C9901 — Endoscopic 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
C9901 is a HCPCS Level II code for endoscopic 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. 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 C9901 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
- 1 unit MAI 2 — Date of Service Edit: Policy · Code Descriptor / CPT Instruction
- outpatient
- 1 unit MAI 2 — Date of Service Edit: Policy · Code Descriptor / CPT Instruction
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 C9901
- Long descriptor
- Endoscopic 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
- Short descriptor
- Endo defect closure gi tract
- Added
- July 1, 2024
- BETOS
- P1G
- 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 C9901
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If C9901 is not quite right, the correct code is very often within a few positions of it.
- 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)
- C9818Suzetrigine, oral, 1 mg
- C9898Radiolabeled product provided during a hospital inpatient stay
- C9899Implanted prosthetic device, payable only for inpatients who do not have inpatient coverage
- 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
- E0113Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip
- E0114Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips
- E0116Crutch, underarm, other than wood, adjustable or fixed, with pad, tip, handgrip, with or without shock absorber, each
Questions about C9901
What is HCPCS code C9901?
C9901 is a HCPCS Level II code for endoscopic 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. It sits in the Outpatient Prospective Payment System section.
Does Medicare cover C9901?
The CMS HCPCS file marks C9901 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.