Key facts for G0327
- Medicare payment
- no PFS amount
- PFS status X; OPPS SI A: paid under another fee schedule or system
- Coverage code
- D
- special coverage instructions apply
- Practitioner MUE
- 1
- MAI 2
- NCCI PTP pairs
- 319
- 319 hospital outpatient
- LCDs and articles
- 0 / 0
TL;DR
CMS describes HCPCS G0327, added in 2021, as "Colorectal cancer screening; blood-based biomarker". The physician fee schedule lists G0327 with status X (statutory exclusion: not a physician service under the fee schedule), so the PFS carries no national amount for it. Its OPPS status indicator is A, which the I/OCE table defines as "Services not paid under OPPS; paid under fee schedule or other payment system": Medicare pays G0327 under a fee schedule or payment system other than OPPS. MUE limits for G0327: practitioner 1 (MAI 2, Code Descriptor / CPT Instruction); hospital outpatient 1 (MAI 2, Code Descriptor / CPT Instruction). In the NCCI PTP files v323r0 G0327 appears in 174 practitioner pairs as column 2 and 145 as column 1 (most often with 0001U, 0004M, 0005U), and in 174 hospital outpatient pairs as column 2 and 145 as column 1. G0327 appears in no active LCD or billing and coding article, so coverage follows HCPCS coverage code D (special coverage instructions apply) and any NCD. HCPCS record: BETOS T1H (lab tests - other (non-Medicare fee schedule)); pricing indicator 21; type of service 5 (diagnostic laboratory). 4 other active codes open with "Colorectal cancer screening"; related codes: G0328, G0121, G0105, G0104.
G0327 descriptor and code status
The October 2026 HCPCS Level II file describes G0327 as “Colorectal cancer screening; blood-based biomarker”. It sits in the G section (procedures and professional services, temporary), listed with the other G codes.
| Field | Value |
|---|---|
| Short descriptor | Colon ca scrn;bld-bsd biomrk |
| Added to HCPCS | 2021-07-01 |
| Last action | N (no maintenance), effective 2021-07-01 |
| Coverage code | D: special coverage instructions apply |
| Pricing indicator | 21: clinical lab fee schedule, subject to the national limitation amount |
| BETOS category | T1H: lab tests - other (non-Medicare fee schedule) |
| Type of service | 5: diagnostic laboratory |
Medicare payment for G0327
The physician fee schedule lists G0327 with status X (statutory exclusion: not a physician service under the fee schedule), so the PFS carries no national amount for it. Its OPPS status indicator is A, which the I/OCE table defines as "Services not paid under OPPS; paid under fee schedule or other payment system": Medicare pays G0327 under a fee schedule or payment system other than OPPS. 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 X: statutory exclusion: not a physician service under the fee schedule. Global period XXX (global surgery concept does not apply); PC/TC indicator 9 (professional/technical concept does not apply).
Clinical Laboratory Fee Schedule (26CLABQ4)
G0327 is paid at $0.00 (local (contractor) pricing). Laboratory fee schedule payments carry no beneficiary coinsurance or deductible.
Hospital outpatient (OPPS Addendum B)
Status indicator A (Services not paid under OPPS; paid under fee schedule or other payment system), with no separate OPPS payment rate.
Medically Unlikely Edits for G0327
MUE limits for G0327: practitioner 1 (MAI 2, Code Descriptor / CPT Instruction); hospital outpatient 1 (MAI 2, Code Descriptor / CPT Instruction). 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 G0327 shows every setting next to any other code on the same claim.
