Key facts for G0268
- Medicare payment
- $50.44
- PFS non-facility, national; facility $27.39
- Coverage code
- C
- carrier judgment, so the Medicare contractor decides coverage
- Practitioner MUE
- 1
- MAI 2
- NCCI PTP pairs
- 296
- 241 hospital outpatient
- LCDs and articles
- 1 / 1
TL;DR
CMS describes HCPCS G0268, added in 2003, as "Removal of impacted cerumen (one or both ears) by physician on same date of service as audiologic function testing". National PFS payment for G0268 is $50.44 in an office and $27.39 in a facility (October 2026), built from 0.59 work, 0.84 practice-expense and 0.08 malpractice RVUs at $33.4009 per RVU. Qualifying APM participants get $50.69 at $33.5675. Global period 000 (0-day global period). CMS caps G0268 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. In the NCCI PTP files v323r0 G0268 appears in 60 practitioner pairs as column 2 and 236 as column 1 (most often with 0583T, 69000, 69005), and in 60 hospital outpatient pairs as column 2 and 181 as column 1. 1 active LCD and 1 billing and coding article list G0268 across 2 states: L33945 (Cerumen (Earwax) Removal), A56454. OPPS status indicator N: Items and Services packaged into APC rates. HCPCS record: BETOS P6C (minor procedures - other (Medicare fee schedule)); pricing indicator 11; type of service 2 (surgery). Nearby codes: G0269, G0270, G0271, G0260.
G0268 descriptor and code status
The October 2026 HCPCS Level II file describes G0268 as “Removal of impacted cerumen (one or both ears) by physician on same date of service as audiologic function testing”. It sits in the G section (procedures and professional services, temporary), listed with the other G codes. Although searches often call it the "G0268 CPT code", G0268 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.
| Field | Value |
|---|---|
| Short descriptor | Removal of impacted wax md |
| Added to HCPCS | 2003-01-01 |
| Last action | N (no maintenance), effective 2003-01-01 |
| Coverage code | C: carrier judgment, so the Medicare contractor decides coverage |
| Pricing indicator | 11: physician fee schedule, priced with national RVUs |
| BETOS category | P6C: minor procedures - other (Medicare fee schedule) |
| Type of service | 2: surgery |
Medicare payment for G0268
National PFS payment for G0268 is $50.44 in an office and $27.39 in a facility (October 2026), built from 0.59 work, 0.84 practice-expense and 0.08 malpractice RVUs at $33.4009 per RVU. Qualifying APM participants get $50.69 at $33.5675. Global period 000 (0-day 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 A: active: paid separately under the physician fee schedule when covered. Global period 000 (0-day global period); PC/TC indicator 0 (physician service; the professional/technical split does not apply).
| Component | Non-facility | Facility |
|---|---|---|
| Work RVU | 0.59 | 0.59 |
| Practice expense RVU | 0.84 | 0.15 |
| Malpractice RVU | 0.08 | 0.08 |
| Total RVUs | 1.51 | 0.82 |
| National payment (CF $33.4009) | $50.44 | $27.39 |
| Qualifying APM participant (CF $33.5675) | $50.69 | $27.53 |
- Multiple procedures (modifier 51): standard multiple-procedure reduction (100%, then 50%)
- Bilateral (modifier 50): already priced as bilateral
- Assistant at surgery: assistant at surgery may not be paid; 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 N (Items and Services packaged into APC rates), with no separate OPPS payment rate.
Medically Unlikely Edits for G0268
CMS caps G0268 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.
| Setting | MUE (units/DOS) | MAI | CMS rationale |
|---|---|---|---|
| Practitioner services | 1 | 2 Date of Service Edit: Policy | Code Descriptor / CPT Instruction |
| Facility outpatient hospital | 1 | 2 Date of Service Edit: Policy | Code Descriptor / CPT Instruction |
The MUE lookup for G0268 shows every setting next to any other code on the same claim.
NCCI edits and add-on rules
In the practitioner PTP file v323r0, G0268 is the column-2 (bundled) code in 60 active pairs, 0% of which allow a modifier and the column-1 code in 236 (71% modifier-allowed); 97 earlier pairs have been deleted. CMS's most frequent rationale for the bundled pairs: Misuse of Column Two code with Column One code.
| Column-1 code | Pairs |
|---|---|
| 0583T (CPT; descriptor licensed by AMA) | 1 |
| 69000 (CPT; descriptor licensed by AMA) | 1 |
| 69005 (CPT; descriptor licensed by AMA) | 1 |
| 69020 (CPT; descriptor licensed by AMA) | 1 |
| 69100 (CPT; descriptor licensed by AMA) | 1 |
| 69105 (CPT; descriptor licensed by AMA) | 1 |
| 69110 (CPT; descriptor licensed by AMA) | 1 |
| 69120 (CPT; descriptor licensed by AMA) | 1 |
| Column-2 code | Pairs |
|---|---|
| 0213T (CPT; descriptor licensed by AMA) | 1 |
| 0216T (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, G0268 is the column-2 (bundled) code in 60 active pairs, 0% of which allow a modifier and the column-1 code in 181 (98% modifier-allowed); 40 earlier pairs have been deleted. CMS's most frequent rationale for the bundled pairs: Misuse of Column Two code with Column One code.
| Column-1 code | Pairs |
|---|---|
| 0583T (CPT; descriptor licensed by AMA) | 1 |
| 69000 (CPT; descriptor licensed by AMA) | 1 |
| 69005 (CPT; descriptor licensed by AMA) | 1 |
| 69020 (CPT; descriptor licensed by AMA) | 1 |
| 69100 (CPT; descriptor licensed by AMA) | 1 |
| 69105 (CPT; descriptor licensed by AMA) | 1 |
| 69110 (CPT; descriptor licensed by AMA) | 1 |
| 69120 (CPT; descriptor licensed by AMA) | 1 |
| Column-2 code | Pairs |
|---|---|
| 0213T (CPT; descriptor licensed by AMA) | 1 |
| 0216T (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 |
G0268 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 G0268 against a second code to see whether the pair bundles and whether a modifier can separate the services.
