HCPCS G0186
Contractor-priced
G0186 · PFS Q4 2026
Contractor-published range
$470.64–$1,175.23
Participating · Office (non-facility) · Whole service
MAC-published fee schedules available in Localis: 60 of 144 payment localities. Missing data does not establish a $0 allowance.
No national PFS rate in Q4 2026
Your Medicare Administrative Contractor prices this code case by case, usually after reviewing documentation.
Check for a published amount in your locality.
HCPCS G0186 carries status C (carrier-priced) in the Q4 2026 release, so there is no single national rate—Medicare contractors publish their own amounts. Your Medicare Administrative Contractor prices this code case by case, usually after reviewing documentation. Contractor-published amounts on file range $470.64–$1,175.23 across 60 localities; enter a ZIP for the exact local amount.
Amount evidence: MAC-published fee schedules and effective dates. The PFS row shows this code is priced by the contractor.
Inspect PFS status evidence
- Code
- G0186
- Release
- Q4 2026, revision 2
- Result
- Contractor-priced
Citations
-
Shows this code’s PFS status (C). Result: Contractor-priced.
Physician relative value file (PPRRVU)Q4 2026 · revision 2
Latest revision of this release
Release period: October 1 – December 31, 2026
This PFS record alone does not establish a $0 allowance or a coverage determination. Any amount from another schedule needs its own evidence.
Record details
PPRRVU2026_Oct_nonQPP.csv in rvu26d-updated-08-26-2026.zip (row 15,135)- hcpcs (col 1)
- G0186
- modifier (col 2)
- blank
- status_code (col 4)
- C
SHA-256: 4d0d3f19bd954ffc0f5b8439169d267da023d4f6911f4539bb6e98723cb1a626
Why is there no national PFS amount for G0186?
Its status indicator is C (carrier-priced). Your Medicare Administrative Contractor prices this code case by case, usually after reviewing documentation.
About this code
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Find the local Medicare amount for G0186 Copy link
Medicare sets this price locally
G0186 has no single national Physician Fee Schedule amount. Use the ZIP, modifier, setting, and participation fields above to match it to a Medicare locality and the contractor amount we have on file.
Your practical estimate will appear here
We hold files from First_coast and Noridian and Novitas across JE and JF and JH and JN, most recently effective Jan 1, 2026. A missing locality means our contractor coverage is incomplete—not that Medicare pays $0.
This is the published amount for this code—not necessarily the entire visit or procedure. A hospital may bill a separate facility charge, and other services, drugs, or supplies can add to the total.
View all 120 published fee rows
| Jurisdiction / locality | Modifier | Note | Par | Non-par | Limiting charge | Effective | Source |
|---|---|---|---|---|---|---|---|
| JE · California, Area 05 CMS 01112-05 | — | — | $730.14 | $693.63 | $797.67 | Jan 1, 2026 | Contractor file |
| JE · California, Area 05 CMS 01112-05 | — | # | $698.67 | $663.74 | $763.30 | Jan 1, 2026 | Contractor file |
| JE · California, Area 09 CMS 01112-09 | — | — | $723.98 | $687.78 | $790.95 | Jan 1, 2026 | Contractor file |
