Most searched codes in this range
Monthly US Google searches for the bare code (Google Ads, measured October 9, 2026) show which codes coders and billers look up most; search demand is one input to which pages are indexed and which the hub lists first.
| Code | Short descriptor | Medicare amount | Searches / month |
|---|---|---|---|
| G2211 | Complex E/M visit add on | $17.37 | 8,100 |
| G0463 | Hospital outpt clinic visit | $136.02 | 2,900 |
| G0439 | Ppps, subseq visit | $137.61 | 2,400 |
| G0438 | Ppps, initial visit | $174.35 | 1,600 |
| G0402 | Initial preventive exam | $174.69 | 1,300 |
| G2212 | Prolong outpt/office vis | $34.07 | 1,300 |
| G0444 | Depression screen annual | $18.70 | 1,000 |
| G0136 | Adm of pa/n assess 5-15 m | $20.04 | 880 |
| G0151 | Hhcp-serv of pt,ea 15 min | — | 880 |
| G0283 | Elec stim other than wound | $12.69 | 720 |
Codes in this range
The table lists the 189 codes in this range whose reference pages are indexed; the other 1087 active codes follow as a list and keep their own pages for lookups. The Medicare amount is the national figure the page leads with.
| Code | Descriptor | Medicare amount | Basis | MUE (setting) | OPPS SI |
|---|---|---|---|---|---|
| G0008 | Administration of influenza virus vaccine | $47.84 | OPPS rate | 1 (hospital outpatient) | S |
| G0009 | Administration of pneumococcal vaccine | $47.84 | OPPS rate | 1 (hospital outpatient) | S |
| G0010 | Administration of hepatitis b vaccine | $47.84 | OPPS rate | 1 (hospital outpatient) | S |
| G0013 | Individual counseling for pre-exposure prophylaxis (prep) by clinical staff to prevent human immunodeficiency virus (hiv), includes: hiv risk assessment (initial or continued assessment of risk), hiv risk reduction and medication adherence | $24.38 | PFS non-facility | — | S |
| G0017 | Psychotherapy for crisis furnished in an applicable site of service (any place of service at which the non-facility rate for psychotherapy for crisis services applies, other than the office setting); first 60 minutes | $218.44 | PFS non-facility | 1 (practitioner) | M |
| G0018 | Psychotherapy for crisis furnished in an applicable site of service (any place of service at which the non-facility rate for psychotherapy for crisis services applies, other than the office setting); each additional 30 minutes (list separately in addition to code for primary service) | $105.21 | PFS non-facility | 3 (practitioner) | M |
| G0019 | Community health integration services performed by certified or trained auxiliary personnel, including a community health worker, under the direction of a physician or other practitioner; 60 minutes per calendar month, in the following activities to address social determinants of health (sdoh) need(s) that are significantly limiting the ability to diagnose or treat problem(s) addressed in an initiating visit: person-centered assessment, performed to better understand the individualized context of the intersection between the sdoh need(s) and the problem(s) addressed in the initiating visit. ++ conducting a person-centered assessment to understand patient's life story, strengths, needs, goals, preferences and desired outcomes, including understanding cultural and linguistic factors and including unmet sdoh needs (that are not separately billed). ++ facilitating patient-driven goal-setting and establishing an action plan. ++ providing tailored support to the patient as needed to accomplish the practitioner's treatment plan. practitioner, home-, and community-based care coordination. ++ coordinating receipt of needed services from healthcare practitioners, providers, and facilities; and from home- and community-based service providers, social service providers, and caregiver (if applicable). ++ communication with practitioners, home- and community-based service providers, hospitals, and skilled nursing facilities (or other health care facilities) regarding the patient's psychosocial strengths and needs, functional deficits, goals, preferences, and desired outcomes, including cultural and linguistic factors. ++ coordination of care transitions between and among health care practitioners and settings, including transitions involving referral to other clinicians; follow-up after an emergency department visit; or follow-up after discharges from hospitals, skilled nursing facilities or other health care facilities. ++ facilitating access to community-based social services (e.g., housing, utilities, transportation, food assistance) to address the sdoh need(s). health education- helping the patient contextualize health education provided by the patient's treatment team with the patient's individual needs, goals, and preferences, in the context of the sdoh need(s), and educating the patient on how to best participate in medical decision-making. building patient self-advocacy skills, so that the patient can interact with members of the health care team and related community-based services addressing the sdoh need(s), in ways that are more likely to promote personalized and effective diagnosis or treatment. health care access / health system navigation. ++ helping the patient access healthcare, including identifying appropriate practitioners or providers for clinical care and helping secure appointments with them. facilitating behavioral change as necessary for meeting diagnosis and treatment goals, including promoting patient motivation to participate in care and reach person-centered diagnosis or treatment goals. facilitating and providing social and emotional support to help the patient cope with the problem(s) addressed in the initiating visit, the sdoh need(s), and adjust daily routines to better meet diagnosis and treatment goals. leveraging lived experience when applicable to provide support, mentorship, or inspiration to meet treatment goals | $86.17 | PFS non-facility | 1 (practitioner) | S |
| G0023 | Principal illness navigation services by certified or trained auxiliary personnel under the direction of a physician or other practitioner, including a patient navigator; 60 minutes per calendar month, in the following activities: person-centered assessment, performed to better understand the individual context of the serious, high-risk condition. ++ conducting a person-centered assessment to understand the patient's life story, strengths, needs, goals, preferences, and desired outcomes, including understanding cultural and linguistic factors and including unmet sdoh needs (that are not separately billed). ++ facilitating patient-driven goal setting and establishing an action plan. ++ providing tailored support as needed to accomplish the practitioner's treatment plan. identifying or referring patient (and caregiver or family, if applicable) to appropriate supportive services. practitioner, home, and community-based care coordination. ++ coordinating receipt of needed services from healthcare practitioners, providers, and facilities; home- and community-based service providers; and caregiver (if applicable). ++ communication with practitioners, home-, and community-based service providers, hospitals, and skilled nursing facilities (or other health care facilities) regarding the patient's psychosocial strengths and needs, functional deficits, goals, preferences, and desired outcomes, including cultural and linguistic factors. ++ coordination of care transitions between and among health care practitioners and settings, including transitions involving referral to other clinicians; follow-up after an emergency department visit; or follow-up after discharges from hospitals, skilled nursing facilities or other health care facilities. ++ facilitating access to community-based social services (e.g., housing, utilities, transportation, food assistance) as needed to address sdoh need(s). health education- helping the patient contextualize health education provided by the patient's treatment team with the patient's individual needs, goals, preferences, and sdoh need(s), and educating the patient (and caregiver if applicable) on how to best participate in medical decision-making. building patient self-advocacy skills, so that the patient can interact with members of the health care team and related community-based services (as needed), in ways that are more likely to promote personalized and effective treatment of their condition. health care access / health system navigation. ++ helping the patient access healthcare, including identifying appropriate practitioners or providers for clinical care, and helping secure appointments with them. ++ providing the patient with information/resources to consider participation in clinical trials or clinical research as applicable. facilitating behavioral change as necessary for meeting diagnosis and treatment goals, including promoting patient motivation to participate in care and reach person-centered diagnosis or treatment goals. facilitating and providing social and emotional support to help the patient cope with the condition, sdoh need(s), and adjust daily routines to better meet diagnosis and treatment goals. leverage knowledge of the serious, high-risk condition and/or lived experience when applicable to provide support, mentorship, or inspiration to meet treatment goals | $87.18 | PFS non-facility | 1 (practitioner) | S |
| G0027 | Semen analysis; presence and/or motility of sperm excluding huhner | $6.50 | CLFS | 1 (practitioner) | Q4 |
| G0101 | Cervical or vaginal cancer screening; pelvic and clinical breast examination | $39.75 | PFS non-facility | 1 (practitioner) | S |
| G0102 | Prostate cancer screening; digital rectal examination | $24.38 | PFS non-facility | 1 (practitioner) | N |
| G0103 | Prostate cancer screening; prostate specific antigen test (psa) | $19.31 | CLFS | 1 (practitioner) | A |
| G0104 | Colorectal cancer screening; flexible sigmoidoscopy | $214.77 | PFS non-facility | 1 (practitioner) | T |
| G0105 | Colorectal cancer screening; colonoscopy on individual at high risk | $378.10 | PFS non-facility | 1 (practitioner) | T |
| G0108 | Diabetes outpatient self-management training services, individual, per 30 minutes | $55.78 | PFS non-facility | 6 (practitioner) | A |
| G0109 | Diabetes outpatient self-management training services, group session (2 or more), per 30 minutes | $16.03 | PFS non-facility | 12 (practitioner) | A |
| G0117 | Glaucoma screening for high risk patients furnished by an optometrist or ophthalmologist | $64.46 | PFS non-facility | 1 (practitioner) | S |
| G0118 | Glaucoma screening for high risk patient furnished under the direct supervision of an optometrist or ophthalmologist | $40.42 | PFS non-facility | 1 (practitioner) | S |
| G0121 | Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk | $378.43 | PFS non-facility | 1 (practitioner) | T |
| G0123 | Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, screening by cytotechnologist under physician supervision | $20.26 | CLFS | 1 (practitioner) | A |
| G0124 | Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, requiring interpretation by physician | $24.05 | PFS non-facility | 1 (practitioner) | B |
| G0127 | Trimming of dystrophic nails, any number | $23.71 | PFS non-facility | 1 (practitioner) | Q1 |
| G0129 | Occupational therapy services requiring the skills of a qualified occupational therapist, furnished as a component of a partial hospitalization or intensive outpatient treatment program, per session (45 minutes or more) | — | none in these files | 6 (hospital outpatient) | P |
| G0130 | Single energy x-ray absorptiometry (sexa) bone density study, one or more sites; appendicular skeleton (peripheral) (e.g., radius, wrist, heel) | $39.75 | PFS non-facility | 1 (practitioner) | S |
| G0136 | Administration of a standardized, evidence-based assessment of physical activity and nutrition, 5-15 minutes, not more often than every 6 months | $20.04 | PFS non-facility | 1 (practitioner) | S |
| G0137 | Intensive outpatient services; weekly bundle, minimum of 9 services over a 7 contiguous day period, which can include individual and group therapy with physicians or psychologists (or other mental health professionals to the extent authorized under state law); occupational therapy requiring the skills of a qualified occupational therapist; services of social workers, trained psychiatric nurses, and other staff trained to work with psychiatric patients; individualized activity therapies that are not primarily recreational or diversionary; family counseling (the primary purpose of which is treatment of the individual's condition); patient training and education (to the extent that training and educational activities are closely and clearly related to individual's care and treatment); diagnostic services; and such other items and services (excluding meals and transportation) that are reasonable and necessary for the diagnosis or active treatment of the individual's condition, reasonably expected to improve or maintain the individual's condition and functional level and to prevent relapse or hospitalization, and furnished pursuant to such guidelines relating to frequency and duration of services in accordance with a physician certification and plan of treatment (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure | — | none in these files | 1 (practitioner) | A |
