Big Changes in 2023 for Ambulatory Surgery Centers

The Centers for Medicare and Medicaid Services (CMS) have created over 50 new C-codes (C7500–C7555) for ambulatory surgery centers (ASCs) that affect many procedures. These codes were created to allow additional payment for packaged services for ASCs.

It is important to note that the new C-codes do not apply to hospital facility coding.

Typically, C-codes also apply to facility coding under OPPS. However, these codes do not. Rather, they are designated as status indicators of E1. Status indicator E1 applies to items, codes, and services that are not covered by any Medicare outpatient benefit category, statutorily excluded, and/or not reasonable and necessary. These are not reimbursed by Medicare when submitted on outpatient claims, which includes any outpatient bill type. Therefore, hospital facility coders should not use the HCPCS codes covered in this article.

This article highlights the new C-codes that affect cardiology, interventional radiology and electrophysiology. There will be situations where a combination of C-codes and Category I codes will need to be reported. The descriptors are very specific to certain combinations of services.

Click through the tabs below to learn about the new C-codes.

Cardiology

As noted in the descriptions, many of these procedures are a combination of coronary angiography (coronary only, coronary with graphs, right heart with coronary, left heart with coronary, right and left with coronary, coronary with graphs, left heart with coronary with graphs, right and left heart with coronary and graphs) with either Fractional Flow Reserve (FFR) or Intravascular Ultrasound (IVUS). If FFR or IVUS are not performed, use regular Category I codes (93451–93461).

These new C-codes do not include percutaneous coronary interventions (PCIs).  Those procedures would be reported in addition to the diagnostic study.

C7516 – Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, with endoluminal imaging of initial coronary vessel or graft using intravascular ultrasound (IVUS) or optical coherence tomography (OCT) during diagnostic evaluation and/or therapeutic intervention including imaging supervision, interpretation and report

Subject to Multiple Procedure Discounting Final CY 2023 Comment Indicator Final CY 2023  Payment Indicator Final CY 2023  Payment Weight Final CY 2023 Payment Rate
N NC G2 44.8773 $2,327.07

C7517 – Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, with iliac and/or femoral artery angiography, non-selective, bilateral or ipsilateral to catheter insertion, performed at the same time as cardiac catheterization and/or coronary angiography, includes positioning or placement of the catheter in the distal aorta or ipsilateral femoral or iliac artery, injection of dye, production of permanent images, and radiologic supervision and interpretation

Subject to Multiple Procedure Discounting Final CY 2023 Comment Indicator Final CY 2023  Payment Indicator Final CY 2023  Payment Weight Final CY 2023 Payment Rate
N NC G2 44.8773 $2,327.07

C7518 – Catheter placement in coronary artery(ies) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation, with catheter placement(s) in bypass graft(s) (internal mammary, free arterial, venous grafts) including intraprocedural injection(s) for bypass graft angiography with endoluminal imaging of initial coronary vessel or graft using intravascular ultrasound (IVUS) or optical coherence tomography (OCT) during diagnostic evaluation and/or therapeutic intervention including imaging, supervision, interpretation and report

Subject to Multiple Procedure Discounting Final CY 2023 Comment Indicator Final CY 2023  Payment Indicator Final CY 2023  Payment Weight Final CY 2023 Payment Rate
N NC G2 44.8773 $2,327.07

C7519 – Catheter placement in coronary artery(ies) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation, with catheter placement(s) in bypass graft(s) (internal mammary, free arterial, venous grafts) including intraprocedural injection(s) for bypass graft angiography with intravascular doppler velocity and/or pressure derived coronary flow reserve measurement (initial coronary vessel or graft) during coronary angiography including pharmacologically induced stress

Subject to Multiple Procedure Discounting Final CY 2023 Comment Indicator Final CY 2023  Payment Indicator Final CY 2023  Payment Weight Final CY 2023 Payment Rate
N NC G2 44.8773 $2,327.07

C7520 – Catheter placement in coronary artery(ies) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation, with catheter placement(s) in bypass graft(s) (internal mammary, free arterial, venous grafts) includes intraprocedural injection(s) for bypass graft angiography with iliac and/or femoral artery angiography, non-selective, bilateral or ipsilateral to catheter insertion, performed at the same time as cardiac catheterization and/or coronary angiography, includes positioning or placement of the catheter in the distal aorta or ipsilateral femoral or iliac artery, injection of dye, production of permanent images, and radiologic supervision and interpretation

