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HCPCS G0247 · Level II · G code

G0247: Routine footcare pt w lops, 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). 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.

Key facts for G0247

Medicare payment
$80.83
PFS non-facility, national; facility $19.04
Coverage code
D
special coverage instructions apply
Practitioner MUE
1
MAI 2
OPPS status
SI Q1
STV-Packaged Codes
NCCI PTP pairs
41
32 hospital outpatient
LCDs and articles
0 / 0
add-on code

TL;DR

G0247 is a Level II code from the G section (procedures and professional services, temporary), in use since 2002: "Routine foot care by a physician of a diabetic patient with diabetic sensory neuropathy resulting in a loss of protective sensation (lops) to include, the local care of superficial wounds (i.e. superficial to muscle and fascia) and at least the following if present: (1) local care of superficial wounds, (2) debridement of corns and calluses, and (3) trimming and debridement of nails". National PFS payment for G0247 is $80.83 in an office and $19.04 in a facility (October 2026), built from 0.49 work, 1.91 practice-expense and 0.02 malpractice RVUs at $33.4009 per RVU. Qualifying APM participants get $81.23 at $33.5675. Global period ZZZ (add-on service inside the primary service's global period). CMS caps G0247 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. G0247 is an add-on code (NCCI edit type 1): Medicare pays it only on a claim that also carries one of 2 primary codes such as G0245, G0246. In the NCCI PTP files v323r0 G0247 appears in 0 practitioner pairs as column 2 and 41 as column 1, and in 0 hospital outpatient pairs as column 2 and 32 as column 1. No current LCD or billing article lists G0247; its HCPCS coverage code is D (special coverage instructions apply). HCPCS record: BETOS M1B (office visits - established); pricing indicator 11; type of service 1 (medical care). Nearby codes: G0246, G0248, G0245, G0249.

G0247 descriptor and code status

The October 2026 HCPCS Level II file describes G0247 as “Routine foot care by a physician of a diabetic patient with diabetic sensory neuropathy resulting in a loss of protective sensation (lops) to include, the local care of superficial wounds (i.e. superficial to muscle and fascia) and at least the following if present: (1) local care of superficial wounds, (2) debridement of corns and calluses, and (3) trimming and debridement of nails”. It sits in the G section (procedures and professional services, temporary), listed with the other G codes. Although searches often call it the "G0247 CPT code", G0247 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 G0247
FieldValue
Short descriptorRoutine footcare pt w lops
Added to HCPCS2002-07-01
Last actionN (no maintenance), effective 2003-07-01
Coverage codeD: special coverage instructions apply
Pricing indicator11: physician fee schedule, priced with national RVUs
BETOS categoryM1B: office visits - established
Type of service1: medical care

Medicare payment for G0247

National PFS payment for G0247 is $80.83 in an office and $19.04 in a facility (October 2026), built from 0.49 work, 1.91 practice-expense and 0.02 malpractice RVUs at $33.4009 per RVU. Qualifying APM participants get $81.23 at $33.5675. Global period ZZZ (add-on service inside the primary service's global period). 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 R: restricted coverage: contractor-priced when covered. Global period ZZZ (add-on service inside the primary service's global period); PC/TC indicator 0 (physician service; the professional/technical split does not apply).

PFS relative values and national payment for G0247
ComponentNon-facilityFacility
Work RVU0.490.49
Practice expense RVU1.910.06
Malpractice RVU0.020.02
Total RVUs2.420.57
National payment (CF $33.4009)$80.83$19.04
Qualifying APM participant (CF $33.5675)$81.23$19.13
  • 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

Hospital outpatient (OPPS Addendum B)

Status indicator Q1 (STV-Packaged Codes), APC 5051 (Level 1 Skin Procedures), national unadjusted payment $204.98 with a minimum unadjusted copayment of $41.00.

Medically Unlikely Edits for G0247

CMS caps G0247 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 G0247 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 G0247 shows every setting next to any other code on the same claim.

