C1875 — Stent, coated/covered, without delivery system
C1875 is a HCPCS Level II code for stent, coated/covered, without delivery system. 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 C1875 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
- 4 units MAI 3 — Date of Service Edit: Clinical · Clinical: CMS Workgroup
- outpatient
- 4 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 C1875
- Long descriptor
- Stent, coated/covered, without delivery system
- Short descriptor
- Stent, coated/cov w/o del sy
- 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 C1875
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If C1875 is not quite right, the correct code is very often within a few positions of it.
- C1833Monitor, cardiac, including intracardiac lead and all system components (implantable)
- C1834Pressure sensor system, includes all components (e.g., introducer, sensor), intramuscular (implantable), excludes mobile (wireless) software applicationterminated
- C1839Iris prosthesis
- C1840Lens, intraocular (telescopic)
- C1841Retinal prosthesis, includes all internal and external componentsterminated
- C1842Retinal prosthesis, includes all internal and external components; add-on to c1841terminated
- C1849Skin substitute, synthetic, resorbable, per square centimeterterminated
- C1874Stent, coated/covered, with delivery system
- C1876Stent, non-coated/non-covered, with delivery system
- C1877Stent, non-coated/non-covered, without delivery system
- C1878Material for vocal cord medialization, synthetic (implantable)
- C1880Vena cava filter
- C1881Dialysis access system (implantable)
- C1882Cardioverter-defibrillator, other than single or dual chamber (implantable)
- C1883Adapter/extension, pacing lead or neurostimulator lead (implantable)
- C1884Embolization protective system
Questions about C1875
What is HCPCS code C1875?
C1875 is a HCPCS Level II code for stent, coated/covered, without delivery system. It sits in the Outpatient Prospective Payment System section.
Does Medicare cover C1875?
The CMS HCPCS file marks C1875 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.