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See a sample rate comparisonHCPCS C9726 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
Placement and removal (if performed) of applicator into breast for intraoperative radiation therapy, add-on to primary breast procedure
| Key Fact | Detail |
|---|---|
| Service Type | Outpatient PPS Other Therapeutic Services and Supplies |
| Complexity Level | Moderate |
National average reimbursement for HCPCS C9726 by major payers:
$313.00
$54.00
$1,252.53
$691.16
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HCPCS C9726
5 of 25 sample ratesHigher to lower in this preview
Piedmont Newnan Hospital, Inc.
Piedmont Newnan Hospital Inc
$2,123.00Published rateClhg-Leesville, Byrd Regional Hospital
$764.00Published rateLafayette Surgery Center Limited Partnership
$522.00Published rateAmerican Legion Hospital
Acadia General Hospital Inc
$204.00Published rateSurgery Center Of West Monroe, LLC
$70.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS C9726 vs. Other Other Therapeutic Services and Supplies Codes
The HCPCS C9726 code is part of the Outpatient PPS services used for Other Therapeutic Services and Supplies. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The HCPCS C9726 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| C9725-HCPCS | Low | Placement of endorectal intracavitary applicator for high intensity brachytherapy |
| C9726-HCPCS | Moderate | Placement and removal (if performed) of applicator into breast for intraoperative radiation therapy, add-on to primary breast procedure |
| C9727-HCPCS | Moderate | Insertion of implants into the soft palate; minimum of three implants |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS C9726. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the C9726 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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