C9726: Placement and removal (if performed) of applicator into breast for intraoperative radiation therapy, add-on to primary breast procedure
C9726 is a HCPCS Level II code for placement and removal (if performed) of applicator into breast for intraoperative radiation therapy, add-on to primary breast procedure. 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 C9726 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 · Clinical: CMS Workgroup
- outpatient
- 2 units MAI 3: Date of Service Edit: Clinical · Anatomic Consideration
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 C9726
- Long descriptor
- Placement and removal (if performed) of applicator into breast for intraoperative radiation therapy, add-on to primary breast procedure
- Short descriptor
- Rxt breast appl place/remov
- Added
- January 1, 2006
- BETOS
- P7A
- 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 C9726
HCPCS has no hierarchy: related items simply sit next to each other in the numbering. If C9726 is not quite right, the correct code is very often within a few positions of it.
- C9604Percutaneous transluminal revascularization of or through coronary artery bypass graft (internal mammary, free arterial, venous), any combination of drug-eluting intracoronary stent, atherectomy and angioplasty, including distal protection when performed; single vessel
- C9605Percutaneous transluminal revascularization of or through coronary artery bypass graft (internal mammary, free arterial, venous), any combination of drug-eluting intracoronary stent, atherectomy and angioplasty, including distal protection when performed; each additional branch subtended by the bypass graft (list separately in addition to code for primary procedure)
- C9606Percutaneous transluminal revascularization of acute total/subtotal occlusion during acute myocardial infarction, coronary artery or coronary artery bypass graft, any combination of drug-eluting intracoronary stent, atherectomy and angioplasty, including aspiration thrombectomy when performed, single vessel
- C9607Percutaneous transluminal revascularization of chronic total occlusion, coronary artery, coronary artery branch, or coronary artery bypass graft, any combination of drug-eluting intracoronary stent, atherectomy and angioplasty; single vessel
- C9608Percutaneous transluminal revascularization of chronic total occlusion, coronary artery, coronary artery branch, or coronary artery bypass graft, any combination of drug-eluting intracoronary stent, atherectomy and angioplasty; each additional coronary artery, coronary artery branch, or bypass graft (list separately in addition to code for primary procedure)
- C9610Catheter, transluminal drug delivery with or without angioplasty, coronary, non-laser (insertable)
- C9724Endoscopic full-thickness plication of the stomach using endoscopic plication system (eps); includes endoscopyterminated
- C9725Placement of endorectal intracavitary applicator for high intensity brachytherapy
- C9727Insertion of implants into the soft palate; minimum of three implants
- C9728Placement of interstitial device(s) for radiation therapy/surgery guidance (e.g., fiducial markers, dosimeter), for other than the following sites (any approach): abdomen, pelvis, prostate, retroperitoneum, thorax, single or multiple
- C9733Non-ophthalmic fluorescent vascular angiography
- C9734Focused ultrasound ablation/therapeutic intervention, other than uterine leiomyomata, with magnetic resonance (mr) guidance
- C9735Anoscopy; with directed submucosal injection(s), any substanceterminated
- C9737Laparoscopy, surgical, esophageal sphincter augmentation with device (e.g., magnetic band)terminated
- C9738Adjunctive blue light cystoscopy with fluorescent imaging agent (list separately in addition to code for primary procedure)
- C9739Cystourethroscopy, with insertion of transprostatic implant; 1 to 3 implants