C9101 — Injection, oliceridine, 0.1 mg
C9101 is a HCPCS Level II code for injection, oliceridine, 0.1 mg. 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 C9101 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
- 300 units MAI 3 — Date of Service Edit: Clinical · CMS Policy
- outpatient
- 300 units MAI 3 — Date of Service Edit: Clinical · CMS Policy
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 C9101
- Long descriptor
- Injection, oliceridine, 0.1 mg
- Short descriptor
- Inj, oliceridine 0.1 mg
- Added
- October 1, 2022
- 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 C9101
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If C9101 is not quite right, the correct code is very often within a few positions of it.
- C9091Injection, sirolimus protein-bound particles, 1 mgterminated
- C9092Injection, triamcinolone acetonide, suprachoroidal (xipere), 1 mgterminated
- C9093Injection, ranibizumab, via sustained release intravitreal implant (susvimo), 0.1 mgterminated
- C9094Inj, sutimlimab-jome, 10 mgterminated
- C9095Inj, tebentafusp-tebn, 1 mcgterminated
- C9096Injection, filgrastim-ayow, biosimilar, (releuko), 1 microgramterminated
- C9097Inj, faricimab-svoa, 0.1 mgterminated
- C9098Ciltacabtagene autoleucel, up to 100 million autologous b-cell maturation antigen (bcma) directed car-positive t cells, including leukapheresis and dose preparation procedures, per therapeutic doseterminated
- C9113Injection, pantoprazole sodium, per vialterminated
- C9121Injection, argatroban, per 5 mgterminated
- C9122Mometasone furoate sinus implant, 10 micrograms (sinuva)terminated
- C9132Prothrombin complex concentrate (human), kcentra, per i.u. of factor ix activityterminated
- C9133Factor ix (antihemophilic factor, recombinant), rixubis, per i.u.terminated
- C9134Factor xiii (antihemophilic factor, recombinant), tretten, per 10 i.u.terminated
- C9135Factor ix (antihemophilic factor, recombinant), alprolix, per i.u.terminated
- C9136Injection, factor viii, fc fusion protein, (recombinant), per i.u.terminated
Questions about C9101
What is HCPCS code C9101?
C9101 is a HCPCS Level II code for injection, oliceridine, 0.1 mg. It sits in the Outpatient Prospective Payment System section.
Does Medicare cover C9101?
The CMS HCPCS file marks C9101 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.