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    v1.0.28
    OpenPayerBilling CodesOutpatient PPSHCPCS hcpcs-c9600-drug-eluting-intracoronary-stent-single-vessel
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    HCPCS C9600: Drug‑Eluting Intracoronary Stent Placement, Single Vessel

    Commercial payers pay $11067 on average nationally for this procedure.

    HCPCS Level II code C9600 describes percutaneous transcatheter placement of drug‑eluting intracoronary stent(s), with coronary angioplasty when performed, for a single major coronary artery or branch; this is an interventional cardiology procedure typically performed in an ambulatory surgery center or hospital catheterization lab and is billed as a percutaneous coronary intervention (PCI) for coronary revascularization.

    For related coverage guidance, see recent payer policy updates: Cardiac Computed Tomography (CCT)/Coronary Computed Tomographic Angiography (CCTA), Cardiovascular Disease Risk Assessment, Biomarkers for Myocardial Infarction and Chronic Heart Failure.

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    National Reimbursement Benchmarks

    National commercial reimbursement for HCPCS C9600 centers around BUCA’s average commercial rate of $11,067.40, which serves as an aggregate benchmark for commercial arrangements. Blue Cross Blue Shield exhibits the highest median and mean levels, while Aetna and UnitedHealth Group show much lower medians and means; BUCA’s positioning near the mid-to-high commercial band suggests a market midpoint between lower-tier payers and Blue Cross Blue Shield’s elevated rates.

    Dispersion measured by the interquartile range (P75–P25) is tightest for Aetna with a range of $414.30 ($780.00–$336.70) and widest for Blue Cross Blue Shield with a range of $7,632.70 ($18,715.50–$11,082.80). UnitedHealth Group has a large spread of $11,766.50 ($16,766.70–$5,000.50), while BUCA’s IQR is $7,020.00 ($14,738.70–$7,717.10). These differences indicate varying commercial volatility across payers.

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    National Payer Mean Reimbursement Rates

    State Reimbursement Rates

    State: Alaska1 / 51

    Rate by payer

    Clinical & Coding Specifications

    Clinical Context

    A 68-year-old patient with known coronary artery disease presents with progressive exertional chest pain and a recent unstable angina episode. Noninvasive testing and coronary angiography identify a focal, flow-limiting atherosclerotic stenosis in the proximal left anterior descending artery (a single major coronary artery). The interventional cardiology team performs percutaneous transcatheter placement of a drug-eluting intracoronary stent with balloon angioplasty during the same session to restore vessel patency and reduce restenosis risk. The typical workflow includes pre-procedural assessment (history, consent, coagulation profile, and antiplatelet planning), vascular access (usually femoral or radial), diagnostic coronary angiography to localize the lesion, percutaneous transluminal coronary angioplasty, deployment of a drug-eluting stent in the target artery, post-deployment angiography to confirm result, hemostasis/closure, and post-procedure monitoring in a recovery or telemetry unit. Typical site of service is an inpatient or outpatient hospital cardiac catheterization laboratory or an ambulatory surgical center with interventional cardiology capability. The service type is percutaneous coronary intervention (PCI) with drug-eluting intracoronary stent placement for a single major coronary artery or branch. Common clinical indications include symptomatic atherosclerotic coronary artery disease, unstable angina, and acute or recent myocardial ischemia requiring revascularization.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    C9601Percutaneous transcatheter placement of drug‑eluting intracoronary stent(s), with coronary angioplasty when performed; each additional branch of a major coronary artery (list separately in addition to code for primary procedure)

    Related Modifiers

    9 rows

    ModifierDescriptionWhen to Use
    26Modifier 26 (Professional Component) identifies and bills only the professional portion of a split service — the physician’s interpretation, report, and medical judgment — when the technical…- Use CPT Modifier -26 when you are billing only the professional component (PC) of a split‑bill eligible service—i.e., you performed the physician interpretation, medical judgment and prepared a…
    50Modifier –50 (Bilateral Procedure) is appended to a CPT code when an identical procedure is performed on paired anatomical structures during the same operative session. The AMA states to add…- Use modifier -50 when the same CPT surgical, diagnostic, or radiology procedure is performed on paired anatomical structures (both sides of the body) during the same operative/session by the same…
    51Modifier –51 (Multiple Procedures) is used when the same provider performs multiple procedures in the same session to identify secondary, non‑exempt procedures and indicate payment reduction logic…- Use modifier -51 when the same provider performs multiple distinct procedures during the same patient encounter: report the highest‑valued procedure first (no modifier) and append -51 to…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    59Modifier 59 indicates a distinct procedural service when two procedures that are not normally billed together are clinically and procedurally separate. The CPT definition (as reiterated by CMS)…- Use modifier -59 to report a distinct procedural service when documentation supports that the procedure reported is not normally billed together with another service on the same day because of a…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    76Modifier -76, Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional, is appended when the same provider performs an identical, medically necessary procedure or…- Use modifier -76 when the same physician or other qualified health care professional performs an identical procedure or service a second (or subsequent) time on the same date of service and the…
    80CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…

