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HCPCS G0289 · Level II · G code

G0289: Arthroscopy, knee, surgical, for removal of loose body, foreign body, 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 G0289

Medicare payment
$72.81
PFS facility, national
Coverage code
C
carrier judgment, so the Medicare contractor decides coverage
Practitioner MUE
1
MAI 2
OPPS status
SI N
Items and Services packaged into APC rates
NCCI PTP pairs
25
16 hospital outpatient
LCDs and articles
0 / 1
add-on code

TL;DR

CMS describes HCPCS G0289, added in 2003, as "Arthroscopy, knee, surgical, for removal of loose body, foreign body, debridement/shaving of articular cartilage (chondroplasty) at the time of other surgical knee arthroscopy in a different compartment of the same knee". National PFS payment for G0289 is no non-facility amount in an office and $72.81 in a facility (October 2026), built from 1.44 work, 0.45 practice-expense and 0.29 malpractice RVUs at $33.4009 per RVU. Qualifying APM participants get $73.18 at $33.5675. Global period ZZZ (add-on service inside the primary service's global period). CMS caps G0289 at practitioner 1 (MAI 2, CMS Policy); hospital outpatient 1 (MAI 2, CMS Policy) units per day in the 2026 Q4 MUE tables. G0289 is an add-on code (NCCI edit type 1): Medicare pays it only on a claim that also carries one of 17 primary codes such as 29871, 29873, 29874, 29875. In the NCCI PTP files v323r0 G0289 appears in 2 practitioner pairs as column 2 and 23 as column 1 (most often with 29880, 29881), and in 2 hospital outpatient pairs as column 2 and 14 as column 1. 1 billing and coding article lists G0289 across 5 states: A52369. OPPS status indicator N: Items and Services packaged into APC rates. HCPCS record: BETOS P8A (endoscopy - arthroscopy); pricing indicator 11; type of service 2 (surgery). Nearby codes: G0283, G0282, G0296, G0281.

G0289 descriptor and code status

The October 2026 HCPCS Level II file describes G0289 as “Arthroscopy, knee, surgical, for removal of loose body, foreign body, debridement/shaving of articular cartilage (chondroplasty) at the time of other surgical knee arthroscopy in a different compartment of the same knee”. It sits in the G section (procedures and professional services, temporary), listed with the other G codes. Although searches often call it the "G0289 CPT code", G0289 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 G0289
FieldValue
Short descriptorArthro, loose body + chondro
Added to HCPCS2003-01-01
Last actionN (no maintenance), effective 2003-01-01
Coverage codeC: carrier judgment, so the Medicare contractor decides coverage
Pricing indicator11: physician fee schedule, priced with national RVUs
BETOS categoryP8A: endoscopy - arthroscopy
Type of service2: surgery

Medicare payment for G0289

National PFS payment for G0289 is no non-facility amount in an office and $72.81 in a facility (October 2026), built from 1.44 work, 0.45 practice-expense and 0.29 malpractice RVUs at $33.4009 per RVU. Qualifying APM participants get $73.18 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 A: active: paid separately under the physician fee schedule 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 G0289
ComponentNon-facilityFacility
Work RVU1.441.44
Practice expense RVUNA0.45
Malpractice RVU0.290.29
Total RVUsNA2.18
National payment (CF $33.4009)n/a$72.81
Qualifying APM participant (CF $33.5675)n/a$73.18
  • Multiple procedures (modifier 51): no multiple-procedure reduction
  • Bilateral (modifier 50): 150% bilateral adjustment applies
  • 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 N (Items and Services packaged into APC rates), with no separate OPPS payment rate.

Medically Unlikely Edits for G0289

CMS caps G0289 at practitioner 1 (MAI 2, CMS Policy); hospital outpatient 1 (MAI 2, CMS Policy) 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 G0289 by setting
SettingMUE (units/DOS)MAICMS rationale
Practitioner services12 Date of Service Edit: PolicyCMS Policy
Facility outpatient hospital12 Date of Service Edit: PolicyCMS Policy

The MUE lookup for G0289 shows every setting next to any other code on the same claim.

