C1734 — Orthopedic/device/drug matrix for opposing bone-to-bone or soft tissue-to bone (implantable)
C1734 is a HCPCS Level II code for orthopedic/device/drug matrix for opposing bone-to-bone or soft tissue-to bone (implantable). 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 C1734 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
- 2 units MAI 3 — Date of Service Edit: Clinical · Nature of Service/Procedure
- outpatient
- 2 units MAI 3 — Date of Service Edit: Clinical · Nature of Service/Procedure
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 C1734
- Long descriptor
- Orthopedic/device/drug matrix for opposing bone-to-bone or soft tissue-to bone (implantable)
- Short descriptor
- Orth/devic/drug bn/bn,tis/bn
- Added
- January 1, 2020
- 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 C1734
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If C1734 is not quite right, the correct code is very often within a few positions of it.
- C1726Catheter, balloon dilatation, non-vascular
- 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
- C1735Catheter(s), intravascular for renal denervation, radiofrequency, including all single use system components
- C1736Catheter(s), intravascular for renal denervation, ultrasound, including all single use system components
- C1737Joint fusion and fixation device(s), sacroiliac and pelvis, including all system components (implantable)
- C1738Powered, single-use (i.e. disposable) endoscopic ultrasound-guided biopsy device
- C1739Tissue marker, uniquely detectable and identifiable with probe/sensor, any method (implantable), with delivery system
- C1740Leadless electrode, transmitter, battery (all implantable), for sequential left ventricular pacing
- C1741Anchor/screw for bone fixation, absorbable, metallic (implantable)
- C1742Pressure monitoring system, compartmental intramuscular (implantable), continuous, including all components (e.g., introducer, sensor), excludes mobile (wireless) software application
Questions about C1734
What is HCPCS code C1734?
C1734 is a HCPCS Level II code for orthopedic/device/drug matrix for opposing bone-to-bone or soft tissue-to bone (implantable). It sits in the Outpatient Prospective Payment System section.
Does Medicare cover C1734?
The CMS HCPCS file marks C1734 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.