Subject to Multiple Procedure Discounting Final CY 2023 Comment Indicator Final CY 2023  Payment Indicator Final CY 2023  Payment Weight Final CY 2023 Payment Rate
N NC G2 44.8773 $2,327.07

C7521 – Catheter placement in coronary artery(ies) for coronary angiography, including intraprocedural injection(s) for coronary angiography with right heart catheterization with endoluminal imaging of initial coronary vessel or graft using intravascular ultrasound (IVUS) or optical coherence tomography (OCT) during diagnostic evaluation and/or therapeutic intervention including imaging supervision, interpretation and report

Subject to Multiple Procedure Discounting Final CY 2023 Comment Indicator Final CY 2023  Payment Indicator Final CY 2023  Payment Weight Final CY 2023 Payment Rate
N NC G2 44.8773 $2,327.07

C7522 – Catheter placement in coronary artery(ies) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation with right heart catheterization, with intravascular doppler velocity and/or pressure derived coronary flow reserve measurement (initial coronary vessel or graft) during  coronary angiography including pharmacologically induced stress

Subject to Multiple Procedure Discounting Final CY 2023 Comment Indicator Final CY 2023  Payment Indicator Final CY 2023  Payment Weight Final CY 2023 Payment Rate
N NC G2 44.8773 $2,327.07

C7523 – Catheter placement in coronary artery(ies) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation, with left heart catheterization including intraprocedural injection(s) for left ventriculography, when performed, with endoluminal imaging of initial coronary vessel or graft using intravascular ultrasound (IVUS) or optical coherence tomography (OCT) during diagnostic evaluation and/or therapeutic intervention including imaging supervision, interpretation and report

Subject to Multiple Procedure Discounting Final CY 2023 Comment Indicator Final CY 2023  Payment Indicator Final CY 2023  Payment Weight Final CY 2023 Payment Rate
N NC G2 44.8773 $2,327.07

C7524 – Catheter placement in coronary artery(ies) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation, with left heart catheterization including intraprocedural injection(s) for left ventriculography, when performed, with intravascular doppler velocity and/or pressure derived coronary flow reserve measurement (initial coronary vessel or graft) during coronary angiography including pharmacologically induced stress

Subject to Multiple Procedure Discounting Final CY 2023 Comment Indicator Final CY 2023  Payment Indicator Final CY 2023  Payment Weight Final CY 2023 Payment Rate
N NC G2 44.8773 $2,327.07

C7525 – Catheter placement in coronary artery(ies) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation, with left heart catheterization including intraprocedural injection(s) for left ventriculography, when performed, catheter placement(s) in bypass graft(s) (internal mammary, free arterial, venous grafts) with bypass graft angiography with endoluminal imaging of initial coronary vessel or graft using intravascular ultrasound (IVUS) or optical coherence tomography (OCT) during diagnostic evaluation and/or therapeutic intervention including imaging supervision, interpretation and report

Subject to Multiple Procedure Discounting Final CY 2023 Comment Indicator Final CY 2023  Payment Indicator Final CY 2023  Payment Weight Final CY 2023 Payment Rate
N NC G2 44.8773 $2,327.07

C7526 – Catheter placement in coronary artery(ies) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation, with left heart catheterization including intraprocedural injection(s) for left ventriculography, when performed, catheter placement(s) in bypass graft(s) (internal mammary, free arterial, venous grafts) with bypass graft angiography with intravascular doppler velocity and/or pressure derived coronary flow reserve measurement (initial coronary vessel or graft) during coronary angiography including pharmacologically induced stress

Subject to Multiple Procedure Discounting Final CY 2023 Comment Indicator Final CY 2023  Payment Indicator Final CY 2023  Payment Weight Final CY 2023 Payment Rate
N NC G2 44.8773 $2,327.07

C7527 – Catheter placement in coronary artery(ies) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation,  with right and left heart catheterization including intraprocedural injection(s) for left ventriculography, when performed, with endoluminal imaging of initial coronary vessel or graft using intravascular ultrasound (IVUS) or optical coherence tomography (OCT) during diagnostic evaluation and/or therapeutic intervention including imaging supervision, interpretation and report