| JE · California, Area 09 CMS 01112-09 | — | # | $693.04 | $658.39 | $757.15 | Jan 1, 2026 | Contractor file |
| JE · California, Area 17 CMS 01182-17 | — | — | $669.94 | $636.44 | $731.91 | Jan 1, 2026 | Contractor file |
| JE · California, Area 17 CMS 01182-17 | — | # | $642.35 | $610.23 | $701.76 | Jan 1, 2026 | Contractor file |
| JE · California, Area 18 CMS 01182-18 | — | — | $659.25 | $626.29 | $720.23 | Jan 1, 2026 | Contractor file |
| JE · California, Area 18 CMS 01182-18 | — | # | $632.55 | $600.92 | $691.06 | Jan 1, 2026 | Contractor file |
| JE · California, Area 51 CMS 01112-51 | — | — | $686.40 | $652.08 | $749.89 | Jan 1, 2026 | Contractor file |
| JE · California, Area 51 CMS 01112-51 | — | # | $657.54 | $624.66 | $718.36 | Jan 1, 2026 | Contractor file |
| JE · California, Area 52 CMS 01112-52 | — | — | $686.40 | $652.08 | $749.89 | Jan 1, 2026 | Contractor file |
| JE · California, Area 52 CMS 01112-52 | — | # | $657.54 | $624.66 | $718.36 | Jan 1, 2026 | Contractor file |
| JE · California, Area 53 CMS 01112-53 | — | — | $686.40 | $652.08 | $749.89 | Jan 1, 2026 | Contractor file |
| JE · California, Area 53 CMS 01112-53 | — | # | $657.54 | $624.66 | $718.36 | Jan 1, 2026 | Contractor file |
| JE · California, Area 54 CMS 01112-54 | — | — | $630.39 | $598.87 | $688.70 | Jan 1, 2026 | Contractor file |
| JE · California, Area 54 CMS 01112-54 | — | # | $605.28 | $575.02 | $661.27 | Jan 1, 2026 | Contractor file |
| JE · California, Area 55 CMS 01112-55 | — | — | $630.39 | $598.87 | $688.70 | Jan 1, 2026 | Contractor file |
| JE · California, Area 55 CMS 01112-55 | — | # | $605.28 | $575.02 | $661.27 | Jan 1, 2026 | Contractor file |
| JE · California, Area 56 CMS 01112-56 | — | — | $630.39 | $598.87 | $688.70 | Jan 1, 2026 | Contractor file |
| JE · California, Area 56 CMS 01112-56 | — | # | $605.28 | $575.02 | $661.27 | Jan 1, 2026 | Contractor file |
| JE · California, Area 57 CMS 01112-57 | — | — | $630.39 | $598.87 | $688.70 | Jan 1, 2026 | Contractor file |
| JE · California, Area 57 CMS 01112-57 | — | # | $605.28 | $575.02 | $661.27 | Jan 1, 2026 | Contractor file |
| JE · California, Area 58 CMS 01112-58 | — | — | $630.39 | $598.87 | $688.70 | Jan 1, 2026 | Contractor file |
| JE · California, Area 58 CMS 01112-58 | — | # | $605.28 | $575.02 | $661.27 | Jan 1, 2026 | Contractor file |
| JE · California, Area 59 CMS 01112-59 | — | — | $630.39 | $598.87 | $688.70 | Jan 1, 2026 | Contractor file |
| JE · California, Area 59 CMS 01112-59 | — | # | $605.28 | $575.02 | $661.27 | Jan 1, 2026 | Contractor file |
| JE · California, Area 60 CMS 01112-60 | — | — | $630.39 | $598.87 | $688.70 | Jan 1, 2026 | Contractor file |
| JE · California, Area 60 CMS 01112-60 | — | # | $605.28 | $575.02 | $661.27 | Jan 1, 2026 | Contractor file |
| JE · California, Area 61 CMS 01112-61 | — | — | $630.39 | $598.87 | $688.70 | Jan 1, 2026 | Contractor file |
| JE · California, Area 61 CMS 01112-61 | — | # | $605.28 | $575.02 | $661.27 | Jan 1, 2026 | Contractor file |
| JE · California, Area 62 CMS 01112-62 | — | — | $630.39 | $598.87 | $688.70 | Jan 1, 2026 | Contractor file |
