C9604
Percutaneous transluminal revascularization of or through coronary artery bypass graft (internal mammary, free arterial, venous), any combination of drug-eluting intracoronary stent, atherectomy and angioplasty, including distal protection when performed; single vessel
Short Description
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Perc d-e cor revasc t cabg s
Procedure Note
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0107 = PAYMENT IS FOR HOSPITAL OUTPATIENT ONLY. NOT PAYABLE UNDER THE PHYSICIAN FEE SCHEDULE; IN ACCORDANCE WITH FR DATE 8/9/2002(HOPPS), PAGE 52105.
HCPCS Coverage Code
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D = Special coverage instructions apply
HCPCS Action Code
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N = No maintenance for this code
HCPCS Action Effective Date
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January 01, 2013
HCPCS Code Added Date
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January 01, 2013
HCPCS Pricing Indicator Code
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53 = Statute
HCPCS Multiple Pricing Indicator Code
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A = Not applicable as HCPCS priced under one methodology
HCPCS Statute Number
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1833(t)
HCPCS Type Of Service Code
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2 = Surgery
HCPCS Anesthesia Base Unit Quantity
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0