HCPCS C9604: Percutaneous Revascularization of Coronary Bypass Graft, Single Vessel
HCPCS Level II code C9604 describes percutaneous transluminal revascularization of or through a coronary artery bypass graft (internal mammary, free arterial, venous) using any combination of drug-eluting intracoronary stent, atherectomy, and angioplasty, including distal protection when performed; this procedure is an endovascular coronary revascularization service typically performed in a cardiac catheterization laboratory or other hospital-based interventional cardiology setting for treatment of graft lesions in a single vessel.
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.
Customize your policy alerts
Sign up for hcpcs C9604 policy alerts
Get alerted when payer policies referencing C9604 are released or updated.
Monitor payer policy activity
National Reimbursement Benchmarks
National commercial pricing for HCPCS C9604 centers around the BUCA average commercial rate of $12,749.90, while individual commercial payers exhibit meaningful spread. Blue Cross Blue Shield shows the largest absolute upper bound at $38,574.80 and a $5,290.00 interquartile range (P75 $16,641.00 minus P25 $11,350.40). Cigna’s distribution is both high and wide, with an IQR of $14,127.50 (P75 $21,424.00 minus P25 $7,296.50), and Aetna’s IQR is $13,506.50 (P75 $16,192.00 minus P25 $2,686.50). UnitedHealth Group’s IQR is $11,716.70 (P75 $16,771.50 minus P25 $5,055.80).
Dispersion is notable: Cigna exhibits the widest interquartile spread at $14,127.50, indicating greater variability around its median, while Blue Cross Blue Shield and UnitedHealth Group sit in the middle range of dispersion. Aetna’s IQR is relatively large versus its mean, reflecting skew toward higher reimbursements, and BUCA’s published quartiles imply moderate spread (P75 $17,385.10 minus P25 $8,181.70 equals $9,203.40) compared with the largest commercial payers.