Top billers · Codes · C-codes

C-codes: paid everywhere, visible nowhere.

C-codes are HCPCS Level II codes that exist only inside Medicare's hospital outpatient payment system (OPPS). Most are device codes, and most of those are packaged: paid, but never priced or itemized on their own. A packaged C-code never appears as its own paid line in any public Medicare file: the procedure is visible, the device is not. This page explains how the payment actually works, and links the 25 device C-codes we cover.

The mechanics

How a C-code actually gets paid.

Packaged (status N): most device C-codes

The hospital reports the device code on its claim, but Medicare pays nothing for it separately. The device's cost is bundled into the APC payment for the procedure it was used in. No APC of its own, no rate, no line item. If you're hunting for a "C-code fee schedule rate" for a packaged code, there isn't one, and anything quoting a dollar figure for it is misreading the file.

Pass-through (status H): the temporary exception

Genuinely new device categories get transitional pass-through status: hospitals are paid separately, on a device pass-through APC, at amounts derived from hospital cost data. It's temporary by design, usually a few years, and when it lapses the code joins the packaged class. A handful of codes (brachytherapy sources, for instance) keep their own per-source OPPS rates.

Why there's no "who bills it" answer, for any of them

Medicare's public claims data is built from professional claims and APC-grain facility summaries. A device code that's packaged into a procedure's payment never surfaces as its own paid line, so no public dataset can rank C-code billers, for any C-code, at any grain. Per-claim detail exists only in restricted CMS research files that can't be used in a commercial product. The honest playbook is the one reps already run: follow the procedures the device rides with. Every code page below maps them.

By code

Pick your device code.

The 25 device C-codes with the deepest rep markets behind them: descriptor, current OPPS status, and the procedures each one rides with.

Selling under a code with real utilization instead? Who bills Medicare's top codes → · Or look any code up in the free code lookup.

Where this comes from. Payment status is CMS's own 2026 OPPS Addendum B and ASC addenda, labeled with the file year; codes with no separate payment render CMS's status in words, never a fake $0. Device-procedure pairings come from CMS's published pairings for pass-through devices plus the procedure codes each device class is documented to ride with. Related-procedure counts come from CMS's public Medicare Provider Utilization & Payment data for 2024 (traditional fee-for-service only; lines under 11 beneficiaries are suppressed by CMS before publication). No public CMS file carries per-code utilization for these device codes at any grain, and these pages say so instead of inventing it. Code descriptions are CMS's own HCPCS Level II text. Prospect 811 organizes public data; it doesn't add to or alter it. Not affiliated with or endorsed by CMS. Full detail on the data page.

The data can't see your device. It can see your buyers.

Prospect 811 ranks who performs the procedures your device rides with: in your exact territory, with phone numbers. $79/month, no contract, 14-day refund.

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