HCPCS Code C7500: Bone Debridement, 20cm2, with Drug Dev

C7500 is separately reimbursable by Medicare, but only in Ambulatory Surgical Centers (ASCs). It is not paid under the Medicare Outpatient Prospective Payment System (OPPS) and is not packaged into an APC payment. To ensure appropriate payments, it is essential to consult the most recent official CMS fee schedules and payment notices, as they define payment status and will show whether the comment period accurately reflects the final payment policy for a given year.

No. You can't bill HCPCS code C7500 per device or per cm². This code is billed as a single unit per session and includes the first 20 cm² of a bone debridement procedure along with the insertion of one or more subfascial drug-delivery devices. Any additional debridement beyond the initial 20 cm² should be reported using the appropriate CPT code for the additional area and depth, such as CPT code +11047 (for bone debridement). ASC facility code is not unit-based on the number of devices. You must ensure that the medical record documentation supports the billing of both the primary procedure and any add-on codes.

No. HCPCS code C7500 is specifically for Ambulatory Surgical Centers (ASCs), not hospital outpatient departments. A CMS document published on Feb. 9, 2024 correcting technical and typographical errors in the final rule on Medicare payment systems confirms the payment methodologies for these services apply to both hospital outpatient and ASC policies, but C7500 itself is exclusive to ASCs. Therefore, it's not billed in a physician's office, which would use different, related CPT codes. OPPS methodology underlies the ASC rates, but hospitals don’t bill C7500.