Summary & Overview
HCPCS Level II C1743: Resorbable Drug-Eluting Endovascular Scaffold, Implantable
HCPCS Level II code C1743 designates a resorbable, drug-eluting endovascular scaffold with delivery system for non-coronary vascular implantation. The code is significant nationally as it captures billing for advanced implantable scaffolds used in endovascular interventions outside the coronary circulation, reflecting growing use of bioresorbable technologies in peripheral and other vascular beds. Accurate coding influences device tracking, coverage determinations, and aggregate utilization reporting for these high-cost implants.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of clinical context for non-coronary resorbable drug-eluting scaffolds, typical sites of service, and the billing implications of using HCPCS Level II code C1743.
This publication summarizes national benchmarks where available, notes that specific payer coverage and prior authorization policies vary, and highlights areas for revenue cycle and clinical teams to consider when documenting endovascular scaffold implantation. Data not available in the input for modifiers, taxonomies, ICD-10 pairings, and related codes are indicated as such; those details should be consulted in payer-specific policy documents and device-specific clinical coding guides.
Billing Code Overview
HCPCS Level II code C1743 describes a scaffold, endovascular non-coronary, resorbable drug eluting, with delivery system (implantable). This code represents an implantable resorbable drug-eluting vascular scaffold intended for endovascular treatment of non-coronary vessels.
Service type: endovascular implantable scaffold placement
Typical site of service: hospital outpatient department, ambulatory surgery center, or specialized endovascular clinic
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A 68-year-old male with peripheral arterial disease presents with lifestyle-limiting claudication and a focal stenotic lesion of the superficial femoral artery confirmed by duplex ultrasound and peripheral angiography. After failed maximal medical therapy and exercise rehabilitation, the vascular surgery and interventional radiology teams decide on endovascular intervention. During a peripheral angioplasty procedure performed in an interventional suite or hybrid operating room, the operator deploys a resorbable drug-eluting endovascular scaffold with its delivery system to scaffold the treated non-coronary vessel segment and deliver antiproliferative drug to reduce restenosis risk. The typical workflow includes pre-procedure vascular imaging review, percutaneous arterial access (commonly femoral), diagnostic angiography, lesion crossing and preparation (balloon angioplasty or atherectomy as needed), deployment of the resorbable drug-eluting scaffold (C1743) with intraprocedural angiographic confirmation of position and flow, and post-deployment imaging to assess result. The patient is observed for access-site complications and hemodynamic stability and discharged same day or admitted overnight based on comorbidities and institutional protocols. Typical site of service: hospital outpatient department, ambulatory surgery center, or hybrid endovascular suite. Service type: implantable endovascular device placement — resorbable drug-eluting scaffold for non-coronary peripheral arteries.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 |