Summary & Overview
HCPCS C1762: Connective Tissue, Human (Includes Fascia Lata)
HCPCS Level II code C1762 designates human-derived connective tissue grafts, including fascia lata, used in reconstructive and soft-tissue reinforcement procedures. This code is important nationally because it standardizes billing for a range of biologic graft materials that support surgical repair across multiple specialties, impacting hospital supply, surgical planning, and payer coverage decisions.
Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of coverage considerations and payer inclusion, typical sites of service, and clinical contexts where C1762 is applied. The publication summarizes payment benchmarks where available, common billing and coding considerations, and potential policy updates affecting graft material reimbursement.
The report supplies clinical context for use of human connective tissue grafts, outlines service settings (hospital OR, ambulatory surgery centers, surgical clinics), and highlights what providers and billing professionals should expect when coding for these grafts. Data not available in the input is noted where applicable.
Billing Code Overview
HCPCS Level II code C1762 identifies connective tissue, human (includes fascia lata). This item represents biologic connective tissue graft material sourced from human donors, commonly used in reconstructive and soft-tissue reinforcement procedures.
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Service type: Biologic graft placement and soft-tissue reconstruction
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Typical site of service: Hospital operating room, ambulatory surgery center, or specialized surgical clinic
Clinical & Coding Specifications
Clinical Context
A 45-year-old patient presents with a full-thickness soft tissue defect of the lower extremity after debridement of a traumatic wound. The orthopedic surgeon and plastic surgeon agree that biological connective tissue grafting is indicated to provide structural support and facilitate reconstruction. In the operating room, an aseptic allograft of human connective tissue (fascia lata) coded as C1762 is implanted to reinforce soft tissue, support tendon repair, or reconstruct the extensor mechanism. The clinical workflow includes preoperative evaluation, confirmation of graft availability and consent for allograft use, intraoperative sizing and fixation of the graft to host tissue, and routine postoperative wound care and monitoring for graft integration or complications such as infection or rejection. Hospital outpatient surgery, ambulatory surgical center, or inpatient operating room are typical sites of service depending on patient comorbidities and procedure complexity.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
59 | Distinct procedural service | Use when the graft implantation is a distinct procedural service separate from another procedure performed at the same session (e.g., separate tendon repair). |