| G0138 | Intravenous infusion of cipaglucosidase alfa-atga, including provider/supplier acquisition and clinical supervision of oral administration of miglustat in preparation of receipt of cipaglucosidase alfa-atga | $196.40 | PFS non-facility | 1 (practitioner) | S |
| G0140 | Principal illness navigation - peer support by certified or trained auxiliary personnel under the direction of a physician or other practitioner, including a certified peer specialist; 60 minutes per calendar month, in the following activities: person-centered interview, performed to better understand the individual context of the serious, high-risk condition. ++ conducting a person-centered interview to understand the patient's life story, strengths, needs, goals, preferences, and desired outcomes, including understanding cultural and linguistic factors, and including unmet sdoh needs (that are not billed separately). ++ facilitating patient-driven goal setting and establishing an action plan. ++ providing tailored support as needed to accomplish the person-centered goals in the practitioner's treatment plan. identifying or referring patient (and caregiver or family, if applicable) to appropriate supportive services. practitioner, home, and community-based care communication. ++ assist the patient in communicating with their practitioners, home-, and community-based service providers, hospitals, and skilled nursing facilities (or other health care facilities) regarding the patient's psychosocial strengths and needs, goals, preferences, and desired outcomes, including cultural and linguistic factors. ++ facilitating access to community-based social services (e.g., housing, utilities, transportation, food assistance) as needed to address sdoh need(s). health education. helping the patient contextualize health education provided by the patient's treatment team with the patient's individual needs, goals, preferences, and sdoh need(s), and educating the patient (and caregiver if applicable) on how to best participate in medical decision-making. building patient self-advocacy skills, so that the patient can interact with members of the health care team and related community-based services (as needed), in ways that are more likely to promote personalized and effective treatment of their condition. developing and proposing strategies to help meet person-centered treatment goals and supporting the patient in using chosen strategies to reach person-centered treatment goals. facilitating and providing social and emotional support to help the patient cope with the condition, sdoh need(s), and adjust daily routines to better meet person-centered diagnosis and treatment goals. leverage knowledge of the serious, high-risk condition and/or lived experience when applicable to provide support, mentorship, or inspiration to meet treatment goals | $89.18 | PFS non-facility | 1 (practitioner) | S |
| G0141 | Screening cytopathology smears, cervical or vaginal, performed by automated system, with manual rescreening, requiring interpretation by physician | $24.05 | PFS non-facility | 1 (practitioner) | B |
| G0145 | Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system and manual rescreening under physician supervision | $26.49 | CLFS | 1 (practitioner) | A |
| G0151 | Services performed by a qualified physical therapist in the home health or hospice setting, each 15 minutes | — | none in these files | — | B |
| G0152 | Services performed by a qualified occupational therapist in the home health or hospice setting, each 15 minutes | — | none in these files | — | B |
| G0153 | Services performed by a qualified speech-language pathologist in the home health or hospice setting, each 15 minutes | — | none in these files | — | B |
| G0155 | Services of clinical social worker in home health or hospice settings, each 15 minutes | — | none in these files | — | B |
| G0156 | Services of home health/hospice aide in home health or hospice settings, each 15 minutes | — | none in these files | — | B |
| G0157 | Services performed by a qualified physical therapist assistant in the home health or hospice setting, each 15 minutes | — | none in these files | — | B |
| G0158 | Services performed by a qualified occupational therapist assistant in the home health or hospice setting, each 15 minutes | — | none in these files | — | B |
| G0159 | Services performed by a qualified physical therapist, in the home health setting, in the establishment or delivery of a safe and effective physical therapy maintenance program, each 15 minutes | — | none in these files | — | B |
| G0160 | Services performed by a qualified occupational therapist, in the home health setting, in the establishment or delivery of a safe and effective occupational therapy maintenance program, each 15 minutes | — | none in these files | — | B |
| G0166 | External counterpulsation, per treatment session | $102.87 | PFS non-facility | 2 (practitioner) | Q1 |
| G0168 | Wound closure utilizing tissue adhesive(s) only | $105.55 | PFS non-facility | 2 (practitioner) | B |
| G0175 | Scheduled interdisciplinary team conference (minimum of three exclusive of patient care nursing staff) with patient present | $426.30 | OPPS rate | 1 (hospital outpatient) | V |
| G0176 | Activity therapy, such as music, dance, art or play therapies not for recreation, related to the care and treatment of patient's disabling mental health problems, per session (45 minutes or more) | — | none in these files | 5 (hospital outpatient) | P |
| G0177 | Training and educational services related to the care and treatment of patient's disabling mental health problems per session (45 minutes or more) | — | none in these files | 0 (practitioner) | N |
| G0179 | Physician or allowed practitioner re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and allowed practitioners to affirm the initial implementation of the plan of care | $44.42 | PFS non-facility | 1 (practitioner) | M |
| G0180 | Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and allowed practitioners to affirm the initial implementation of the plan of care | $56.78 | PFS non-facility | 1 (practitioner) | M |
| G0181 | Physician or allowed practitioner supervision of a patient receiving medicare-covered services provided by a participating home health agency (patient not present) requiring complex and multidisciplinary care modalities involving regular physician or allowed practitioner development and/or revision of care plans | $109.89 | PFS non-facility | 1 (practitioner) | M |
| G0182 | Physician supervision of a patient under a medicare-approved hospice (patient not present) requiring complex and multidisciplinary care modalities involving regular physician development and/or revision of care plans, review of subsequent reports of patient status, review of laboratory and other studies, communication (including telephone calls) with other health care professionals involved in the patient's care, integration of new information into the medical treatment plan and/or adjustment of medical therapy, within a calendar month, 30 minutes or more | $108.55 | PFS non-facility | 1 (practitioner) | M |
| G0237 | Therapeutic procedures to increase strength or endurance of respiratory muscles, face to face, one on one, each 15 minutes (includes monitoring) | $12.69 | PFS non-facility | 8 (practitioner) | S |
| G0238 | Therapeutic procedures to improve respiratory function, other than described by g0237, one on one, face to face, per 15 minutes (includes monitoring) | $11.36 | PFS non-facility | 8 (practitioner) | S |
| G0239 | Therapeutic procedures to improve respiratory function or increase strength or endurance of respiratory muscles, two or more individuals (includes monitoring) | $14.36 | PFS non-facility | 1 (practitioner) | S |
| G0245 | Initial physician evaluation and management of a diabetic patient with diabetic sensory neuropathy resulting in a loss of protective sensation (lops) which must include: (1) the diagnosis of lops, (2) a patient history, (3) a physical examination that consists of at least the following elements: (a) visual inspection of the forefoot, hindfoot and toe web spaces, (b) evaluation of a protective sensation, (c) evaluation of foot structure and biomechanics, (d) evaluation of vascular status and skin integrity, and (e) evaluation and recommendation of footwear and (4) patient education | $65.47 | PFS non-facility | 1 (practitioner) | V |
| G0246 | Follow-up physician evaluation and management of a diabetic patient with diabetic sensory neuropathy resulting in a loss of protective sensation (lops) to include at least the following: (1) a patient history, (2) a physical examination that includes: (a) visual inspection of the forefoot, hindfoot and toe web spaces, (b) evaluation of protective sensation, (c) evaluation of foot structure and biomechanics, (d) evaluation of vascular status and skin integrity, and (e) evaluation and recommendation of footwear, and (3) patient education | $38.75 | PFS non-facility | 1 (practitioner) | V |
| G0247 | Routine foot care by a physician of a diabetic patient with diabetic sensory neuropathy resulting in a loss of protective sensation (lops) to include, the local care of superficial wounds (i.e. superficial to muscle and fascia) and at least the following if present: (1) local care of superficial wounds, (2) debridement of corns and calluses, and (3) trimming and debridement of nails | $80.83 | PFS non-facility | 1 (practitioner) | Q1 |
| G0248 | Demonstration, prior to initiation of home inr monitoring, for patient with either mechanical heart valve(s), chronic atrial fibrillation, or venous thromboembolism who meets medicare coverage criteria, under the direction of a physician; includes: face-to-face demonstration of use and care of the inr monitor, obtaining at least one blood sample, provision of instructions for reporting home inr test results, and documentation of patient's ability to perform testing and report results | $105.55 | PFS non-facility | 1 (practitioner) | V |
| G0249 | Provision of test materials and equipment for home inr monitoring of patient with either mechanical heart valve(s), chronic atrial fibrillation, or venous thromboembolism who meets medicare coverage criteria; includes: provision of materials for use in the home and reporting of test results to physician; testing not occurring more frequently than once a week; testing materials, billing units of service include 4 tests | $65.80 | PFS non-facility | 3 (practitioner) | V |
| G0250 | Physician review, interpretation, and patient management of home inr testing for patient with either mechanical heart valve(s), chronic atrial fibrillation, or venous thromboembolism who meets medicare coverage criteria; testing not occurring more frequently than once a week; billing units of service include 4 tests | $9.02 | PFS non-facility | 1 (practitioner) | M |
| G0257 | Unscheduled or emergency dialysis treatment for an esrd patient in a hospital outpatient department that is not certified as an esrd facility | $701.18 | OPPS rate | 1 (hospital outpatient) | S |
| G0260 | Injection procedure for sacroiliac joint; provision of anesthetic, steroid and/or other therapeutic agent, with or without arthrography | $721.17 | OPPS rate | 2 (hospital outpatient) | T |
| G0268 | Removal of impacted cerumen (one or both ears) by physician on same date of service as audiologic function testing | $50.44 | PFS non-facility | 1 (practitioner) | N |
| G0269 | Placement of occlusive device into either a venous or arterial access site, post surgical or interventional procedure (e.g., angioseal plug, vascular plug) | — | none in these files | 0 (practitioner) | N |
| G0270 | Medical nutrition therapy; reassessment and subsequent intervention(s) following second referral in same year for change in diagnosis, medical condition or treatment regimen (including additional hours needed for renal disease), individual, face to face with the patient, each 15 minutes | $31.73 | PFS non-facility | 8 (practitioner) | A |
| G0271 | Medical nutrition therapy, reassessment and subsequent intervention(s) following second referral in same year for change in diagnosis, medical condition, or treatment regimen (including additional hours needed for renal disease), group (2 or more individuals), each 30 minutes | $17.03 | PFS non-facility | 4 (practitioner) | A |
| G0277 | Hyperbaric oxygen under pressure, full body chamber, per 30 minute interval | $193.73 | PFS non-facility | 5 (practitioner) | S |
| G0278 | Iliac and/or femoral artery angiography, non-selective, bilateral or ipsilateral to catheter insertion, performed at the same time as cardiac catheterization and/or coronary angiography, includes positioning or placement of the catheter in the distal aorta or ipsilateral femoral or iliac artery, injection of dye, production of permanent images, and radiologic supervision and interpretation (list separately in addition to primary procedure) | $11.69 | PFS facility | 1 (practitioner) | N |
| G0279 | Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) | $40.42 | PFS non-facility | 1 (practitioner) | A |
