HCPCS Codes Explained
Healthcare Common Procedure Coding System codes for medical procedures and services. Understand what each code means on your medical bills.
We can only show HCPCS Level II codes with A-V prefixes due to expensive AMA licensing restrictions.Learn more about these restrictions →
Showing 50 of 100 HCPCS codes
G0500Moderate sedation during endoscopy procedure for patients 5 years and older (first 15 minutes)
This code represents moderate sedation services provided during a gastrointestinal endoscopic procedure (such as colonoscopy or upper endoscopy) for patients who are 5 years of age or older. The sedation is administered by the same doctor performing the endoscopy and requires a trained observer to monitor the patient's consciousness level and vital signs. This code covers the initial 15 minutes of sedation time during the procedure. Moderate sedation helps patients remain comfortable and relaxed while still being able to respond to verbal commands.
G8731Documentation that a standardized pain assessment showed no pain present and no follow-up treatment is needed
This code is used when healthcare providers document that they assessed a patient's pain level using a standardized measurement tool (such as a pain scale from 0-10) and found that the patient reported no pain or minimal pain. Because no significant pain was detected, no additional pain management plan or follow-up care is required at this time.
G8982Tracking progress toward goals for changing and maintaining body positions during physical therapy
This code is used by physical therapists and other rehabilitation professionals to document and track a patient's progress toward their goals for changing and maintaining body positions. This includes abilities like sitting up, standing, lying down, rolling over, and maintaining balance in different positions. The code tracks the projected goals at the start of therapy, progress at regular intervals, and final status when therapy ends or reporting concludes.
Q9956Injection of octafluoropropane microspheres, measured per milliliter
This code represents a billing unit for an injection containing octafluoropropane microspheres, which are tiny gas-filled bubbles used as a contrast agent. The medication is measured and billed per milliliter (ml) administered. Octafluoropropane microspheres are specialized contrast agents that help healthcare providers see internal structures more clearly during certain medical imaging procedures.
G0381Level 2 emergency department visit at a Type B emergency department
This code represents a moderate complexity emergency department visit at a Type B emergency department. A Type B emergency department is a facility that meets specific licensing and operational requirements - it must be either licensed by the state as an emergency room/department, publicly advertised as providing emergency care without appointments, or provide at least one-third of its outpatient visits for emergency conditions without requiring scheduled appointments. Level 2 visits typically involve straightforward medical decision making for patients with low to moderate complexity medical problems.
G8907Documentation that patient had no safety events during facility stay
This code indicates that medical staff documented that you did not experience any of the following safety events during your stay at a healthcare facility: burns before being discharged, falls within the facility, wrong site/side/patient/procedure/implant events, or the need for hospital transfer or hospital admission when leaving the facility. This is a quality measure code used to track patient safety outcomes.
G8732Documentation code indicating pain assessment was not recorded
This is a quality reporting code used by healthcare providers to indicate that a pain assessment was not documented in your medical record, and no reason was provided for why the assessment wasn't done. This code is used for tracking and quality improvement purposes rather than billing for medical services. It helps healthcare systems monitor whether pain is being properly assessed and documented during patient care.
G8484Documentation that a flu vaccine was not given (reason not specified)
This code is used by healthcare providers to document that an influenza (flu) vaccination was not administered to a patient, but no specific reason was recorded for why the vaccination was not given. This is a tracking code used for medical record keeping and quality reporting purposes.
G9637Documentation of radiation dose reduction techniques used during imaging
This code indicates that your medical imaging report includes documentation showing that one or more techniques were used to reduce your radiation exposure during the procedure. These techniques may include automated exposure control (which adjusts radiation automatically), adjusting technical settings based on your body size, or using advanced computer processing methods to create clear images with less radiation. This code represents quality reporting that shows your healthcare provider took steps to minimize your radiation dose while still obtaining the necessary diagnostic images.
