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HCPCS C9766 · Level II · C code

C9766: Revascularization, endovascular, open or percutaneous, lower extremity artery(ies), 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 C9766

Medicare payment
$18,728.69
OPPS rate, SI J1
Coverage code
D
special coverage instructions apply
Facility outpatient MUE
2
MAI 3
OPPS status
SI J1
Hospital Part B services paid through a comprehensive APC
NCCI PTP pairs
2
2 hospital outpatient
LCDs and articles
1 / 1

TL;DR

C9766 is a Level II code from the C section (hospital outpatient prospective payment system, temporary codes), in use since 2020: "Revascularization, endovascular, open or percutaneous, lower extremity artery(ies), except tibial/peroneal; with intravascular lithotripsy and atherectomy, includes angioplasty within the same vessel(s), when performed". Hospital outpatient departments are paid $18,728.69 for C9766 under status indicator J1, APC 5194 (Level 4 Endovascular Procedures), minimum unadjusted copayment $3,745.74 (October 2026 Addendum B). CMS caps C9766 at practitioner 2 (MAI 3, Nature of Service/Procedure); hospital outpatient 2 (MAI 3, Nature of Service/Procedure) units per day in the 2026 Q4 MUE tables. C9766 is a primary code for 2 add-on codes (37252, 37253). In the NCCI PTP files v323r0 C9766 appears in 1 practitioner pairs as column 2 and 1 as column 1 (most often with C9767), and in 1 hospital outpatient pairs as column 2 and 1 as column 1. 1 active LCD and 1 billing and coding article list C9766 across 4 states: L40228 (Endovascular Management for Peripheral Arterial Disease of the Upper and Lower Extremities), A60247. HCPCS record: BETOS P2F (major procedure, cardiovascular - other); pricing indicator 53; type of service 2 (surgery). 10 other active codes open with "Revascularization"; related codes: C9765, C9764, C9767, C9772.

C9766 descriptor and code status

The October 2026 HCPCS Level II file describes C9766 as “Revascularization, endovascular, open or percutaneous, lower extremity artery(ies), except tibial/peroneal; with intravascular lithotripsy and atherectomy, includes angioplasty within the same vessel(s), when performed”. It sits in the C section (hospital outpatient prospective payment system, temporary codes), listed with the other C codes.

HCPCS file attributes of C9766
FieldValue
Short descriptorRevasc intra lithotrip-ather
Added to HCPCS2020-07-01
Last actionN (no maintenance), effective 2020-07-01
Coverage codeD: special coverage instructions apply
Pricing indicator53: statute
BETOS categoryP2F: major procedure, cardiovascular - other
Type of service2: surgery
Statute1833(t)

Medicare payment for C9766

Hospital outpatient departments are paid $18,728.69 for C9766 under status indicator J1, APC 5194 (Level 4 Endovascular Procedures), minimum unadjusted copayment $3,745.74 (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 5194 (Level 4 Endovascular Procedures), national unadjusted payment $18,728.69 with a minimum unadjusted copayment of $3,745.74.

Ambulatory surgical center (Addendum AA)

Payment indicator J8 (Device-intensive procedure; paid at adjusted rate), national rate $13,627.89 at a payment weight of 241.9639. The multiple-procedure discount applies when it is billed with another ASC procedure.

Medically Unlikely Edits for C9766

CMS caps C9766 at practitioner 2 (MAI 3, Nature of Service/Procedure); hospital outpatient 2 (MAI 3, Nature of Service/Procedure) units per day in the 2026 Q4 MUE tables. 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 C9766 by setting
SettingMUE (units/DOS)MAICMS rationale
Practitioner services23 Date of Service Edit: ClinicalNature of Service/Procedure
Facility outpatient hospital23 Date of Service Edit: ClinicalNature of Service/Procedure

The MUE lookup for C9766 shows every setting next to any other code on the same claim.

NCCI edits and add-on rules

In the practitioner PTP file v323r0, C9766 is the column-2 (bundled) code in 1 active pair, 100% of which allow a modifier and the column-1 code in 1 (100% modifier-allowed); 3 earlier pairs have been deleted. CMS's most frequent rationale for the bundled pairs: Mutually exclusive procedures.

Column-1 codes most often paired with C9766 (practitioner)
Column-1 codePairs
C9767 Revasc lithotrip-stent-ather1
Column-2 codes bundled into C9766 (practitioner)
Column-2 codePairs
C9764 Revasc intravasc lithotripsy1

In the hospital outpatient PTP file v323r0, C9766 is the column-2 (bundled) code in 1 active pair, 100% of which allow a modifier and the column-1 code in 1 (100% modifier-allowed); 3 earlier pairs have been deleted. CMS's most frequent rationale for the bundled pairs: Mutually exclusive procedures.

Column-1 codes most often paired with C9766 (hospital outpatient)
Column-1 codePairs
C9767 Revasc lithotrip-stent-ather1
Column-2 codes bundled into C9766 (hospital outpatient)
Column-2 codePairs
C9764 Revasc intravasc lithotripsy1

C9766 is a designated primary code for 2 add-on codes (37252, 37253).

Pair counts show exposure, not the answer for one claim. Check C9766 against a second code to see whether the pair bundles and whether a modifier can separate the services.

Medicare coverage policies for C9766

1 active Local Coverage Determination and 1 billing and coding article list C9766. 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 C9766
ArticleTitleContractor(s)Related LCD
A60247Billing and Coding: Endovascular Management for Peripheral Arterial Disease of the Upper and Lower Extremities Palmetto GBAL40228

Denials to expect on C9766

CARC 50 · N115

the diagnosis or documentation does not meet the LCD or billing article that lists C9766

CARC 151 · N362

units of C9766 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 C9766 claims

QuickCode supports qualified coder review of units, modifiers and NCCI pairs for C9766 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 C9766

What does HCPCS code C9766 describe?

"Revascularization, endovascular, open or percutaneous, lower extremity artery(ies), except tibial/peroneal; with intravascular lithotripsy and atherectomy, includes angioplasty within the same vessel(s), when performed" (short descriptor "Revasc intra lithotrip-ather"), in the C section (hospital outpatient prospective payment system, temporary codes). Added 2020-07-01.

Is C9766 a CPT code?

It is not. C9766 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 C9766?

Hospital outpatient departments are paid $18,728.69 for C9766 under status indicator J1, APC 5194 (Level 4 Endovascular Procedures), minimum unadjusted copayment $3,745.74 (October 2026 Addendum B).

Is C9766 an add-on code?

C9766 is a primary code for 2 add-on codes (37252, 37253).

How many units of C9766 can be billed per day?

CMS caps C9766 at practitioner 2 (MAI 3, Nature of Service/Procedure); hospital outpatient 2 (MAI 3, Nature of Service/Procedure) units per day in the 2026 Q4 MUE tables. For the facility outpatient MUE (MAI 3), units above 2 deny for the day but can be paid on appeal with documentation; denials arrive as CARC 151.

Does Medicare cover C9766?

Coverage code D (special coverage instructions apply). 1 active LCD and 1 billing and coding article list C9766 across 4 states: L40228 (Endovascular Management for Peripheral Arterial Disease of the Upper and Lower Extremities), A60247.

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.