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HCPCS
C7565

HCPCS Code C7565

Official Description

Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (i.e., open, laparoscopic, robotic), recurrent, including implantation of mesh or other prosthesis when performed, total length of defect(s) less than 3 cm, reducible with removal of total or near total non-infected mesh or other prosthesis at the time of initial or recurrent anterior abdominal hernia repair or parastomal hernia repair
Short Descr Rpr aa hrn < 3 rdc w/ rmvl
Coverage Special coverage instructions apply
Pricing Indicator(s) 99 – Value not established
MPI 9 – Not applicable, as HCPCS not priced separately by part B (pricing indicator is 00) or value is not established (pricing indicator is '99')
Statute 1833(t)
BETOS P1G – Major procedure - Other
TOS Code(s) 2 – Surgery
Added Date 1/1/2025
Action Code A – Add procedure or modifier code (effective 1/1/2025)
APC Status Indicator Non-Covered Service, not paid under OPPS
ASC Payment Indicator Non office-based surgical procedure added in CY 2008 or later; payment based on OPPS relative payment weight.
MUE Not applicable/unspecified.
MUE Not applicable/unspecified.
OTS Orthotic No
Date
Action
Notes
2026-01-01 Added First appearance of addition in codebook.
2025-01-01 Added Code added.
2025-01-01 Note Clerical change.
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