Find out what you need to know new coding for surface mesh files and what's next as 3D technologies advance.
From the Chair of the Commission on Economics
Frank J. Rybicki MD, PhD, FACR
Chair of the ACR Artificial Intelligence Economics Committee and Department of Radiology at Banner University Medical Center & University of Arizona — Phoenix
Guest Columnist
Radiology plays a central role in 3D technical and professional services. In traditional services, Digital Imaging and Communications in Medicine (DICOM) data (using the file extension .dcm) undergoes digital manipulation into new DCM files, and the work is coded with CPT® 76376 and 76377 that are paid under the Medicare Physician Fee Schedule. These CPT codes are not paid separately under the Hospital Outpatient Prospective Payment System (HOPPS) system, as they are bundled into payment for other services.
This article (the first in a two-part series) focuses on the conversion of DCM files to surface mesh files, a procedure that is performed for a small-but-growing cohort of complex patients. Those files, with file extensions such as .stl and.obj, can be further manipulated and used by proceduralists as a 3D PDF. Surface mesh files are also:
Surface mesh files are common in medicine, and they are high-value digital medical assets. The applications and pecuniary implications are breathtaking. For example, a DCM-to-surface-mesh conversion is required for all robotic-assisted procedures, for all CT estimates of coronary artery fractional flow reserve and for all patient-specific 3D-printed surgical guides.
Until recently, the usual workflow was that the DCM data are sent to a vendor, who creates a new surface mesh file called Final Anatomic Representation. Over the past few years, radiologists have realized that high-value work traditionally purchased from vendors can be done in the hospital. There is now widespread use of surface mesh files created in the healthcare facility, and ACR advocates for proper reimbursement for these services by CMS.
Surface mesh files are common in medicine, and they are high-value digital medical assets. The applications and pecuniary implications are breathtaking.
In the January HOPPS Quarterly update, CMS created the new Healthcare Common Procedure Coding System (HCPCS) code C8001 for the 3D anatomical segmentation. In the April update, CMS revised the Ambulatory Payment Classification (APC) placement from APC 5521 to APC 5721, with a notable increase in reimbursement.
The HOPPS proposed rule was released in July 2025, and additional details on C8001 are expected in the calendar year 2026.
The Evolution of C8001
| Code | Description | Status Indicator | January 2025 APC | January 2025 Payment Rate | April 2025 APC | April 2025 Payment Rate |
| C8001 | 3D anatomical segmentation imaging for preoperative planning, data preparation and transmission, obtained from previous diagnostic computed tomographic or MR examination of the same anatomy | S* | 5521 — Level 1 Imaging without Contrast | $88.05 | 5721 — Level 1 Diagnostic Tests and Procedures | $156.46 |
*Status indicator S = paid under HOPPS; separate APC payment
These updates are important for providers who perform these services. Specifically, C8001 can be utilized now for all hospital outpatient services for which a DCM dataset is converted to a surface mesh.
Additionally, the C8001 code descriptor does not specify the file type. The working wording of the description (see “The Evolution of C8001”) provides the choice to apply C8001 to work that digitally manipulates DCM files with the output of new DCM data. This would include multiplanar reformations, maximum and minimum intensity projections and surface rendering with DCM output. Prior to the new HCPCS code C8001, this work could only be captured with CPT 73676 and 76377.
ACR will continue to monitor and advocate for the portfolio of 3D services as generated from DICOM data, as this work should be available for radiology service lines.
A follow-up column in September will review the relevant, related codes and consider how HCPCS code C8001 can (and cannot) be utilized.
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