C9726
What C9726 is
Placement and removal (if performed) of applicator into breast for intraoperative radiation therapy, add-on to primary breast procedure
HCPCS Level II long description, CMS October 2026 file. See the C codes page for the full section.
Medically Unlikely Edit (MUE)
Medicare caps C9726 at 2 units per date of service for practitioner claims (MAI 3 - date of service edit (clinical): units above the MUE may pay with documentation on appeal), rationale: Clinical: CMS Workgroup. Units above the cap are denied unless the edit's adjudication rules allow an appeal with documentation.
Billed with C9726? These codes are bundled into it
C9726 is a Column 1 code in 17 active NCCI PTP edits. When one of these Column 2 codes is reported on the same date of service, it is denied as bundled - unless the edit's modifier indicator is 1 and documentation supports a distinct service with an NCCI-associated modifier.
| Column 2 code | Short description | Modifier indicator | |
|---|---|---|---|
11000 | Dbrdmt ecz/infected skin<10% | 1 - modifier may bypass | Check pair |
11001 | Dbrdmt ecz/infct skn ea addl | 1 - modifier may bypass | Check pair |
11004 | Dbrdmt skin xtrnl gent&per | 1 - modifier may bypass | Check pair |
11005 | Dbrdmt skin abdominal wall | 1 - modifier may bypass | Check pair |
11006 | Dbrdmt skin xtrnl gent per | 1 - modifier may bypass | Check pair |
11042 | Dbrdmt subq tis 1st 20sqcm/< | 1 - modifier may bypass | Check pair |
11043 | Dbrdmt musc&/fsca 1st 20/< | 1 - modifier may bypass | Check pair |
11044 | Dbrdmt bone 1st 20 sq cm/< | 1 - modifier may bypass | Check pair |
11045 | Dbrdmt subq tiss each addl | 1 - modifier may bypass | Check pair |
11046 | Dbrdmt musc&/fsca ea addl | 1 - modifier may bypass | Check pair |
11047 | Dbrdmt bone each addl | 1 - modifier may bypass | Check pair |
36591 | Draw blood off venous device | 0 - no modifier bypass | Check pair |
36592 | Collect blood from picc | 0 - no modifier bypass | Check pair |
96523 | Irrig drug delivery device | 0 - no modifier bypass | Check pair |
97597 | Dbrdmt opn wnd 1st 20 cm/< | 1 - modifier may bypass | Check pair |
97598 | Dbrdmt opn wnd addl 20cm/< | 1 - modifier may bypass | Check pair |
97602 | Wound(s) care non-selective | 1 - modifier may bypass | Check pair |
Data: CMS CY2026 Physician Fee Schedule RVU file (October release, RVU26D) and Medicare NCCI PTP practitioner edits v32.3 (2026 Q4). Verify against the official files before billing or contracting decisions.