Key facts for G0448
- Medicare payment
- no PFS amount
- PFS status E
- Coverage code
- C
- carrier judgment, so the Medicare contractor decides coverage
- Practitioner MUE
- 1
- MAI 3
- NCCI PTP pairs
- 229
- 218 hospital outpatient
- LCDs and articles
- 0 / 1
TL;DR
CMS describes HCPCS G0448, added in 2012, as "Insertion or replacement of a permanent pacing cardioverter-defibrillator system with transvenous lead(s), single or dual chamber with insertion of pacing electrode, cardiac venous system, for left ventricular pacing". The physician fee schedule lists G0448 with status E (excluded from the physician fee schedule by regulation), so the PFS carries no national amount for it. CMS caps G0448 at practitioner 1 (MAI 3, Nature of Service/Procedure); hospital outpatient 1 (MAI 3, Nature of Service/Procedure) units per day in the 2026 Q4 MUE tables. In the NCCI PTP files v323r0 G0448 appears in 7 practitioner pairs as column 2 and 222 as column 1 (most often with 0515T, 0516T, 0520T), and in 6 hospital outpatient pairs as column 2 and 212 as column 1. 1 billing and coding article lists G0448 across 4 states: A56391. OPPS status indicator B: Non-allowed item or service for OPPS. HCPCS record: BETOS Y1 (other - Medicare fee schedule); pricing indicator 13; type of service 2 (surgery). Nearby codes: G0447, G0446, G0445, G0451.
G0448 descriptor and code status
The October 2026 HCPCS Level II file describes G0448 as “Insertion or replacement of a permanent pacing cardioverter-defibrillator system with transvenous lead(s), single or dual chamber with insertion of pacing electrode, cardiac venous system, for left ventricular pacing”. It sits in the G section (procedures and professional services, temporary), listed with the other G codes.
| Field | Value |
|---|---|
| Short descriptor | Place perm pacing cardiovert |
| Added to HCPCS | 2012-01-01 |
| Last action | N (no maintenance), effective 2014-01-01 |
| Coverage code | C: carrier judgment, so the Medicare contractor decides coverage |
| Pricing indicator | 13: physician fee schedule, priced by the contractor |
| BETOS category | Y1: other - Medicare fee schedule |
| Type of service | 2: surgery |
Medicare payment for G0448
The physician fee schedule lists G0448 with status E (excluded from the physician fee schedule by regulation), so the PFS carries no national amount for it. 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 B (Non-allowed item or service for OPPS), with no separate OPPS payment rate.
Medically Unlikely Edits for G0448
CMS caps G0448 at practitioner 1 (MAI 3, Nature of Service/Procedure); hospital outpatient 1 (MAI 3, Nature of Service/Procedure) units per day in the 2026 Q4 MUE tables. The practitioner MUE is a date-of-service clinical edit: units above the limit deny but can be paid on appeal with documentation.
| Setting | MUE (units/DOS) | MAI | CMS rationale |
|---|---|---|---|
| Practitioner services | 1 | 3 Date of Service Edit: Clinical | Nature of Service/Procedure |
| Facility outpatient hospital | 1 | 3 Date of Service Edit: Clinical | Nature of Service/Procedure |
The MUE lookup for G0448 shows every setting next to any other code on the same claim.
NCCI edits and add-on rules
In the practitioner PTP file v323r0, G0448 is the column-2 (bundled) code in 7 active pairs, 29% of which allow a modifier and the column-1 code in 222 (66% modifier-allowed); 35 earlier pairs have been deleted. CMS's most frequent rationale for the bundled pairs: Mutually exclusive procedures.
