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    v1.0.28
    OpenPayerBilling CodesOutpatient PPSHCPCS hcpcs-c9603-percutaneous-coronary-atherectomy-additional-branch-stent
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    HCPCS Level II C9603: Percutaneous Coronary Atherectomy, Additional Branch

    Commercial payers pay $6212 on average nationally for this procedure.

    HCPCS Level II code C9603 describes a percutaneous transluminal coronary atherectomy procedure performed with placement of a drug-eluting intracoronary stent and coronary angioplasty when performed, reported for each additional branch of a major coronary artery separate from the primary procedure; the service is a percutaneous coronary intervention typically performed in a hospital catheterization laboratory or interventional cardiology suite and is categorized as an interventional cardiovascular procedure.

    For related coverage guidance, see recent payer policy updates: Cardiac Computed Tomography (CCT)/Coronary Computed Tomographic Angiography (CCTA), Cardiovascular Disease Risk Assessment, Biomarkers for Myocardial Infarction and Chronic Heart Failure.

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    National Reimbursement Benchmarks

    National commercial reimbursement for HCPCS C9603 centers on BUCA’s average commercial rate of $6,211.80, which serves as a midpoint reference among national payers. Blue Cross Blue Shield ($1,665.30 mean) and UnitedHealth Group ($4,195.20 mean) display lower central tendencies compared with Cigna ($18,436.00 mean) and Aetna ($5,097.40 mean), while BUCA’s mean sits above Aetna and UnitedHealth Group but well below Cigna’s very high mean. Minimums and maximums vary widely across payers but are not available for BUCA. Dispersion measured as the interquartile range (P75–P25) highlights substantial differences in consistency: Aetna’s IQR is $5,530.70, Blue Cross Blue Shield’s is $3,528.30, BUCA’s is $5,387.80, Cigna’s is $12,925.00, and UnitedHealth Group’s is $2,443.40. Cigna exhibits the widest IQR at $12,925.00, indicating the greatest spread between typical lower and upper quartile commercial rates, while UnitedHealth Group is the tightest at $2,443.40, indicating comparatively concentrated commercial pricing.

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    National Payer Mean Reimbursement Rates

    State Reimbursement Rates

    State: Alaska1 / 51

    Rate by payer

    Clinical & Coding Specifications

    Clinical Context

    A 68-year-old male with a history of hypertension, hyperlipidemia, and known multivessel coronary artery disease presents to the emergency department with chest pain, elevated cardiac biomarkers, and electrocardiographic changes concerning for acute myocardial infarction. Coronary angiography demonstrates significant stenoses in the left anterior descending artery and a large diagonal branch. Primary percutaneous coronary intervention is performed using percutaneous transluminal coronary atherectomy to debulk calcified plaque, followed by placement of a drug-eluting intracoronary stent and adjunctive balloon angioplasty as needed. C9603 is reported for the additional treated branch beyond the primary vessel. Typical workflow includes pre-procedure consent and antiplatelet loading, vascular access (radial or femoral) in the cardiac catheterization laboratory, intraprocedural imaging and hemodynamic monitoring, use of atherectomy device for plaque modification, stent deployment, assessment of flow and residual stenosis, and post-procedure monitoring in a coronary care unit or step-down unit. Typical site of service is an inpatient or outpatient cardiac catheterization laboratory within a hospital or ambulatory surgical center. The typical service type is invasive therapeutic interventional cardiology (percutaneous coronary intervention) for multivessel coronary artery disease or acute myocardial infarction.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    C9602Percutaneous transluminal coronary atherectomy, with drug eluting intracoronary stent, with coronary angioplasty when performed; single major coronary artery or branch

    Related Modifiers

    8 rows

    ModifierDescriptionWhen to Use
    22Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
    23Modifier -23 (Unusual Anesthesia) is used on anesthesia service CPT codes when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia…- Use modifier -23 only on anesthesia CPT codes (00100–01999) when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia because of…
    50Modifier –50 (Bilateral Procedure) is appended to a CPT code when an identical procedure is performed on paired anatomical structures during the same operative session. The AMA states to add…- Use modifier -50 when the same CPT surgical, diagnostic, or radiology procedure is performed on paired anatomical structures (both sides of the body) during the same operative/session by the same…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    80CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…
    82Modifier 82 is appended to a surgical CPT code to indicate that an attending physician acted as an assistant because a qualified resident surgeon was unavailable. In teaching hospitals it documents…- When to use: Append modifier 82 in teaching-hospital settings to indicate a physician served as an assistant surgeon because a qualified resident surgeon was unavailable (includes situations where…