| G0281 | Electrical stimulation, (unattended), to one or more areas, for chronic stage iii and stage iv pressure ulcers, arterial ulcers, diabetic ulcers, and venous stasis ulcers not demonstrating measurable signs of healing after 30 days of conventional care, as part of a therapy plan of care | $11.69 | PFS non-facility | 1 (practitioner) | A |
| G0282 | Electrical stimulation, (unattended), to one or more areas, for wound care other than described in g0281 | — | none in these files | 0 (practitioner) | E1 |
| G0283 | Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care | $12.69 | PFS non-facility | 1 (practitioner) | A |
| G0289 | 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 | $72.81 | PFS facility | 1 (practitioner) | N |
| G0296 | Counseling visit to discuss need for lung cancer screening using low dose ct scan (ldct) (service is for eligibility determination and shared decision making) | $28.72 | PFS non-facility | 1 (practitioner) | S |
| G0316 | Prolonged hospital inpatient or observation care evaluation and management service(s) beyond the total time for the primary service (when the primary service has been selected using time on the date of the primary service); each additional 15 minutes by the physician or qualified healthcare professional, with or without direct patient contact (list separately in addition to cpt codes 99223, 99233, and 99236 for hospital inpatient or observation care evaluation and management services). (do not report g0316 on the same date of service as other prolonged services for evaluation and management 99358, 99359, 99418, 99415, 99416). (do not report g0316 for any time unit less than 15 minutes) | $34.74 | PFS non-facility | 4 (practitioner) | N |
| G0317 | Prolonged nursing facility evaluation and management service(s) beyond the total time for the primary service (when the primary service has been selected using time on the date of the primary service); each additional 15 minutes by the physician or qualified healthcare professional, with or without direct patient contact (list separately in addition to cpt codes 99306, 99310 for nursing facility evaluation and management services). (do not report g0317 on the same date of service as other prolonged services for evaluation and management 99358, 99359, 99418). (do not report g0317 for any time unit less than 15 minutes) | $33.73 | PFS non-facility | 4 (practitioner) | B |
| G0318 | Prolonged home or residence evaluation and management service(s) beyond the total time for the primary service (when the primary service has been selected using time on the date of the primary service); each additional 15 minutes by the physician or qualified healthcare professional, with or without direct patient contact (list separately in addition to cpt codes 99345, 99350 for home or residence evaluation and management services). (do not report g0318 on the same date of service as other prolonged services for evaluation and management 99358, 99359, 99417). (do not report g0318 for any time unit less than 15 minutes) | $34.07 | PFS non-facility | 4 (practitioner) | B |
| G0323 | Care management services for behavioral health conditions, at least 20 minutes of clinical psychologist, clinical social worker, mental health counselor, or marriage and family therapist time, per calendar month. (these services include the following required elements: initial assessment or follow-up monitoring, including the use of applicable validated rating scales; behavioral health care planning in relation to behavioral/psychiatric health problems, including revision for patients who are not progressing or whose status changes; facilitating and coordinating treatment such as psychotherapy, coordination with and/or referral to physicians and practitioners who are authorized by medicare to prescribe medications and furnish e/m services, counseling and/or psychiatric consultation; and continuity of care with a designated member of the care team) | $57.78 | PFS non-facility | 1 (practitioner) | S |
| G0327 | Colorectal cancer screening; blood-based biomarker | — | none in these files | 1 (practitioner) | A |
| G0328 | Colorectal cancer screening; fecal occult blood test, immunoassay, 1-3 simultaneous | $18.05 | CLFS | 1 (practitioner) | A |
| G0330 | Facility services for dental rehabilitation procedure(s) performed on a patient who requires monitored anesthesia (e.g., general, intravenous sedation (monitored anesthesia care) and use of an operating room | $3,387.27 | OPPS rate | 1 (hospital outpatient) | J1 |
| G0339 | Image-guided robotic linear accelerator-based stereotactic radiosurgery, complete course of therapy in one session or first session of fractionated treatment | — | none in these files | 1 (practitioner) | B |
| G0340 | Image-guided robotic linear accelerator-based stereotactic radiosurgery, delivery including collimator changes and custom plugging, fractionated treatment, all lesions, per session, second through fifth sessions, maximum five sessions per course of treatment | — | none in these files | 1 (practitioner) | B |
| G0372 | Physician service required to establish and document the need for a power mobility device | $9.35 | PFS non-facility | 1 (practitioner) | M |
| G0378 | Hospital observation service, per hour | — | none in these files | 0 (practitioner) | N |
| G0379 | Direct admission of patient for hospital observation care | $608.43 | OPPS rate | 1 (hospital outpatient) | J2 |
| G0380 | Level 1 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room or emergency department; (2) it is held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment; or (3) during the calendar year immediately preceding the calendar year in which a determination under 42 cfr 489.24 is being made, based on a representative sample of patient visits that occurred during that calendar year, it provides at least one-third of all of its outpatient visits for the treatment of emergency medical conditions on an urgent basis without requiring a previously scheduled appointment) | $75.94 | OPPS rate | 2 (hospital outpatient) | J2 |
| G0381 | Level 2 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room or emergency department; (2) it is held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment; or (3) during the calendar year immediately preceding the calendar year in which a determination under 42 cfr 489.24 is being made, based on a representative sample of patient visits that occurred during that calendar year, it provides at least one-third of all of its outpatient visits for the treatment of emergency medical conditions on an urgent basis without requiring a previously scheduled appointment) | $94.90 | OPPS rate | 2 (hospital outpatient) | J2 |
| G0382 | Level 3 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room or emergency department; (2) it is held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment; or (3) during the calendar year immediately preceding the calendar year in which a determination under 42 cfr 489.24 is being made, based on a representative sample of patient visits that occurred during that calendar year, it provides at least one-third of all of its outpatient visits for the treatment of emergency medical conditions on an urgent basis without requiring a previously scheduled appointment) | $175.61 | OPPS rate | 2 (hospital outpatient) | J2 |
| G0383 | Level 4 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room or emergency department; (2) it is held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment; or (3) during the calendar year immediately preceding the calendar year in which a determination under 42 cfr 489.24 is being made, based on a representative sample of patient visits that occurred during that calendar year, it provides at least one-third of all of its outpatient visits for the treatment of emergency medical conditions on an urgent basis without requiring a previously scheduled appointment) | $270.03 | OPPS rate | 2 (hospital outpatient) | J2 |
| G0390 | Trauma response team associated with hospital critical care service | $1,361.78 | OPPS rate | 1 (hospital outpatient) | S |
| G0396 | Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and brief intervention 15 to 30 minutes | $37.07 | PFS non-facility | 1 (practitioner) | S |
| G0397 | Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and intervention, greater than 30 minutes | $67.47 | PFS non-facility | 1 (practitioner) | S |
| G0398 | Home sleep study test (hst) with type ii portable monitor, unattended; minimum of 7 channels: eeg, eog, emg, ecg/heart rate, airflow, respiratory effort and oxygen saturation | $220.60 | OPPS rate | 1 (hospital outpatient) | S |
| G0399 | Home sleep test (hst) with type iii portable monitor, unattended; minimum of 4 channels: 2 respiratory movement/airflow, 1 ecg/heart rate and 1 oxygen saturation | $220.60 | OPPS rate | 1 (hospital outpatient) | S |
| G0400 | Home sleep test (hst) with type iv portable monitor, unattended; minimum of 3 channels | $220.60 | OPPS rate | 1 (hospital outpatient) | S |
| G0402 | Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment | $174.69 | PFS non-facility | 1 (practitioner) | V |
| G0403 | Electrocardiogram, routine ecg with 12 leads; performed as a screening for the initial preventive physical examination with interpretation and report | $15.36 | PFS non-facility | 1 (practitioner) | M |
| G0404 | Electrocardiogram, routine ecg with 12 leads; tracing only, without interpretation and report, performed as a screening for the initial preventive physical examination | $7.01 | PFS non-facility | 1 (practitioner) | S |
| G0405 | Electrocardiogram, routine ecg with 12 leads; interpretation and report only, performed as a screening for the initial preventive physical examination | $8.35 | PFS non-facility | 1 (practitioner) | B |
| G0406 | Follow-up inpatient consultation, limited, physicians typically spend 15 minutes communicating with the patient via telehealth | $36.07 | PFS facility | 1 (practitioner) | B |
| G0407 | Follow-up inpatient consultation, intermediate, physicians typically spend 25 minutes communicating with the patient via telehealth | $63.80 | PFS facility | 1 (practitioner) | B |
| G0408 | Follow-up inpatient consultation, complex, physicians typically spend 35 minutes communicating with the patient via telehealth | $93.52 | PFS facility | 1 (practitioner) | B |
| G0410 | Group psychotherapy other than of a multiple-family group, in a partial hospitalization or intensive outpatient setting, approximately 45 to 50 minutes | — | none in these files | 4 (practitioner) | P |
| G0411 | Interactive group psychotherapy, in a partial hospitalization or intensive outpatient setting, approximately 45 to 50 minutes | — | none in these files | 4 (practitioner) | P |
| G0413 | Percutaneous skeletal fixation of posterior pelvic bone fracture and/or dislocation, for fracture patterns which disrupt the pelvic ring, unilateral or bilateral, (includes ilium, sacroiliac joint and/or sacrum) | $977.98 | PFS facility | 1 (practitioner) | J1 |
| G0416 | Surgical pathology, gross and microscopic examinations, for prostate needle biopsy, any method | $356.72 | PFS non-facility | 1 (practitioner) | Q2 |
| G0420 | Face-to-face educational services related to the care of chronic kidney disease; individual, per session, per one hour | $113.56 | PFS non-facility | 2 (practitioner) | A |
| G0422 | Intensive cardiac rehabilitation; with or without continuous ecg monitoring with exercise, per session | $131.60 | PFS non-facility | 6 (practitioner) | S |
| G0423 | Intensive cardiac rehabilitation; with or without continuous ecg monitoring; without exercise, per session | $131.60 | PFS non-facility | 6 (practitioner) | S |
| G0425 | Telehealth consultation, emergency department or initial inpatient, typically 30 minutes communicating with the patient via telehealth | $84.17 | PFS facility | 1 (practitioner) | B |
| G0426 | Telehealth consultation, emergency department or initial inpatient, typically 50 minutes communicating with the patient via telehealth | $117.24 | PFS facility | 1 (practitioner) | B |
| G0427 | Telehealth consultation, emergency department or initial inpatient, typically 70 minutes or more communicating with the patient via telehealth | $168.34 | PFS facility | 1 (practitioner) | B |
| G0429 | Dermal filler injection(s) for the treatment of facial lipodystrophy syndrome (lds) (e.g., as a result of highly active antiretroviral therapy) | $99.53 | PFS non-facility | 1 (practitioner) | T |
| G0432 | Infectious agent antibody detection by enzyme immunoassay (eia) technique, hiv-1 and/or hiv-2, screening | $19.57 | CLFS | 1 (practitioner) | A |
| G0433 | Infectious agent antibody detection by enzyme-linked immunosorbent assay (elisa) technique, hiv-1 and/or hiv-2, screening | $18.29 | CLFS | 1 (practitioner) | A |
| G0438 | Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit | $174.35 | PFS non-facility | 1 (practitioner) | A |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | $137.61 | PFS non-facility | 1 (practitioner) | A |
| G0442 | Annual alcohol misuse screening, 5 to 15 minutes | $18.70 | PFS non-facility | 1 (practitioner) | S |
