C1839 — Iris prosthesis
C1839 is a HCPCS Level II code for iris prosthesis. 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 C1839 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
- 2 units MAI 2 — Date of Service Edit: Policy · Anatomic Consideration
- outpatient
- 2 units MAI 2 — Date of Service Edit: Policy · Anatomic Consideration
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 C1839
- Long descriptor
- Iris prosthesis
- Short descriptor
- Iris prosthesis
- Added
- January 1, 2020
- 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 C1839
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If C1839 is not quite right, the correct code is very often within a few positions of it.
- C1825Generator, neurostimulator (implantable), non-rechargeable with carotid sinus baroreceptor stimulation lead(s)
- C1826Generator, neurostimulator (implantable), includes closed feedback loop leads and all implantable components, with rechargeable battery and charging system
- C1827Generator, neurostimulator (implantable), non-rechargeable, with implantable stimulation lead and external paired stimulation controller
- C1830Powered bone marrow biopsy needle
- C1831Interbody cage, anterior, lateral or posterior, personalized (implantable)
- C1832Autograft suspension, including cell processing and application, and all system components
- C1833Monitor, cardiac, including intracardiac lead and all system components (implantable)
- C1834Pressure sensor system, includes all components (e.g., introducer, sensor), intramuscular (implantable), excludes mobile (wireless) software applicationterminated
- C1840Lens, intraocular (telescopic)
- C1841Retinal prosthesis, includes all internal and external componentsterminated
- C1842Retinal prosthesis, includes all internal and external components; add-on to c1841terminated
- C1849Skin substitute, synthetic, resorbable, per square centimeterterminated
- C1874Stent, coated/covered, with delivery system
- C1875Stent, coated/covered, without delivery system
- C1876Stent, non-coated/non-covered, with delivery system
- C1877Stent, non-coated/non-covered, without delivery system
Questions about C1839
What is HCPCS code C1839?
C1839 is a HCPCS Level II code for iris prosthesis. It sits in the Outpatient Prospective Payment System section.
Does Medicare cover C1839?
The CMS HCPCS file marks C1839 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.