Subject to Multiple Procedure Discounting Final CY 2023 Comment Indicator Final CY 2023  Payment Indicator Final CY 2023  Payment Weight Final CY 2023 Payment Rate
N NC G2 44.8773 $2,327.07

C7528 – Catheter placement in coronary artery(ies) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation, with right and left heart catheterization including intraprocedural injection(s) for left ventriculography, when performed, with intravascular doppler velocity and/or pressure derived coronary flow reserve measurement (initial coronary vessel or graft) during coronary angiography including pharmacologically induced stress

Subject to Multiple Procedure Discounting Final CY 2023 Comment Indicator Final CY 2023  Payment Indicator Final CY 2023  Payment Weight Final CY 2023 Payment Rate
N NC G2 44.8773 $2,327.07

C7529 – Catheter placement in coronary artery(ies) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation, with right and left heart catheterization including intraprocedural injection(s) for left ventriculography, when performed, catheter placement(s) in bypass graft(s) (internal mammary, free arterial, venous grafts) with bypass graft angiography with intravascular doppler velocity and/or pressure derived coronary flow reserve measurement (initial coronary vessel or graft) during coronary angiography including pharmacologically induced stress

Subject to Multiple Procedure Discounting Final CY 2023 Comment Indicator Final CY 2023  Payment Indicator Final CY 2023  Payment Weight Final CY 2023 Payment Rate
N NC G2 44.8773 $2,327.07

C7533 – Percutaneous transluminal coronary angioplasty, single major coronary artery or branch with transcatheter placement of radiation delivery device for subsequent coronary intravascular brachytherapy

Subject to Multiple Procedure Discounting Final CY 2023 Comment Indicator Final CY 2023  Payment Indicator Final CY 2023  Payment Weight Final CY 2023 Payment Rate
N NC J8 106.5754 $5,526.36

C7552 – Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with catheter placement(s) in bypass graft(s) (internal mammary, free arterial, venous grafts) including intraprocedural injection(s) for bypass graft angiography and right heart catheterization with intravascular doppler velocity and/or pressure derived coronary flow reserve measurement (coronary vessel or graft) during coronary angiography including pharmacologically induced stress, initial vessel

Subject to Multiple Procedure Discounting Final CY 2023 Comment Indicator Final CY 2023  Payment Indicator Final CY 2023  Payment Weight Final CY 2023 Payment Rate
N NI G2 44.8773 $2,327.07

C7553 – Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with right and left heart catheterization including intraprocedural injection(s) for left ventriculography, when performed, catheter placement(s) in bypass graft(s) (internal mammary, free arterial, venous grafts) with bypass graft angiography with pharmacologic agent administration (eg, inhaled nitric oxide, intravenous infusion of nitroprusside, dobutamine, milrinone, or other agent) including assessing hemodynamic measurements before, during, after and repeat pharmacologic agent administration, when performed

Subject to Multiple Procedure Discounting Final CY 2023 Comment Indicator Final CY 2023  Payment Indicator Final CY 2023  Payment Weight Final CY 2023 Payment Rate
N NI G2 44.8773 $2,327.07

Interventional Radiology

As noted in the descriptions, these are combinations of procedures that have incorporated add-on code procedures into the main descriptor. For example:

  • C7501 describes percutaneous biopsy of breast lesions under stereotactic guidance. If only one breast lesion is biopsied, use regular Category I code 19081.
  • Code C7504 describes vertebroplasties in more than one level under one C-code. If only a single level vertebroplasty is performed, use Category I codes, not the C-code.

C7501 – Percutaneous breast biopsies using stereotactic guidance, with placement of breast localization device(s) (eg, clip, metallic pellet), when performed, and imaging of the biopsy specimen, when performed, all lesions unilateral and bilateral (for single lesion biopsy, use appropriate code)

Subject to Multiple Procedure Discounting Final CY 2023 Comment Indicator Final CY 2023  Payment Indicator Final CY 2023  Payment Weight Final CY 2023 Payment Rate
N NC G2 20.6832 $1,072.51

C7502 – Percutaneous breast biopsies using magnetic resonance guidance, with placement of breast localization device(s) (eg, clip, metallic pellet), when performed, and imaging of the biopsy specimen, when performed, all lesions unilateral or bilateral (for single lesion biopsy, use appropriate code)