| JE · California, Area 62 CMS 01112-62 | — | # | $605.28 | $575.02 | $661.27 | Jan 1, 2026 | Contractor file |
| JE · California, Area 63 CMS 01112-63 | — | — | $630.39 | $598.87 | $688.70 | Jan 1, 2026 | Contractor file |
| JE · California, Area 63 CMS 01112-63 | — | # | $605.28 | $575.02 | $661.27 | Jan 1, 2026 | Contractor file |
| JE · California, Area 64 CMS 01112-64 | — | — | $630.39 | $598.87 | $688.70 | Jan 1, 2026 | Contractor file |
| JE · California, Area 64 CMS 01112-64 | — | # | $605.28 | $575.02 | $661.27 | Jan 1, 2026 | Contractor file |
| JE · California, Area 65 CMS 01112-65 | — | — | $630.39 | $598.87 | $688.70 | Jan 1, 2026 | Contractor file |
| JE · California, Area 65 CMS 01112-65 | — | # | $605.28 | $575.02 | $661.27 | Jan 1, 2026 | Contractor file |
| JE · California, Area 66 CMS 01112-66 | — | — | $630.39 | $598.87 | $688.70 | Jan 1, 2026 | Contractor file |
| JE · California, Area 66 CMS 01112-66 | — | # | $605.28 | $575.02 | $661.27 | Jan 1, 2026 | Contractor file |
| JE · California, Area 67 CMS 01112-67 | — | — | $630.39 | $598.87 | $688.70 | Jan 1, 2026 | Contractor file |
| JE · California, Area 67 CMS 01112-67 | — | # | $605.28 | $575.02 | $661.27 | Jan 1, 2026 | Contractor file |
| JE · California, Area 68 CMS 01112-68 | — | — | $630.39 | $598.87 | $688.70 | Jan 1, 2026 | Contractor file |
| JE · California, Area 68 CMS 01112-68 | — | # | $605.28 | $575.02 | $661.27 | Jan 1, 2026 | Contractor file |
| JE · California, Area 69 CMS 01112-69 | — | — | $630.39 | $598.87 | $688.70 | Jan 1, 2026 | Contractor file |
| JE · California, Area 69 CMS 01112-69 | — | # | $605.28 | $575.02 | $661.27 | Jan 1, 2026 | Contractor file |
| JE · California, Area 70 CMS 01112-70 | — | — | $630.39 | $598.87 | $688.70 | Jan 1, 2026 | Contractor file |
| JE · California, Area 70 CMS 01112-70 | — | # | $605.28 | $575.02 | $661.27 | Jan 1, 2026 | Contractor file |
| JE · California, Area 71 CMS 01182-71 | — | — | $630.39 | $598.87 | $688.70 | Jan 1, 2026 | Contractor file |
| JE · California, Area 71 CMS 01182-71 | — | # | $605.28 | $575.02 | $661.27 | Jan 1, 2026 | Contractor file |
| JE · California, Area 72 CMS 01182-72 | — | — | $630.39 | $598.87 | $688.70 | Jan 1, 2026 | Contractor file |
| JE · California, Area 72 CMS 01182-72 | — | # | $605.28 | $575.02 | $661.27 | Jan 1, 2026 | Contractor file |
| JE · California, Area 73 CMS 01182-73 | — | — | $630.39 | $598.87 | $688.70 | Jan 1, 2026 | Contractor file |
| JE · California, Area 73 CMS 01182-73 | — | # | $605.28 | $575.02 | $661.27 | Jan 1, 2026 | Contractor file |
| JE · California, Area 74 CMS 01182-74 | — | — | $630.39 | $598.87 | $688.70 | Jan 1, 2026 | Contractor file |
| JE · California, Area 74 CMS 01182-74 | — | # | $605.28 | $575.02 | $661.27 | Jan 1, 2026 | Contractor file |
| JE · California, Area 75 CMS 01112-75 | — | — | $630.39 | $598.87 | $688.70 | Jan 1, 2026 | Contractor file |
| JE · California, Area 75 CMS 01112-75 | — | # | $605.28 | $575.02 | $661.27 | Jan 1, 2026 | Contractor file |
| JE · Hawaii, Area 01 CMS 01212-01 | — | — | $652.30 | $619.69 | $712.64 | Jan 1, 2026 | Contractor file |