U0003COVID-19 diagnostic test using advanced laboratory technology
This code represents a specific type of COVID-19 test that detects the genetic material (DNA or RNA) of the SARS-CoV-2 virus that causes COVID-19. The test uses an 'amplified probe technique,' which means it makes many copies of any viral genetic material present to make it easier to detect. This particular test is performed using 'high throughput technologies,' meaning the laboratory can process many samples quickly and efficiently, often hundreds or thousands of tests per day. This type of testing is typically done in large commercial or hospital laboratories rather than at point-of-care locations.
Q9966Low osmolar contrast dye with 200-299 mg/ml iodine concentration, per milliliter
This code represents one milliliter of low osmolar contrast material (also called contrast dye) that contains between 200-299 milligrams of iodine per milliliter. Contrast materials are special dyes injected into the body during medical imaging procedures like CT scans, angiograms, or other X-ray studies to help make blood vessels, organs, or other body structures more visible on the images. Low osmolar contrast materials are gentler on the body and cause fewer side effects compared to older types of contrast dyes.
Q2037Fluvirin flu vaccine for people 3 years and older, given as a shot in the muscle
This code represents the Fluvirin influenza (flu) vaccine that is specifically designed for people who are 3 years of age or older. It is a split virus vaccine, which means the flu virus has been broken apart to make it safer while still providing protection. The vaccine is given as an injection into the muscle (intramuscular), typically in the upper arm. This is an annual flu shot that helps protect against seasonal influenza.
G8985Assessment of goals for carrying and moving objects during therapy
This code is used to track and document your therapy goals related to your ability to carry, move, and handle objects. It captures your projected goals at the start of therapy, during regular check-ins throughout treatment, and at the end of therapy or when reporting ends. This helps your therapy team monitor your progress in developing or regaining skills needed for daily activities that involve lifting, carrying, or manipulating objects.
J1596Injection of glycopyrrolate, 0.1 mg dose
This code represents a 0.1 mg injection of glycopyrrolate, a medication that blocks certain nerve signals. Glycopyrrolate is commonly used to reduce saliva and respiratory secretions during medical procedures, treat excessive sweating, or manage certain digestive conditions. The code specifically covers the supply and administration of this exact dosage amount.
J7120Ringer's lactate IV fluid solution, up to 1000cc (about 1 liter)
This code represents Ringer's lactate, which is a sterile fluid given through an IV (intravenous line) to help maintain proper fluid and electrolyte balance in your body. Ringer's lactate contains water, sodium, potassium, calcium, and lactate in concentrations similar to your body's natural fluids. This code covers up to 1000cc (approximately 1 liter) of this IV solution.
Q9967Low osmolar contrast dye with 300-399 mg of iodine per ml, billed per ml
This code represents one milliliter of low osmolar contrast material (contrast dye) that contains between 300-399 milligrams of iodine per milliliter. Low osmolar contrast materials are special dyes used during medical imaging procedures like CT scans or certain X-rays to help make internal structures more visible. The 'low osmolar' type is designed to be gentler on the body and cause fewer side effects compared to older contrast materials. This specific code is used for billing purposes when this particular concentration of contrast dye is administered during your procedure.
G8978Assessment of current walking and mobility abilities during therapy
This code is used by healthcare providers to document and track your current ability to walk and move around during physical or occupational therapy. It represents an evaluation of your mobility functional limitations at the beginning of your therapy episode and at regular reporting intervals throughout your treatment. This assessment helps therapists monitor your progress and adjust your treatment plan as needed.
G9225Documentation that a foot examination was not performed, with no reason provided
This code is used by healthcare providers to document that a foot examination was not completed during a patient visit, and no specific reason was given for why the examination was omitted. This is primarily an administrative code used for medical record keeping and quality reporting purposes.
A6023Large sterile collagen wound dressing (bigger than 48 square inches)
This code represents a sterile collagen dressing that is larger than 48 square inches in size. Collagen dressings are medical wound coverings made from collagen protein that help promote healing. These are specifically the larger-sized versions used for covering extensive wounds or surgical sites. Each unit represents one individual dressing.
