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HCPCS G0260 · Level II · G code

G0260: Injection procedure for sacroiliac joint; provision of anesthetic, 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 G0260

Medicare payment
$721.17
OPPS rate, SI T
Coverage code
D
special coverage instructions apply
Facility outpatient MUE
2
MAI 3
OPPS status
SI T
Procedure or service, multiple reduction applies
NCCI PTP pairs
152
144 hospital outpatient
LCDs and articles
5 / 5

TL;DR

G0260 is a Level II code from the G section (procedures and professional services, temporary), in use since 2003: "Injection procedure for sacroiliac joint; provision of anesthetic, steroid and/or other therapeutic agent, with or without arthrography". Hospital outpatient departments are paid $721.17 for G0260 under status indicator T, APC 5442 (Level 2 Nerve Injections), minimum unadjusted copayment $144.24 (October 2026 Addendum B). Its 2026 Q4 MUEs per date of service: practitioner 2 (MAI 3, Anatomic Consideration); hospital outpatient 2 (MAI 3, Anatomic Consideration). In the NCCI PTP files v323r0 G0260 appears in 0 practitioner pairs as column 2 and 152 as column 1, and in 0 hospital outpatient pairs as column 2 and 144 as column 1. 5 active LCDs and 5 billing and coding articles list G0260 across 21 states: L39475 (Sacroiliac Joint Injections and Procedures), L39383 (Sacroiliac Joint Injections and Procedures), A59154, A59192. HCPCS record: BETOS O1E (other drugs); pricing indicator 00; type of service F (ambulatory surgical center). 1 other active code opens with "Injection procedure for sacroiliac joint"; related codes: G0259, G0257, G0268, G0269.

G0260 descriptor and code status

The October 2026 HCPCS Level II file describes G0260 as “Injection procedure for sacroiliac joint; provision of anesthetic, steroid and/or other therapeutic agent, with or without arthrography”. It sits in the G section (procedures and professional services, temporary), listed with the other G codes. Although searches often call it the "G0260 CPT code", G0260 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 G0260
FieldValue
Short descriptorInj for sacroiliac jt anesth
Added to HCPCS2003-01-01
Last actionN (no maintenance), effective 2004-10-01
Coverage codeD: special coverage instructions apply
Pricing indicator00: not separately priced by Part B
BETOS categoryO1E: other drugs
Type of serviceF: ambulatory surgical center

Medicare payment for G0260

Hospital outpatient departments are paid $721.17 for G0260 under status indicator T, APC 5442 (Level 2 Nerve Injections), minimum unadjusted copayment $144.24 (October 2026 Addendum B). 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 E: excluded from the physician fee schedule by regulation. Global period XXX (global surgery concept does not apply); PC/TC indicator 9 (professional/technical concept does not apply).

Hospital outpatient (OPPS Addendum B)

Status indicator T (Procedure or service, multiple reduction applies), APC 5442 (Level 2 Nerve Injections), national unadjusted payment $721.17 with a minimum unadjusted copayment of $144.24.

Ambulatory surgical center (Addendum AA)

Payment indicator A2 (Surgical procedure on ASC list in CY 2007; payment based on OPPS relative payment weight), national rate $387.46 at a payment weight of 6.8793. The multiple-procedure discount applies when it is billed with another ASC procedure.

Medically Unlikely Edits for G0260

Its 2026 Q4 MUEs per date of service: practitioner 2 (MAI 3, Anatomic Consideration); hospital outpatient 2 (MAI 3, Anatomic Consideration). The facility outpatient MUE is a date-of-service clinical edit: units above the limit deny but can be paid on appeal with documentation.

MUE values for G0260 by setting
SettingMUE (units/DOS)MAICMS rationale
Practitioner services23 Date of Service Edit: ClinicalAnatomic Consideration
Facility outpatient hospital23 Date of Service Edit: ClinicalAnatomic Consideration

The MUE lookup for G0260 shows every setting next to any other code on the same claim.

NCCI edits and add-on rules

In the practitioner PTP file v323r0, G0260 is the column-2 (bundled) code in 0 active pairs and the column-1 code in 152 (89% modifier-allowed); 47 earlier pairs have been deleted.