| G0443 | Brief face-to-face behavioral counseling for alcohol misuse, 15 minutes | $34.40 | PFS non-facility | 1 (practitioner) | S |
| G0444 | Annual depression screening, 5 to 15 minutes | $18.70 | PFS non-facility | 1 (practitioner) | S |
| G0445 | High intensity behavioral counseling to prevent sexually transmitted infection; face-to-face, individual, includes: education, skills training and guidance on how to change sexual behavior; performed semi-annually, 30 minutes | $34.40 | PFS non-facility | 1 (practitioner) | S |
| G0446 | Annual, face-to-face intensive behavioral therapy for cardiovascular disease, individual, 15 minutes | $34.07 | PFS non-facility | 1 (practitioner) | S |
| G0447 | Face-to-face behavioral counseling for obesity, 15 minutes | $34.07 | PFS non-facility | 1 (practitioner) | S |
| G0448 | 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 | — | none in these files | 1 (practitioner) | B |
| G0451 | Development testing, with interpretation and report, per standardized instrument form | $12.36 | PFS non-facility | 1 (practitioner) | Q3 |
| G0452 | Molecular pathology procedure; physician interpretation and report | $46.76 | PFS non-facility | 6 (practitioner) | B |
| G0453 | Continuous intraoperative neurophysiology monitoring, from outside the operating room (remote or nearby), per patient, (attention directed exclusively to one patient) each 15 minutes (list in addition to primary procedure) | $27.39 | PFS facility | 40 (practitioner) | N |
| G0454 | Physician documentation of face-to-face visit for durable medical equipment determination performed by nurse practitioner, physician assistant or clinical nurse specialist | $9.02 | PFS non-facility | 1 (practitioner) | B |
| G0459 | Inpatient telehealth pharmacologic management, including prescription, use, and review of medication with no more than minimal medical psychotherapy | $39.75 | PFS facility | 1 (practitioner) | B |
| G0460 | Autologous platelet rich plasma or other blood-derived product for non-diabetic chronic wounds/ulcers, including as applicable phlebotomy, centrifugation or mixing, and all other preparatory procedures, administration and dressings, per treatment | $2,107.97 | OPPS rate | 1 (hospital outpatient) | T |
| G0463 | Hospital outpatient clinic visit for assessment and management of a patient | $136.02 | OPPS rate | 4 (hospital outpatient) | J2 |
| G0465 | Autologous platelet rich plasma (prp) or other blood-derived product for diabetic chronic wounds/ulcers, using an fda-cleared device for this indication, (includes as applicable administration, dressings, phlebotomy, centrifugation or mixing, and all other preparatory procedures, per treatment) | $1,063.48 | PFS non-facility | 2 (practitioner) | T |
| G0466 | Federally qualified health center (fqhc) visit, new patient; a medically-necessary, face-to-face encounter (one-on-one) between a new patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a fqhc visit | — | none in these files | 1 (practitioner) | A |
| G0467 | Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a fqhc visit | — | none in these files | 1 (practitioner) | A |
| G0468 | Federally qualified health center (fqhc) visit, ippe or awv; a fqhc visit that includes an initial preventive physical examination (ippe) or annual wellness visit (awv) and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving an ippe or awv | — | none in these files | 1 (practitioner) | A |
| G0469 | Federally qualified health center (fqhc) visit, mental health, new patient; a medically-necessary, face-to-face mental health encounter (one-on-one) between a new patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a mental health visit | — | none in these files | 1 (practitioner) | A |
| G0471 | Collection of venous blood by venipuncture or urine sample by catheterization from an individual in a skilled nursing facility (snf) or by a laboratory on behalf of a home health agency (hha) | $11.34 | CLFS | 2 (practitioner) | A |
| G0472 | Hepatitis c antibody screening, for individual at high risk and other covered indication(s) | $46.35 | CLFS | 1 (practitioner) | A |
| G0473 | Face-to-face behavioral counseling for obesity, group (2-10), 30 minutes | $12.69 | PFS non-facility | 1 (practitioner) | S |
| G0475 | Hiv antigen/antibody, combination assay, screening | $24.08 | CLFS | 1 (practitioner) | A |
| G0476 | Infectious agent detection by nucleic acid (dna or rna); human papillomavirus (hpv), high-risk types (e.g., 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68) for cervical cancer screening, must be performed in addition to pap test | $35.09 | CLFS | 1 (practitioner) | A |
| G0480 | Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 1-7 drug class(es), including metabolite(s) if performed | $114.43 | CLFS | 1 (practitioner) | Q4 |
| G0481 | Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 8-14 drug class(es), including metabolite(s) if performed | $156.59 | CLFS | 1 (practitioner) | Q4 |
| G0491 | Dialysis procedure at a medicare certified esrd facility for acute kidney injury without esrd | — | none in these files | 1 (practitioner) | B |
| G0498 | Chemotherapy administration, intravenous infusion technique; initiation of infusion in the office/clinic setting using office/clinic pump/supplies, with continuation of the infusion in the community setting (e.g., home, domiciliary, rest home or assisted living) using a portable pump provided by the office/clinic, includes follow up office/clinic visit at the conclusion of the infusion | $337.46 | OPPS rate | 1 (hospital outpatient) | S |
| G0499 | Hepatitis b screening in non-pregnant, high risk individual includes hepatitis b surface antigen (hbsag), antibodies to hbsag (anti-hbs) and antibodies to hepatitis b core antigen (anti-hbc), and is followed by a neutralizing confirmatory test, when performed, only for an initially reactive hbsag result | $28.27 | CLFS | 1 (practitioner) | A |
| G0500 | Moderate sedation services provided by the same physician or other qualified health care professional performing a gastrointestinal endoscopic service that sedation supports, requiring the presence of an independent trained observer to assist in the monitoring of the patient's level of consciousness and physiological status; initial 15 minutes of intra-service time; patient age 5 years or older (additional time may be reported with 99153, as appropriate) | $66.47 | PFS non-facility | 1 (practitioner) | N |
| G0506 | Comprehensive assessment of and care planning for patients requiring chronic care management services (list separately in addition to primary monthly care management service) | $66.47 | PFS non-facility | 1 (practitioner) | N |
| G0508 | Telehealth consultation, critical care, initial , physicians typically spend 60 minutes communicating with the patient and providers via telehealth | $184.71 | PFS facility | 1 (practitioner) | B |
| G0513 | Prolonged preventive service(s) (beyond the typical service time of the primary procedure), in the office or other outpatient setting requiring direct patient contact beyond the usual service; first 30 minutes (list separately in addition to code for preventive service) | $64.80 | PFS non-facility | 1 (practitioner) | N |
| G0514 | Prolonged preventive service(s) (beyond the typical service time of the primary procedure), in the office or other outpatient setting requiring direct patient contact beyond the usual service; each additional 30 minutes (list separately in addition to code g0513 for additional 30 minutes of preventive service) | $64.80 | PFS non-facility | 1 (practitioner) | N |
| G0516 | Insertion of non-biodegradable drug delivery implants, 4 or more (services for subdermal rod implant) | $175.02 | PFS non-facility | 1 (practitioner) | Q1 |
| G0537 | Administration of a standardized, evidence-based atherosclerotic cardiovascular disease (ascvd) risk assessment, 5-15 minutes, not more often than every 12 months | $20.04 | PFS non-facility | 1 (practitioner) | S |
| G0538 | Atherosclerotic cardiovascular disease (ascvd) risk management services; clinical staff time; per calendar month | $17.03 | PFS non-facility | 1 (practitioner) | S |
| G0539 | Caregiver training in behavior management/modification for caregiver(s) of patients with a mental or physical health diagnosis, administered by physician or other qualified health care professional (without the patient present), face-to-face; initial 30 minutes | $53.11 | PFS non-facility | 1 (practitioner) | A |
| G0541 | Caregiver training in direct care strategies and techniques to support care for patients with an ongoing condition or illness and to reduce complications (including, but not limited to, techniques to prevent decubitus ulcer formation, wound care, and infection control) (without the patient present), face-to-face; initial 30 minutes | $53.11 | PFS non-facility | 1 (practitioner) | S |
| G0542 | Caregiver training in direct care strategies and techniques to support care for patients with an ongoing condition or illness and to reduce complications (including, but not limited to, techniques to prevent decubitus ulcer formation, wound care, and infection control) (without the patient present), face-to-face; each additional 15 minutes (list separately in addition to code for primary service) (use g0542 in conjunction with g0541) | $26.05 | PFS non-facility | 2 (practitioner) | N |
| G0544 | Post discharge telephonic follow-up contacts performed in conjunction with a discharge from the emergency department for behavioral health or other crisis encounter, 4 calls per calendar month | $66.80 | PFS non-facility | 1 (practitioner) | S |
| G0545 | Visit complexity inherent to hospital inpatient or observation care associated with a confirmed or suspected infectious disease by an infectious diseases specialist, including disease transmission risk assessment and mitigation, public health investigation, analysis, and testing, and complex antimicrobial therapy counseling and treatment (add-on code, list separately in addition to hospital inpatient or observation evaluation and management visit, initial, same day discharge, subsequent or discharge) | $48.43 | PFS non-facility | 1 (practitioner) | B |
| G0553 | First 20 minutes of monthly treatment management services directly related to the patient's therapeutic use of the digital mental health treatment (dmht) device that augments a behavioral therapy plan, physician/other qualified health care professional time reviewing information related to the use of the dmht device, including patient observations and patient specific inputs in a calendar month and requiring at least one interactive communication with the patient/caregiver during the calendar month | $54.11 | PFS non-facility | 1 (practitioner) | V |
| G0557 | Advanced primary care management services for a patient with multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient, which place the patient at significant risk of death, acute exacerbation/decompensation, or functional decline, provided by clinical staff and directed by a physician or other qualified health care professional who is responsible for all primary care and serves as the continuing focal point for all needed health care services, per calendar month, with the following elements, as appropriate: consent; ++ inform the patient of the availability of the service; that only one practitioner can furnish and be paid for the service during a calendar month; of the right to stop the services at any time (effective at the end of the calendar month); and that cost sharing may apply. ++ document in patient's medical record that consent was obtained. initiation during a qualifying visit for new patients or patients not seen within 3 years; provide 24/7 access for urgent needs to care team/practitioner, including providing patients/caregivers with a way to contact health care professionals in the practice to discuss urgent needs regardless of the time of day or day of week; continuity of care with a designated member of the care team with whom the patient is able to schedule successive routine appointments; deliver care in alternative ways to traditional office visits to best meet the patient's needs, such as home visits and/or expanded hours; overall comprehensive care management; ++ systematic needs assessment (medical and psychosocial). ++ system-based approaches to ensure receipt of preventive services. ++ medication reconciliation, management and oversight of self-management. development, implementation, revision, and maintenance of an electronic patient-centered comprehensive care plan; ++ care plan is available timely within and outside the billing practice as appropriate to individuals involved in the beneficiary's care, can be routinely accessed and updated by care team/practitioner, and copy of care plan to patient/caregiver; coordination of care transitions between and among health care providers and settings, including referrals to other clinicians and follow-up after an emergency department visit and discharges from hospitals, skilled nursing facilities or other health care facilities as applicable; ++ ensure