NCCI edits and add-on rules

In the practitioner PTP file v323r0, G0289 is the column-2 (bundled) code in 2 active pairs, 100% of which allow a modifier and the column-1 code in 23 (61% modifier-allowed); 0 earlier pairs have been deleted. CMS's most frequent rationale for the bundled pairs: HCPCS/CPT procedure code definition.

Column-1 codes most often paired with G0289 (practitioner)
Column-1 codePairs
29880 (CPT; descriptor licensed by AMA)1
29881 (CPT; descriptor licensed by AMA)1
Column-2 codes bundled into G0289 (practitioner)
Column-2 codePairs
11000 (CPT; descriptor licensed by AMA)1
11001 (CPT; descriptor licensed by AMA)1
11004 (CPT; descriptor licensed by AMA)1
11005 (CPT; descriptor licensed by AMA)1
11006 (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

In the hospital outpatient PTP file v323r0, G0289 is the column-2 (bundled) code in 2 active pairs, 100% of which allow a modifier and the column-1 code in 14 (100% modifier-allowed); 0 earlier pairs have been deleted. CMS's most frequent rationale for the bundled pairs: HCPCS/CPT procedure code definition.

Column-1 codes most often paired with G0289 (hospital outpatient)
Column-1 codePairs
29880 (CPT; descriptor licensed by AMA)1
29881 (CPT; descriptor licensed by AMA)1
Column-2 codes bundled into G0289 (hospital outpatient)
Column-2 codePairs
11000 (CPT; descriptor licensed by AMA)1
11001 (CPT; descriptor licensed by AMA)1
11004 (CPT; descriptor licensed by AMA)1
11005 (CPT; descriptor licensed by AMA)1
11006 (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

G0289 is an add-on code: it is payable only with a primary service on the same claim (29871, 29873, 29874, 29875, 29876, 29877, 29879, 29880, 29881, 29882, 29883, 29884, and others). CPT primary codes are shown as numbers only.

Pair counts show exposure, not the answer for one claim. Check G0289 against a second code to see whether the pair bundles and whether a modifier can separate the services.

Medicare coverage policies for G0289

0 active Local Coverage Determinations and 1 billing and coding article list G0289. 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 G0289
ArticleTitleContractor(s)Related LCD
A52369Billing and Coding: Arthroscopic Lavage and Arthroscopic Debridement for the Osteoarthritic Knee – Medical Policy ArticleWellpoint Federal—

Denials to expect on G0289

CARC 50 · N115

the diagnosis or documentation does not meet the LCD or billing article that lists G0289

CARC 151 · N362

units of G0289 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 G0289 claims

QuickCode supports qualified coder review of units, modifiers and NCCI pairs for G0289 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 G0289

What does HCPCS code G0289 describe?

"Arthroscopy, knee, surgical, for removal of loose body, foreign body, debridement/shaving of articular cartilage (chondroplasty) at the time of other surgical knee arthroscopy in a different compartment of the same knee" (short descriptor "Arthro, loose body + chondro"), in the G section (procedures and professional services, temporary). Added 2003-01-01.

Is G0289 a CPT code?

It is not. G0289 belongs to the G section (procedures and professional services, temporary) of HCPCS Level II, the CMS code set, not to AMA CPT. "G0289 CPT code" searches refer to it.

What does Medicare pay for G0289?

National PFS payment for G0289 is no non-facility amount in an office and $72.81 in a facility (October 2026), built from 1.44 work, 0.45 practice-expense and 0.29 malpractice RVUs at $33.4009 per RVU. Qualifying APM participants get $73.18 at $33.5675. Global period ZZZ (add-on service inside the primary service's global period).

Is G0289 an add-on code?

G0289 is an add-on code (NCCI edit type 1): Medicare pays it only on a claim that also carries one of 17 primary codes such as 29871, 29873, 29874, 29875.

How many units of G0289 can be billed per day?

CMS caps G0289 at practitioner 1 (MAI 2, CMS Policy); hospital outpatient 1 (MAI 2, CMS Policy) 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 G0289?

Coverage code C (carrier judgment, so the Medicare contractor decides coverage). 1 billing and coding article lists G0289 across 5 states: A52369.

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.