Centers for Medicare & Medicaid Services (CMS) have acknowledged stakeholder questions regarding the appropriate coding for hypoglossal nerve neurostimulator procedures used to treat obstructive sleep apnea. Specifically, CMS recognized that existing Current Procedural Terminology (CPT) codes do not fully describe certain newer systems.

To address these concerns, CMS will implement six new HCPCS Level II C codes, effective Jan. 1, 2026, with inclusion in the April Integrated Outpatient Code Editor update. These codes are intended for use in the hospital outpatient setting and provide more precise reporting options for implantation, revision, replacement, and removal of hypoglossal nerve neurostimulator systems.

New HCPCS codes

  • C8007: Open implantation of hypoglossal nerve neurostimulator array and pulse generator, not requiring insertion of a separate distal respiratory sensor electrode or electrode array
  • C8008: Revision or replacement of hypoglossal nerve neurostimulator array, including connection to existing pulse generator
  • C8009: Removal of hypoglossal nerve neurostimulator array and pulse generator
  • C8011: Open implantation of hypoglossal nerve(s) neurostimulator electrode array(s) and receiver, including external power source and all system components
  • C8012: Revision or replacement of hypoglossal nerve(s) neurostimulator electrode array(s) and receiver
  • C8013: Removal of hypoglossal nerve(s) neurostimulator electrode array(s) and receiver

CPT codes vs. new HCPCS C codes

  • Physicians report CPT codes
  • Hospital outpatient departments (provider-based) report HCPCS Level II C Codes
  • They are not interchangeable
  • The new HCPCS C codes apply only to hospital outpatient facility billing under OPPS

For guidance regarding the appropriate use of hypoglossal nerve stimulator CPT codes by sleep medicine clinicians, see the Coding and Reimbursement Advisory Committee’s Montage article, “Hypoglossal nerve stimulation for the treatment of obstructive sleep apnea.”

Please send any questions regarding the new codes to coding@aasm.org.