C1896 — Lead, cardioverter-defibrillator, other than endocardial single or dual coil (implantable)
C1896 is a HCPCS Level II code for lead, cardioverter-defibrillator, other than endocardial single or dual coil (implantable). 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 C1896 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 3 — Date of Service Edit: Clinical · Clinical: CMS Workgroup
- outpatient
- 2 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 C1896
- Long descriptor
- Lead, cardioverter-defibrillator, other than endocardial single or dual coil (implantable)
- Short descriptor
- Lead, aicd, non sing/dual
- Added
- April 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 C1896
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If C1896 is not quite right, the correct code is very often within a few positions of it.
- C1888Catheter, ablation, non-cardiac, endovascular (implantable)
- C1889Implantable/insertable device, not otherwise classified
- C1890No implantable/insertable device used with device-intensive procedures
- C1891Infusion pump, non-programmable, permanent (implantable)
- C1892Introducer/sheath, guiding, intracardiac electrophysiological, fixed-curve, peel-away
- C1893Introducer/sheath, guiding, intracardiac electrophysiological, fixed-curve, other than peel-away
- C1894Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser
- C1895Lead, cardioverter-defibrillator, endocardial dual coil (implantable)
- C1897Lead, neurostimulator test kit (implantable)
- C1898Lead, pacemaker, other than transvenous vdd single pass
- C1899Lead, pacemaker/cardioverter-defibrillator combination (implantable)
- C1900Lead, left ventricular coronary venous system
- C1982Catheter, pressure-generating, (e.g., one-way valve, intermittently occlusive)
- C2596Probe, image-guided, robotic, waterjet ablation
- C2613Lung biopsy plug with delivery system
- C2614Probe, percutaneous lumbar discectomy
Questions about C1896
What is HCPCS code C1896?
C1896 is a HCPCS Level II code for lead, cardioverter-defibrillator, other than endocardial single or dual coil (implantable). It sits in the Outpatient Prospective Payment System section.
Does Medicare cover C1896?
The CMS HCPCS file marks C1896 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.