Subject to Multiple Procedure Discounting Final CY 2023 Comment Indicator Final CY 2023  Payment Indicator Final CY 2023  Payment Weight Final CY 2023 Payment Rate
N NC G2 20.6832 $1,072.51

C7504 – Percutaneous vertebroplasties (bone biopsies included when performed), first cervicothoracic and any additional cervicothoracic or lumbosacral vertebral bodies, unilateral or bilateral injection, inclusive of all imaging guidance

Subject to Multiple Procedure Discounting Final CY 2023 Comment Indicator Final CY 2023  Payment Indicator Final CY 2023  Payment Weight Final CY 2023 Payment Rate
N NC G2 60.5171 $3,138.05

C7505 – Percutaneous vertebroplasties (bone biopsies included when performed), first lumbosacral and any additional cervicothoracic or lumbosacral vertebral bodies, unilateral or bilateral injection, inclusive of all imaging guidance

Subject to Multiple Procedure Discounting Final CY 2023 Comment Indicator Final CY 2023  Payment Indicator Final CY 2023  Payment Weight Final CY 2023 Payment Rate
N NC G2 60.5171 $3,138.05

C7507 – Percutaneous vertebral augmentations, first thoracic and any additional thoracic or lumbar vertebral bodies, including cavity creations (fracture reductions and bone biopsies included when performed) using mechanical device (eg, kyphoplasty), unilateral or bilateral cannulations, inclusive of all imaging guidance

Subject to Multiple Procedure Discounting Final CY 2023 Comment Indicator Final CY 2023  Payment Indicator Final CY 2023  Payment Weight Final CY 2023 Payment Rate
N NC G2 124.0889 $6,434.51

C7508 – Percutaneous vertebral augmentations, first lumbar and any additional thoracic or lumbar vertebral bodies, including cavity creations (fracture reductions and bone biopsies included when performed) using mechanical device (eg, kyphoplasty), unilateral or bilateral cannulations, inclusive of all imaging guidance

Subject to Multiple Procedure Discounting Final CY 2023 Comment Indicator Final CY 2023  Payment Indicator Final CY 2023  Payment Weight Final CY 2023 Payment Rate
N NC G2 124.0889 $6,434.51

C7513 – Dialysis circuit, introduction of needle(s) and/or catheter(s), with diagnostic angiography of the dialysis circuit, including all direct puncture(s) and catheter placement(s), injection(s) of contrast, all necessary imaging from the arterial anastomosis and adjacent artery through entire venous outflow including the inferior or superior vena cava, fluoroscopic guidance, with transluminal balloon angioplasty of central dialysis segment, performed through dialysis circuit, including all required imaging, radiological supervision and interpretation, image documentation and report

Subject to Multiple Procedure Discounting Final CY 2023 Comment Indicator Final CY 2023  Payment Indicator Final CY 2023  Payment Weight Final CY 2023 Payment Rate
N NC R2 27.8465 $1,443.95

C7514 – Dialysis circuit, introduction of needle(s) and/or catheter(s), with diagnostic angiography of the dialysis circuit, including all direct puncture(s) and catheter placement(s), injection(s) of contrast, all necessary imaging from the arterial anastomosis and adjacent artery through entire venous outflow including the inferior or superior vena cava, fluoroscopic guidance, with all angioplasty in the central dialysis segment, and transcatheter placement of  intravascular stent(s), central dialysis segment, performed through dialysis circuit, including all required imaging, radiological supervision and interpretation, image documentation and report

Subject to Multiple Procedure Discounting Final CY 2023 Comment Indicator Final CY 2023  Payment Indicator Final CY 2023  Payment Weight Final CY 2023 Payment Rate
N NC R2 27.8465 $1,443.95

C7515 – Dialysis circuit, introduction of needle(s) and/or catheter(s), with diagnostic angiography of the dialysis circuit, including all direct puncture(s) and catheter placement(s), injection(s) of contrast, all necessary imaging from the arterial anastomosis and adjacent artery through entire venous outflow including the inferior or superior vena cava, fluoroscopic guidance, with dialysis circuit permanent endovascular embolization or occlusion of main circuit or any accessory veins, including all required imaging, radiological supervision and interpretation, image documentation and report

