Summary & Overview
HCPCS Level II C9355: Collagen Nerve Cuff (Neuromatrix), per 0.5 cm
HCPCS Level II code C9355 denotes a collagen nerve cuff (neuromatrix), billed per 0.5 centimeter length. The code applies to an implantable biologic device used in surgical peripheral nerve repair to provide scaffold support and potentially improve regeneration outcomes. As an HCPCS Level II supply code, C9355 matters nationally for hospital and ambulatory surgery billing, device supply inventory, and surgical implant coding clarity.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of how the code is used in surgical settings, expected sites of service, and the clinical context for peripheral nerve reconstruction procedures. The publication presents benchmark considerations for utilization and claim processing, common modifier usage patterns when applicable, and gaps where payer-specific coverage guidance or pricing information is not available.
This resource is intended to help coding, billing, and procurement teams understand the clinical purpose of C9355, the typical service environment, and what to look for when preparing claims and documentation for collagen nerve cuff implants.
Billing Code Overview
HCPCS Level II code C9355 describes a collagen nerve cuff (neuromatrix), per 0.5 centimeter length. This item is a biologic or implantable surgical adjunct used to support peripheral nerve repair and regeneration by providing a scaffold around injured nerves.
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Service type: Implantable biologic device for surgical nerve repair
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Typical site of service: Hospital operating room or ambulatory surgical center
Clinical & Coding Specifications
Clinical Context
A 48-year-old patient with a painful, symptomatic peripheral nerve neuroma of the superficial radial nerve following prior trauma presents for surgical management. Conservative care including physical therapy, neuropathic pain medications, and local injections provided limited relief. The peripheral nerve surgeon plans excision of the neuroma with reconstruction using a collagen nerve cuff (neuromatrix) to protect the repaired nerve and guide axonal regeneration. The procedure is performed in an outpatient ambulatory surgery center under regional or general anesthesia with intraoperative nerve stimulation to identify healthy proximal and distal nerve segments. The surgeon measures the defect and trims nerve ends, applies microsurgical repair or interposition graft as indicated, and places C9355 collagen nerve cuff segments (billed per 0.5 cm) around the repair to reinforce the repair and reduce scar formation. Typical intraoperative documentation includes nerve defect length, number and length of C9355 segments used, microsuture technique, presence of nerve conduit or graft, anesthesia type, estimated blood loss, and postoperative pain and motor/sensory assessment. Postoperative workflow includes short PACU recovery, wound care instructions, early sensory rehabilitation, and outpatient follow-up for wound check and serial neurologic evaluation.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 |