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HCPCS G0130 · Level II · G code

G0130: Single energy x-ray absorptiometry (sexa) bone density study, one or more sites, HCPCS Level II G code

Compiled from CMS files by the QuickIntell RCM Editorial Team · Data effective · Method: reference methodology · Report a data correction

Data currency: HCPCS Level II file: October 2026 (effective October 1, 2026); PFS relative value file: RVU26D, released August 26, 2026 (effective October 1, 2026); NCCI MUE tables: 2026 Q4 (effective October 1, 2026); NCCI PTP edits: v323r0 (2026 Q4) (effective October 1, 2026); OPPS Addendum B: October 2026 (effective October 1, 2026); Medicare Coverage Database LCD export: MCD release October 8, 2026 (effective October 4, 2026). Next CMS release: January 1, 2027 (quarterly update) for the HCPCS Level II file and NCCI MUE tables and NCCI PTP edits and OPPS Addendum B; RVU27A with the CY2027 PFS final rule, effective January 1, 2027 for the PFS relative value file; weekly, every Thursday for the Medicare Coverage Database LCD export.

Key facts for G0130

Medicare payment
$39.75
PFS non-facility, national
Coverage code
D
special coverage instructions apply
Practitioner MUE
1
MAI 2
OPPS status
SI S
Procedure or service, not discounted when multiple
NCCI PTP pairs
9
6 hospital outpatient
LCDs and articles
2 / 3

TL;DR

G0130 is a Level II code from the G section (procedures and professional services, temporary), in use since 1998: "Single energy x-ray absorptiometry (sexa) bone density study, one or more sites; appendicular skeleton (peripheral) (e.g., radius, wrist, heel)". National PFS payment for G0130 is $39.75 in an office and no facility amount in a facility (October 2026), built from 0.21 work, 0.96 practice-expense and 0.02 malpractice RVUs at $33.4009 per RVU. Qualifying APM participants get $39.95 at $33.5675. CMS caps G0130 at practitioner 1 (MAI 2, Code Descriptor / CPT Instruction); hospital outpatient 1 (MAI 2, Code Descriptor / CPT Instruction) units per day in the 2026 Q4 MUE tables. G0130 is a primary code for 1 add-on code (G0513). In the NCCI PTP files v323r0 G0130 appears in 3 practitioner pairs as column 2 and 6 as column 1 (most often with 77078, 77081, 77085), and in 3 hospital outpatient pairs as column 2 and 3 as column 1. 2 active LCDs and 3 billing and coding articles list G0130 across 9 states: L39268 (Bone Mass Measurement), L36460 (Bone Mass Measurement), A57132, A58559. HCPCS record: BETOS I4B (imaging/procedure - other); pricing indicator 11; type of service 4 (diagnostic radiology). Nearby codes: G0129, G0127, G0124, G0136.

G0130 descriptor and code status

The October 2026 HCPCS Level II file describes G0130 as “Single energy x-ray absorptiometry (sexa) bone density study, one or more sites; appendicular skeleton (peripheral) (e.g., radius, wrist, heel)”. It sits in the G section (procedures and professional services, temporary), listed with the other G codes. Although searches often call it the "G0130 CPT code", G0130 is a HCPCS Level II code maintained by CMS, not an AMA CPT code; both go in the same procedure-code field on the claim.

HCPCS file attributes of G0130
FieldValue
Short descriptorSingle energy x-ray study
Added to HCPCS1998-07-01
Last actionN (no maintenance), effective 1998-07-01
Coverage codeD: special coverage instructions apply
Pricing indicator11: physician fee schedule, priced with national RVUs
BETOS categoryI4B: imaging/procedure - other
Type of service4: diagnostic radiology

Medicare payment for G0130

National PFS payment for G0130 is $39.75 in an office and no facility amount in a facility (October 2026), built from 0.21 work, 0.96 practice-expense and 0.02 malpractice RVUs at $33.4009 per RVU. Qualifying APM participants get $39.95 at $33.5675. The amounts below are national figures from the October 2026 CMS files; the contractor applies the locality, rural or state adjustment and the beneficiary's cost sharing.

