HCPCS G0154
Hhcp-svs of rn,ea 15 min
Priced under the Clinical Laboratory Fee Schedule (CLFS), not the RVU formula.
No national payment amount
Status X is not separately payable under the PFS.
Did Medicare pay separately for HCPCS G0154 in Q4 2015? Copy link
Not at a published national rate. HCPCS G0154 carries status X (statutory exclusion) in the Q4 2015 release. The statutory definition of physician services does not include this item. Treat the blank amount as unpriced, not as $0.
Source: Physician relative value file (Q4 2015) · effective October 2015 · materially updated Aug 4, 2026 · compact facts
Why isn't there a national PFS amount?
- Status X (Statutory exclusion): The statutory definition of physician services does not include this item.
- Status X is not separately payable under the PFS.
CMS evidence · 2 sources
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Common questions Copy link
Why is there no payment amount for G0154?
Its status indicator is X (statutory exclusion). The statutory definition of physician services does not include this item. The blank is deliberate: the amount is either unknown or paid under another provision, so reading it as $0 would be wrong.
Why would a Medicare claim for G0154 be denied or paid less?
These come from CMS indicators on this page, not general billing advice.
- Its status indicator is X (statutory exclusion) — The statutory definition of physician services does not include this item. See status indicators
Payer-specific coverage and documentation rules live outside these files, so a claim that clears every check here can still be denied on other grounds.
When does this rate change?
CMS publishes a fee schedule release every quarter (January, April, July, October), and each is versioned here. See what changed each release, or get an email when a new release moves rates.
Sources: CMS Medicare Physician Fee Schedule Relative Value Files.
Applicable payment rules Copy link
Only the rules that can matter for G0154, each linking to its detail on this page.
Global period: what G0154's fee already covers Copy link
The global surgery concept does not apply to this code.
| Modifier | Reports |
|---|---|
| -25 | A significant, separately identifiable E/M on the same day as the procedure, beyond its usual pre- and post-operative care. |
A modifier reports what happened; it does not by itself make a service payable. Documentation has to support it.
Can you bill it with another code? Copy link
Enter a second CPT or HCPCS code billed on the same date of service. We'll check the current NCCI procedure-to-procedure edit between it and G0154.
Rate history by release Copy link
National non-facility amount for G0154 across quarterly releases.
| Release | Status | Non-facility | Facility |
|---|---|---|---|
| Q4 2015 Oct 1, 2015 – present | X | — | — |
| Q3 2015 Jul 1, 2015 – Sep 30, 2015 | X | — | — |
| Q2 2015 Apr 1, 2015 – Jun 30, 2015 | X | — | — |
| Q1 2015 Jan 1, 2015 – Mar 31, 2015 | X | — | — |
| Q4 2014 Oct 1, 2014 – Dec 31, 2014 | X | — | — |
| Q3 2014 Jul 1, 2014 – Sep 30, 2014 | X | — | — |
| Q2 2014 Apr 1, 2014 – Jun 30, 2014 | X | — | — |
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Source & method
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This is computed from CMS's Medicare Physician Fee Schedule Q4 2015 release (schedule pfs, effective October 2015). National amounts apply a GPCI of 1.000 and leave sequestration off. The status indicator decides payability, never the RVU values, so a blank RVU stays blank. Releases are immutable: a rate retrieved for a past quarter always reflects that release. CMS owns the code description shown for HCPCS Level II codes. Our methodology covers the depth: sourcing, parsing, versioning, and how we cross-check claims before they ship.
Use the (i) buttons next to each amount above for the exact row, columns, and math.
Cite this rate
This link keeps pointing at the Q4 2015 figures, even after a newer release lands.
HCPCS G0154 Medicare Physician Fee Schedule rate (Q4 2015). Localis. https://localishealth.com/hcpcs/G0154/2015/D