Medicare coverage policies for G0268
1 active Local Coverage Determination and 1 billing and coding article list G0268. Each applies only in its contractor's jurisdiction, and the article carries the diagnosis codes that support the item or service.
- L33945 Cerumen (Earwax) Removal · CGS Administrators, LLC
| Article | Title | Contractor(s) | Related LCD |
|---|---|---|---|
| A56454 | Billing and Coding: Cerumen (Earwax) Removal | CGS Administrators, LLC | L33945 |
Denials to expect on G0268
the diagnosis or documentation does not meet the LCD or billing article that lists G0268
the modifier reported is inconsistent with the code
the claim lacks information needed to adjudicate the line, such as an order, NPI or required modifier
Where QuickIntell fits for G0268 claims
QuickCode supports qualified coder review of units, modifiers and NCCI pairs for G0268 before the claim leaves, and QuickRCM carries claim readiness and the denial follow-up when an edit or coverage policy is missed.
Frequently asked questions: HCPCS G0268
What does HCPCS code G0268 describe?
"Removal of impacted cerumen (one or both ears) by physician on same date of service as audiologic function testing" (short descriptor "Removal of impacted wax md"), in the G section (procedures and professional services, temporary). Added 2003-01-01.
Is G0268 a CPT code?
It is not. G0268 belongs to the G section (procedures and professional services, temporary) of HCPCS Level II, the CMS code set, not to AMA CPT. "G0268 CPT code" searches refer to it.
What does Medicare pay for G0268?
National PFS payment for G0268 is $50.44 in an office and $27.39 in a facility (October 2026), built from 0.59 work, 0.84 practice-expense and 0.08 malpractice RVUs at $33.4009 per RVU. Qualifying APM participants get $50.69 at $33.5675. Global period 000 (0-day global period).
How many units of G0268 can be billed per day?
CMS caps G0268 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 G0268?
Coverage code C (carrier judgment, so the Medicare contractor decides coverage). 1 active LCD and 1 billing and coding article list G0268 across 2 states: L33945 (Cerumen (Earwax) Removal), A56454.
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.
- HCPCS Level II alpha-numeric file, October 2026Version October 2026 · effective 2026-10-01 · file HCPC2026_OCT_ANWEB_09232026.txtSHA-256 c25240c63108756d…
- Medicare PFS national relative value file RVU26D (non-QPP), October 2026Version RVU26D, released 2026-08-26 · effective 2026-10-01 · file PPRRVU2026_Oct_nonQPP.csvSHA-256 4d0d3f19bd954ffc…
- Medicare PFS national relative value file RVU26D (qualifying APM participants), October 2026Version RVU26D, released 2026-08-26 · effective 2026-10-01 · file PPRRVU2026_Oct_QPP.csvSHA-256 59d3734704853936…
- OPPS Addendum B, October 2026Version October 2026 · effective 2026-10-01 · file 508-compliant-version-2026_October_Web_Addendum_B.09.28.26.csvSHA-256 6ad7393a318bf1b9…
- Integrated Outpatient Code Editor v27.3 data tables: status and payment indicatorsVersion I/OCE v27.3 (October 2026) · effective 2026-10-01 · file Data_Status_Indicator.txtSHA-256 78f119ef0a435351…
- NCCI MUE table, practitioner services, effective 2026-10-01Version 2026 Q4 · effective 2026-10-01 · file MCR_MUE_PractitionerServices_Eff_10-01-2026.csvSHA-256 ef038efaf902b7bd…
- NCCI MUE table, facility services, effective 2026-10-01Version 2026 Q4 · effective 2026-10-01 · file MCR_MUE_OutpatientHospitalServices_Eff_10-01-2026.csvSHA-256 3af9f4e99cc587e2…
- NCCI MUE table, dme services, effective 2026-10-01Version 2026 Q4 · effective 2026-10-01 · file MCR_MUE_DMESupplierServices_Eff_10-01-2026.csvSHA-256 6fa4fbba852f7b74…
- NCCI PTP edits, practitioner, v323r0 (four files)Version v323r0 (2026 Q4) · effective 2026-10-01 · file ccipra-v323r0-f1.TXTSHA-256 7793c0b6686c1e22…
- NCCI PTP edits, hospital outpatient, v323r0 (four files)Version v323r0 (2026 Q4) · effective 2026-10-01 · file ccioph-v323r0-f1.txtSHA-256 063f41b91ef9faa2…
- Medicare Coverage Database, current Billing and Coding Articles exportVersion MCD release 2026-10-08 · effective 2026-10-04 · file article.csvSHA-256 5e95c4a8ac3664be…
- Medicare Coverage Database, current LCD exportVersion MCD release 2026-10-08 · effective 2026-10-04 · file lcd.csvSHA-256 9aee1bd7f14056b0…
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.