C9818 — Suzetrigine, oral, 1 mg
C9818 is a HCPCS Level II code for suzetrigine, oral, 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.
The CMS record for C9818
- Long descriptor
- Suzetrigine, oral, 1 mg
- Short descriptor
- Suzetrigine, orl, 1mg
- Added
- January 23, 2026
- 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 C9818
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If C9818 is not quite right, the correct code is very often within a few positions of it.
- C9810Water circulating motorized cold therapy device (e.g., iceman) including all system components (e.g. pads, console, disposable parts), non-opioid medical device (must be a qualifying medicare non-opioid medical device for post-surgical pain relief in accordance with section 4135 of the caa, 2023)
- C9811Electronic ambulatory infusion pump (e.g. sapphire pump), including all pump components, including disposable components , non-opioid medical device (must be a qualifying medicare non-opioid medical device for post-surgical pain relief in accordance with section 4135 of the caa, 2023)
- C9812Echogenic nerve block needles (e.g. sonoplex, sonoblock, sonotap), non-opioid medical device (must be a qualifying medicare non-opioid medical device for post-surgical pain relief in accordance with section 4135 of the caa, 2023)
- C9813Perforated continuous infusion catheter set (e.g. infiltralong), including all components, non-opioid medical device (must be a qualifying medicare non-opioid medical device for post-surgical pain relief in accordance with section 4135 of the caa, 2023)
- C9814Continuous anesthesia echogenic conduction catheter set (e.g. sonolong, e-cath), including all components, non-opioid medical device (must be a qualifying medicare non-opioid medical device for post-surgical pain relief in accordance with section 4135 of the caa, 2023)
- C9815Linear peristaltic pain management infusion pump (e.g. cadd-solis ambulatory infusion pump), and all disposable system components, non-opioid medical device (must be a qualifying medicare non-opioid medical device for post-surgical pain relief in accordance with section 4135 of the caa, 2023)
- C9816Rotary peristaltic infusion pump (e.g., reusable ambit pump) including all disposable system components, reusable non-opioid medical device (must be a qualifying medicare non-opioid medical device for post-surgical pain relief in accordance with section 4135 of the caa, 2023)
- C9817Electronic cryo-pneumatic compression, pain management system (e.g. game ready grpro 2.1 system), including control unit, anatomically correct wrap(s), and other system component(s), non-opioid medical device (must be a qualifying medicare non-opioid medical device for post-surgical pain relief in accordance with section 4135 of the caa, 2023)
- C9898Radiolabeled product provided during a hospital inpatient stay
- C9899Implanted prosthetic device, payable only for inpatients who do not have inpatient coverage
- C9901Endoscopic defect closure within the entire gastrointestinal tract, including upper endoscopy (including diagnostic, if performed) or colonoscopy (including diagnostic, if performed), with all system and tissue anchoring components
- E0100Cane, includes canes of all materials, adjustable or fixed, with tip
- E0105Cane, quad or three prong, includes canes of all materials, adjustable or fixed, with tips
- E0110Crutches, forearm, includes crutches of various materials, adjustable or fixed, pair, complete with tips and handgrips
- E0111Crutch forearm, includes crutches of various materials, adjustable or fixed, each, with tip and handgrips
- E0112Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips
Questions about C9818
What is HCPCS code C9818?
C9818 is a HCPCS Level II code for suzetrigine, oral, 1 mg. It sits in the Outpatient Prospective Payment System section.
Does Medicare cover C9818?
The CMS HCPCS file marks C9818 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.