Physician fee schedule (RVU26D)

Status A: active: paid separately under the physician fee schedule when covered. Global period XXX (global surgery concept does not apply); PC/TC indicator 1 (diagnostic test with professional (26) and technical (TC) components).

PFS relative values and national payment for G0130
ComponentNon-facilityFacility
Work RVU0.210.21
Practice expense RVU0.96NA
Malpractice RVU0.020.02
Total RVUs1.19NA
National payment (CF $33.4009)$39.75n/a
Qualifying APM participant (CF $33.5675)$39.95n/a
  • Multiple procedures (modifier 51): no multiple-procedure reduction
  • Bilateral (modifier 50): 150% bilateral adjustment does not apply
  • Assistant at surgery: assistant at surgery paid only with documentation; co-surgeons: co-surgeons not permitted; team surgery: team surgeons not permitted
  • Physician supervision of diagnostic procedures: supervision concept does not apply

G0130 also carries 26 and TC rows in the RVU file, priced separately from the global service.

Component rows for G0130
ModifierStatusNon-facilityFacility
26A$11.02$11.02
TCA$28.72n/a

Hospital outpatient (OPPS Addendum B)

Status indicator S (Procedure or service, not discounted when multiple), APC 5522 (Level 2 Imaging without Contrast), national unadjusted payment $106.81 with a minimum unadjusted copayment of $0.00.

Ambulatory surgical center (Addendum BB)

Payment indicator Z3 (Radiology or diagnostic service paid separately when provided integral to a surgical procedure on ASC list; payment based on MPFS nonfacility PE RVUs), national rate $28.53.

Medically Unlikely Edits for G0130

CMS caps G0130 at practitioner 1 (MAI 2, Code Descriptor / CPT Instruction); hospital outpatient 1 (MAI 2, Code Descriptor / CPT Instruction) units per day in the 2026 Q4 MUE tables. The practitioner MUE is a date-of-service policy edit: units above the limit deny even when split across lines, and appeals rarely succeed.

MUE values for G0130 by setting
SettingMUE (units/DOS)MAICMS rationale
Practitioner services12 Date of Service Edit: PolicyCode Descriptor / CPT Instruction
Facility outpatient hospital12 Date of Service Edit: PolicyCode Descriptor / CPT Instruction

The MUE lookup for G0130 shows every setting next to any other code on the same claim.

NCCI edits and add-on rules

In the practitioner PTP file v323r0, G0130 is the column-2 (bundled) code in 3 active pairs, 67% of which allow a modifier and the column-1 code in 6 (17% modifier-allowed); 79 earlier pairs have been deleted. CMS's most frequent rationale for the bundled pairs: Mutually exclusive procedures.

Column-1 codes most often paired with G0130 (practitioner)
Column-1 codePairs
77078 (CPT; descriptor licensed by AMA)1
77081 (CPT; descriptor licensed by AMA)1
77085 (CPT; descriptor licensed by AMA)1
Column-2 codes bundled into G0130 (practitioner)
Column-2 codePairs
36591 (CPT; descriptor licensed by AMA)1
36592 (CPT; descriptor licensed by AMA)1
76977 (CPT; descriptor licensed by AMA)1
77080 (CPT; descriptor licensed by AMA)1
78445 (CPT; descriptor licensed by AMA)1
96523 (CPT; descriptor licensed by AMA)1

In the hospital outpatient PTP file v323r0, G0130 is the column-2 (bundled) code in 3 active pairs, 67% of which allow a modifier and the column-1 code in 3 (33% modifier-allowed); 13 earlier pairs have been deleted. CMS's most frequent rationale for the bundled pairs: Mutually exclusive procedures.

Column-1 codes most often paired with G0130 (hospital outpatient)
Column-1 codePairs
77078 (CPT; descriptor licensed by AMA)1
77081 (CPT; descriptor licensed by AMA)1
77085 (CPT; descriptor licensed by AMA)1
Column-2 codes bundled into G0130 (hospital outpatient)
Column-2 codePairs
76977 (CPT; descriptor licensed by AMA)1
77080 (CPT; descriptor licensed by AMA)1
78445 (CPT; descriptor licensed by AMA)1

G0130 is a designated primary code for 1 add-on code (G0513).