    Related Provider Taxonomies

    8 rows

    Taxonomy CodeSpecialtyNotes
    207RC0000XCardiovascular Disease PhysicianAn internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threaten…
    207RI0011XInterventional Cardiology PhysicianAn area of medicine within the subspecialty of cardiology, which uses specialized imaging and other diagnostic techniques to evaluate blood flow and p…
    2086S0129XVascular Surgery PhysicianA surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart.
    2080P1004XPhysician Nutrition Specialist (Pediatrics)A physician who specializes in the diagnosis and treatment of primary nutritional diseases (e.g., undernutrition, overnutrition, and genetic or acquir…
    207RA0000XAdolescent Medicine (Internal Medicine) PhysicianAn internist who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and so…
    208VP0000XPain Medicine PhysicianPain Medicine is a primary medical specialty based on a distinct body of knowledge and a well-defined scope of clinical practice that is founded on sc…
    207Y00000XOtolaryngology PhysicianAn otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ea…
    2080H0002XPediatric Hospice and Palliative Medicine PhysicianA pediatrician with special knowledge and skills to prevent and relieve the suffering experienced by patients with life-limiting illnesses. This speci…

    Related Payer Policy Updates

    Specialty: Cardiology1 / 3

    10 rows

    PolicyPayerEffective Date
    Cardiac Computed Tomography (CCT)/Coronary Computed Tomographic Angiography (CCTA)univerahealthcare2026-10-15
    Cardiovascular Disease Risk AssessmentOscar Health2026-10-01
    Biomarkers for Myocardial Infarction and Chronic Heart FailureOscar Health2026-10-01
    Multiple Procedure Payment Reduction for Diagnostic Cardiovascular ProceduresBlue Cross Blue Shield - Maine2026-10-01
    Cardiovascular Disease Risk Assessmentblue cross blue shield - louisiana2026-09-15
    Cardiovascular Disease Risk AssessmentBlue Cross Blue Shield - New Mexico2026-09-04
    Computed Tomography to Detect Coronary Artery CalcificationBluecross Idaho2026-09-01
    Intracoronary Drug Delivery Balloon ProceduresBlue Cross Blue Shield - Rhode Island2026-09-01
    Cardiac Imaging Guidelinesevicore2026-09-01
    Percutaneous Left Atrial Appendage Closure Device for Stroke PreventionAmbetter Georgia2026-08-26

    Related Codes

    HCPCS-C1713-IMPLANTABLE-ANCHOR-SCREW-BONE-FIXATION

    HCPCS C1713: Anchor/Screw for Bone or Soft Tissue Fixation (Implantable)

    HCPCS-C1714-TRANSLUMINAL-DIRECTIONAL-ATHERECTOMY-CATHETER

    HCPCS C1714: Catheter, transluminal atherectomy, directional

    HCPCS-C1715-BRACHYTHERAPY-NEEDLE

    HCPCS C1715: Brachytherapy Needle

    HCPCS-C1716-BRACHYTHERAPY-GOLD-198-SOURCE

    HCPCS C1716: Brachytherapy Source, Gold-198, Per Source

    HCPCS-C1717-HDR-BRACHYTHERAPY-IRIDIUM-192-SOURCE

    HCPCS C1717: HDR Iridium-192 Brachytherapy Source, Per Source

    HCPCS-C1719-BRACHYTHERAPY-IRIDIUM-192-SOURCE-NON-STRANDED

    HCPCS C1719: Brachytherapy Source, Iridium-192, Non-Stranded

    HCPCS-C1721-IMPLANTABLE-DUAL-CHAMBER-CARDIOVERTER-DEFIBRILLATOR

    HCPCS C1721: Cardioverter-Defibrillator, Dual Chamber (Implantable)

    HCPCS-C1724-ROTATIONAL-TRANSLUMINAL-ATHERECTOMY-CATHETER

    HCPCS Level II C1724: Rotational Transluminal Atherectomy Catheter

    HCPCS-C1725-TRANSLUMINAL-ANGIOPLASTY-CATHETER-NON-LASER

    HCPCS Level II C1725: Transluminal Angioplasty Catheter, Non-Laser

    HCPCS-C1726-NON-VASCULAR-BALLOON-DILATATION-CATHETER

    HCPCS C1726: Catheter, Balloon Dilatation, Non-Vascular

    Showing 1–10 of 603

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    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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    Represents the primary code for the initial treated major coronary artery or branch; C9603 is reported for each additional branch beyond C9602.