HCPCS Code C1875: Stent, coated/covered, without delivery system

Key takeaways

HCPCS Code C1875 describes a coated or covered stent supplied without its delivery system, reported by hospital outpatient departments and ambulatory surgical centers.

C1875 carries status indicator N in the CMS OPPS Addendum B, which packages the device cost into the APC payment for the primary procedure.

There is no separate APC, relative weight, or 2026 payment rate for C1875, and no stent-specific exception to the packaging rule.

You still report C1875 with the primary procedure code. The charge keeps the claim complete and feeds the data CMS uses to set future rates.

The only difference between C1874 and C1875 is the delivery system. Use C1874 for a stent supplied as a kit and C1875 for the device alone.

Practice management software like Pabau keeps device codes, procedure codes, and implant records together, so claims leave complete the first time.

HCPCS Code C1875 covers a coated or covered stent supplied without its delivery system. Hospital outpatient departments and ambulatory surgical centers report it. Under the Medicare Outpatient Prospective Payment System (OPPS), the code pays nothing on its own. The device cost is packaged into the payment for the procedure that placed the stent.

This guide covers what the code describes, how it differs from C1874, and where it is valid. It also explains why no separate 2026 rate exists for C1875. You will find the device credit rules that do change payment, plus the documentation an auditor will ask to see.

HCPCS Code C1875: Official description and code details

HCPCS Code C1875 is the correct code when a coated or covered stent is supplied without its delivery system. The Centers for Medicare and Medicaid Services (CMS) lists it in HCPCS Level II with this long description: Stent, coated/covered, without delivery system. The short descriptor used in claims processing is: Stent, coat/cover w/o deliv sys.

The code sits in the Temporary Hospital Outpatient PPS category, usually called C codes. That category exists to capture device use in hospital outpatient and ambulatory surgical center (ASC) settings. C1875 was first reportable on August 1, 2000 and retired at the end of 2002. CMS reactivated it effective January 1, 2004 as a reporting-only device code.

Coated and covered stents and their delivery systems

A coated or covered stent is a stent whose metal frame carries a surface coating or a graft covering, rather than being left bare. Covered stents use a fabric or polymer sleeve over the frame. Coated stents carry a surface treatment applied to the metal. Both point to C1874 or C1875 rather than to the bare-metal codes.

The delivery system is the hardware that gets the stent to the lesion. That usually means a catheter, a balloon, a guidewire, or a sheath. When the manufacturer ships the stent pre-mounted on that hardware, the supply is a kit. When the stent arrives on its own, the supply is a device only, and C1875 describes it.

Supply decides the code here, not clinical technique. Two identical procedures can take different C codes because of how the stent was packaged on arrival. That is why the purchase record matters as much as the operative note.

C1874 vs C1875: With and without a delivery system

The most common stent coding error is using C1875 where C1874 applies, or the reverse. The two codes share a device description and differ on one variable. C1874 describes the stent with a delivery system, and C1875 describes it without. Our guide to C1874 covers the kit version in the same detail.

In practice the difference matters because the delivery system carries its own cost. If your facility receives the stent and the deployment hardware as one packaged unit, C1874 is correct. If the stent arrives separately from any deployment hardware, C1875 applies.

Key documentation check: your operative or procedure note should state whether the stent was supplied as a kit or as a device only. Without that language, an auditor has no basis to confirm which code applies.

Care settings where C1875 is valid

C codes, including HCPCS Code C1875, are setting-specific. They support the hospital outpatient prospective payment system, and they are valid in exactly two environments.

• Hospital outpatient department (HOPD): the primary setting for C1875. Report the C code on the UB-04 claim alongside the CPT procedure code whenever a coated or covered stent is used.
• Ambulatory surgical center (ASC): Medicare-certified ASCs also report C codes. The reporting rules mirror HOPD requirements, with payment governed by the ASC payment system rather than OPPS directly.
• Physician office (professional claims): C1875 is not valid here. C codes do not belong on CMS-1500 professional claim forms, and submitting one will produce a denial.

The code goes on the claim in addition to the procedure code used to place the stent, never instead of it. Solid HIPAA-compliant documentation habits also make the setting easy to evidence if a post-payment audit lands.

