |
| 00103 (CPT; descriptor licensed by AMA) | 1 |
| 00104 (CPT; descriptor licensed by AMA) | 1 |
| 00120 (CPT; descriptor licensed by AMA) | 1 |
| 00124 (CPT; descriptor licensed by AMA) | 1 |
| 00126 (CPT; descriptor licensed by AMA) | 1 |
| 00140 (CPT; descriptor licensed by AMA) | 1 |
| Column-2 code | Pairs |
|---|---|
| 0708T (CPT; descriptor licensed by AMA) | 1 |
| 0709T (CPT; descriptor licensed by AMA) | 1 |
| 36000 (CPT; descriptor licensed by AMA) | 1 |
| 36005 (CPT; descriptor licensed by AMA) | 1 |
| 36410 (CPT; descriptor licensed by AMA) | 1 |
| 76998 (CPT; descriptor licensed by AMA) | 1 |
| 93040 (CPT; descriptor licensed by AMA) | 1 |
| 93041 (CPT; descriptor licensed by AMA) | 1 |
C8921 is a designated primary code for 4 add-on codes (93320, 93321, 93325, 93356).
Pair counts show exposure, not the answer for one claim. Check C8921 against a second code to see whether the pair bundles and whether a modifier can separate the services.
Medicare coverage policies for C8921
2 active Local Coverage Determinations and 2 billing and coding articles list C8921. Each applies only in its contractor's jurisdiction, and the article carries the diagnosis codes that support the item or service.
- Transthoracic Echocardiography (TTE) (L33577) · Wellpoint Federal
- L34338 Transthoracic Echocardiography (TTE) · CGS Administrators, LLC
Denials to expect on C8921
the diagnosis or documentation does not meet the LCD or billing article that lists C8921
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 C8921 claims
QuickCode supports qualified coder review of units, modifiers and NCCI pairs for C8921 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 C8921
What does HCPCS code C8921 describe?
"Transthoracic echocardiography with contrast, or without contrast followed by with contrast, for congenital cardiac anomalies; complete" (short descriptor "Tte w or w/o fol w/cont, com"), in the C section (hospital outpatient prospective payment system, temporary codes). Added 2008-01-01.
Is C8921 a CPT code?
No. C8921 is a CMS HCPCS Level II code; CPT codes are the AMA's five-character set.
What does Medicare pay for C8921?
Hospital outpatient departments are paid $800.90 for C8921 under status indicator S, APC 5573 (Level 3 Imaging with Contrast), minimum unadjusted copayment $160.18 (October 2026 Addendum B).
Is C8921 an add-on code?
C8921 is a primary code for 4 add-on codes (93320, 93321, 93325, 93356).
How many units of C8921 can be billed per day?
Its 2026 Q4 MUEs per date of service: practitioner 1 (MAI 3, Nature of Service/Procedure); hospital outpatient 1 (MAI 3, Nature of Service/Procedure). 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 C8921?
Coverage code D (special coverage instructions apply). 2 active LCDs and 2 billing and coding articles list C8921 across 7 states: L33577 (Transthoracic Echocardiography (TTE)), L34338 (Transthoracic Echocardiography (TTE)), A56781, A57306.
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…
- NCCI MUE table, practitioner services, effective 2026-10-01Version 2026 Q4 · effective 2026-10-01 · file MCR_MUE_PractitionerServices_Eff_10-01-2026.csvSHA-256 ef038efaf902b7bd…
- NCCI MUE table, facility services, effective 2026-10-01Version 2026 Q4 · effective 2026-10-01 · file MCR_MUE_OutpatientHospitalServices_Eff_10-01-2026.csvSHA-256 3af9f4e99cc587e2…
- NCCI MUE table, dme services, effective 2026-10-01Version 2026 Q4 · effective 2026-10-01 · file MCR_MUE_DMESupplierServices_Eff_10-01-2026.csvSHA-256 6fa4fbba852f7b74…
- NCCI PTP edits, practitioner, v323r0 (four files)Version v323r0 (2026 Q4) · effective 2026-10-01 · file ccipra-v323r0-f1.TXTSHA-256 7793c0b6686c1e22…
- NCCI PTP edits, hospital outpatient, v323r0 (four files)Version v323r0 (2026 Q4) · effective 2026-10-01 · file ccioph-v323r0-f1.txtSHA-256 063f41b91ef9faa2…
- NCCI Add-On Code edits, effective 2026-10-01Version 2026 Q4 · effective 2026-10-01 · file AOC_V2026Q4-F-MCR.xlsxSHA-256 eabb519623134549…
- 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.