timely exchange of electronic health information with other practitioners and providers to support continuity of care. ++ ensure timely follow-up communication (direct contact, telephone, electronic) with the patient and/or caregiver after an emergency department visit and discharges from hospitals, skilled nursing facilities, or other health care facilities, within 7 calendar days of discharge, as clinically indicated. ongoing communication and coordinating receipt of needed services from practitioners, home- and community-based service providers, community-based social service providers, hospitals, and skilled nursing facilities (or other health care facilities), and document communication regarding the patient's psychosocial strengths and needs, functional deficits, goals, preferences, and desired outcomes, including cultural and linguistic factors, in the patient's medical record; enhanced opportunities for the beneficiary and any caregiver to communicate with the care team/practitioner regarding the beneficiary's care through the use of asynchronous non-face-to-face consultation methods other than telephone, such as secure messaging, email, internet, or patient portal, and other communication-technology based services, including remote evaluation of pre-recorded patient information and interprofessional telephone/internet/ehr referral service(s), to maintain ongoing communication with patients, as appropriate; ++ ensure access to patient-initiated digital communications that require a clinical decision, such as virtual check-ins and digital online assessment and management and e/m visits (or e-visits). analyze patient population data to identify gaps in care and offer additional interventions, as appropriate; risk stratify the practice population based on defined diagnoses, claims, or other electronic data to identify and target services to patients; be assessed through performance measurement of primary care quality, total cost of care, and meaningful use of certified ehr technology | $53.78 | PFS non-facility | 1 (practitioner) | S |
| G0560 | Safety planning interventions, each 20 minutes personally performed by the billing practitioner, including assisting the patient in the identification of the following personalized elements of a safety plan: recognizing warning signs of an impending suicidal or substance use-related crisis; employing internal coping strategies; utilizing social contacts and social settings as a means of distraction from suicidal thoughts or risky substance use; utilizing family members, significant others, caregivers, and/or friends to help resolve the crisis; contacting mental health or substance use disorder professionals or agencies; and making the environment safe | $42.42 | PFS non-facility | 1 (practitioner) | A |
| G0570 | Care management services for behavioral health conditions, directed by a physician or other qualified health care professional, per calendar month, with the following required elements: initial assessment or follow-up monitoring, including the use of applicable validated rating scales, behavioral health care planning in relation to behavioral/psychiatric health problems, including revision for patients who are not progressing or whose status changes, facilitating and coordinating treatment such as psychotherapy, pharmacotherapy, counseling and/or psychiatric consultation, and continuity of care with a designated member of the care team (list separately in addition to advanced primary care management code) | $57.78 | PFS non-facility | — | S |
| G0659 | Drug test(s), definitive, utilizing drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem), excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase), performed without method or drug-specific calibration, without matrix-matched quality control material, or without use of stable isotope or other universally recognized internal standard(s) for each drug, drug metabolite or drug class per specimen; qualitative or quantitative, all sources, includes specimen validity testing, per day, any number of drug classes | $62.14 | CLFS | 1 (practitioner) | Q4 |
| G2000 | Blinded administration of convulsive therapy procedure, either electroconvulsive therapy (ect, current covered gold standard) or magnetic seizure therapy (mst, non-covered experimental therapy), performed in an approved ide-based clinical trial, per treatment session | $381.24 | OPPS rate | 1 (hospital outpatient) | S |
| G2001 | Brief (20 minutes) in-home visit for a new patient post-discharge. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary's home, domiciliary, rest home, assisted living and/or nursing facility within 90 days following discharge from an inpatient facility and no more than 9 times.) | $49.43 | PFS non-facility | 1 (practitioner) | B |
| G2002 | Limited (30 minutes) in-home visit for a new patient post-discharge. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary's home, domiciliary, rest home, assisted living and/or nursing facility within 90 days following discharge from an inpatient facility and no more than 9 times.) | $74.48 | PFS non-facility | 1 (practitioner) | B |
| G2003 | Moderate (45 minutes) in-home visit for a new patient post-discharge. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary's home, domiciliary, rest home, assisted living and/or nursing facility within 90 days following discharge from an inpatient facility and no more than 9 times.) | $120.24 | PFS non-facility | 1 (practitioner) | B |
| G2005 | Extensive (75 minutes) in-home visit for a new patient post-discharge. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary's home, domiciliary, rest home, assisted living and/or nursing facility within 90 days following discharge from an inpatient facility and no more than 9 times.) | $217.11 | PFS non-facility | 1 (practitioner) | B |
| G2006 | Brief (20 minutes) in-home visit for an existing patient post-discharge. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary's home, domiciliary, rest home, assisted living and/or nursing facility within 90 days following discharge from an inpatient facility and no more than 9 times.) | $49.43 | PFS non-facility | 1 (practitioner) | B |
| G2010 | Remote evaluation of recorded video and/or images submitted by an established patient (e.g., store and forward), including interpretation with follow-up with the patient within 24 business hours, not originating from a related e/m service provided within the previous 7 days nor leading to an e/m service or procedure within the next 24 hours or soonest available appointment | $13.03 | PFS non-facility | 1 (practitioner) | B |
| G2011 | Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and brief intervention, 5-14 minutes | $17.37 | PFS non-facility | 1 (practitioner) | S |
| G2014 | Limited (30 minutes) care plan oversight. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary's home, domiciliary, rest home, assisted living and/or nursing facility within 90 days following discharge from an inpatient facility and no more than 9 times.) | $73.82 | PFS non-facility | 1 (practitioner) | B |
| G2067 | Medication assisted treatment, methadone; weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing, if performed (provision of the services by a medicare-enrolled opioid treatment program) | — | none in these files | 1 (practitioner) | A |
| G2068 | Medication assisted treatment, buprenorphine (oral); weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing if performed (provision of the services by a medicare-enrolled opioid treatment program) | — | none in these files | 1 (practitioner) | A |
| G2069 | Medication assisted treatment, buprenorphine (injectable) administered on a monthly basis; bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing if performed (provision of the services by a medicare-enrolled opioid treatment program) | — | none in these files | 1 (practitioner) | A |
| G2076 | Intake activities, including initial medical examination that is conducted by an appropriately licensed practitioner and preparation of a care plan, which may be informed by administration of a standardized, evidence-based assessment, and that includes the patient's goals and mutually agreed-upon actions for the patient to meet those goals, including harm reduction interventions; the patient's needs and goals in the areas of education, vocational training, and employment; and the medical and psychiatric, psychosocial, economic, legal, housing, physical activity and/or nutrition needs and other recovery support services that a patient needs and wishes to pursue, conducted by an appropriately licensed/credentialed personnel (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to each primary code | — | none in these files | 1 (practitioner) | A |
| G2078 | Take-home supply of methadone; up to 7 additional day supply (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure | — | none in these files | 3 (practitioner) | A |
| G2079 | Take-home supply of buprenorphine (oral); up to 7 additional day supply (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure | — | none in these files | 3 (practitioner) | A |
| G2082 | Office or other outpatient visit for the evaluation and management of an established patient that requires the supervision of a physician or other qualified health care professional and provision of up to 56 mg of esketamine nasal self-administration, includes 2 hours post-administration observation | $952.59 | PFS non-facility | 1 (practitioner) | S |
| G2083 | Office or other outpatient visit for the evaluation and management of an established patient that requires the supervision of a physician or other qualified health care professional and provision of greater than 56 mg esketamine nasal self-administration, includes 2 hours post-administration observation | $1,356.08 | PFS non-facility | 1 (practitioner) | S |
| G2086 | Office-based treatment for opioid use disorder, including development of the treatment plan, care coordination, individual therapy and group therapy and counseling; at least 70 minutes in the first calendar month | $491.33 | PFS non-facility | 1 (practitioner) | S |
| G2087 | Office-based treatment for opioid use disorder, including care coordination, individual therapy and group therapy and counseling; at least 60 minutes in a subsequent calendar month | $443.23 | PFS non-facility | 2 (practitioner) | S |
| G2211 | Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to home or residence or office/outpatient evaluation and management service, new or established) | $17.37 | PFS non-facility | — | B |
| G2212 | Prolonged office or other outpatient evaluation and management service(s) beyond the maximum required time of the primary procedure which has been selected using total time on the date of the primary service; each additional 15 minutes by the physician or qualified healthcare professional, with or without direct patient contact (list separately in addition to cpt codes 99205, 99215, 99483 for office or other outpatient evaluation and management services) (do not report g2212 on the same date of service as 99358, 99359, 99415, 99416). (do not report g2212 for any time unit less than 15 minutes) | $34.07 | PFS non-facility | 6 (practitioner) | N |
| G2214 | Initial or subsequent psychiatric collaborative care management, first 30 minutes in a month of behavioral health care manager activities, in consultation with a psychiatric consultant, and directed by the treating physician or other qualified health care professional | $60.79 | PFS non-facility | 1 (practitioner) | S |
| G2250 | Remote assessment of recorded video and/or images submitted by an established patient (e.g., store and forward), including interpretation with follow-up with the patient within 24 business hours, not originating from a related service provided within the previous 7 days nor leading to a service or procedure within the next 24 hours or soonest available appointment | $13.03 | PFS non-facility | 1 (practitioner) | A |
| G2251 | Brief communication technology-based service, e.g. virtual check-in, by a qualified health care professional who cannot report evaluation and management services, provided to an established patient, not originating from a related service provided within the previous 7 days nor leading to a service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of clinical discussion | $14.03 | PFS non-facility | 1 (practitioner) | A |
| G2252 | Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related e/m service provided within the previous 7 days nor leading to an e/m service or procedure within the next 24 hours or soonest available appointment; 11-20 minutes of medical discussion | $28.39 | PFS non-facility | 1 (practitioner) | A |