G0378Hourly billing for hospital observation services
This code is used by hospitals to bill for observation services on an hourly basis. Hospital observation is a type of outpatient service where you are monitored in the hospital for a specific medical condition or after a procedure, but you are not formally admitted as an inpatient. The hospital uses this code to charge for each hour you spend under observation care, which includes nursing supervision, monitoring of your condition, and medical oversight by healthcare staff.
G0297Low-dose CT scan specifically for lung cancer screening
This code represents a low-dose computed tomography (CT) scan that is specifically performed to screen for lung cancer. This is a specialized imaging test that uses lower amounts of radiation than a standard CT scan while still providing detailed images of the lungs to detect potential early signs of lung cancer in people who meet certain screening criteria.
G8483Documentation that flu vaccine was not given for a documented medical reason
This code is used by healthcare providers to document when a flu (influenza) vaccination was not administered to a patient, and the reason for not giving the vaccine was properly documented. Common documented reasons include: patient allergies to vaccine components, other medical contraindications, patient refusal of the vaccine, vaccine not being available at the time, or other system-related issues that prevented vaccination.
G8509Pain assessment was positive but no follow-up plan was documented
This code indicates that a healthcare provider conducted a pain assessment using a standardized pain measurement tool (such as a pain scale from 0-10), and the results showed that you were experiencing pain. However, the medical record shows that no follow-up plan was documented to address the identified pain, and no reason was given for why a follow-up plan wasn't created. This code is used for quality reporting purposes to track whether appropriate pain management protocols are being followed.
A9500Radioactive tracer injection used for heart imaging studies
This code represents Technetium tc-99m sestamibi, a radioactive tracer medication that is injected into your bloodstream for diagnostic heart imaging tests. The tracer helps doctors see how well blood flows to your heart muscle and can detect areas of damaged or poorly functioning heart tissue. This is typically used in nuclear medicine procedures like stress tests or heart scans. The 'per study dose' means this code covers the amount of medication needed for one complete imaging examination.
J1100Injectable dexamethasone sodium phosphate medication (1 mg dose)
This code represents a 1 mg injection of dexamethasone sodium phosphate, which is a corticosteroid medication given by injection. Dexamethasone is an anti-inflammatory and immunosuppressive medication that mimics the hormone cortisol naturally produced by your adrenal glands. The sodium phosphate form allows it to be dissolved in water for injection. This code is used for billing purposes when you receive this specific dose and form of the medication.
E0601CPAP machine for continuous airway pressure therapy
A Continuous Positive Airway Pressure (CPAP) device is a medical machine that delivers a steady stream of pressurized air through a mask or nasal interface to keep your airways open while you sleep. This device is commonly used to treat sleep apnea and other breathing disorders by preventing airway collapse during sleep.
A6021Sterile collagen wound dressing, 16 square inches or smaller
This code represents a single sterile collagen dressing that measures 16 square inches or less in size. Collagen dressings are specialized wound care products made from collagen (a natural protein found in skin and other tissues) that help promote healing. These dressings are applied directly to wounds to provide a moist healing environment and support the body's natural healing process.
G8983Final assessment of body positioning abilities at end of physical therapy
This code is used by healthcare providers to document a patient's final ability to change and maintain body positions (such as sitting, standing, lying down, or moving between positions) when physical therapy treatment ends or when reporting concludes. It represents the discharge status assessment that shows how well a patient can control their body positioning after completing therapy.
A7037Tubing for positive airway pressure machines
This code covers the replacement tubing that connects to positive airway pressure devices, such as CPAP or BiPAP machines used for sleep apnea and other breathing conditions. The tubing carries pressurized air from the machine to the patient's mask or nasal interface.
G9664Patient is taking statin medication or received a prescription for statin therapy
This code indicates that you are currently taking statin medications (cholesterol-lowering drugs) or that your healthcare provider has given you a prescription order for statin therapy. Statins are commonly prescribed medications used to help lower cholesterol levels and reduce the risk of heart disease and stroke. This code is used for tracking and quality measurement purposes to document statin therapy status.
