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For CY 2026, we proposed to maintain HCPCS code C9779, which had a geometric mean cost of $5,516.81, in APC 5303 (Level 3 Upper GI Procedures)

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6 Based on the International Evidencebased Guideline PCOS diagnostic criteria, 3 which builds on the earlier consensusbased Rotterdam criteria, 7 PCOS is diagnosed in adults on the basis of two of three components: (i) clinical and/or biochemical hyperandrogenism, (ii) ovulatory dysfunction, including anovulation or chronic oligoovulation, and (iii) polycystic ovary morphology or elevated antiMllerian hormone (AMH) levels, 8 after exclusion of other possible aetiologies

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Thorough documentation should include a full medical history, any relevant blood test results (though not always mandatory), consent, the product used, batch number, site of injection, and any adverse reactions