| G3002 | Chronic pain management and treatment, monthly bundle including, diagnosis; assessment and monitoring; administration of a validated pain rating scale or tool; the development, implementation, revision, and/or maintenance of a person-centered care plan that includes strengths, goals, clinical needs, and desired outcomes; overall treatment management; facilitation and coordination of any necessary behavioral health treatment; medication management; pain and health literacy counseling; any necessary chronic pain related crisis care; and ongoing communication and care coordination between relevant practitioners furnishing care, e.g. physical therapy and occupational therapy, complementary and integrative approaches, and community-based care, as appropriate. required initial face-to-face visit at least 30 minutes provided by a physician or other qualified health professional; first 30 minutes personally provided by physician or other qualified health care professional, per calendar month. (when using g3002, 30 minutes must be met or exceeded.) | $86.17 | PFS non-facility | 1 (practitioner) | M |
| G3003 | Each additional 15 minutes of chronic pain management and treatment by a physician or other qualified health care professional, per calendar month. (list separately in addition to code for g3002. when using g3003, 15 minutes must be met or exceeded.) | $31.73 | PFS non-facility | 4 (practitioner) | M |
Show the other 1087 codes (pages not in search results)
- G0011 HIV prep counsel, md 15-30m
- G0012 Injection of HIV prep drug
- G0022 Comm hlth intg svs add 30 m
- G0024 Pin srv add 30 min pr m
- G0029 No tob scr/cess int
- G0030 Pt scr tob & cess int
- G0031 Pall serv during meas
- G0032 2+ antipsy schiz
- G0033 2+ benzo seiz
- G0034 Pall serv during meas
- G0035 Pt ed pos 23
- G0036 Pt/ptn decln assess
- G0037 Pt not able to participate
- G0038 Clin pt no ref
- G0039 Pt no ref, rn spec
- G0040 Pt phys/occ therapy
- G0041 Pt/ptn decln referral
- G0042 Ref to therapy
- G0043 Pt mech pros ht valv
- G0044 Pt mitral stenosis
- G0045 Mrs 90 days post stk
- G0046 No mrs 90 days post stk
- G0047 Ped blunt hd traum
- G0048 Pall serv during meas
- G0049 Main hemo in-cntr
- G0050 Pt w/ lmted life expec
- G0051 Pt hospice mnth
- G0052 Pt peri dialysis dur mo
- G0053 Adv rheum pt care mvp
- G0054 Strk cr prev pos outcme mvp
- G0055 Adv care heart dx mvp
- G0057 Best pct pt safety em mvp
- G0058 Imprv care le jnt repr mvp
- G0059 Pt sfty pos exp w aneth mvp
- G0060 Allergy/immunology ss
- G0061 Anesthesiology ss
- G0062 Audiology ss
- G0063 Cardiology ss
- G0064 Cert nurse midwife ss
- G0065 Chiropractic ss
- G0066 Clinical social work ss
- G0067 Dentistry ss
- G0068 Adm iv infusion drug in home
- G0069 Adm sq infusion drug in home
- G0070 Adm of chemo drug in home
- G0076 Care manag h vst new pt 20 m
- G0077 Care manag h vst new pt 30 m
- G0078 Care manag h vst new pt 45 m
- G0079 Care manag h vst new pt 60 m
- G0080 Care manag h vst new pt 75 m
- G0081 Care man h v ext pt 20 mi
- G0082 Care man h v ext pt 30 m
- G0083 Care man h v ext pt 45 m
- G0084 Care man h v ext pt 60 m
- G0085 Care man h v ext pt 75 m
- G0086 Care man home care plan 30 m
- G0087 Care man home care plan 60 m
- G0088 Adm iv drug 1st home visit
- G0089 Adm subq drug 1st home visit
- G0090 Adm iv chemo 1st home visit
- G0128 Corf skilled nursing service
- G0143 Scr c/v cyto,thinlayer,rescr
- G0144 Scr c/v cyto,thinlayer,rescr
- G0146 Nav srv peer sup add 30 pr m
- G0147 Scr c/v cyto, automated sys
- G0148 Scr c/v cyto, autosys, rescr
- G0161 Hhc slp ea 15 min
- G0162 Hhc rn e&m plan svs, 15 min
- G0183 Software meas of cardiac vol
- G0186 Dstry eye lesn,fdr vssl tech
- G0219 PET img wholbod melano nonco
- G0235 PET not otherwise specified
- G0252 PET imaging initial dx
- G0255 Current percep threshold tst
- G0259 Inject for sacroiliac joint
- G0276 Pild/placebo control clin tr
- G0288 Recon, cta for surg plan
- G0293 Non-cov surg proc,clin trial
- G0294 Non-cov proc, clinical trial
- G0295 Electromagnetic therapy onc
- G0299 Hhs/hospice of rn ea 15 min
- G0300 Hhs/hospice of lpn ea 15 min
- G0302 Pre-op service lvrs complete
- G0303 Pre-op service lvrs 10-15dos
- G0304 Pre-op service lvrs 1-9 dos
- G0305 Post op service lvrs min 6
- G0306 Cbc/diffwbc w/o platelet
- G0307 Cbc without platelet
- G0310 Immunize counsel 5-15 min
- G0311 Immunize counsel 16-30 mins
- G0312 Immunize couns < 21yr 5-15 m
- G0313 Immunize couns < 21yr 6-30 m
- G0314 Counsel immune <21 16-30 m
- G0315 Counsel immune <21 5-15 m
- G0320 Two-way audio and video hhs
- G0321 Audio-only hhs
- G0322 Home h physio data collec tr
- G0329 Electromagntic tx for ulcers
- G0333 Dispense fee initial 30 day
- G0337 Hospice evaluation preelecti
- G0341 Percutaneous islet celltrans
- G0342 Laparoscopy islet cell trans
- G0343 Laparotomy islet cell transp
- G0384 Lev 5 hosp type b ed visit
- G0409 Corf related serv 15 mins ea
- G0412 Open tx iliac spine uni/bil
- G0414 Pelvic ring fx treat int fix
- G0415 Open tx post pelvic fxcture
- G0421 Ed svc ckd grp per session
- G0428 Collagen meniscus implant
- G0435 Oral HIV-1/HIV-2 screen
- G0455 Fecal microbiota prep instil
- G0458 Ldr prostate brachy comp rat
- G0470 FQHC visit, mh estab pt
- G0482 Drug test def 15-21 classes
- G0483 Drug test def 22+ classes
- G0490 Home visit rn, lpn by RHC/fq
- G0492 Md/oth eval acut kid no ESRD
- G0493 Rn care ea 15 min hh/hospice
- G0494 Lpn care ea 15min hh/hospice
- G0495 Rn care train/edu in hh
- G0496 Lpn care train/edu in hh
- G0501 Resource-inten svc during ov
- G0509 Crit care telehea consult 50
- G0517 Remove drug implant
- G0518 Remove w insert drug implant
- G0519 New pt-cg dyad dem low cmplx
- G0520 New pt-cg dyad dem mod cmplx
- G0521 New pt-cg dyad dem hig cmplx
- G0522 Mgt nw pt dementia low cmplx
- G0523 Mgt nw pt dem mod-high cmplx
- G0524 Est pt-cg dyad dem low cmplx
- G0525 Est pt-cg dyad dem mod cmplx
- G0526 Est pt-cg dyad dem hig cmplx
- G0527 Mgt est pt dmentia low cmplx
- G0528 Mgt est pt dem mod-hi cmplx
- G0529 In home respite care, 4 hr u
- G0530 Adult daycare center, 8 hr u
- G0531 Fclty-based respite, 24 hr u
- G0532 Take home supp nasal spray
- G0533 Buprenorphone inj weekly
- G0534 Coordinated care/or referral
- G0535 Pt navigat svs direct/ref
- G0536 Peer recover support svs
- G0540 Train for caregiver add 15
- G0543 Group train w/o patient
- G0546 Phone/internet ehr assess
- G0547 Phone/internet svs 11-20 m
- G0548 Phone/inter svs 21-30 m
- G0549 Phone/inter for treat>31m
- G0550 Phone/inter for dx/treat >5m
- G0551 Phn/intr svs fr dx treat 30m
- G0552 Supply of digital device
- G0554 Add 20 m of monthly tx
- G0555 Replacment pt electronic sys
- G0556 Adv prim care mgmt lvl 1
- G0558 Adv prim care mgmt lvl 3
- G0559 Unrelat prac follow up visit
- G0561 Temp tube delivery, unil
- G0562 Complex simulation w/PET-CT
- G0563 Sbrt w/positron emission del
- G0566 3d bn img algor drvd fr MRI
- G0567 Screening hep c detect
- G0568 Int psych care mng, 1 cal mo
- G0569 Subs psych care mng, subs mo
- G0571 Intraop nerve cryoablation
- G0574 Mgt new pt dem res care cmmi
- G0575 Mgt est pt dem res care cmmi
- G0577 Vasc emb/occl organ, pgc
- G0660 Team remote E/M new pt 10 mn
- G0661 Team remote E/M new pt 20 mn
- G0662 Team remote E/M new pt 30 mn
- G0663 Team remote E/M new pt 45 mn
- G0664 Team remote E/M new pt 60 mn
- G0665 Team remote E/M est pt 10 mn
- G0666 Team remote E/M est pt 15 mn
- G0667 Team remote E/M est pt 25 mn
- G0668 Team remote E/M est pt 40 mn
- G0669 Eckm oap-initial period
- G0670 Eckm oap-follow-on period(s)
- G0671 Ckm oap-initial period
- G0672 Ckm oap-follow-on period(s)
- G0673 Msk oap-initial period
- G0674 Bh oap-initial period
- G0675 Bh oap-follow-on period(s)
- G0676 Std co-mgmt-eckm, ckm
- G0677 Std co-mgmt-msk
- G0678 Std co-mgmt-bh
- G0680 Cr art clc art vlv clc w rpt
- G0681 App of non-sheet skin sub
- G0682 App non-sheet skin sub add
- G0683 App of non-sheet skin sub g
- G0684 App non-sheet skin sb g addl
- G0685 Algorithm assessment for asd
- G0913 Improve visual funct
- G0914 Survey not complete
- G0915 No improve visual funct
- G0916 Satisfy with care
- G0917 Care survey not complete
- G0918 No satisfy with care
- G1025 Pt mnth 1 mcp prov
- G1026 Pt hemo > 3mo
- G1027 Pt hemo < 3mo
- G1028 Take home supply 8mg per 0.1
- G2004 Post-d/c h vst new pt 60 m
- G2007 Post-d/c h vst ext pt 30 m
- G2008 Post-d/c h vst ext pt 45 m
- G2009 Post-d/c h vst ext pt 60 m
- G2013 Post-d/c h vst ext pt 75 m
- G2015 Post-d/c care plan overs 60m
- G2020 Hi inten serv for sip model
- G2021 Hea care pract tx in place
- G2022 Benef refuses service, mod
- G2025 Dis site tele svcs RHC/FQHC
- G2073 Med tx naltrexone
- G2074 Med assist tx no drug
- G2075 Med tx meds NOS
- G2077 Periodic assessment
- G2080 Add 30 mins counsel
- G2081 Pt 66+ snp or ltc pos > 90d
- G2088 Off base opioid tx, add30
- G2090 Pt 66+ frailty and med dem
- G2091 Pt 66+ frailty and adv ill
- G2092 Ace arb arni
- G2093 Med doc rsn no ace arn arni
- G2094 Pt rsn no ace arn arni
- G2096 No rsn ace arb arni
- G2097 Dx uri 3d after other dx
- G2098 Pt 66+ frailty and med dem
- G2099 Pt 66+ frailty and adv ill
- G2100 Pt 66+ frailty and med dem
- G2101 Pt 66+ frailty and adv ill
- G2105 Pt 66+ snp or ltc pos > 90d
- G2106 Pt 66+ frailty and med dem
- G2107 Pt 66+ frailty and adv ill
- G2112 Pred<=5 mg ra glu <6m
- G2113 Pred>5 mg >6m, no chg da
- G2115 Pt 66-80 frailty and med dem
- G2116 Pt 66-80 frailty and adv ill
- G2118 Pt 81+ frailty
- G2121 Psy dep anx ap and ICD asse
- G2122 Psy/dep/anx/apandicd noasse
- G2125 Pt 81+ frailty
- G2126 Pt 66-80 frailty and adv ill
- G2127 Pt 66-80 frailty and med dem
- G2128 No aspirin med rsn
- G2129 No bp outpt
- G2136 Bk pain vas 6-20wk <= 3
- G2137 Bk pain vas 6-20wk > 3
- G2138 Bk pain vas 9-15mo <= 3
- G2139 Bk pain vas 9-15mo > 3
- G2140 Leg pain vas 6-20wk <= 3
- G2141 Leg pain vas 6-20wk > 3
- G2142 Fs odi 9-15mo postop<= 22
- G2143 Fs odi 9-15mo > 22
- G2144 Fs odi 6-20wk postop <= 22
- G2145 Fsodi 6-20wk >22 or chg 30pt
- G2146 Leg pain vas 9-15mo <= 3
- G2147 Leg pain vas 9-15mo > 3
- G2148 Mpm used
- G2149 No mpm med rsn
- G2150 No mpm
- G2151 Dx degen neuro
- G2152 Res change sc >=0
- G2167 Res change sc < 0
- G2168 Svs by pt in home health
- G2169 Svs by ot in home health
- G2172 Tx for opioid use demo proj
- G2173 Uri w comorb 12m oth dx
- G2174 Uri new rx antibiotic 30d
- G2175 Pt comorb dx 12m of epi
- G2176 Outpt ed obs w inpt admit
- G2177 Bronch w rx antibx 30d
- G2178 Pt not elig low neuro ex
- G2179 Med doc rsn no low ex
- G2180 Inelig footwr eval
- G2181 Bmi not doc medrsn ptref
- G2182 Pt 1st biolog antirheum
- G2183 Doc pt unable comm
- G2184 No caregiver
- G2185 Caregiver dem trained
- G2186 Pt ref app rsrcs
- G2187 Clin ind img hd trauma
- G2188 Pt 50 yrs w/clin ind hd
- G2189 Img hd abnml neuro exam
- G2190 Ind img hd rad neck
- G2191 Ind img hd pos hd ache
- G2192 >55 yrs temp hd ache
- G2193 <6yr new onset hd ache
- G2194 New hdache ped pt dis
- G2195 Occip hdache child
- G2196 Screen unhlthy etoh use
- G2197 Screen hlthy etoh use
- G2199 Not scrn etoh no rsn
- G2200 Unhlthy etoh rcvd couns
- G2202 No rsn no brief couns
- G2204 Pt 45-85 w/ scope
- G2205 Preg drng adjv trtmt
- G2206 Adjv trtmt chemo her2
- G2207 Rsn no trtmt chem her2
- G2208 No trtmt chemo and her2
- G2209 Refused to participate
- G2210 No neck fs prom no rsn
- G2213 Initiat med assist tx in er
- G2215 Home supply nasal naloxone
- G2216 Home supply inject naloxon
- G4000 Dermatology ss
- G4001 Diagnostic rad ss
- G4002 Ep cardio ss
- G4003 Emergency med ss
- G4004 Endocrinology ss
- G4005 Family medicine ss
- G4006 Gastroenterology ss
- G4007 General surgery ss
- G4008 Geriatrics ss
- G4009 Hospitalists ss
- G4010 Infectious disease ss
- G4011 Internal medicine ss
- G4012 Interventional rad ss
- G4013 Mntal/behav/psych hlth ss
- G4014 Nephrology ss
- G4015 Neurology ss
- G4016 Neurosurgical ss
- G4017 Nutrition/dietician ss
- G4018 Ob/gyn ss
- G4019 Oncology/hema ss
- G4020 Ophthalmology/optometry ss
- G4021 Orthopedic surgery ss
- G4022 Otolaryngology ss
- G4023 Pathology ss
- G4024 Pediatrics ss
- G4025 Physical medicine ss
- G4026 Phys/occ therapy ss
- G4027 Plastic surgery ss
- G4028 Podiatry ss
- G4029 Preventive medicine ss
- G4030 Pulmonology ss
- G4031 Radiation oncology ss
- G4032 Rheumatology ss
- G4033 Skilled nursing facility ss
- G4034 Speech language path ss
- G4035 Thoracic surgery ss
- G4036 Urgent care ss
- G4037 Urology ss
- G4038 Vascular surgery ss
- G8395 Lvef>=40% doc normal or mild
- G8396 Lvef not performed
- G8397 Dil macula/fundus exam/w doc
- G8399 Pt w/dxa results document
- G8400 Pt w/dxa no results doc
- G8404 Low extemity neur exam docum
- G8405 Low extemity neur not perfor
- G8410 Eval on foot documented
- G8415 Eval on foot not performed
- G8416 Pt inelig footwear evaluatio
- G8417 Calc bmi abv up param f/u
- G8418 Calc bmi blw low param f/u
- G8419 Calc bmi out nrm param nof/u
- G8420 Calc bmi norm parameters
- G8421 Bmi not calculated
- G8427 Docrev cur meds by elig clin
- G8428 Cur meds not document
- G8430 Doc med rsn no medrec
- G8431 Pos clin depres scrn f/u doc
- G8432 Dep scr not doc, rng
- G8433 Scr for dep not cpt doc rsn
- G8450 Beta-bloc rx pt w/abn lvef
- G8451 Pt w/abn lvef inelig b-bloc
- G8452 Pt w/abn lvef b-bloc no rx
- G8465 High risk recurrence pro ca
- G8473 Ace/arb thxpy rx'd
- G8474 Ace/arb not rx'd; doc reas
- G8475 Ace/arb thxpy not rx'd
- G8476 Bp sys <140 and dias <90
- G8477 Bp sys>=140 and/or dias >=90
- G8478 Bp not performed/doc
- G8510 Scr dep neg, no plan reqd
- G8511 Scr dep pos, no plan doc rng
