C1726 — Catheter, balloon dilatation, non-vascular
C1726 is a HCPCS Level II code for catheter, balloon dilatation, non-vascular. 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 C1726 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
- 5 units MAI 3 — Date of Service Edit: Clinical · Clinical: CMS Workgroup
- outpatient
- 5 units MAI 3 — Date of Service Edit: Clinical · Clinical: Data
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 C1726
- Long descriptor
- Catheter, balloon dilatation, non-vascular
- Short descriptor
- Cath, bal dil, non-vascular
- Added
- April 1, 2001
- 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 C1726
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If C1726 is not quite right, the correct code is very often within a few positions of it.
- C1715Brachytherapy needle
- C1716Brachytherapy source, non-stranded, gold-198, per source
- C1717Brachytherapy source, non-stranded, high dose rate iridium-192, per source
- C1719Brachytherapy source, non-stranded, non-high dose rate iridium-192, per source
- C1721Cardioverter-defibrillator, dual chamber (implantable)
- C1722Cardioverter-defibrillator, single chamber (implantable)
- C1724Catheter, transluminal atherectomy, rotational
- C1725Catheter, transluminal angioplasty, non-laser (may include guidance, infusion/perfusion capability)
- C1727Catheter, balloon tissue dissector, non-vascular (insertable)
- C1728Catheter, brachytherapy seed administration
- C1729Catheter, drainage
- C1730Catheter, electrophysiology, diagnostic, other than 3d mapping (19 or fewer electrodes)
- C1731Catheter, electrophysiology, diagnostic, other than 3d mapping (20 or more electrodes)
- C1732Catheter, electrophysiology, diagnostic/ablation, 3d or vector mapping
- C1733Catheter, electrophysiology, diagnostic/ablation, other than 3d or vector mapping, other than cool-tip
- C1734Orthopedic/device/drug matrix for opposing bone-to-bone or soft tissue-to bone (implantable)
Questions about C1726
What is HCPCS code C1726?
C1726 is a HCPCS Level II code for catheter, balloon dilatation, non-vascular. It sits in the Outpatient Prospective Payment System section.
Does Medicare cover C1726?
The CMS HCPCS file marks C1726 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.