U0005COVID-19 test using advanced lab techniques with results within 2 days
This code represents a COVID-19 test that detects the SARS-CoV-2 virus (the virus that causes COVID-19) using a laboratory technique called nucleic acid amplification. The test analyzes genetic material (DNA or RNA) from your specimen to identify the virus. This particular code is for tests that use high-throughput technologies (automated systems that can process many samples quickly) and provide results within 2 calendar days of when your specimen was collected. This code is used as an add-on to other COVID-19 testing codes (U0003 or U0004) and represents the specific amplified probe technique portion of the testing process.
G0268Removal of impacted earwax by a doctor on the same day as hearing tests
This code represents a medical procedure where a physician removes impacted cerumen (earwax) from one or both ears. This procedure is specifically performed on the same day that you receive audiologic function testing (hearing tests). The removal is necessary when hardened or excessive earwax blocks the ear canal and could interfere with accurate hearing test results.
G0009Administration of pneumococcal vaccine
This code represents the service of giving a pneumococcal vaccine to a patient. The pneumococcal vaccine helps protect against pneumococcal disease, which can cause serious infections like pneumonia, meningitis, and bloodstream infections. This code covers the healthcare provider's service of administering the vaccine, including the injection itself and any associated clinical activities.
E0562Heated humidifier device used with sleep apnea breathing machines
This code represents a heated humidifier that is specifically designed to work with positive airway pressure (PAP) devices, such as CPAP or BiPAP machines commonly used to treat sleep apnea. The heated humidifier adds warm, moist air to the pressurized air delivered by the PAP device, helping to prevent dryness and irritation in the nose, mouth, and throat during sleep therapy. This accessory helps make PAP therapy more comfortable and tolerable for patients.
A7032Replacement cushion part for a nasal CPAP or BiPAP mask
This code covers a replacement nasal cushion, which is the soft part of a nasal mask that sits against your nose to create a seal. These cushions are used with CPAP (Continuous Positive Airway Pressure) or BiPAP machines for sleep apnea treatment. The cushion needs periodic replacement due to wear, loss of seal, or hygiene reasons. This code is specifically for the cushion component only, not the entire mask.
A9502Technetium Tc-99m tetrofosmin diagnostic imaging agent
This code represents a radioactive imaging agent called Technetium Tc-99m tetrofosmin that is used for diagnostic medical imaging studies. It is a radiopharmaceutical (radioactive medication) that is injected into the body to help doctors see and evaluate certain organs or tissues, most commonly the heart muscle. The radioactive tracer allows special cameras to create detailed images that help diagnose medical conditions. This code covers the cost of one complete study dose of this imaging agent.
A7046Replacement water chamber for CPAP/BiPAP humidifier
This code covers a replacement water chamber (tank) that is part of a humidifier system used with positive airway pressure devices like CPAP or BiPAP machines. The water chamber holds water that gets heated to add moisture to the air you breathe through your sleep apnea device, making therapy more comfortable. This is a single replacement part that needs to be changed periodically for hygiene and proper function.
G1004Clinical decision support system from a national company
This code represents a clinical decision support mechanism provided by a national decision support company, as defined by Medicare's appropriate use criteria program. Clinical decision support systems are computer-based tools that help healthcare providers make better treatment decisions by providing evidence-based recommendations and guidelines at the point of care.
J2704Injection of propofol, 10 mg dose
This code represents a 10 milligram injection of propofol, which is a medication commonly used for anesthesia and sedation during medical procedures. The code is used for billing purposes to track the specific amount of this medication administered to a patient.
G0444Annual depression screening visit lasting 5-15 minutes
This code represents a yearly screening appointment specifically designed to check for signs of depression. During this 5 to 15 minute visit, a healthcare provider will ask you questions or have you complete a questionnaire to assess your mental health and identify any symptoms of depression. This is a preventive care service meant to catch depression early, even if you haven't reported feeling depressed.