Subject to Multiple Procedure Discounting Final CY 2023 Comment Indicator Final CY 2023  Payment Indicator Final CY 2023  Payment Weight Final CY 2023 Payment Rate
N NC R2 27.8465 $1,443.95

C7530 – Dialysis circuit, introduction of needle(s) and/or catheter(s), with diagnostic angiography of the dialysis circuit, including all direct puncture(s) and catheter placement(s), injection(s) of contrast, all necessary imaging from the arterial anastomosis and adjacent artery through entire venous outflow including the inferior or superior vena cava, fluoroscopic guidance, with transluminal balloon angioplasty, peripheral dialysis segment, including all imaging and radiological supervision and interpretation necessary to perform the angioplasty and all angioplasty in the central dialysis segment, with transcatheter placement of  intravascular stent(s), central dialysis segment, performed through dialysis circuit, including all imaging, radiological supervision and interpretation, documentation and report

Subject to Multiple Procedure Discounting Final CY 2023 Comment Indicator Final CY 2023  Payment Indicator Final CY 2023  Payment Weight Final CY 2023 Payment Rate
N NC G2 88.3120 $4,579.33

C7531 – Revascularization, endovascular, open or percutaneous, femoral, popliteal artery(ies), unilateral, with transluminal angioplasty with intravascular ultrasound (initial noncoronary vessel) during diagnostic evaluation and/or therapeutic intervention, including radiological supervision and interpretation

Subject to Multiple Procedure Discounting Final CY 2023 Comment Indicator Final CY 2023  Payment Indicator Final CY 2023  Payment Weight Final CY 2023 Payment Rate
N NC J8 105.7203 $5,482.02

C7532 – Transluminal balloon angioplasty (except lower extremity artery(ies) for occlusive disease, intracranial, coronary, pulmonary, or dialysis circuit), initial artery, open or percutaneous, including all imaging and radiological supervision and interpretation necessary to perform the angioplasty within the same artery, with intravascular ultrasound (initial noncoronary vessel) during diagnostic evaluation and/or therapeutic intervention, including radiological supervision and interpretation

Subject to Multiple Procedure Discounting Final CY 2023 Comment Indicator Final CY 2023  Payment Indicator Final CY 2023  Payment Weight Final CY 2023 Payment Rate
N NC J8 102.0024 $5,289.23

C7534 – Revascularization, endovascular, open or percutaneous, femoral, popliteal artery(ies), unilateral, with atherectomy, includes angioplasty within the same vessel, when performed with intravascular ultrasound (initial noncoronary vessel) during diagnostic evaluation and/or therapeutic intervention, including radiological supervision and interpretation

Subject to Multiple Procedure Discounting Final CY 2023 Comment Indicator Final CY 2023  Payment Indicator Final CY 2023  Payment Weight Final CY 2023 Payment Rate
N NC J8 194.5291 $10,087.11

C7535 – Revascularization, endovascular, open or percutaneous, femoral, popliteal artery(ies), unilateral, with transluminal stent placement(s), includes angioplasty within the same vessel, when performed, with intravascular ultrasound (initial noncoronary vessel) during diagnostic evaluation and/or therapeutic intervention, including radiological supervision and interpretation

Subject to Multiple Procedure Discounting Final CY 2023 Comment Indicator Final CY 2023  Payment Indicator Final CY 2023  Payment Weight Final CY 2023 Payment Rate
N NC J8 192.8382 $9,999.43

C7545 – Percutaneous exchange of biliary drainage catheter (eg, external, internal-external, or conversion of internal-external to external only), with removal of calculi/debris from biliary duct(s) and/or gallbladder, including destruction of calculi by any method (eg, mechanical, electrohydraulic, lithotripsy) when performed, including diagnostic cholangiography(ies) when performed, imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation

Subject to Multiple Procedure Discounting Final CY 2023 Comment Indicator Final CY 2023  Payment Indicator Final CY 2023  Payment Weight Final CY 2023 Payment Rate
N NC G2 43.8422 $2,273.39

C7546 – Removal and replacement of externally accessible nephroureteral catheter (eg, external/internal stent) requiring fluoroscopic guidance, with ureteral stricture balloon dilation, including imaging guidance and all associated radiological supervision and interpretation

Subject to Multiple Procedure Discounting Final CY 2023 Comment Indicator Final CY 2023  Payment Indicator Final CY 2023  Payment Weight Final CY 2023 Payment Rate
N NC G2 28.8611 $1,496.56

