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 2026Q4-Oct. 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 2026Q4.
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