HCPCS C1738: Powered Single-Use Endoscopic Ultrasound-Guided Biopsy Device - OpenPayer

Summary & Overview

HCPCS C1738: Powered Single-Use Endoscopic Ultrasound-Guided Biopsy Device

HCPCS Level II code C1738 identifies a powered, single-use endoscopic ultrasound-guided biopsy device used to obtain tissue samples during EUS procedures. As EUS-guided tissue acquisition grows in diagnostic importance for gastrointestinal, pancreatic and thoracic lesions, clear coding for disposable biopsy devices supports accurate supply reporting and claims processing nationwide. This code matters for hospitals, ambulatory surgery centers, and endoscopy suites that supply devices as part of procedural episodes and for payers establishing coverage and payment policies.

Key payers in scope include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare and Medicare. Readers will find a concise synthesis of what the code represents, the clinical and site-of-service context, and the payer landscape covered. The publication summarizes expected use cases, common billing modifiers (listed separately), and where to find related coding and policy references. It is intended to help revenue cycle, coding, and clinical teams understand the administrative classification of a powered, disposable EUS biopsy device, how it fits into procedural supply reporting, and what payers typically consider when processing claims. Data not available in the input is noted where applicable.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareC1738HCPCS Level IIendoscopic ultrasoundEUS biopsydisposable medical deviceprocedural supplyendoscopyambulatory surgery

Billing Code Overview

HCPCS Level II code C1738 describes a powered, single-use (disposable) endoscopic ultrasound-guided biopsy device. This device is intended for use during endoscopic ultrasound (EUS) procedures to obtain tissue samples from lesions or masses visualized via endoscopic ultrasound imaging.

Service type: EUS-guided biopsy device supply and procedural accessory

Typical site of service: Hospital outpatient department, ambulatory surgery center, or endoscopy suite

Clinical & Coding Specifications

Clinical Context

A 62-year-old patient with a history of chronic smoking and recent unexplained weight loss presents with a 2.5 cm submucosal mass in the posterior mediastinum identified on chest CT. The thoracic surgeon and pulmonologist coordinate an endoscopic ultrasound-guided tissue sampling to obtain diagnostic material for histology and molecular studies. The patient is scheduled to undergo conscious sedation in an ambulatory endoscopy suite. The procedure uses a C1738 powered, single-use endoscopic ultrasound-guided biopsy device to obtain core and/or needle biopsy specimens from the mediastinal mass via an endoscopic ultrasound (EUS) approach.

During the encounter the clinical workflow includes pre-procedure consent and time-out, topical and/or monitored anesthesia care, endoscopic ultrasound imaging to localize the lesion, deployment of the disposable powered biopsy device to obtain targeted samples, on-site specimen handling (slide preparation, cell block, and preservation for molecular testing), hemostasis if needed, and post-procedure recovery with discharge instructions. The device is billed as C1738 when a powered, single-use EUS-guided biopsy device is used for tissue acquisition during the endoscopic procedure.

Coding Specifications

Modifier	Description	When to Use
`22`

HCPCS C9751: Bronchoscopy with Transbronchial Microwave Ablation and Image-Guided EBUS

HCPCS-C8957-PROLONGED-INFUSION-INITIATION-PORTABLE-IMPLANTABLE-PUMP

HCPCS C8957: Initiation of Prolonged IV Infusion Using Portable or Implantable Pump

HCPCS-C2617-TEMPORARY-NON-CORONARY-STENT-DEVICE-ONLY

HCPCS C2617: Temporary Non-Coronary Stent, Device Only

HCPCS-C9487-USTEKINUMAB-INTRAVENOUS-INJECTION-1-MG

HCPCS C9487: Ustekinumab, Intravenous Injection, 1 mg

HCPCS-C9478-SEBELIPASE-ALFA-INJECTION-1MG

HCPCS C9478: Injection, sebelipase alfa, 1 mg

HCPCS-C9360-DERMAL-SUBSTITUTE-NEONATAL-BOVINE-COLLAGEN

HCPCS C9360: Neonatal Bovine Collagen Dermal Substitute, per 0.5 sq cm

HCPCS-C9760-TRANSCATHETER-INTERATRIAL-SHUNT-IMPLANTATION-IDE

HCPCS C9760: Transcatheter Interatrial Shunt Implantation (IDE)

HCPCS-C9101-OLICERIDINE-INJECTION-0-1-MG

HCPCS C9101: Injection, oliceridine, 0.1 mg

HCPCS-C9055-BREXANOLONE-INJECTION-1MG-INFUSION-THERAPY

HCPCS Level II C9055: Injection, brexanolone, 1mg

HCPCS-C1818-INTEGRATED-KERATOPROSTHESIS

HCPCS C1818: Integrated Keratoprosthesis

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Taxonomy Code	Specialty	Notes
`2084P0206X`	Gastroenterology	Gastroenterologists commonly perform EUS-guided biopsies of GI-adjacent structures and mediastinum.
`2085R0202X`	Pulmonary Disease	Interventional pulmonologists frequently perform EUS and EBUS-guided sampling of thoracic lesions.
`208D00000X`	Surgery - Thoracic Cardiovascular	Thoracic surgeons may perform or collaborate on endoscopic or surgical biopsies of mediastinal masses.
`207K00000X`	Anesthesiology	Anesthesiologists provide monitored anesthesia care or general anesthesia for complex or high-risk EUS procedures.
`363A00000X`	Pathology	Pathologists oversee specimen handling, onsite assessment (ROSE), and final histopathology interpretation.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`C78.1`	Secondary malignant neoplasm of lung	Mediastinal or pulmonary metastatic lesions commonly sampled by EUS-guided biopsy to confirm metastatic disease.
`C34.90`	Malignant neoplasm of unspecified part of unspecified bronchus or lung	Primary lung malignancies adjacent to the esophagus or airways may require EUS or combined EBUS/EUS sampling.
`C15.9`	Malignant neoplasm of esophagus, unspecified	Esophageal wall masses or submucosal lesions are sampled using EUS-guided biopsy devices.
`D16.9`	Benign neoplasm of bone and articular cartilage, unspecified	Benign mediastinal or chest wall masses occasionally require tissue diagnosis via EUS-guided approaches.
`R91.8`	Other nonspecific abnormal finding of lung field	Indeterminate pulmonary nodules identified on imaging that need tissue diagnosis via EUS/EBUS-guided biopsy.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`43242`	Esophagoscopy, flexible, transoral; with directed submucosal or transmural sampling (eg, deep biopsy, FNA, core)	Often used for upper GI endoscopic ultrasound with tissue sampling; EUS-guided biopsy device `C1738` may be used during this service.
`43243`	Esophagoscopy, flexible, transoral; with insertion of esophageal stent or dilatation (note: here included for context)	May be performed before/after biopsy if airway or luminal obstruction requires dilation or stenting.
`43259`	Upper gastrointestinal endoscopy with EUS and fine needle aspiration/biopsy, diagnostic	Represents EUS with FNA/biopsy; `C1738` is the powered disposable device used for tissue acquisition during this service.
`31628`	Bronchoscopy, flexible or rigid, with transbronchial biopsy(s), single lobe	Interventional pulmonology procedures that may be performed in the same session or as alternative approaches to mediastinal sampling.
`76942`	Ultrasonic guidance for needle placement (eg, biopsy, aspiration, injection); imaging supervision and interpretation	Used when separate billing for ultrasound guidance of needle placement is appropriate in conjunction with EUS-guided biopsy using `C1738`.

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