HCPCS Code C1713: Anchor/screw for opposing bone-to-bone or soft tissue-to-bone implantable

Key takeaways

HCPCS Code C1713 describes an anchor or screw used for opposing bone-to-bone or soft tissue-to-bone fixation in implantable procedures.

C1713 is a Level II HCPCS supply code billed by ASCs and outpatient hospitals, never by physician offices or inpatient facilities.

Missing a modifier, billing the wrong units, or confusing C1713 with a CPT code are the most common causes of denial.

Practice management software like Pabau embeds HCPCS reference data into the billing workflow, helping practices catch C1713 coding errors early.

HCPCS Code C1713 is a Level II HCPCS supply code for an anchor or screw used in opposing bone-to-bone or soft tissue-to-bone fixation. It describes the implant device, not the surgical technique, and is billed alongside a CPT procedure code in ASC and outpatient hospital settings.

The most common denial driver is billing staff treating C1713 like a CPT code. Watch for wrong units, missing modifiers, or documentation that doesn’t name the device implanted. This guide covers the code definition, clinical uses, billing rules by setting, 2026 Medicare rates, coverage criteria, common errors, and related crosswalk codes.

HCPCS Code C1713: Definition and code details

HCPCS Code C1713 is a Level II HCPCS supply code maintained by the Centers for Medicare and Medicaid Services (CMS). The official description reads: Anchor/screw for opposing bone-to-bone or soft tissue-to-bone implantable. Unlike CPT codes, which describe the procedure performed, C1713 describes the physical device used during that procedure.

Clinical applications: Where C1713 is used

C1713 covers two mechanically distinct fixation scenarios that share one code. Understanding which scenario applies helps coders choose the right device and confirm the procedure documentation supports the claim.

Bone-to-bone fixation involves an anchor or screw used to secure two opposing bone structures. This appears most often in spinal fusion procedures and orthopedic joint reconstruction. Soft tissue-to-bone fixation involves attaching tendon, ligament, or labral tissue to bone, which is the dominant application in sports medicine surgery. The code covers both scenarios, but the operative report must clearly describe which type of fixation was performed and what device was used.

Surgical specialties that commonly bill C1713 include sports medicine and orthopedic and physical therapy practices that perform or coordinate ASC procedures. Common procedure contexts include:

• Rotator cuff repair (tendon-to-bone fixation using soft tissue anchors)
• Shoulder labrum repair (arthroscopic Bankart procedures)
• ACL reconstruction with bony fixation
• Spinal fusion procedures using pedicle screws or interbody fixation devices
• Foot and ankle reconstruction requiring bone-to-bone fixation
• Hip labrum repair

Confirm that the operative report names the anchor or screw device, its manufacturer, and the fixation type. A general reference to “anchor placed” is not sufficient documentation for C1713 to survive audit.

Billing settings: ASC vs outpatient hospital

C1713 is not billable in physician offices or inpatient hospital settings. It is a facility-side supply code used in ASCs and outpatient hospital departments (HOPDs). The payment mechanism, claim form, and revenue code rules all differ between these two settings.

Some commercial and Medicaid payers still require ASCs to submit facility claims on UB-04 instead of CMS-1500. Confirm the required claim form in each payer contract before billing.

ASC coders should verify current CMS payment indicator files each year. This confirms whether C1713 is separately reimbursable or packaged into the procedure’s ASC rate. CMS updates these indicators annually in the OPPS/ASC final rule.

How to bill C1713: Step-by-step guidelines

Billing C1713 correctly requires pairing the supply code with the right procedure code and supporting it with device-specific documentation. These steps apply to both ASC and outpatient hospital claims, following the guidance in standard medical billing workflows.

1. Confirm the device and procedure. Verify with the operative report that an anchor or screw meeting the C1713 description was implanted during a covered bone-to-bone or soft tissue-to-bone fixation procedure.
2. Identify the paired CPT code. C1713 is a supply code billed with the matching CPT code, such as CPT 29827 for rotator cuff repair or CPT 22630 for spinal fusion. The CPT code describes the procedure. C1713 describes the device.
3. Set the correct unit count. Each unit of C1713 represents one anchor or screw. Bill three units if the operative report documents three anchors placed. Do not bill a flat “1” if the operative report documents multiple devices.
4. Match the claim to the setting. Outpatient hospital (HOPD) claims carry revenue code 0278 (“Other implants”) on the UB-04. Medicare ASC facility claims skip the revenue code and use the CMS-1500 instead, identified by place of service 24.
5. Attach supporting documentation. Include the device implant log identifying manufacturer name, model number, and lot number. This documentation is required for implant supply codes and is the most common missing item in C1713 audits.
6. Apply required modifiers and confirm the claim form. Medicare has not required the SG modifier on ASC facility claims since 2008, though many commercial and Medicaid payers still do. Check laterality modifiers (RT/LT) too, and confirm which claim form each payer expects.
7. Verify payer coverage before submission. Medicare and commercial payer rules differ, including which claim form an ASC must use. Run eligibility verification and confirm prior authorization requirements before the procedure date.

A clean claim for C1713 has consistent device documentation, units, and a paired CPT code that match the operative report before it leaves the facility.

2026 Medicare reimbursement and fee schedule for C1713

Medicare reimbursement for C1713 varies by setting and geographic locality. Rates are set annually by CMS through the OPPS/ASC final rule. Always verify current-year rates directly from CMS rather than third-party aggregator tools, as rates change each January 1. Use the CMS fee schedule search tool to confirm 2026 rates for your locality.