NCCI edits and add-on rules

In the practitioner PTP file v323r0, G0247 is the column-2 (bundled) code in 0 active pairs and the column-1 code in 41 (27% modifier-allowed); 6 earlier pairs have been deleted.

Column-2 codes bundled into G0247 (practitioner)
Column-2 codePairs
0552T (CPT; descriptor licensed by AMA)1
0936T (CPT; descriptor licensed by AMA)1
11042 (CPT; descriptor licensed by AMA)1
11043 (CPT; descriptor licensed by AMA)1
11044 (CPT; descriptor licensed by AMA)1
11055 (CPT; descriptor licensed by AMA)1
11056 (CPT; descriptor licensed by AMA)1
11057 (CPT; descriptor licensed by AMA)1

In the hospital outpatient PTP file v323r0, G0247 is the column-2 (bundled) code in 0 active pairs and the column-1 code in 32 (56% modifier-allowed); 6 earlier pairs have been deleted.

Column-2 codes bundled into G0247 (hospital outpatient)
Column-2 codePairs
0552T (CPT; descriptor licensed by AMA)1
0936T (CPT; descriptor licensed by AMA)1
11042 (CPT; descriptor licensed by AMA)1
11043 (CPT; descriptor licensed by AMA)1
11044 (CPT; descriptor licensed by AMA)1
11055 (CPT; descriptor licensed by AMA)1
11056 (CPT; descriptor licensed by AMA)1
11057 (CPT; descriptor licensed by AMA)1

G0247 is an add-on code: it is payable only with a primary service on the same claim (G0245, G0246). CPT primary codes are shown as numbers only.

Pair counts show exposure, not the answer for one claim. Check G0247 against a second code to see whether the pair bundles and whether a modifier can separate the services.

Medicare coverage policies for G0247

No current LCD or billing and coding article lists G0247. The HCPCS coverage code D means special coverage instructions apply, and any National Coverage Determination for the service still applies.

Denials to expect on G0247

CARC 50 · N115

the service is not reasonable and necessary for the diagnosis on the claim

CARC 151 · N362

units of G0247 exceed the practitioner MUE of 1 per date of service

CARC 4

the modifier reported is inconsistent with the code

CARC 16

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

Where QuickIntell fits for G0247 claims

QuickCode supports qualified coder review of units, modifiers and NCCI pairs for G0247 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 G0247

What does HCPCS code G0247 describe?

"Routine foot care by a physician of a diabetic patient with diabetic sensory neuropathy resulting in a loss of protective sensation (lops) to include, the local care of superficial wounds (i.e. superficial to muscle and fascia) and at least the following if present: (1) local care of superficial wounds, (2) debridement of corns and calluses, and (3) trimming and debridement of nails" (short descriptor "Routine footcare pt w lops"), in the G section (procedures and professional services, temporary). Added 2002-07-01; last action N (no maintenance) effective 2003-07-01.

Is G0247 a CPT code?

It is not. G0247 belongs to the G section (procedures and professional services, temporary) of HCPCS Level II, the CMS code set, not to AMA CPT. "G0247 CPT code" searches refer to it.

What does Medicare pay for G0247?

National PFS payment for G0247 is $80.83 in an office and $19.04 in a facility (October 2026), built from 0.49 work, 1.91 practice-expense and 0.02 malpractice RVUs at $33.4009 per RVU. Qualifying APM participants get $81.23 at $33.5675. Global period ZZZ (add-on service inside the primary service's global period).

Is G0247 an add-on code?

G0247 is an add-on code (NCCI edit type 1): Medicare pays it only on a claim that also carries one of 2 primary codes such as G0245, G0246.

How many units of G0247 can be billed per day?

CMS caps G0247 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 G0247?

No current LCD or billing article lists G0247; its HCPCS coverage code is D (special coverage instructions apply).

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.