How Medicare pays for C1875 under OPPS

Medicare makes no separate payment for C1875. In the CY2026 OPPS Addendum B, CMS lists C1875 with status indicator N and leaves the APC, relative weight, and payment rate columns blank.

Status indicator N means the item is packaged, so the device cost is already built into the APC payment for the primary procedure. Sibling codes C1874, C1876, and C1877 are treated the same way.

The packaging is deliberate. CMS reactivated the stent C codes on January 1, 2004 so that hospitals would report device use and charges. Those charges give the agency cost data for future OPPS ratesetting. The codes were never restored as separately payable line items, and no stent-specific exception applies.

Reporting C1875 still matters. OPPS hospitals are expected to report the device HCPCS code and its charge. That applies whenever a procedure requires a device and a code exists for it. The charge supports claim completeness, survives audit review, and feeds the cost data behind next year’s rates.

Why there is no separate 2026 fee schedule amount for C1875

Searches for a 2026 fee schedule figure for C1875 come back empty because no such figure is published. A packaged code has no relative weight, so there is nothing for the OPPS conversion factor or the wage index to act on. The dollars attached to the encounter sit entirely in the APC for the stent placement procedure.

Other HCPCS Level II codes do carry published amounts. A supply code like A4426 is priced on the DMEPOS fee schedule. C codes appear on no fee schedule at all, because OPPS pays through the APC.

That also rules out a common shortcut. The Physician Fee Schedule lookup does not price OPPS device codes, so it is the wrong tool here. Third-party sites showing a dollar amount for C1875 are estimating, not quoting CMS.

C1875 in the ASC setting

ASCs report C1875 the same way hospitals do, on the claim with the covered surgical procedure. Device items of this kind appear in ASC Addendum BB as packaged services, so no separate payment is made.

The rule does not change by specialty. A vascular suite and a plastic surgery center file the device the same way. Check the payment indicator for C1875 in the CY2026 Addendum BB before you file. The ASC list is republished each year.

Is C1875 a pass-through code?

No. Device pass-through categories carry status indicator H and receive a separate, time-limited payment on top of the procedure APC. C1875 carries status indicator N, so it is packaged instead. Any source describing C1875 as a pass-through device is describing a different category of C code.

Device credit reporting: Where a C1875 claim changes payment

Because the device is packaged, the one situation that moves money on a C1875 claim is a manufacturer credit. A hospital may receive the device at no cost, or receive a credit worth 50 percent or more of its cost. Medicare expects that credit to be reported, and reduces payment accordingly.

The reporting method changed on January 1, 2014. Modifiers FB and FC were discontinued for outpatient claims on that date. Hospitals now report the credit amount under value code FD, described as credit received from the manufacturer for a replaced medical device.

• Value code FD: carries the dollar amount of the credit the hospital received. CMS deducts that amount from the OPPS payment, capped at the device offset built into the APC.
• Condition code 49: product replacement within the product lifecycle. Use it when a device is replaced early because it was not functioning properly.
• Condition code 50: product replacement for a known recall. Use it when the manufacturer or the FDA has identified the product for recall.
• The 50 percent threshold: reporting is triggered when the credit is 50 percent or more of the device cost. Smaller credits do not carry the same requirement.

Unreported device credits are what auditors recover on. The HHS Office of Inspector General has audited hospitals over unreported cardiac device credits, and the overpayments identified were substantial. A packaged code still carries financial risk when the credit rules are missed.

CPT procedure codes reported with C1875

C1875 never travels alone. It goes on the claim with the CPT code for the procedure that placed the stent. That procedure code is what carries the APC payment. The families below are the ones most often paired with a coated or covered stent. Confirm the current descriptor before reporting any of them.

The lower extremity family has its own rules about vascular territories and combined services. Check the CPT guidelines for that range rather than treating those codes as interchangeable with 37236 and 37238.

C1875 billing guidelines and documentation requirements

Accurate billing for HCPCS Code C1875 starts with code selection and ends with records that hold up under audit. The same Medicare billing discipline applies across HCPCS device codes. The record must confirm what was used, when, and in which setting. For C1875, four areas need to be covered.

