HCPCS Level II code C1813 denotes an inflatable penile prosthesis — an implanted device used to restore erectile function when other therapies are ineffective. Nationally, this code is relevant for urology, sexual medicine, and surgical specialty billing, and it has implications for device coverage, prior authorization processes, and reimbursement for prosthetic implants.

Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the code’s clinical context, typical site-of-service use (operating room or ambulatory surgical center), common modifiers, and payer coverage patterns where available. The publication summarizes benchmark payment considerations, coding nuances for device implantation claims, and procedural documentation elements that influence claim adjudication.

The summary provides practical reference points for revenue cycle, clinical coding, and payer policy teams seeking to align clinical documentation with claim submission for penile inflatable prosthesis services. Data not available in the input is noted where applicable.