- G8535 Eld maltreatment not doc
- G8536 No doc elder mal scrn
- G8539 Doc funct and care plan
- G8540 Foa not doc as being perf
- G8541 No doc cur funct assess
- G8542 Doc funct no deficiencies
- G8543 Cur funct asses; no care pln
- G8559 Pt ref doc oto eval
- G8560 Pt hx act drain prev 90 days
- G8561 Pt inelig for ref oto eval
- G8562 Pt no hx act drain 90 d
- G8563 Pt no ref oto reas no spec
- G8564 Pt ref oto eval
- G8565 Ver doc hear loss
- G8566 Pt inelig ref oto eval
- G8567 Pt no doc hear loss
- G8568 Pt no ref otolo no spec
- G8569 Prol intubation req
- G8570 No prol intub req
- G8575 Postop ren fail
- G8576 No postop ren fail
- G8577 Reop req bld grft oth
- G8578 No reop req bld grft oth
- G8598 Asa/antiplat ther used
- G8599 No asa/antiplat ther use rng
- G8600 Tpa initi w/in 4.5 hr
- G8601 No elig tpa init w/in 4.5 hr
- G8602 No tpa init w/in 4.5 hr
- G8633 Pharm ther osteo rx
- G8635 No pharm ther osteo rx
- G8647 Rafscrs ki scor >= 0
- G8648 Rafscrs ki scor < 0
- G8650 Rafs crs ki no scor no rsn
- G8651 Rafscrs hi scor >=0
- G8652 Rafscrs hi scor < 0
- G8654 Rafs crs hi no scor no surv
- G8655 Rafscrs llfai scor >= 0
- G8656 Rafscrs llfai scor < 0
- G8658 Rafscrs llfai no scor + surv
- G8659 Rafscrs lbi scor >= 0
- G8660 Rafscrs lbi scor < 0
- G8661 Rafscrs lbi no scor
- G8662 Rafs crs lbi no scor no surv
- G8663 Rafscrs si scor >= 0
- G8664 Rafscrs si scor < 0
- G8666 Rafs crs si no scor no surv
- G8667 Rafscrs ewh scor >= 0
- G8668 Rafscrs ewh scor < 0
- G8670 Rafs crs ewh no scor no surv
- G8694 Lvef <=40%
- G8708 Antibiotic not pres
- G8709 Uri ep compete diag
- G8710 Pt pres antibiotic
- G8711 Pres antibx on/within 3 day
- G8712 Not pres antibiotic
- G8721 Pt, pn, hist grade doc
- G8722 Med reas pt, pn, not doc
- G8723 Spec sit not prim tumor
- G8724 Pt, pn, hist grade not doc
- G8733 Doc pos elder mal scrn plan
- G8734 Doc neg eld req
- G8735 Eld mal scrn pos no plan
- G8749 No signs melanoma
- G8752 Sys bp less 140
- G8753 Sys bp > or = 140
- G8754 Dias bp less 90
- G8755 Dias bp > or = 90
- G8756 No bp measure doc
- G8783 Bp scrn perf rec interval
- G8785 Bp scrn no perf at interval
- G8797 Specimen site not esophagus
- G8798 Specimen site not prostate
- G8806 Perf ultrsnd to lct preg doc
- G8807 No ta tv ultrasnd
- G8808 Ultrasound not perf, rng
- G8815 Doc reas no statin therapy
- G8816 Statin med pres at disch
- G8817 Doc reas no statin med disch
- G8826 Pt disch home day #2 evar
- G8833 Pt not disch home day#2 evar
- G8834 Pt disch home day #2 cea
- G8838 Not disch home by day #2
- G8839 Sleep apnea assess
- G8840 Doc reas no sleep apnea
- G8841 No sleep apnea assess
- G8842 Ahi rdi rei doc win 2mo
- G8843 Doc reas no ahi rdi rei
- G8844 No ahi rdi rei ini dx no rsn
- G8845 Pos airway press prescribed
- G8846 Mod or severe osa
- G8849 Doc reas no pos air press
- G8850 No Pap prescribed
- G8851 Adhere tx assess at lst ann
- G8854 Reas no adhere therapy
- G8855 Ther not assessed annually
- G8856 Ref for oto eval
- G8857 No elig ref for oto eval
- G8858 Not ref for oto eval
- G8863 No assess bone loss
- G8864 Pneumococcal vaccine admin
- G8865 Doc med reas no pneumococcal
- G8866 Doc pt reas no pneumococcal
- G8867 No pneumococcal admin
- G8869 Doc immune hep b antitnf
- G8875 Breast cancer dx min invsive
- G8876 Doc reas no min inv dx
- G8877 No brst cncr dx min invasive
- G8878 Sent lymph node biopsy
- G8880 Sen lym p node biop not perf
- G8881 Brst cncr stage > t1n0m0
- G8882 No sent lymph node biopsy
- G8907 Pt doc no events on discharg
- G8908 Pt doc w burn prior to d/c
- G8909 Pt doc no burn prior to d/c
- G8910 Pt doc to have fall in asc
- G8911 Pt doc no fall in asc
- G8912 Pt doc with wrong event
- G8913 Pt doc no wrong event
- G8914 Pt trans to hosp post d/c
- G8915 Pt not trans to hosp at d/c
- G8916 Pt w iv ab given on time
- G8917 Pt w iv ab not given on time
- G8918 Pt w/o preop order iv ab pro
- G8923 Lvef <= 40% or lvsd
- G8924 Spir res doc fev1/fvc<70%
- G8934 Lvef <=40% or dep lv sys fcn
- G8935 Rx ace or arb therapy
- G8936 Pt not eligible ace/arb
- G8937 No rx ace/arb therapy
- G8942 Doc fcn/care plan w/30 days
- G8944 Ajcc mel cnr stg 0 - iic
- G8946 Mibm but no dx of breast ca
- G8950 Pre-htn or htn doc, f/u indc
- G8952 Pre-htn/htn, no f/u, not gvn
- G8955 Most recent assess vol mgmt
- G8956 Pt rcv hedia outpt dyls fac
- G8958 Assess vol mgmt not doc
- G8961 Csit lowrisk surg pts preop
- G8962 Csit on pt any reas 30 days
- G8967 Warf or other FDA drug presc
- G8968 Doc med not presb
- G8969 Doc pt rsn no presc warf/FDA
- G8970 No rsk fac or 1 mod risk te
- G9001 Mccd, initial rate
- G9002 Mccd,maintenance rate
- G9003 Mccd, risk adj hi, initial
- G9004 Mccd, risk adj lo, initial
- G9005 Mccd, risk adj, maintenance
- G9006 Mccd, home monitoring
- G9007 Mccd, sch team conf
- G9008 Mccd,phys coor-care ovrsght
- G9009 Mccd, risk adj, level 3
- G9010 Mccd, risk adj, level 4
- G9011 Mccd, risk adj, level 5
- G9012 Other specified case mgmt
- G9013 ESRD demo bundle level i
- G9014 ESRD demo bundle-level ii
- G9016 Demo-smoking cessation coun
- G9050 Oncology work-up evaluation
- G9051 Oncology tx decision-mgmt
- G9052 Onc surveillance for disease
- G9053 Onc expectant management pt
- G9054 Onc supervision palliative
- G9055 Onc visit unspecified NOS
- G9056 Onc prac mgmt adheres guide
- G9057 Onc pract mgmt differs trial
- G9058 Onc prac mgmt disagree w/gui
- G9059 Onc prac mgmt pt opt alterna
- G9060 Onc prac mgmt dif pt comorb
- G9061 Onc prac cond noadd by guide
- G9062 Onc prac guide differs NOS
- G9063 Onc dx nsclc stgi no progres
- G9064 Onc dx nsclc stg2 no progres
- G9065 Onc dx nsclc stg3a no progre
- G9066 Onc dx nsclc stg3b-4 metasta
- G9067 Onc dx nsclc dx unknown NOS
- G9068 Onc dx sclc/nsclc limited
- G9069 Onc dx sclc/nsclc ext at dx
- G9070 Onc dx sclc/nsclc ext unknwn
- G9071 Onc dx brst stg1-2b hr,nopro
- G9072 Onc dx brst stg1-2 noprogres
- G9073 Onc dx brst stg3-hr, no pro
- G9074 Onc dx brst stg3-noprogress
- G9075 Onc dx brst metastic/ recur
- G9077 Onc dx prostate t1no progres
- G9078 Onc dx prostate t2no progres
- G9079 Onc dx prostate t3b-t4noprog
- G9080 Onc dx prostate w/rise PSA
- G9083 Onc dx prostate unknwn NOS
- G9084 Onc dx colon t1-3,n1-2,no pr
- G9085 Onc dx colon t4, n0 w/o prog
- G9086 Onc dx colon t1-4 no dx prog
- G9087 Onc dx colon metas evid dx
- G9088 Onc dx colon metas noevid dx
- G9089 Onc dx colon extent unknown
- G9090 Onc dx rectal t1-2 no progr
- G9091 Onc dx rectal t3 n0 no prog
- G9092 Onc dx rectal t1-3,n1-2noprg
- G9093 Onc dx rectal t4,n,m0 no prg
- G9094 Onc dx rectal m1 w/mets prog
- G9095 Onc dx rectal extent unknwn
- G9096 Onc dx esophag t1-t3 noprog
- G9097 Onc dx esophageal t4 no prog
- G9098 Onc dx esophageal mets recur
- G9099 Onc dx esophageal unknown
- G9100 Onc dx gastric no recurrence
- G9101 Onc dx gastric p r1-r2noprog
- G9102 Onc dx gastric unresectable
- G9103 Onc dx gastric recurrent
- G9104 Onc dx gastric unknown NOS
- G9105 Onc dx pancreatc p r0 res no
- G9106 Onc dx pancreatc p r1/r2 no
- G9107 Onc dx pancreatic unresectab
- G9108 Onc dx pancreatic unknwn NOS
- G9109 Onc dx head/neck t1-t2no prg
- G9110 Onc dx head/neck t3-4 noprog
- G9111 Onc dx head/neck m1 mets rec
- G9112 Onc dx head/neck ext unknown
- G9113 Onc dx ovarian stg1a-b no pr
- G9114 Onc dx ovarian stg1a-b or 2
- G9115 Onc dx ovarian stg3/4 noprog
- G9116 Onc dx ovarian recurrence
- G9117 Onc dx ovarian unknown NOS
- G9123 Onc dx cml chronic phase
- G9124 Onc dx cml acceler phase
- G9125 Onc dx cml blast phase
- G9126 Onc dx cml remission
- G9128 Onc dx multi myeloma stage i
- G9129 Onc dx mult myeloma stg2 hig
- G9130 Onc dx multi myeloma unknown
- G9131 Onc dx brst unknown NOS
- G9132 Onc dx prostate mets no cast
- G9133 Onc dx prostate clinical met
- G9134 Onc nhlstg 1-2 no relap no
- G9135 Onc dx nhl stg 3-4 not relap
- G9136 Onc dx nhl trans to lg bcell
- G9137 Onc dx nhl relapse/refractor
- G9138 Onc dx nhl stg unknown
- G9139 Onc dx cml dx status unknown
- G9140 Frontier extended stay demo
- G9143 Warfarin respon genetic test
- G9147 Outpt iv insulin tx any mea
- G9148 Medical home level 1
- G9149 Medical home level ii
- G9150 Medical home level iii
- G9151 Mapcp demo state
- G9152 Mapcp demo community
- G9153 Mapcp demo physician
- G9156 Evaluation for wheelchair
- G9157 Transesoph doppl cardiac mon
- G9187 Bpci home visit
- G9188 Beta not given no reason
- G9189 Beta pres or already taking
- G9190 Medical reason for no beta
- G9191 Pt reason for no beta
- G9212 Doc of dsm-iv init eval
- G9213 No doc of dsm-iv
- G9223 Pjp proph ordered cd4 low
- G9225 Norsn no foot exam
- G9226 3 comp foot exam completed
- G9227 Foa doc, care plan not doc
- G9228 Gc chl syp documented
- G9230 Norsn for gc chl syp test
- G9231 Doc ESRD dia trans preg
- G9242 Doc viral load >=200
- G9243 Doc viral load <200
- G9246 No enc or enc/vir ld 90days
- G9247 2 enc enc/vir ld 90d
- G9254 Doc pt dischg >2d
- G9255 Pt dc home 2nd po day
- G9273 Sys<140 and dia<90
- G9274 Bp out of nrml limits
- G9275 Doc of non tobacco user
- G9276 Doc of tobacco user
- G9277 Doc daily aspirin or contra
- G9278 Doc no daily aspirin
- G9279 Pne scrn done doc vac done
- G9280 Pne not given norsn
- G9281 Pne scrn done doc not ind
- G9282 Doc medrsn no histo type
- G9283 Hist type doc on report
- G9284 No hist type doc on report
- G9285 Site not small cell lung ca
- G9286 Antibio rx w in 10d of sympt
- G9287 No antibio w in 10d of sympt
- G9288 Doc medrsn no hist type rpt
- G9289 Doc type nsm lung ca
- G9290 No doc type nsm lung ca
- G9291 Not nsm lung ca
- G9292 Medrsn no pt category
- G9293 No pt category on report
- G9294 Pt cat and thck on report
- G9295 Non cutaneous loc
- G9296 Doc share dec prior proc
- G9297 No doc share dec prior proc
- G9298 Eval risk vte card 30d prior
- G9299 No eval risk vte card prior
- G9305 No interv req for leak
- G9306 Interv req for leak
- G9307 No ret for surg w in 30d
- G9308 Unpl ret or w/compl w/in 30d
- G9309 No unplnd hosp readm in 30d
- G9310 Unplnd hosp readm in 30d
- G9311 No surg site infection
- G9312 Surgical site infection
- G9313 Amoxic not presc as 1st line
- G9314 Norsn not first line amox
- G9315 Amox w/wo clav rx
- G9316 Doc comm risk calc
- G9317 No doc comm risk calc
- G9318 Image std nomenclature
- G9319 Image not std nomenclature
- G9321 Prev CT nuc med cnt doc 12mo
- G9322 No cnt CT nuc med doc 12mo
- G9341 Srch for CT w in 12 mos
- G9342 No srch for CT in 12mo norsn
- G9344 Sysrsn no dicom srch
- G9345 Follow up pulm nod
- G9347 No follow up pulm nod norsn
- G9351 Doc >1 sinus CT w 90d dx
- G9352 Not >1 sinus CT w 90d dx
- G9353 Medrsn >1 sinus CT w 90d dx
- G9354 1 or no CT sinus w/in 90d dx
- G9355 No early ind/delivery
- G9356 Early ind/delivery
- G9357 Pp eval/edu perf
- G9358 Pp eval/edu not perf
- G9361 Doc rsn elect c-sec/induct
- G9364 Sinus caus bac inx
- G9367 >= 2 same hi-rsk med ord
- G9368 >= 2 same hi-rsk med not ord
- G9380 Off assis eol iss
- G9382 No off assis eol
- G9383 Recd scrn hcv infec
- G9384 Doc med rsn no hcv scrn
- G9385 Doc pt reas not rec hcv srn
- G9386 Scrn hcv infec not recd
- G9393 Ini phq9 >9 remiss <5
- G9394 Dx bipol, death, nhres, hosp
- G9395 Ini phq9 >9 no remiss >=5
- G9396 Ini phq9 >9 not assess
- G9408 Card tamp w/in 30d
- G9409 No card tamp e/in 30d
- G9410 Admit w/in 180d req remov
- G9411 No admit w/in 180d req remov
- G9412 Admit w/in 180d req surg rev
- G9413 No admit req surg rev
- G9414 1dose menig vac btwn 10 & 13
- G9415 No 1dose meni vac btwn 10&13
- G9416 Pt 1 tdap betw 10-13 yrs
- G9417 Pt not 1 tdap betw 10-13 yrs
- G9418 Lungcx bx rpt docs class
- G9419 Med reas not incl histo type
- G9420 Spec site no lung
- G9421 Lung cx bx rpt no doc class
- G9422 Rpt doc class histo type
- G9423 Med reas rpt no histo type
- G9424 Site no lung or lung cx
- G9425 Spec rpt no doc class histo
- G9426 Impr med time edarr pain med
- G9427 No impro med time pain med
- G9428 Patho rpt incl pt ctg
- G9429 Doc med rsn no pt cat
- G9430 Spec site no cutaneous
- G9431 Patho rpt no pt ctg
- G9432 Asth controlled
- G9434 Asth not controlled
- G9452 Doc med reas no hcv test
- G9455 Abd imag w/us, CT or MRI
- G9456 Doc med pt reas no hcc scrn
- G9457 Pt no abd img no doc rsn
- G9468 No recd cortico>=10mg/d >60d
- G9470 No rec cortico>60d 1rx 600mg
- G9471 W/in 2yr dxa not order
- G9473 Chap services at hospice
- G9474 Diet counsel at hospice
- G9475 Other counselor at hospice
- G9476 Volun service at hospice
- G9477 Care coord at hospice
- G9478 Othe therapist at hospice
- G9479 Pharmacist at hospice
- G9480 Admission to mccm
- G9481 Remote E/M new pt 10mins
- G9482 Remote E/M new pt 20mins
- G9483 Remote E/M new pt 30mins
- G9484 Remote E/M new pt 45mins
- G9485 Remote E/M new pt 60mins
- G9486 Remote E/M est. pt 10mins
- G9487 Remote E/M est. pt 15mins
- G9488 Remote E/M est. pt 25mins
- G9489 Remote E/M est. pt 40mins
- G9490 Cmmi mod home visit
- G9497 Rec inst no smoke day surg
- G9498 Abx reg prescribed
- G9500 Rad expos ind/exp tm doc
- G9501 Rad expos ind/exp tm no doc
- G9502 Med reas no perf foot exam
- G9504 Doc rsn hep b stat not asses
- G9505 Abx pres w/in 10 dys of symp
- G9507 Doc reas on statin or contra
- G9508 Doc pt not on statin
- G9509 Adit mdd dys rem 12 mnths