Column-2 codes bundled into G0260 (practitioner)
Column-2 codePairs
0216T (CPT; descriptor licensed by AMA)1
0566T (CPT; descriptor licensed by AMA)1
0596T (CPT; descriptor licensed by AMA)1
0597T (CPT; descriptor licensed by AMA)1
0708T (CPT; descriptor licensed by AMA)1
0709T (CPT; descriptor licensed by AMA)1
0903T (CPT; descriptor licensed by AMA)1
0904T (CPT; descriptor licensed by AMA)1

In the hospital outpatient PTP file v323r0, G0260 is the column-2 (bundled) code in 0 active pairs and the column-1 code in 144 (98% modifier-allowed); 51 earlier pairs have been deleted.

Column-2 codes bundled into G0260 (hospital outpatient)
Column-2 codePairs
0216T (CPT; descriptor licensed by AMA)1
0566T (CPT; descriptor licensed by AMA)1
0596T (CPT; descriptor licensed by AMA)1
0597T (CPT; descriptor licensed by AMA)1
0708T (CPT; descriptor licensed by AMA)1
0709T (CPT; descriptor licensed by AMA)1
0903T (CPT; descriptor licensed by AMA)1
0904T (CPT; descriptor licensed by AMA)1

G0260 is neither an add-on code nor a designated primary code in the 2026 Q4 NCCI add-on edit file.

Pair counts show exposure, not the answer for one claim. Check G0260 against a second code to see whether the pair bundles and whether a modifier can separate the services.

Medicare coverage policies for G0260

5 active Local Coverage Determinations and 5 billing and coding articles list G0260. Each applies only in its contractor's jurisdiction, and the article carries the diagnosis codes that support the item or service.

  • LCD L39475: Sacroiliac Joint Injections and Procedures · Wisconsin Physicians Service Insurance Corporation
  • L39383 Sacroiliac Joint Injections and Procedures · CGS Administrators, LLC
  • L39402 Sacroiliac Joint Injections and Procedures · Palmetto GBA
  • L39455 Sacroiliac Joint Injections and Procedures · Wellpoint Federal
  • L39462 Sacroiliac Joint Injections and Procedures · Noridian Healthcare Solutions, LLC
Billing and Coding Articles listing G0260
ArticleTitleContractor(s)Related LCD
A59154Billing and Coding: Sacroiliac Joint Injections and ProceduresCGS Administrators, LLCL39383
A59192Billing and Coding: Sacroiliac Joint Injections and ProceduresPalmetto GBAL39402
A59233Billing and Coding: Sacroiliac Joint Injections and ProceduresWellpoint FederalL39455
A59244Billing and Coding: Sacroiliac Joint Injections and ProceduresNoridian Healthcare Solutions, LLCL39462
A59257Billing and Coding: Sacroiliac Joint Injections and ProceduresWisconsin Physicians Service Insurance CorporationL39475

Denials to expect on G0260

CARC 50 · N115

the diagnosis or documentation does not meet the LCD or billing article that lists G0260

CARC 151 · N362

units of G0260 exceed the facility outpatient MUE of 2 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 G0260 claims

QuickCode supports qualified coder review of units, modifiers and NCCI pairs for G0260 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 G0260

What does HCPCS code G0260 describe?

"Injection procedure for sacroiliac joint; provision of anesthetic, steroid and/or other therapeutic agent, with or without arthrography" (short descriptor "Inj for sacroiliac jt anesth"), in the G section (procedures and professional services, temporary). Added 2003-01-01; last action N (no maintenance) effective 2004-10-01.

Is G0260 a CPT code?

No. G0260 is a CMS HCPCS Level II code; CPT codes are the AMA's five-character set. Searches for "G0260 CPT code" mean this Level II code.

What does Medicare pay for G0260?

Hospital outpatient departments are paid $721.17 for G0260 under status indicator T, APC 5442 (Level 2 Nerve Injections), minimum unadjusted copayment $144.24 (October 2026 Addendum B).

How many units of G0260 can be billed per day?

Its 2026 Q4 MUEs per date of service: practitioner 2 (MAI 3, Anatomic Consideration); hospital outpatient 2 (MAI 3, Anatomic Consideration). For the facility outpatient MUE (MAI 3), units above 2 deny for the day but can be paid on appeal with documentation; denials arrive as CARC 151.

Does Medicare cover G0260?

Coverage code D (special coverage instructions apply). 5 active LCDs and 5 billing and coding articles list G0260 across 21 states: L39475 (Sacroiliac Joint Injections and Procedures), L39383 (Sacroiliac Joint Injections and Procedures), A59154, A59192.

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.