    Related Provider Taxonomies

    8 rows

    Taxonomy CodeSpecialtyNotes
    207RC0000XCardiovascular Disease PhysicianAn internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threaten…
    207RI0011XInterventional Cardiology PhysicianAn area of medicine within the subspecialty of cardiology, which uses specialized imaging and other diagnostic techniques to evaluate blood flow and p…
    207RG0300XGeriatric Medicine (Internal Medicine) PhysicianAn internist who has special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects o…
    273100000XEpilepsy Hospital UnitAn Epilepsy Unit is a distinct unit of a hospital that provides services that may include observation, urgent care, diagnostic testing, treatment, and…
    133VN1006XMetabolic Nutrition Registered DietitianA registered dietitian who achieves specialized competency in metabolic nutrition.
    152WC0802XCorneal and Contact Management OptometristThe professional activities performed by an Optometrist related to the fitting of contact lenses to an eye, ongoing evaluation of the cornea's ability…
    246ZB0301XBiomedical EngineerNone
    364SX0106XOccupational Health Clinical Nurse SpecialistPhysician Assistants & Advanced Practice Nursing Providers · Clinical Nurse Specialist

    Related ICD-10-CM Codes

    29 rows

    ICD-10-CM CodeDescription
    E11.51Type 2 diabetes mellitus with diabetic peripheral angiopathy without gangrene
    E78.5Hyperlipidemia, unspecified
    I20.0Unstable angina
    I20.9Angina pectoris, unspecified
    I21.09ST elevation (STEMI) myocardial infarction involving other coronary artery of anterior wall
    I21.19ST elevation (STEMI) myocardial infarction involving other coronary artery of inferior wall
    I21.3ST elevation (STEMI) myocardial infarction of unspecified site
    I21.4Non-ST elevation (NSTEMI) myocardial infarction
    I21.9Acute myocardial infarction, unspecified
    I22.0Subsequent ST elevation (STEMI) myocardial infarction of anterior wall

    Showing 1–10 of 29

    Related Payer Policy Updates

    Specialty: Cardiology1 / 3

    6 rows

    PolicyPayerEffective Date
    Cardiac Computed Tomography (CCT)/Coronary Computed Tomographic Angiography (CCTA)univerahealthcare2026-10-15
    Cardiovascular Disease Risk AssessmentOscar Health2026-10-01
    Biomarkers for Myocardial Infarction and Chronic Heart FailureOscar Health2026-10-01
    Multiple Procedure Payment Reduction for Diagnostic Cardiovascular ProceduresBlue Cross Blue Shield - Maine2026-10-01
    Cardiovascular Disease Risk Assessmentblue cross blue shield - louisiana2026-09-15
    Cardiovascular Disease Risk AssessmentBlue Cross Blue Shield - New Mexico2026-09-04

    Related Codes

    HCPCS-C1713-IMPLANTABLE-ANCHOR-SCREW-BONE-FIXATION

    HCPCS C1713: Anchor/Screw for Bone or Soft Tissue Fixation (Implantable)

    HCPCS-C1714-TRANSLUMINAL-DIRECTIONAL-ATHERECTOMY-CATHETER

    HCPCS C1714: Catheter, transluminal atherectomy, directional

    HCPCS-C1715-BRACHYTHERAPY-NEEDLE

    HCPCS C1715: Brachytherapy Needle

    HCPCS-C1716-BRACHYTHERAPY-GOLD-198-SOURCE

    HCPCS C1716: Brachytherapy Source, Gold-198, Per Source

    HCPCS-C1717-HDR-BRACHYTHERAPY-IRIDIUM-192-SOURCE

    HCPCS C1717: HDR Iridium-192 Brachytherapy Source, Per Source

    HCPCS-C1719-BRACHYTHERAPY-IRIDIUM-192-SOURCE-NON-STRANDED

    HCPCS C1719: Brachytherapy Source, Iridium-192, Non-Stranded

    HCPCS-C1721-IMPLANTABLE-DUAL-CHAMBER-CARDIOVERTER-DEFIBRILLATOR

    HCPCS C1721: Cardioverter-Defibrillator, Dual Chamber (Implantable)

    HCPCS-C1724-ROTATIONAL-TRANSLUMINAL-ATHERECTOMY-CATHETER

    HCPCS Level II C1724: Rotational Transluminal Atherectomy Catheter

    HCPCS-C1725-TRANSLUMINAL-ANGIOPLASTY-CATHETER-NON-LASER

    HCPCS Level II C1725: Transluminal Angioplasty Catheter, Non-Laser

    HCPCS-C1726-NON-VASCULAR-BALLOON-DILATATION-CATHETER

    HCPCS C1726: Catheter, Balloon Dilatation, Non-Vascular

    Showing 1–10 of 603

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    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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    Reported for each additional branch treated in the same session in addition to the primary C9600 service
    C9602Percutaneous transluminal coronary atherectomy, with drug eluting intracoronary stent, with coronary angioplasty when performed; single major coronary artery or branchUsed when atherectomy is performed in addition to stent placement for the target vessel
    C9604Percutaneous transluminal revascularization of or through coronary artery bypass graft (internal mammary, free arterial, venous), any combination of drug‑eluting intracoronary stent, atherectomy and angioplasty, including distal protection when performed; single vesselApplicable when intervention is performed through or on a coronary bypass graft rather than a native coronary artery
    C9606Percutaneous transluminal revascularization of acute total/subtotal occlusion during acute myocardial infarction, coronary artery or coronary artery bypass graft, any combination of drug‑eluting intracoronary stent, atherectomy and angioplasty, including aspiration thrombectomy when performed, single vesselUsed for PCI during acute MI with thrombectomy and stent placement for an occluded vessel
    92928Percutaneous transcatheter placement of intracoronary stent(s), with coronary angioplasty when performed; single major coronary artery or branchHistorically used CPT equivalent; may be referenced by payers when evaluating services similar to C9600