Pair counts show exposure, not the answer for one claim. Check G0130 against a second code to see whether the pair bundles and whether a modifier can separate the services.

Medicare coverage policies for G0130

2 active Local Coverage Determinations and 3 billing and coding articles list G0130. Each applies only in its contractor's jurisdiction, and the article carries the diagnosis codes that support the item or service.

Billing and Coding Articles listing G0130
ArticleTitleContractor(s)Related LCD
A57132Billing and Coding: Bone Mass MeasurementCGS Administrators, LLCL36460
A58559Billing and Coding: Independent Diagnostic Testing Facilities (IDTF)Palmetto GBA—
A59040Billing and Coding: Bone Mass MeasurementPalmetto GBAL39268

Denials to expect on G0130

CARC 50 · N115

the diagnosis or documentation does not meet the LCD or billing article that lists G0130

CARC 151 · N362

units of G0130 exceed the practitioner MUE of 1 per date of service

CARC 4

the 26 or TC modifier does not fit the component billed

CARC 16

the claim lacks information needed to adjudicate the line, such as an order, NPI or required modifier

Where QuickIntell fits for G0130 claims

QuickCode supports qualified coder review of units, modifiers and NCCI pairs for G0130 before the claim leaves, and QuickRCM carries claim readiness and the denial follow-up when an edit or coverage policy is missed.

See QuickCode for coder reviewSee QuickRCM for denial follow-upBook a meeting

Frequently asked questions: HCPCS G0130

What does HCPCS code G0130 describe?

"Single energy x-ray absorptiometry (sexa) bone density study, one or more sites; appendicular skeleton (peripheral) (e.g., radius, wrist, heel)" (short descriptor "Single energy x-ray study"), in the G section (procedures and professional services, temporary). Added 1998-07-01.

Is G0130 a CPT code?

It is not. G0130 belongs to the G section (procedures and professional services, temporary) of HCPCS Level II, the CMS code set, not to AMA CPT. "G0130 CPT code" searches refer to it.

What does Medicare pay for G0130?

National PFS payment for G0130 is $39.75 in an office and no facility amount in a facility (October 2026), built from 0.21 work, 0.96 practice-expense and 0.02 malpractice RVUs at $33.4009 per RVU. Qualifying APM participants get $39.95 at $33.5675.

Is G0130 an add-on code?

G0130 is a primary code for 1 add-on code (G0513).

How many units of G0130 can be billed per day?

CMS caps G0130 at practitioner 1 (MAI 2, Code Descriptor / CPT Instruction); hospital outpatient 1 (MAI 2, Code Descriptor / CPT Instruction) units per day in the 2026 Q4 MUE tables. For the practitioner MUE (MAI 2), units above 1 deny for the whole day as a policy limit; denials arrive as CARC 151.

Does Medicare cover G0130?

Coverage code D (special coverage instructions apply). 2 active LCDs and 3 billing and coding articles list G0130 across 9 states: L39268 (Bone Mass Measurement), L36460 (Bone Mass Measurement), A57132, A58559.

Sources

Every figure on this page is taken from the CMS publications below, as released by the Centers for Medicare & Medicaid Services. Projection built 2026-10-10. Verify against the primary file before billing or contracting decisions. The reference methodology explains how each figure is computed from these files.

Disclaimer

This page is an operational reference compiled from CMS publications: the HCPCS Level II file, the physician, DMEPOS and clinical laboratory fee schedules, OPPS and ASC addenda, NCCI MUE, PTP and add-on edit tables and the Medicare Coverage Database. Amounts are Medicare national figures before locality and state adjustment; Medicaid and commercial payers set their own. CPT codes are shown as numbers only; CPT descriptors are copyright AMA. Nothing here is legal, clinical or billing advice.

Found a figure that does not match the CMS file? Report a data correction with the CMS file and the value you expected; the request reaches the editorial team through the contact form.