Don’t Report HCPCS “C” Codes for Professional Services in 2026
Don’t Report HCPCS “C” Codes for Professional Services
As new services and technologies are introduced, the Centers for Medicare & Medicaid Services (CMS) uses HCPCS Level II “C” codes to allow hospitals to report and receive reimbursement for Medicare outpatient procedures in a timely manner. While these codes play an important role in facility billing, they are not appropriate for professional coding or reimbursement.
For 2026, CMS has released several HCPCS Level II “C” codes that apply specifically to surgical procedures performed on Medicare hospital outpatients. Understanding how, and when, to use these codes is essential to maintaining coding accuracy and compliance.
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What Are HCPCS “C” Codes?
HCPCS Level II “C” codes are temporary codes created by CMS to describe new or emerging services, procedures, or technologies. Their purpose is to support facility-level reporting and payment under the Hospital Outpatient Prospective Payment System (OPPS).
Key distinction:
These codes do not replace CPT codes for professional billing and should never be reported on the professional claim.
2026 HCPCS “C” Codes for Hospital Outpatients
The following HCPCS “C” codes apply to Medicare hospital outpatient procedures in 2026:
These codes are intended strictly for facility reporting.
How to Code Professional Services Correctly
When a Medicare hospital outpatient undergoes one of these procedures—and the same coder is responsible for both facility and professional coding—the professional service must be reported using the appropriate CPT code(s) instead of the HCPCS “C” code.
Use the crosswalk below to identify the correct professional CPT® codes:
| Facility HCPCS Code | Professional CPT® Code(s) |
|---|---|
| C7566 | 26862, 26863 |
| C7567 | 31627, 31629, 31633 |
| C7568 | 93454–93572 |
| C7569 | 92920–92979 |
| C7570 | 92920–92979, 0523T |
| C7571 | 92920–92979 |
Why This Matters
Reporting HCPCS “C” codes on professional claims can result in:
Clear separation between facility coding and professional coding is critical especially as new technologies and procedures continue to emerge.
Bottom Line
HCPCS Level II “C” codes are a facility-only reporting tool designed to support hospital outpatient reimbursement. For professional services, coders must always select the appropriate CPT® code(s) based on the procedure performed.
Staying current with CMS guidance and understanding the intent of “C” codes helps ensure accurate claims, cleaner audits, and faster payment cycles.