NCCI edits and add-on rules
In the practitioner PTP file v323r0, G0327 is the column-2 (bundled) code in 174 active pairs, 98% of which allow a modifier and the column-1 code in 145 (95% modifier-allowed); 129 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 |
|---|---|
| 0001U (CPT; descriptor licensed by AMA) | 1 |
| 0004M (CPT; descriptor licensed by AMA) | 1 |
| 0005U (CPT; descriptor licensed by AMA) | 1 |
| 0006M (CPT; descriptor licensed by AMA) | 1 |
| 0007M (CPT; descriptor licensed by AMA) | 1 |
| 0008U (CPT; descriptor licensed by AMA) | 1 |
| 0010U (CPT; descriptor licensed by AMA) | 1 |
| 0011M (CPT; descriptor licensed by AMA) | 1 |
| Column-2 code | Pairs |
|---|---|
| 0009U (CPT; descriptor licensed by AMA) | 1 |
| 0068U (CPT; descriptor licensed by AMA) | 1 |
| 0086U (CPT; descriptor licensed by AMA) | 1 |
| 0091U (CPT; descriptor licensed by AMA) | 1 |
| 0112U (CPT; descriptor licensed by AMA) | 1 |
| 0115U (CPT; descriptor licensed by AMA) | 1 |
| 0140U (CPT; descriptor licensed by AMA) | 1 |
| 0141U (CPT; descriptor licensed by AMA) | 1 |
In the hospital outpatient PTP file v323r0, G0327 is the column-2 (bundled) code in 174 active pairs, 98% of which allow a modifier and the column-1 code in 145 (95% modifier-allowed); 48 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 |
|---|---|
| 0001U (CPT; descriptor licensed by AMA) | 1 |
| 0004M (CPT; descriptor licensed by AMA) | 1 |
| 0005U (CPT; descriptor licensed by AMA) | 1 |
| 0006M (CPT; descriptor licensed by AMA) | 1 |
| 0007M (CPT; descriptor licensed by AMA) | 1 |
| 0008U (CPT; descriptor licensed by AMA) | 1 |
| 0010U (CPT; descriptor licensed by AMA) | 1 |
| 0011M (CPT; descriptor licensed by AMA) | 1 |
| Column-2 code | Pairs |
|---|---|
| 0009U (CPT; descriptor licensed by AMA) | 1 |
| 0068U (CPT; descriptor licensed by AMA) | 1 |
| 0086U (CPT; descriptor licensed by AMA) | 1 |
| 0091U (CPT; descriptor licensed by AMA) | 1 |
| 0112U (CPT; descriptor licensed by AMA) | 1 |
| 0115U (CPT; descriptor licensed by AMA) | 1 |
| 0140U (CPT; descriptor licensed by AMA) | 1 |
| 0141U (CPT; descriptor licensed by AMA) | 1 |
G0327 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 G0327 against a second code to see whether the pair bundles and whether a modifier can separate the services.
Medicare coverage policies for G0327
No current LCD or billing and coding article lists G0327. The HCPCS coverage code D means special coverage instructions apply, and any National Coverage Determination for the service still applies.
Denials to expect on G0327
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 G0327 claims
QuickCode supports qualified coder review of units, modifiers and NCCI pairs for G0327 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 G0327
What does HCPCS code G0327 describe?
"Colorectal cancer screening; blood-based biomarker" (short descriptor "Colon ca scrn;bld-bsd biomrk"), in the G section (procedures and professional services, temporary). Added 2021-07-01.
Is G0327 a CPT code?
No: CMS maintains G0327 in HCPCS Level II, while the AMA maintains CPT. It goes in the same procedure-code field.
What does Medicare pay for G0327?
The physician fee schedule lists G0327 with status X (statutory exclusion: not a physician service under the fee schedule), so the PFS carries no national amount for it. Its OPPS status indicator is A, which the I/OCE table defines as "Services not paid under OPPS; paid under fee schedule or other payment system": Medicare pays G0327 under a fee schedule or payment system other than OPPS.
How many units of G0327 can be billed per day?
MUE limits for G0327: practitioner 1 (MAI 2, Code Descriptor / CPT Instruction); hospital outpatient 1 (MAI 2, Code Descriptor / CPT Instruction). 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 G0327?
G0327 appears in no active LCD or billing and coding article, so coverage follows HCPCS coverage code D (special coverage instructions apply) and any NCD.
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…
- Clinical Laboratory Fee Schedule public use file, 2026 fourth quarter (26CLABQ4)Version 26CLABQ4 (CY2026 Q4) · effective 2026-10-01 · file PUF_CLFS_CY2026_Q4V1.csvSHA-256 fcfec34526c44390…
- 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…
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.