• Device identification: the operative or procedure note should name the specific stent used. Record the manufacturer, model, and lot or serial number, and confirm the device was coated or covered.
• Delivery system status: state explicitly whether the stent was supplied with or without its delivery system. This is the field that decides C1874 against C1875. An implant log that skips it leaves the coder guessing.
• Procedure setting confirmation: the claim header and supporting records should show the encounter took place in a hospital outpatient department or a certified ASC.
• Companion CPT procedure code: the claim must carry the CPT code for the stent placement. C1875 is a device code, not a procedure code, and it cannot stand on a claim by itself.

Common billing errors and how to avoid them

Four errors show up repeatedly in audits involving stent C codes.

• C1874 and C1875 confusion: both errors trace back to documentation that never records whether the delivery system was included. Fix it by making the delivery system a required field on the implant log before coding starts.
• Expecting separate payment: some teams budget for device revenue that never arrives, because C1875 is packaged. Model the encounter on the procedure APC, and treat the device charge as cost reporting rather than income.
• Omitting the device code: leaving C1875 off the claim costs you no payment. It does leave the claim incomplete, and it weakens the charge data CMS uses to set future rates. Report it every time the device is used.
• Reporting C1875 in the wrong setting: C codes are invalid on CMS-1500 professional claims, so a physician office submission will deny. Using digital intake forms that capture setting and device details at the point of care reduces that risk.

Related HCPCS codes for stents and cardiovascular devices

HCPCS Code C1875 sits in the C18xx series alongside three closely related stent codes. Each captures a different device configuration, and all four are packaged under OPPS. Picking the wrong one carries the same audit risk as reporting C1875 incorrectly.

Verify the current descriptors against the active code set before reporting, since CMS updates HCPCS quarterly and annually. The CMS HCPCS quarterly update page lists each change as it takes effect.

Sibling device codes are covered in the same depth. C1881 walks through an implantable dialysis access system reported under the same OPPS packaging rule.

How Pabau supports HCPCS device code billing

For hospital outpatient and ASC billing teams, C1875 is a coordination job. The device code has to travel with its companion procedure code on the same claim. Errors enter in the space between the implant log, the procedure note, and the claim form.

Any practice that places implants runs the same risk, from a vascular service to a sports medicine center. Pabau is practice management software that keeps clinical records, procedure documentation, and claims data in one connected system.

Coders can read the procedure note next to the claim fields without moving between platforms. That heads off the three most common C code errors. A missing delivery system flag shows up before the claim leaves. So does an absent companion CPT code or an unconfirmed setting.

• Connected notes and claims: procedure documentation and device details sit on the same record. The coder sees exactly what the clinician wrote at the time.
• Workflow automation: automated billing workflows can flag a claim that carries a device code with no companion procedure code, before it is submitted.
• Audit-ready records: device name, lot number, delivery system status, and care setting are captured as structured fields. Inventory tracking holds the stock side, so nothing important stays buried in free text.

Pabau’s claims management software then submits and tracks the claim from the same record, so nothing is rekeyed on the way out. For a wider view of billing alongside scheduling and records, see practice management software features.

Keep device codes and procedure codes on the same claim

Pabau connects clinical notes, implant details, and claims in one system. Outpatient billing teams can catch an incomplete device claim before submission, rather than after a denial.

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Conclusion

C1875 offers nothing to optimize. No payment is available, and no modifier unlocks one. What you control is whether the claim is complete and whether the record backs it up.

Put the effort where it changes the outcome. Make the delivery system a required field on the implant log. Then make the manufacturer credit a required check before the claim goes out. Those two habits close almost every stent C code finding an auditor raises.

Get those right and the packaged code stops being a risk. It goes back to doing its job, which is feeding the charge data behind next year’s rates.

Pabau connects the clinical record to the claim, so the fields that decide correct HCPCS selection are visible before submission. Book a demo to see how it works for outpatient billing teams.

Continue your research

Coding the kit version of the same stent? HCPCS Code C1874 covers the coated or covered stent supplied with its delivery system, and the reporting rules that go with it.

Reporting other implantable device C codes? HCPCS Code C1881 walks through an implantable dialysis access system in the same ASC and outpatient context.

Working with bare-metal stents as well? HCPCS Code C1876 covers the non-coated stent supplied as a kit, and how its packaging plays out on a claim.

Building audit-ready documentation habits? HIPAA compliance software covers the record-keeping and security controls that sit underneath a clean device claim.

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