HCPCS Code C1713: Anchor/Screw for Opposing Bone-to-Bone or Soft Tissue-to-Bone (Implantable)

Report HCPCS Code C1713 correctly—capture device use, meet Medicare OPPS rules, and ensure compliant outpatient billing.

Use Code

## **What is HCPCS code C1713?** HCPCS code C1713 refers to an implantable anchor or screw used to secure bone-to-bone or soft tissue-to-bone structures during surgical procedures. These devices are most commonly applied in orthopedic and reconstructive surgeries and are categorized by CMS under the hospital outpatient device grouping. C codes are temporary HCPCS Level II codes established by CMS for Medicare reporting (Centers for Medicare & Medicaid Services, 2023). They are assigned to new technology devices, drugs, biologicals, and radiopharmaceuticals that receive transitional pass-through status under the Medicare Hospital Outpatient Prospective Payment System (OPPS). Hospitals must report C1713 whenever these implantable devices are provided in outpatient settings. Although Medicare requires reporting to document device use, payment for C1713 is generally packaged into the overall reimbursement for the related surgical procedure rather than paid separately.

## **Documentation requirements** Accurate and thorough documentation is critical when reporting HCPCS Code C1713, as it establishes both the medical necessity and the appropriate use of implantable anchors or screws in surgical procedures. Records must clearly demonstrate the role of the device in patient care and ensure compliance with Medicare and payer requirements. ### **Physician or operative note** The operative report should specify that an implantable anchor or screw was used, the surgical procedure performed, and how the device contributed to bone-to-bone or soft tissue-to-bone fixation. This ensures the device is tied directly to the patient’s treatment. ### **Device details** The documentation must include the device’s description, such as anchor or screw type, manufacturer, model, and lot or serial number if available. These details are often required for tracking, quality assurance, and audit purposes. ### **Patient and clinical indication** Records should describe the patient’s diagnosis and condition that required implantation of the device (e.g., fracture repair, ligament stabilization, or reconstructive surgery). Linking the device to a clinical indication strengthens the case for medical necessity. ### **Implant verification** The medical record must confirm that the device was implanted in the patient, not merely ordered or supplied. Implant stickers or device packaging labels are often attached to the operative note to verify use.

## **Billing requirements** Billing for HCPCS Code C1713 requires close adherence to Medicare rules under the OPPS. Although this code must be reported to register the use of an implantable anchor or screw, payment is generally packaged into the related surgical service. Providers should still follow CMS reporting instructions and payer-specific guidelines to avoid claim denials and ensure the claim is properly recorded on the billing page. ### **Reporting under OPPS** Hospitals are required to report C1713 whenever an anchor or screw is implanted in an outpatient procedure. C1713 originally carried transitional pass-through status, but that designation has expired (Centers for Medicare & Medicaid Services, 2025). Today, reimbursement is bundled into the global payment for the associated service, even though the code must still be reported for tracking and resource allocation purposes. ### **Units and claim submission** C1713 should be billed based on the number of devices implanted, with documentation in the operative report confirming each unit. Ensuring that the number of units billed matches the operative record helps providers register the correct device usage and supports accurate service reporting. ### **Payer considerations** While Medicare requires reporting, Medicaid and commercial payers may apply different policies. Some payers may deny separate payment because the device cost is considered part of the overall surgical service. Providers should review each payer’s resource materials or coverage page, and appeal when appropriate, especially in cases involving multiple or high-cost implants. ### **Compliance and audit readiness** Hospitals should maintain all supporting documentation, including implant stickers, manufacturer information, and operative notes, in the patient’s record. These resources are critical for compliance, audit readiness, and accurate reporting under CMS device requirements. Proper record retention ensures that providers can demonstrate device use and defend claims if questioned.

## **Other related codes** - **C1714** – Catheter, transluminal atherectomy, directional - **C1715** – Brachytherapy needle - **L8699** – Prosthetic implant, not otherwise specified

### **References** Centers for Medicare & Medicaid Services. (2025). CMS manual system pub 100-04 medicare claims processing. https://www.cms.gov/files/document/r13032cp.pdf Centers for Medicare & Medicaid Services. (2023, September 6). Overview of coding & classification systems. https://www.cms.gov/cms-guide-medical-technology-companies-and-other-interested-parties/coding/overview-coding-classification-systems

Frequently asked questions

Yes. Medicare requires hospitals to report C1713 when applicable, but payment is usually bundled into the surgical procedure under OPPS rather than reimbursed separately.

No. C1713 is intended for use in hospital outpatient settings under OPPS. It should not be reported in physician offices or inpatient claims.

Reporting C1713 allows CMS and payers to register accurate data on device usage, allocate resources appropriately, and track the cost of services provided to patients. Proper reporting also ensures compliance and audit readiness.