For revenue cycle teams managing high-volume orthopedic or spinal ASC billing, tracking C1713 reimbursement trends is part of broader revenue cycle management. It helps identify when payer contracts under-reimburse for implant costs relative to facility acquisition price.

Medicare coverage rules for C1713

Medicare covers C1713 when the device is medically necessary for a covered surgical procedure performed in an eligible setting. Coverage is not automatic. The claim must satisfy several criteria, and medical billing compliance requires documenting each one in the patient record before the claim is submitted.

• Medical necessity: The anchor or screw must be medically necessary for the procedure. Support this with documented diagnosis codes, imaging findings, and conservative treatment failure where applicable.
• Covered setting: The procedure must be performed in a Medicare-approved ASC or outpatient hospital department, not an inpatient facility or physician office.
• Covered procedure pairing: The surgical CPT code billed alongside C1713 must be a covered Medicare procedure. If the procedure itself is excluded, the device code will also deny.
• Device documentation: The implant log must be present in the patient record. Medicare auditors routinely request device logs during post-payment reviews of implant supply codes.
• LCD/NCD compliance: Check whether a Local Coverage Determination (LCD) or National Coverage Determination (NCD) applies to the specific procedure being coded. LCDs set procedure-specific coverage criteria that vary by Medicare Administrative Contractor (MAC) region.

When in doubt about Medicare coverage for a C1713 application, consult the CMS LCD database at CMS.gov. Contacting your MAC directly before the procedure also works.

Common billing errors with C1713 and how to avoid them

C1713 denial patterns are predictable. Most errors fall into one of five categories, and each one has a straightforward prevention measure. Understanding these through proper denial management strategies reduces write-offs on high-cost implant claims.

• Confusing C1713 with a CPT code. C1713 is a HCPCS supply code, not a CPT procedure code. Billing it as a standalone claim without a paired CPT procedure code will deny. The CPT code describes what the surgeon did. C1713 describes the device used.
• Incorrect unit count. Each anchor or screw is one unit. Billing “1 unit” when three anchors were placed leaves revenue on the table. Billing more units than documented in the operative report triggers fraud flags. Match units to the implant log exactly.
• Missing or incomplete device documentation. A chargemaster line item for “anchor” is not sufficient documentation. The claim must be supported by a device implant log that includes the manufacturer name, model, and lot number.
• Wrong claim form or NPI. C1713 belongs on the facility’s own claim, not the surgeon’s professional claim. Medicare ASC claims use CMS-1500 with place of service 24. HOPD claims use UB-04 with revenue code 0278. Some commercial and Medicaid payers still require ASCs to bill on UB-04, so confirm the correct form with each payer before submitting.
• Assuming separate payment when device is packaged. CMS bundles certain supply codes into the procedure’s composite rate under OPPS. If the CMS payment indicator for C1713 shows it is packaged for a given procedure, billing it separately will result in a denial. Check the OPPS Addendum B annually.

Related HCPCS codes and crosswalk

Several other Level II HCPCS codes cover related implant devices. Choosing the wrong code when C1713 applies (or vice versa) is a common coding error in orthopedic and spinal billing. Use the AAPC HCPCS lookup tool or the PGM Billing HCPCS search to verify current descriptions before selecting a code.

How Pabau simplifies C1713 billing

Standalone HCPCS lookup tools like HcpcsData.com and PayerPrice show the code description and a fee-schedule estimate. They don’t connect to the billing workflow. Coders manually retype code details into a separate system, and that’s where transcription errors creep into high-cost implant claims like C1713.

Practice management software like Pabau embeds claim scrubbing directly into the billing workflow, catching C1713 errors before submission. It flags mismatched units, missing modifiers, and missing device documentation at the point of entry, before a denial arrives.

For high-volume implant billing, automated billing workflows cut the manual work of checking device documentation on every case. The platform’s superbill documentation captures the device detail C1713 claims need. Reporting surfaces denial patterns by code, so billing teams catch recurring errors before they compound.

For practices with multiple locations, a consistent HCPCS billing workflow reduces revenue leakage from coding variation between sites. The billing software comparison for ASC practices covers what to prioritize when evaluating platforms.

Reduce C1713 billing errors before they become denials

Pabau’s claims management software embeds HCPCS code reference and claim scrubbing directly into your billing workflow. Catch missing modifiers, incorrect units, and missing documentation at the point of entry, not after the denial arrives.

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Conclusion

C1713 denials are rarely mysterious. The repeat offenders are wrong units, missing device logs, a wrong claim form, and a packaged procedure rate the biller didn’t check. Practices that recover the most on implant supply billing standardize their documentation checklist for C1713 before the claim is built. They don’t wait for the denial to arrive.

Pabau’s integrated claims management tools help orthopedic and spinal ASC billing teams catch these errors at the point of entry. To see how claim scrubbing and HCPCS workflow automation work inside the platform, book a demo with the Pabau team.

Continue your research

Need a framework for reducing claim denials across your practice? Denial management in healthcare covers the structured approaches billing teams use to track, appeal, and prevent recurring denials.

Want to understand how ASC billing fits into the broader billing picture? What is revenue cycle management explains how supply code billing connects to overall practice financial performance.

Looking for guidance on medical billing compliance requirements? Medical billing compliance outlines the documentation and regulatory requirements that apply to implant supply code claims.

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