| Column-1 code | Pairs |
|---|---|
| 0515T (CPT; descriptor licensed by AMA) | 1 |
| 0516T (CPT; descriptor licensed by AMA) | 1 |
| 0520T (CPT; descriptor licensed by AMA) | 1 |
| 0574T (CPT; descriptor licensed by AMA) | 1 |
| 33218 (CPT; descriptor licensed by AMA) | 1 |
| 33220 (CPT; descriptor licensed by AMA) | 1 |
| 33226 (CPT; descriptor licensed by AMA) | 1 |
| Column-2 code | Pairs |
|---|---|
| 00530 (CPT; descriptor licensed by AMA) | 1 |
| 00534 (CPT; descriptor licensed by AMA) | 1 |
| 0213T (CPT; descriptor licensed by AMA) | 1 |
| 0216T (CPT; descriptor licensed by AMA) | 1 |
| 0410T (CPT; descriptor licensed by AMA) | 1 |
| 0411T (CPT; descriptor licensed by AMA) | 1 |
| 0415T (CPT; descriptor licensed by AMA) | 1 |
| 0417T (CPT; descriptor licensed by AMA) | 1 |
In the hospital outpatient PTP file v323r0, G0448 is the column-2 (bundled) code in 6 active pairs, 33% of which allow a modifier and the column-1 code in 212 (92% modifier-allowed); 35 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 |
|---|---|
| 0515T (CPT; descriptor licensed by AMA) | 1 |
| 0516T (CPT; descriptor licensed by AMA) | 1 |
| 0520T (CPT; descriptor licensed by AMA) | 1 |
| 33218 (CPT; descriptor licensed by AMA) | 1 |
| 33220 (CPT; descriptor licensed by AMA) | 1 |
| 33226 (CPT; descriptor licensed by AMA) | 1 |
| Column-2 code | Pairs |
|---|---|
| 0213T (CPT; descriptor licensed by AMA) | 1 |
| 0216T (CPT; descriptor licensed by AMA) | 1 |
| 0410T (CPT; descriptor licensed by AMA) | 1 |
| 0411T (CPT; descriptor licensed by AMA) | 1 |
| 0415T (CPT; descriptor licensed by AMA) | 1 |
| 0417T (CPT; descriptor licensed by AMA) | 1 |
| 0418T (CPT; descriptor licensed by AMA) | 1 |
| 0521T (CPT; descriptor licensed by AMA) | 1 |
G0448 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 G0448 against a second code to see whether the pair bundles and whether a modifier can separate the services.
Medicare coverage policies for G0448
0 active Local Coverage Determinations and 1 billing and coding article list G0448. Each applies only in its contractor's jurisdiction, and the article carries the diagnosis codes that support the item or service.
| Article | Title | Contractor(s) | Related LCD |
|---|---|---|---|
| A56391 | Billing and Coding: Implantable Automatic Defibrillators | Wisconsin Physicians Service Insurance Corporation | — |
Denials to expect on G0448
the diagnosis or documentation does not meet the LCD or billing article that lists G0448
the modifier reported is inconsistent with the code
the claim lacks the description, invoice or pricing detail a contractor-priced code needs
Where QuickIntell fits for G0448 claims
QuickCode supports qualified coder review of units, modifiers and NCCI pairs for G0448 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 G0448
What does HCPCS code G0448 describe?
"Insertion or replacement of a permanent pacing cardioverter-defibrillator system with transvenous lead(s), single or dual chamber with insertion of pacing electrode, cardiac venous system, for left ventricular pacing" (short descriptor "Place perm pacing cardiovert"), in the G section (procedures and professional services, temporary). Added 2012-01-01; last action N (no maintenance) effective 2014-01-01.
Is G0448 a CPT code?
It is not. G0448 belongs to the G section (procedures and professional services, temporary) of HCPCS Level II, the CMS code set, not to AMA CPT.
What does Medicare pay for G0448?
The physician fee schedule lists G0448 with status E (excluded from the physician fee schedule by regulation), so the PFS carries no national amount for it.
How many units of G0448 can be billed per day?
CMS caps G0448 at practitioner 1 (MAI 3, Nature of Service/Procedure); hospital outpatient 1 (MAI 3, Nature of Service/Procedure) units per day in the 2026 Q4 MUE tables. For the practitioner MUE (MAI 3), units above 1 deny for the day but can be paid on appeal with documentation; denials arrive as CARC 151.
Does Medicare cover G0448?
Coverage code C (carrier judgment, so the Medicare contractor decides coverage). 1 billing and coding article lists G0448 across 4 states: A56391.
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…
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.