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HCPCS C9757 · Level II · C code

C9757: Laminotomy (hemilaminectomy), with decompression of nerve root(s), 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 C9757

Medicare payment
$13,116.76
OPPS rate, SI J1
Coverage code
D
special coverage instructions apply
Facility outpatient MUE
2
MAI 2
OPPS status
SI J1
Hospital Part B services paid through a comprehensive APC
NCCI PTP pairs
9
9 hospital outpatient
LCDs and articles
0 / 0

TL;DR

C9757 is a Level II code from the C section (hospital outpatient prospective payment system, temporary codes), in use since 2020: "Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and excision of herniated intervertebral disc, and repair of annular defect with implantation of bone anchored annular closure device, including annular defect measurement, alignment and sizing assessment, and image guidance; 1 interspace, lumbar". Hospital outpatient departments are paid $13,116.76 for C9757 under status indicator J1, APC 5115 (Level 5 Musculoskeletal Procedures), minimum unadjusted copayment $2,623.36 (October 2026 Addendum B). CMS caps C9757 at practitioner 2 (MAI 2, Anatomic Consideration); hospital outpatient 2 (MAI 2, Anatomic Consideration) units per day in the 2026 Q4 MUE tables. In the NCCI PTP files v323r0 C9757 appears in 0 practitioner pairs as column 2 and 9 as column 1, and in 0 hospital outpatient pairs as column 2 and 9 as column 1. C9757 appears in no active LCD or billing and coding article, so coverage follows HCPCS coverage code D (special coverage instructions apply) and any NCD. HCPCS record: BETOS P6B (minor procedures - musculoskeletal); pricing indicator 53; type of service 1 (medical care). Nearby codes: C9761, C9764, C9765, C9766.

C9757 descriptor and code status

The October 2026 HCPCS Level II file describes C9757 as “Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and excision of herniated intervertebral disc, and repair of annular defect with implantation of bone anchored annular closure device, including annular defect measurement, alignment and sizing assessment, and image guidance; 1 interspace, lumbar”. It sits in the C section (hospital outpatient prospective payment system, temporary codes), listed with the other C codes.

HCPCS file attributes of C9757
FieldValue
Short descriptorSpine device implant surgery
Added to HCPCS2020-01-01
Last actionN (no maintenance), effective 2024-01-01
Coverage codeD: special coverage instructions apply
Pricing indicator53: statute
BETOS categoryP6B: minor procedures - musculoskeletal
Type of service1: medical care
Statute1833(T)

Medicare payment for C9757

Hospital outpatient departments are paid $13,116.76 for C9757 under status indicator J1, APC 5115 (Level 5 Musculoskeletal Procedures), minimum unadjusted copayment $2,623.36 (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 5115 (Level 5 Musculoskeletal Procedures), national unadjusted payment $13,116.76 with a minimum unadjusted copayment of $2,623.36.

Ambulatory surgical center (Addendum AA)

Payment indicator J8 (Device-intensive procedure; paid at adjusted rate), national rate $9,696.16 at a payment weight of 172.1558. The multiple-procedure discount applies when it is billed with another ASC procedure.

Medically Unlikely Edits for C9757

CMS caps C9757 at practitioner 2 (MAI 2, Anatomic Consideration); hospital outpatient 2 (MAI 2, Anatomic Consideration) units per day in the 2026 Q4 MUE tables. The facility outpatient 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 C9757 by setting
SettingMUE (units/DOS)MAICMS rationale
Practitioner services22 Date of Service Edit: PolicyAnatomic Consideration
Facility outpatient hospital22 Date of Service Edit: PolicyAnatomic Consideration

The MUE lookup for C9757 shows every setting next to any other code on the same claim.

NCCI edits and add-on rules

In the practitioner PTP file v323r0, C9757 is the column-2 (bundled) code in 0 active pairs and the column-1 code in 9 (78% modifier-allowed); 0 earlier pairs have been deleted.

Column-2 codes bundled into C9757 (practitioner)
Column-2 codePairs
63030 (CPT; descriptor licensed by AMA)1
63052 (CPT; descriptor licensed by AMA)1
76000 (CPT; descriptor licensed by AMA)1
76380 (CPT; descriptor licensed by AMA)1
76942 (CPT; descriptor licensed by AMA)1
76998 (CPT; descriptor licensed by AMA)1
77002 (CPT; descriptor licensed by AMA)1
77012 (CPT; descriptor licensed by AMA)1

In the hospital outpatient PTP file v323r0, C9757 is the column-2 (bundled) code in 0 active pairs and the column-1 code in 9 (78% modifier-allowed); 0 earlier pairs have been deleted.

Column-2 codes bundled into C9757 (hospital outpatient)
Column-2 codePairs
63030 (CPT; descriptor licensed by AMA)1
63052 (CPT; descriptor licensed by AMA)1
76000 (CPT; descriptor licensed by AMA)1
76380 (CPT; descriptor licensed by AMA)1
76942 (CPT; descriptor licensed by AMA)1
76998 (CPT; descriptor licensed by AMA)1
77002 (CPT; descriptor licensed by AMA)1
77012 (CPT; descriptor licensed by AMA)1

C9757 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 C9757 against a second code to see whether the pair bundles and whether a modifier can separate the services.

Medicare coverage policies for C9757

No current LCD or billing and coding article lists C9757. The HCPCS coverage code D means special coverage instructions apply, and any National Coverage Determination for the service still applies.

Denials to expect on C9757

CARC 50 · N115

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

CARC 151 · N362

units of C9757 exceed the facility outpatient 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 C9757 claims

QuickCode supports qualified coder review of units, modifiers and NCCI pairs for C9757 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 C9757

What does HCPCS code C9757 describe?

"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and excision of herniated intervertebral disc, and repair of annular defect with implantation of bone anchored annular closure device, including annular defect measurement, alignment and sizing assessment, and image guidance; 1 interspace, lumbar" (short descriptor "Spine device implant surgery"), in the C section (hospital outpatient prospective payment system, temporary codes). Added 2020-01-01; last action N (no maintenance) effective 2024-01-01.

Is C9757 a CPT code?

It is not. C9757 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 C9757?

Hospital outpatient departments are paid $13,116.76 for C9757 under status indicator J1, APC 5115 (Level 5 Musculoskeletal Procedures), minimum unadjusted copayment $2,623.36 (October 2026 Addendum B).

How many units of C9757 can be billed per day?

CMS caps C9757 at practitioner 2 (MAI 2, Anatomic Consideration); hospital outpatient 2 (MAI 2, Anatomic Consideration) units per day in the 2026 Q4 MUE tables. For the facility outpatient MUE (MAI 2), units above 2 deny for the whole day as a policy limit; denials arrive as CARC 151.

Does Medicare cover C9757?

C9757 appears in no active LCD or billing and coding article, so coverage follows HCPCS coverage code D (special coverage instructions apply) and any NCD.

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.