C7547 – Convert nephrostomy catheter to nephroureteral catheter, percutaneous via pre-existing nephrostomy tract, with ureteral stricture balloon dilation, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation

Subject to Multiple Procedure Discounting Final CY 2023 Comment Indicator Final CY 2023  Payment Indicator Final CY 2023  Payment Weight Final CY 2023 Payment Rate
N NC J8 33.4466 $1,734.34

C7548 – Exchange nephrostomy catheter, percutaneous, with ureteral stricture balloon dilation, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation

Subject to Multiple Procedure Discounting Final CY 2023 Comment Indicator Final CY 2023  Payment Indicator Final CY 2023  Payment Weight Final CY 2023 Payment Rate
N NC G2 28.8611 $1,496.56

C7549 – Change of ureterostomy tube or externally accessible ureteral stent via ileal conduit with ureteral stricture balloon dilation, including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation

Subject to Multiple Procedure Discounting Final CY 2023 Comment Indicator Final CY 2023  Payment Indicator Final CY 2023  Payment Weight Final CY 2023 Payment Rate
N NC G2 28.8611 $1,496.56

Electrophysiology

These procedures include the placing or replacing of a pacemaker with placement of a left coronary sinus lead.  If a coronary sinus lead is not placed in addition to the pacemaker procedure, use regular Category I codes.

C7537 – Insertion of new or replacement of permanent pacemaker with atrial transvenous electrode(s), with insertion of pacing electrode, cardiac venous system, for left ventricular pacing, at time of insertion of implantable defibrillator or pacemaker pulse generator (eg, for upgrade to dual chamber system)

Subject to Multiple Procedure Discounting Final CY 2023 Comment Indicator Final CY 2023  Payment Indicator Final CY 2023  Payment Weight Final CY 2023 Payment Rate
N NC J8 194.7346 $10,097.77

C7538 – Insertion of new or replacement of permanent pacemaker with ventricular transvenous electrode(s), with insertion of pacing electrode, cardiac venous system, for left ventricular pacing, at time of insertion of implantable defibrillator or pacemaker pulse generator (eg, for upgrade to dual chamber system)

Subject to Multiple Procedure Discounting Final CY 2023 Comment Indicator Final CY 2023  Payment Indicator Final CY 2023  Payment Weight Final CY 2023 Payment Rate
N NC J8 194.1979 $10,069.94

C7539 – Insertion of new or replacement of permanent pacemaker with atrial and ventricular transvenous electrode(s), with insertion of pacing electrode, cardiac venous system, for left ventricular pacing, at time of insertion of implantable defibrillator or pacemaker pulse generator (eg, for upgrade to dual chamber system)

Subject to Multiple Procedure Discounting Final CY 2023 Comment Indicator Final CY 2023  Payment Indicator Final CY 2023  Payment Weight Final CY 2023 Payment Rate
N NC J8 197.9109 $10,262.47

C7540 – Removal of permanent pacemaker pulse generator with replacement of pacemaker pulse generator, dual lead system, with insertion of pacing electrode, cardiac venous system, for left ventricular pacing, at time of insertion of implantable defibrillator or pacemaker pulse generator (eg, for upgrade to dual chamber system)

Subject to Multiple Procedure Discounting Final CY 2023 Comment Indicator Final CY 2023  Payment Indicator Final CY 2023  Payment Weight Final CY 2023 Payment Rate
N NC J8 194.5441 $10,087.89

Payment Indicators

Listed below is the CY 2023 ASC DD1, which describes payment indicators and their definitions:

Comment Indicators

Listed below is the CY 2023 ASC DD2, which describes the comment indicators and definitions:

Resources

For a complete list of services covered under the new C-codes, please refer to Addendum AA — Final ASC Covered Surgical Procedures for CY 2023 (Including Surgical Procedures for Which Payment is Packaged) within the 2023 NFRM ASC Addenda (linked below).

2023 NFRM ASC Addenda

2023 NFRM ASC Addendum O

2023 NFRM OPPS Addenda

Note: CPT codes and descriptions only are copyright 2022 American Medical Association.  All Rights Reserved.  Applicable FARS/DFARS Apply.  Dental codes (D codes) are copyright 2022 American Dental Association.  All Rights Reserved.