- G9510 Remis12m not phq-9 score <5
- G9511 Idx evt dte phq>9 doc 12 mo
- G9512 Indiv pdc > 0.8
- G9513 Indiv pdc not > 0.8
- G9514 Req ret or w/in 90d of surg
- G9515 No reas, no ret or w/in 90d
- G9516 Impr vis acuit w/in 90d
- G9517 No impr vis acuit w/in 90d
- G9518 Doc active inj drug use
- G9519 Final ref +/- 1.0 w/in 90d
- G9520 Refract not +/- 1.0 w/in 90d
- G9521 Er and ip hosp <2 in 12 mos
- G9522 Er/ip hosp =/>2 in 12 mos
- G9529 Minor blunt trauma w/head CT
- G9530 Pt mbht hd CT ord ec prov
- G9531 Pt doc
- G9533 Indic for head CT not valid
- G9537 Img hd clin trial
- G9539 Intent pot remv time placemt
- G9540 Pt alive 3 mos post proc
- G9541 Filter rem 3 mon plmt
- G9542 Doc reass appr remo filt 3ms
- G9543 Doc 2x re-assess filt remov
- G9544 No filt remov w/in 3mos plcm
- G9547 Cys ren les or adren
- G9548 No f/u rec image study
- G9549 Doc med rsn for f/u imag
- G9550 Imag rec
- G9551 Imag no les
- G9552 Inc thyr node <1.0 in rpt
- G9553 Prior thyroid dise dx
- G9554 CT/cta/MRI/a chst foll rec
- G9555 Doc med rsn for follup image
- G9556 CT/cta/MRI/a no follup imag
- G9557 CT/cta/MRI/a no thyr <1.0cm
- G9580 Door to punc time <2hrs
- G9582 Door to punc time >2hr, nrg
- G9593 Low pecarn ped head trauma
- G9594 Pt mbht hd CT ord ec prov
- G9595 Doc shnt/tum/coag
- G9597 No low pecarn ped head traum
- G9598 Aor ane 5.5-5.9 cm max diam
- G9599 Aor ane >=6.0 cm max diam
- G9603 Pt surv improv bsline tx
- G9605 Surv score no improv w/tx
- G9606 Intraop cyst eval trac inj
- G9607 Doc med rsn not perf cystosc
- G9608 Intraop cyst eval not done
- G9609 Doc order anti-plat
- G9610 Doc md rsn no antipla
- G9611 No doc order anti-plat rng
- G9621 Scr unheal etoh w/counsel
- G9622 No unheal etoh user
- G9624 Pt not scrn or no counseling
- G9625 Pt bl srg 30 day pst srg
- G9626 Med rsn no rpt bladder inj
- G9627 Pt no bl srg 30 day pst srg
- G9628 Pt bwli srg 30 day pst srg
- G9629 Med rsn no rpt bowel inj
- G9630 Pt no bwli srg 30 day srg
- G9637 Doc >1 dose reduc tech
- G9638 No doc >1 dose reduc tech
- G9642 Current smoker
- G9643 Elective surgery
- G9644 No smok b/4 anes day of surg
- G9645 Had smoke b/4 anes day surg
- G9646 Pt w/90d mrs 0-2
- G9648 Pt w/90d mrs >2
- G9649 Psor as doc spc bm
- G9651 Psor as doc no spc bm
- G9654 Mon anesth care
- G9655 Toc tool incl key elem
- G9656 Pt trans from anest to pacu
- G9658 Toc tool incl elem not used
- G9659 >=86y scr colo nomed rsn
- G9660 Doc med rsn colo pt >= 86y
- G9661 Pt >= 86 w/ hi risk
- G9662 Prior dx/active clin ascvd
- G9663 Fast/dir ldl >= 190 mg/dl
- G9664 Taking statin or rec'd order
- G9665 No statin/no order statin
- G9674 Pt w/clin ascvd dx
- G9675 Pt w/fast/dir lab ldl-c >190
- G9676 40-75y w/type 1/2 w/ldl-c rs
- G9679 Acute care pneumonia
- G9680 Acute care congestive heart
- G9681 Acute care chronic obstruct
- G9682 Acute care skin infection
- G9683 Acute fluid/electro disorder
- G9684 Acute care urinary tract inf
- G9685 Acute nursing facility care
- G9687 Hospice anytime msmt per
- G9688 Pt w/hosp anytime msmt per
- G9689 Inpt elect carotid intervent
- G9690 Pt in hos
- G9691 Pt hosp dur msmt period
- G9692 Hosp recd by pt dur msmt per
- G9693 Pt use hosp during msmt per
- G9694 Hosp srv used pt in msmt per
- G9695 Long act inhal bronchdil pre
- G9696 Med rsn no presc bronchdil
- G9698 Sys rsn no presc bronchdil
- G9699 Long inhal bronchdil no pres
- G9700 Pt is w/hosp during msmt per
- G9702 Pt use hosp during msmt per
- G9703 Anbx 30 prior to episode
- G9704 Ajcc br ca stg i: t1 mic/t1a
- G9705 Ajcc br ca stg ib
- G9706 Low recur prost ca
- G9708 Bilat mast/hx bi /unilat mas
- G9709 Hosp srv used pt in msmt per
- G9710 Pt prov hosp srv msmt per
- G9711 Pt hx tot col or colon ca
- G9712 Doc med rsn presc anbx
- G9713 Pt use hosp during msmt per
- G9714 Pt is w/hosp during msmt per
- G9716 Bmi doc onl fup not cmpltd
- G9717 Doc pt dx bipol
- G9719 Pt not ambul/immob/wc
- G9720 Hospice anytime msmt per
- G9721 Pt not ambul/immob/wc
- G9722 Doc hx renal fail or cr+ >=4
- G9723 Hosp recd by pt dur msmt per
- G9724 Pt w/doc use anticoag mst yr
- G9726 Refused to participate
- G9727 Pt unable cmplt lepf prom
- G9728 Refused to participate
- G9729 Pt unbl cmplt lepf prom
- G9730 Refused to participate
- G9731 Pt unbl cmplt lepf prom
- G9732 Refused to participate
- G9733 Pt unbl cmplt lb fs prom
- G9734 Refused to participate
- G9735 Pt unbl cmplt shld fs prom
- G9736 Refused to participate
- G9737 Pt unbl cmplt ewh fs prom
- G9740 Hosp srv to pt dur msmt per
- G9741 Pt w/hosp anytime msmt per
- G9744 Pt not eli d/t act dig htn
- G9745 Doc rsn no hbp scrn or f/u
- G9746 Mit sten, valve or trans af
- G9752 Urgent surgery
- G9753 Doc no dicom, CT other fac
- G9754 Incid pulm nodule
- G9755 Doc med rsn no fllw up
- G9756 Surg proc w/silicone oil
- G9757 Surg proc w/silicone oil
- G9758 Pt in hos
- G9761 Pt w/hosp anytime msmt per
- G9762 Pt had >= 2-3 HPV vaccines
- G9763 Pt not have 2-3 HPV vaccines
- G9764 Pt treatd w/oral syst or bio
- G9765 Doc pat declined therapy
- G9766 Cva stroke dx tx transf fac
- G9767 Hosp new dx cva consid evst
- G9768 Pt w/hosp anytime msmt per
- G9769 Bn den 2yr/got ost med/ther
- G9770 Perip nerve block
- G9771 Anes end, 1 temp >35.5(95.9)
- G9772 Doc med rsn no temp >= 35.5
- G9773 1 bod temp >=35.5
- G9775 Recd 2 anti-emet pre/intraop
- G9776 Doc med rsn no proph antiem
- G9777 Pt no antiemet pre/intraop
- G9779 Pts breastfeeding
- G9780 Pts dx w/rhabdomyolysis
- G9781 Doc rsn no statin
- G9782 Hx dx fam/pure hypercholes
- G9784 Path/derm prov 2nd biop opin
- G9785 Path report sent
- G9786 Path report not sent
- G9787 Pt alive
- G9788 Most rct bp </= 130/80
- G9789 Record bp ip, er, urg/self
- G9790 Most rct bp >/= 130/80
- G9791 Most rct tob stat free
- G9792 Most rct tob stat not free
- G9793 Pt on daily asa/antiplat
- G9794 Doc med rsn no daily aspirin
- G9795 Pt no daily asa/antiplat
- G9796 Pt currently on statin
- G9797 Pt not currently on statin
- G9805 Pt w/hosp anytime msmt per
- G9806 Pt recd cerv cyto/HPV
- G9807 Pt no recd cerv cyto/HPV
- G9812 Pt died during inpt/30d aft
- G9813 Pt not died w/in 30d of proc
- G9818 Doc sex activity
- G9819 Pt w/hosp anytime msmt per
- G9820 Doc chlam scr test w/follow
- G9821 No doc chlam scr ts w/follow
- G9822 Endo abl proc yr prev ind dt
- G9823 Endo smpl/hyst bx res doc
- G9824 Endo smpl/hyst bx res no doc
- G9830 Her-2 pos
- G9831 Ajcc stg brt ca dx ii or iii
- G9832 Br ca stg = 1 t stg = t1c
- G9838 Pt met dis at dx
- G9839 Anti-egfr mon anti ther
- G9840 Gene testing performed
- G9841 Gene testing not performed
- G9842 Pt met dis at dx
- G9843 Kras or nras gene mutation
- G9844 Pt no recd anti-egfr ther
- G9845 Pt recd anti-egfr ther
- G9846 Pt died from cancer
- G9847 Pt recd chemo last 14d life
- G9848 Pt no chemo last 14d life
- G9858 Pt enroll hospice
- G9859 Pt died from cancer
- G9860 Pt less 3d hospice
- G9861 Pt more than 3d hospice
- G9862 Doc rsn no 10 yr follow
- G9868 Cmmi asyntelehealth <10min
- G9869 Cmmi asyntelehealth 10-20min
- G9870 Cmmi asyntelehealth >20min
- G9871 Bhv couns dm prev, onln 60 m
- G9873 1 em core session
- G9874 4 em core sessions
- G9875 9 em core sessions
- G9876 2 em core ms mo 7-9 no wl
- G9877 2 em core ms mo 10-12 no wl
- G9878 2 em core ms mo 7-9 wl
- G9879 2 em core ms mo 10-12 wl
- G9880 Em 5 percent wl
- G9881 Em 9 percent wl
- G9882 2 em ongoing ms mo 13-15 wl
- G9883 2 em ongoing ms mo 16-18 wl
- G9884 2 em ongoing ms mo 19-21 wl
- G9885 2 em ongoing ms mo 22-24 wl
- G9886 In-person attendance g code
- G9887 Distance learning attendance
- G9888 5% wl maintnd from bsline wt
- G9890 Em bridge payment
- G9891 Em session reporting
- G9894 Adr dep thrpy prescribed
- G9895 Doc med rsn no adr dep thrpy
- G9896 Doc pt rsn no adr dep thrpy
- G9897 Pt nt prsc adr dep thrpy rng
- G9898 Pt 66+ snp or ltc pos > 90d
- G9899 Scrn mam perf rslts doc
- G9900 Scrn mam perf rslts not doc
- G9901 Pt 66+ snp or ltc pos > 90d
- G9902 Pt scrn tbco and id as user
- G9903 Pt scrn tbco id as non user
- G9905 No pt tbco scrn rng
- G9906 Pt recv tbco cess interv
- G9908 No pt tbco cess interv rng
- G9910 Pt 66+ snp or ltc pos > 90d
- G9911 Node neg pre/post syst ther
- G9912 Hbv status assesed and int
- G9913 No hbv status assesd and int
- G9914 Pt initiated anti-tnf agent
- G9915 No documntd hbv results rcd
- G9916 Funct status past 12 months
- G9917 Adv dem crgvr limited
- G9918 No funct stat perf, rsn NOS
- G9919 Scrn nd pos nd prov of rec
- G9920 Scrning perf and negative
- G9922 Sfty cncrns scrn nd mit recs
- G9923 Safty cncrns scrn and neg
- G9925 No scrn prov rsn NOS
- G9926 Sfty cncrns scrn but no recs
- G9928 No warf or FDA drug presc
- G9929 Trs/rev af
- G9930 Com care
- G9931 No chad or chad scr 0 or 1
- G9938 Pt 66+ snp or ltc pos > 90d
- G9939 Same path/derm perf biopsy
- G9940 Doc reas no statin therapy
- G9943 Bk pn nt msr vas scl pre/pst
- G9945 Pt w/cancer scoliosis
- G9946 Bk pain no vas
- G9949 Leg pain no vas
- G9954 Pt >2 rsk fac post-op vomit
- G9955 Inhlnt anesth only for induc
- G9956 Combo thrpy of >= 2 prophly
- G9957 Doc med rsn no combo thrpy
- G9958 No combo prohpyl thrp for pt
- G9959 Systemic antimicro not presc
- G9960 Med rsn sys antimi nt rx
- G9961 Systemic antimicro presc
- G9962 Embolization doc separatly
- G9963 Embolization not doc separat
- G9964 Pt recv >=1 well-chld visit
- G9965 No well-chld vist recv by pt
- G9968 Pt refrd 2 pvdr/spclst in pp
- G9969 Pvdr rfrd pt rprt rcvd
- G9970 Pvdr rfrd pt no rprt rcvd
- G9978 Remote E/M new pt 10mins
- G9979 Remote E/M new pt 20mins
- G9980 Remote E/M new pt 30 mins
- G9981 Remote E/M new pt 45mins
- G9982 Remote E/M new pt 60mins
- G9983 Remote E/M est. pt 10mins
- G9984 Remote E/M est. pt 15mins
- G9985 Remote E/M est. pt 25mins
- G9986 Remote E/M est. pt 40mins
- G9987 Bpci advanced in home visit
- G9988 Pall serv during meas
- G9992 Pall serv during meas
- G9993 Pall serv during meas
- G9994 Pall serv during meas
- G9996 Doc pt pal or hospice
- G9997 Doc pt preg dur msrmt pd
- G9998 Doc med rsn <3 colon
- G9999 Doc sys rsn <3 colon
How to read this table
The Medicare amount is a national figure from the October 2026 CMS files: for codes on the physician fee schedule it is the non-facility payment at the 2026 conversion factor, for DMEPOS items the national ceiling or, where competitive bidding sets the fees, the highest non-rural state fee, and for laboratory, hospital outpatient and ASC codes the published rate. Each code page shows the full breakdown, every modifier row and the state range. MUE is the Medically Unlikely Edit for the setting that bills the code, named in brackets: the DME supplier MUE for items on the DMEPOS fee schedule, the hospital outpatient MUE for codes with an OPPS payment rate but no national physician fee schedule amount, and the practitioner MUE otherwise; when that setting has no MUE, the next published one is shown. OPPS SI is the status indicator from Addendum B, which tells a hospital whether the code is paid separately, packaged, not payable under the outpatient system or, for status A, paid under another fee schedule or payment system. “None in these files” means none of the physician fee schedule, DMEPOS, lab, OPPS or ASC files lists a national amount; the code page says which payment rules apply. A dash means CMS publishes no value for that code in that file.
Where QuickIntell fits for G codes
QuickCode supports qualified coder review of units, modifiers and NCCI pairs before the claim leaves, and QuickAuth coordinates requirement checks and documentation for items and services that a coverage policy governs, each with human review.
Frequently asked questions
How many G codes are there?
The October 2026 HCPCS Level II file has 1,276 active codes in this hub. 266 of them carry a national Medicare amount in a 2026 fee schedule or OPPS/ASC addendum; the highest is G0330 at $3,387.27 (OPPS rate).
Are G codes CPT codes?
No. They are HCPCS Level II codes, a letter followed by four digits, maintained by CMS; CPT codes are five-character codes maintained by the AMA. Both are reported in the same procedure-code field on Medicare claims.
How often do G codes change?
CMS updates the HCPCS Level II file every quarter (January, April, July and October) and publishes the fee schedules, MUE and NCCI tables on the same quarterly cycle; this hub is rebuilt from each release.
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…
- DMEPOS fee schedule DME26-D, October 2026Version DME26-D (October 2026) · effective 2026-10-01 · file DMEPOS_OCT.csvSHA-256 a2824d58aadf4004…
- 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 PTP edits, practitioner, v323r0 (four files)Version v323r0 (2026 Q4) · effective 2026-10-01 · file ccipra-v323r0-f1.TXTSHA-256 7793c0b6686c1e22…
- 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…
- Medicare Coverage Database, current LCD exportVersion MCD release 2026-10-08 · effective 2026-10-04 · file lcd.csvSHA-256 9aee1bd7f14056b0…
Disclaimer
Operational reference compiled from CMS publications. Amounts are Medicare national figures before locality and state adjustment; other payers differ. CPT codes appear as numbers only. Not 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.