G0467Visit to a Federally Qualified Health Center for an established patient
This code represents a face-to-face medical visit at a Federally Qualified Health Center (FQHC) for a patient who has been seen there before. FQHCs are community-based healthcare providers that receive federal funding to provide primary care services in underserved areas. This visit includes a one-on-one encounter between you and a healthcare practitioner where medical services are provided. The code covers a bundle of typical Medicare-covered services that would be provided during your visit to the FQHC.
G0446Annual face-to-face behavioral therapy session for heart disease prevention (15 minutes)
This code represents a 15-minute, one-on-one counseling session with a healthcare provider focused on behavioral therapy for cardiovascular (heart) disease prevention. This is an annual service where the provider works with you individually to discuss and develop strategies for heart-healthy behaviors such as diet, exercise, smoking cessation, and stress management. The session must be conducted in person (face-to-face) and is specifically designed to help prevent or manage cardiovascular disease through behavioral interventions.
A7038Disposable filter for positive airway pressure (PAP) devices
This code represents a disposable filter that is used with positive airway pressure devices, such as CPAP or BiPAP machines. These filters help keep the air clean by removing dust, pollen, and other particles from the air that flows through your sleep apnea or breathing assistance device. The filter needs to be replaced regularly to maintain proper function and hygiene of your PAP equipment.
P9604Travel fee for one-way trip to collect lab samples from homebound patients
This code represents a travel allowance fee that covers the cost of a healthcare worker making a one-way trip to collect laboratory specimens from patients who are confined to their home or nursing home. The fee is prorated, meaning it's calculated based on the actual distance or time required for the trip. This service is only used when the lab sample collection is medically necessary and the patient cannot travel to a medical facility.
G0299Registered nurse care services in your home or hospice, billed per 15-minute period
This code represents direct skilled nursing care provided by a registered nurse (RN) in either a home health or hospice care setting. The service is measured and billed in 15-minute increments. This includes hands-on nursing care, medical assessments, medication management, wound care, patient education, and other skilled nursing interventions that can only be performed by a licensed registered nurse. The care is provided in your home or at a hospice facility rather than in a hospital or clinic setting.
G0300Licensed practical nurse (LPN) care in home or hospice setting, billed per 15-minute period
This code represents direct skilled nursing services provided by a licensed practical nurse (LPN) in either a home health care or hospice care setting. The service is measured and billed in 15-minute increments. LPNs provide nursing care under the supervision of registered nurses or physicians, which may include medication administration, wound care, monitoring vital signs, and other skilled nursing tasks as part of your home-based or hospice care plan.
J3301Injection of triamcinolone acetonide, 10 mg dose
This code represents a 10 mg injection of triamcinolone acetonide, a corticosteroid medication. The 'not otherwise specified' designation means this code is used when the specific brand or formulation of triamcinolone acetonide isn't identified by other more specific codes. Triamcinolone acetonide is an anti-inflammatory steroid medication that can be injected into joints, muscles, or other body areas to reduce inflammation and pain.
G0463Hospital outpatient clinic visit for patient assessment and management
This code represents a visit to a hospital's outpatient clinic where a healthcare provider evaluates and manages a patient's medical condition. This type of visit occurs when you receive care at a hospital-based clinic but are not admitted as an inpatient. The provider will assess your health status, review symptoms, and develop or adjust your treatment plan during this appointment.
G0439Follow-up annual wellness visit with personalized prevention plan
This code represents a subsequent (follow-up) annual wellness visit that includes creating or updating a personalized prevention plan of service (PPS). This is typically the second or later annual wellness visit, building on your previous wellness visit. During this visit, your healthcare provider will review your health status, update your personalized prevention plan based on your current health risks and needs, and discuss preventive care services that may be appropriate for you.
G0179Doctor's review and approval to continue home health services
This code represents when a doctor or qualified healthcare provider reviews and re-certifies that a patient should continue receiving Medicare-covered home health services. The doctor reviews reports about the patient's condition and progress from the home health agency, then confirms that ongoing home health care is still medically necessary. This review happens without the patient being present and is required by Medicare to ensure continued coverage of home health services.
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