C9796

What C9796 is

Repair of enterocutaneous fistula small intestine or colon (excluding anorectal fistula) with plug (e.g., porcine small intestine submucosa [sis])

HCPCS Level II long description, CMS October 2026 file. See the C codes page for the full section.

Medically Unlikely Edit (MUE)

Medicare caps C9796 at 1 unit 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: Code Descriptor / CPT Instruction. Units above the cap are denied unless the edit's adjudication rules allow an appeal with documentation.

Billed with C9796? These codes are bundled into it

C9796 is a Column 1 code in 197 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.

Showing 30 of 197 column 2 codes. Use the pair checker for any specific combination.

C9796 is bundled into these codes

C9796 appears as a Column 2 code in 35 active edits. Reported with one of these Column 1 codes on the same date of service, C9796 is the code that denies.

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.