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HCPCS C9789 · Level II · C code

C9789: Instillation of anti-neoplastic pharmacologic/biologic agent into renal pelvis, any method, 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 C9789

Medicare payment
$1,250.50
OPPS rate, SI T
Coverage code
D
special coverage instructions apply
Facility outpatient MUE
1
MAI 3
OPPS status
SI T
Procedure or service, multiple reduction applies
NCCI PTP pairs
0
practitioner file
LCDs and articles
0 / 0

TL;DR

HCPCS Level II C9789 reads "Instillation of anti-neoplastic pharmacologic/biologic agent into renal pelvis, any method, including all imaging guidance, including volumetric measurement if performed" in the October 2026 file; it dates from 2023. Hospital outpatient departments are paid $1,250.50 for C9789 under status indicator T, APC 1551 (New Technology - Level 14 ($1201- $1300)), minimum unadjusted copayment $250.10 (October 2026 Addendum B). MUE limits for C9789: practitioner 1 (MAI 3, Code Descriptor / CPT Instruction); hospital outpatient 1 (MAI 3, Code Descriptor / CPT Instruction). No current LCD or billing article lists C9789; its HCPCS coverage code is D (special coverage instructions apply). HCPCS record: BETOS P5E (ambulatory procedures - other); pricing indicator 53; type of service 2 (surgery), F (ambulatory surgical center). Nearby codes: C9785, C9781, C9797, C9779.

C9789 descriptor and code status

The October 2026 HCPCS Level II file describes C9789 as “Instillation of anti-neoplastic pharmacologic/biologic agent into renal pelvis, any method, including all imaging guidance, including volumetric measurement if performed”. It sits in the C section (hospital outpatient prospective payment system, temporary codes), listed with the other C codes.

HCPCS file attributes of C9789
FieldValue
Short descriptorInstill pharm renal pelvis
Added to HCPCS2023-10-01
Last actionN (no maintenance), effective 2023-10-01
Coverage codeD: special coverage instructions apply
Pricing indicator53: statute
BETOS categoryP5E: ambulatory procedures - other
Type of service2: surgery; F: ambulatory surgical center
Statute1833(t)

Medicare payment for C9789

Hospital outpatient departments are paid $1,250.50 for C9789 under status indicator T, APC 1551 (New Technology - Level 14 ($1201- $1300)), minimum unadjusted copayment $250.10 (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 T (Procedure or service, multiple reduction applies), APC 1551 (New Technology - Level 14 ($1201- $1300)), national unadjusted payment $1,250.50 with a minimum unadjusted copayment of $250.10.

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 $671.83 at a payment weight of 11.9284. The multiple-procedure discount applies when it is billed with another ASC procedure.

Medically Unlikely Edits for C9789

MUE limits for C9789: 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 C9789 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 C9789 shows every setting next to any other code on the same claim.

NCCI edits and add-on rules

No active practitioner PTP pair lists C9789 in v323r0.

C9789 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 C9789 against a second code to see whether the pair bundles and whether a modifier can separate the services.

Medicare coverage policies for C9789

No current LCD or billing and coding article lists C9789. The HCPCS coverage code D means special coverage instructions apply, and any National Coverage Determination for the service still applies.

Denials to expect on C9789

CARC 50 · N115

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

CARC 151 · N362

units of C9789 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 C9789 claims

QuickCode supports qualified coder review of units, modifiers and NCCI pairs for C9789 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 C9789

What does HCPCS code C9789 describe?

"Instillation of anti-neoplastic pharmacologic/biologic agent into renal pelvis, any method, including all imaging guidance, including volumetric measurement if performed" (short descriptor "Instill pharm renal pelvis"), in the C section (hospital outpatient prospective payment system, temporary codes). Added 2023-10-01.

Is C9789 a CPT code?

No: CMS maintains C9789 in HCPCS Level II, while the AMA maintains CPT. It goes in the same procedure-code field.

What does Medicare pay for C9789?

Hospital outpatient departments are paid $1,250.50 for C9789 under status indicator T, APC 1551 (New Technology - Level 14 ($1201- $1300)), minimum unadjusted copayment $250.10 (October 2026 Addendum B).

How many units of C9789 can be billed per day?

MUE limits for C9789: 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 C9789?

No current LCD or billing article lists C9789; its HCPCS coverage code is D (special coverage instructions apply).

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.