C1604 — Graft, transmural transvenous arterial bypass (implantable), with all delivery system components
C1604 is a HCPCS Level II code for graft, transmural transvenous arterial bypass (implantable), with all delivery system components. It belongs to the Outpatient Prospective Payment System section. Whether Medicare pays it depends on the coverage rule below.
Medicare coverage: Special coverage instructions apply
There are published conditions attached to this code. Check the applicable coverage policy before billing it: the code being valid is not the same as the service being covered.
From the coverage field of the CMS Alpha-Numeric HCPCS File, release 2026Q3-Jul. This states Medicare’s position on the code, not on your particular claim.
Medically Unlikely Edits — units per day
The most units of C1604 Medicare will pay on one date of service. Bill more on a single line and it is denied. The limit is not the same in every setting, so the row that matters is the one matching the claim you are building.
- practitioner
- 1 unit MAI 3 — Date of Service Edit: Clinical · Nature of Equipment
- outpatient
- 1 unit MAI 3 — Date of Service Edit: Clinical · Nature of Equipment
The adjudication indicator decides whether exceeding the limit is worth appealing at all: MAI 1 is a line edit you can support with documentation, MAI 3 is a date-of-service edit that is also appealable, and MAI 2 is absolute — no documentation overrides it. CMS MUE 2026Q3.
The CMS record for C1604
- Long descriptor
- Graft, transmural transvenous arterial bypass (implantable), with all delivery system components
- Short descriptor
- Grft, trnsmurl/trnsvens byps
- Added
- January 1, 2024
- BETOS
- D1A
- Pricing indicator
- 53 — Other
The official wording. This is what the code means.
CMS's 28-character form, which is what shows up on a remittance advice.
When CMS introduced the code.
Berenson-Eggers Type of Service — CMS's own analytic grouping.
Statute.
Codes adjacent to C1604
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If C1604 is not quite right, the correct code is very often within a few positions of it.
- B9999Noc for parenteral supplies
- C1052Hemostatic agent, gastrointestinal, topical
- C1062Intravertebral body fracture augmentation with implant (e.g., metal, polymer)
- C1300Hyperbaric oxygen under pressure, full body chamber, per 30 minute intervalterminated
- C1600Catheter, transluminal intravascular lesion preparation device, bladed, sheathed (insertable)
- C1601Endoscope, single-use (i.e. disposable), pulmonary, imaging/illumination device (insertable)
- C1602Orthopedic/device/drug matrix/absorbable bone void filler, antimicrobial-eluting (implantable)
- C1603Retrieval device, insertable, laser (used to retrieve intravascular inferior vena cava filter)
- C1605Pacemaker, leadless, dual chamber (right atrial and right ventricular implantable components), rate-responsive, including all necessary components for implantation
- C1606Adapter, single-use (i.e. disposable), for attaching ultrasound system to upper gastrointestinal endoscope
- C1607Neurostimulator, integrated (implantable), rechargeable with all implantable and external components including charging system
- C1608Prosthesis, total, dual mobility, first carpometacarpal joint (implantable)
- C1609Vertebral device, motion-preserving, with screw fixation
- C1713Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable)
- C1714Catheter, transluminal atherectomy, directional
- C1715Brachytherapy needle
Questions about C1604
What is HCPCS code C1604?
C1604 is a HCPCS Level II code for graft, transmural transvenous arterial bypass (implantable), with all delivery system components. It sits in the Outpatient Prospective Payment System section.
Does Medicare cover C1604?
The CMS HCPCS file marks C1604 as "Special coverage instructions apply". There are published conditions attached to this code. Check the applicable coverage policy before billing it: the code being valid is not the same as the service being covered.