Key facts for C9779
- Medicare payment
- $3,938.98
- OPPS rate, SI J1
- Coverage code
- D
- special coverage instructions apply
- MUE
- none published
- no MUE in the 2026 Q4 tables
- NCCI PTP pairs
- 60
- 60 hospital outpatient
- LCDs and articles
- 0 / 0
TL;DR
C9779 is a Level II code from the C section (hospital outpatient prospective payment system, temporary codes), in use since 2021: "Endoscopic submucosal dissection (esd), including endoscopy or colonoscopy, mucosal closure, when performed". Hospital outpatient departments are paid $3,938.98 for C9779 under status indicator J1, APC 5303 (Level 3 Upper GI Procedures), minimum unadjusted copayment $787.80 (October 2026 Addendum B). In the NCCI PTP files v323r0 C9779 appears in 0 practitioner pairs as column 2 and 60 as column 1, and in 0 hospital outpatient pairs as column 2 and 60 as column 1. C9779 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 P8D (endoscopy - colonoscopy); pricing indicator 53; type of service 9 (other medical items or services), F (ambulatory surgical center). Nearby codes: C9777, C9781, C9785, C9789.
C9779 descriptor and code status
The October 2026 HCPCS Level II file describes C9779 as “Endoscopic submucosal dissection (esd), including endoscopy or colonoscopy, mucosal closure, when performed”. It sits in the C section (hospital outpatient prospective payment system, temporary codes), listed with the other C codes.
| Field | Value |
|---|---|
| Short descriptor | Esd endoscopy or colonoscopy |
| Added to HCPCS | 2021-10-01 |
| Last action | N (no maintenance), effective 2026-01-01 |
| Coverage code | D: special coverage instructions apply |
| Pricing indicator | 53: statute |
| BETOS category | P8D: endoscopy - colonoscopy |
| Type of service | 9: other medical items or services; F: ambulatory surgical center |
| Statute | 1833(t) |
Medicare payment for C9779
Hospital outpatient departments are paid $3,938.98 for C9779 under status indicator J1, APC 5303 (Level 3 Upper GI Procedures), minimum unadjusted copayment $787.80 (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 5303 (Level 3 Upper GI Procedures), national unadjusted payment $3,938.98 with a minimum unadjusted copayment of $787.80.
Ambulatory surgical center (Addendum AA)
Payment indicator G2 (Non office-based surgical procedure added in CY 2008 or later; payment based on OPPS relative payment weight), national rate $1,986.55 at a payment weight of 35.2713. The multiple-procedure discount applies when it is billed with another ASC procedure.
Medically Unlikely Edits for C9779
CMS publishes no MUE for C9779 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 C9779 shows every setting next to any other code on the same claim.
NCCI edits and add-on rules
In the practitioner PTP file v323r0, C9779 is the column-2 (bundled) code in 0 active pairs and the column-1 code in 60 (78% modifier-allowed); 0 earlier pairs have been deleted.
| Column-2 code | Pairs |
|---|---|
| 43191 (CPT; descriptor licensed by AMA) | 1 |
| 43192 (CPT; descriptor licensed by AMA) | 1 |
| 43193 (CPT; descriptor licensed by AMA) | 1 |
| 43197 (CPT; descriptor licensed by AMA) | 1 |
| 43198 (CPT; descriptor licensed by AMA) | 1 |
| 43200 (CPT; descriptor licensed by AMA) | 1 |
| 43201 (CPT; descriptor licensed by AMA) | 1 |
| 43202 (CPT; descriptor licensed by AMA) | 1 |
In the hospital outpatient PTP file v323r0, C9779 is the column-2 (bundled) code in 0 active pairs and the column-1 code in 60 (78% modifier-allowed); 0 earlier pairs have been deleted.
| Column-2 code | Pairs |
|---|---|
| 43191 (CPT; descriptor licensed by AMA) | 1 |
| 43192 (CPT; descriptor licensed by AMA) | 1 |
| 43193 (CPT; descriptor licensed by AMA) | 1 |
| 43197 (CPT; descriptor licensed by AMA) | 1 |
| 43198 (CPT; descriptor licensed by AMA) | 1 |
| 43200 (CPT; descriptor licensed by AMA) | 1 |
| 43201 (CPT; descriptor licensed by AMA) | 1 |
| 43202 (CPT; descriptor licensed by AMA) | 1 |
C9779 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 C9779 against a second code to see whether the pair bundles and whether a modifier can separate the services.
Medicare coverage policies for C9779
No current LCD or billing and coding article lists C9779. The HCPCS coverage code D means special coverage instructions apply, and any National Coverage Determination for the service still applies.
Denials to expect on C9779
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 C9779 claims
QuickCode supports qualified coder review of units, modifiers and NCCI pairs for C9779 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 C9779
What does HCPCS code C9779 describe?
"Endoscopic submucosal dissection (esd), including endoscopy or colonoscopy, mucosal closure, when performed" (short descriptor "Esd endoscopy or colonoscopy"), in the C section (hospital outpatient prospective payment system, temporary codes). Added 2021-10-01; last action N (no maintenance) effective 2026-01-01.
Is C9779 a CPT code?
No. C9779 is a CMS HCPCS Level II code; CPT codes are the AMA's five-character set.
What does Medicare pay for C9779?
Hospital outpatient departments are paid $3,938.98 for C9779 under status indicator J1, APC 5303 (Level 3 Upper GI Procedures), minimum unadjusted copayment $787.80 (October 2026 Addendum B).
Does Medicare cover C9779?
C9779 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.
- 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…
- NCCI PTP edits, hospital outpatient, v323r0 (four files)Version v323r0 (2026 Q4) · effective 2026-10-01 · file ccioph-v323r0-f1.txtSHA-256 063f41b91ef9faa2…
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.