C1765 — Adhesion barrier
C1765 is a HCPCS Level II code for adhesion barrier. It belongs to the Outpatient Prospective Payment System section. Whether Medicare pays it depends on the coverage rule below.
Medicare coverage: Special coverage instructions apply
There are published conditions attached to this code. Check the applicable coverage policy before billing it: the code being valid is not the same as the service being covered.
From the coverage field of the CMS Alpha-Numeric HCPCS File, release 2026Q3-Jul. This states Medicare’s position on the code, not on your particular claim.
Medically Unlikely Edits — units per day
The most units of C1765 Medicare will pay on one date of service. Bill more on a single line and it is denied. The limit is not the same in every setting, so the row that matters is the one matching the claim you are building.
- practitioner
- 4 units MAI 3 — Date of Service Edit: Clinical · Clinical: CMS Workgroup
- outpatient
- 4 units MAI 3 — Date of Service Edit: Clinical · Clinical: Data
The adjudication indicator decides whether exceeding the limit is worth appealing at all: MAI 1 is a line edit you can support with documentation, MAI 3 is a date-of-service edit that is also appealable, and MAI 2 is absolute — no documentation overrides it. CMS MUE 2026Q3.
The CMS record for C1765
- Long descriptor
- Adhesion barrier
- Short descriptor
- Adhesion barrier
- Added
- July 1, 2001
- BETOS
- D1A
- Pricing indicator
- 53 — Other
The official wording. This is what the code means.
CMS's 28-character form, which is what shows up on a remittance advice.
When CMS introduced the code.
Berenson-Eggers Type of Service — CMS's own analytic grouping.
Statute.
Codes adjacent to C1765
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If C1765 is not quite right, the correct code is very often within a few positions of it.
- C1757Catheter, thrombectomy/embolectomy
- C1758Catheter, ureteral
- C1759Catheter, intracardiac echocardiography
- C1760Closure device, vascular (implantable/insertable)
- C1761Catheter, transluminal intravascular lithotripsy, coronary
- C1762Connective tissue, human (includes fascia lata)
- C1763Connective tissue, non-human (includes synthetic)
- C1764Event recorder, cardiac (implantable)
- C1766Introducer/sheath, guiding, intracardiac electrophysiological, steerable, other than peel-away
- C1767Generator, neurostimulator (implantable), non-rechargeable
- C1768Graft, vascular
- C1769Guide wire
- C1770Imaging coil, magnetic resonance (insertable)
- C1771Repair device, urinary, incontinence, with sling graft
- C1772Infusion pump, programmable (implantable)
- C1773Retrieval device, insertable (used to retrieve fractured medical devices)
Questions about C1765
What is HCPCS code C1765?
C1765 is a HCPCS Level II code for adhesion barrier. It sits in the Outpatient Prospective Payment System section.
Does Medicare cover C1765?
The CMS HCPCS file marks C1765 as "Special coverage instructions apply". There are published conditions attached to this code. Check the applicable coverage policy before billing it: the code being valid is not the same as the service being covered.