| JE · Hawaii, Area 01 CMS 01212-01 | — | # | $625.61 | $594.33 | $683.48 | Jan 1, 2026 | Contractor file |
| JE · Nevada, Area 00 CMS 01312-00 | — | — | $641.25 | $609.19 | $700.57 | Jan 1, 2026 | Contractor file |
| JE · Nevada, Area 00 CMS 01312-00 | — | # | $616.78 | $585.94 | $673.83 | Jan 1, 2026 | Contractor file |
| JF · Alaska, Area 01 CMS 02102-01 | — | — | $1,175.23 | $1,116.47 | $1,283.94 | Jan 1, 2026 | Contractor file |
| JF · Alaska, Area 01 CMS 02102-01 | — | # | $1,117.76 | $1,061.87 | $1,221.15 | Jan 1, 2026 | Contractor file |
| JF · Arizona, Area 00 CMS 03102-00 | — | — | $1,038.64 | $986.71 | $1,134.72 | Jan 1, 2026 | Contractor file |
| JF · Arizona, Area 00 CMS 03102-00 | — | # | $990.82 | $941.28 | $1,082.47 | Jan 1, 2026 | Contractor file |
| JF · North Dakota, Area 01 CMS 03302-01 | — | — | $958.09 | $910.19 | $1,046.72 | Jan 1, 2026 | Contractor file |
| JF · North Dakota, Area 01 CMS 03302-01 | — | # | $914.99 | $869.24 | $999.63 | Jan 1, 2026 | Contractor file |
| JF · Oregon, Area 01 CMS 02302-01 | — | — | $1,054.43 | $1,001.71 | $1,151.97 | Jan 1, 2026 | Contractor file |
| JF · Oregon, Area 01 CMS 02302-01 | — | # | $1,003.66 | $953.48 | $1,096.50 | Jan 1, 2026 | Contractor file |
| JF · Oregon, Area 99 CMS 02302-99 | — | — | $987.62 | $938.24 | $1,078.98 | Jan 1, 2026 | Contractor file |
| JF · Oregon, Area 99 CMS 02302-99 | — | # | $941.75 | $894.66 | $1,028.86 | Jan 1, 2026 | Contractor file |
| JF · South Dakota, Area 02 CMS 03402-02 | — | — | $943.26 | $896.10 | $1,030.52 | Jan 1, 2026 | Contractor file |
| JF · South Dakota, Area 02 CMS 03402-02 | — | # | $900.30 | $855.29 | $983.58 | Jan 1, 2026 | Contractor file |
| JF · Washington, Area 02 CMS 02402-02 | — | — | $1,090.94 | $1,036.39 | $1,191.85 | Jan 1, 2026 | Contractor file |
| JF · Washington, Area 02 CMS 02402-02 | — | # | $1,037.52 | $985.64 | $1,133.49 | Jan 1, 2026 | Contractor file |
| JF · Washington, Area 99 CMS 02402-99 | — | — | $1,023.22 | $972.06 | $1,117.87 | Jan 1, 2026 | Contractor file |
| JF · Washington, Area 99 CMS 02402-99 | — | # | $975.44 | $926.67 | $1,065.67 | Jan 1, 2026 | Contractor file |
| JF · Wyoming, Area 21 CMS 03602-21 | — | — | $979.41 | $930.44 | $1,070.01 | Jan 1, 2026 | Contractor file |
| JF · Wyoming, Area 21 CMS 03602-21 | — | # | $935.50 | $888.73 | $1,022.04 | Jan 1, 2026 | Contractor file |
| JH · Arkansas, Area 13 CMS 07102-13 | — | — | $470.64 | $447.11 | $514.18 | Jan 1, 2026 | Contractor file |
| JH · Arkansas, Area 13 CMS 07102-13 | — | # | $372.45 | $353.83 | $406.90 | Jan 1, 2026 | Contractor file |
| JH · Colorado, Area 01 CMS 04112-01 | — | — | $553.24 | $525.58 | $604.42 | Jan 1, 2026 | Contractor file |
| JH · Colorado, Area 01 CMS 04112-01 | — | # | $432.01 | $410.41 | $471.97 | Jan 1, 2026 | Contractor file |
| JH · Louisiana, Area 01 CMS 07202-01 | — | — | $508.86 | $483.42 | $555.93 | Jan 1, 2026 | Contractor file |
| JH · Louisiana, Area 01 CMS 07202-01 | — | # | $402.83 | $382.69 | $440.09 | Jan 1, 2026 | Contractor file |
| JH · Louisiana, Area 99 CMS 07202-99 | — | — | $485.55 | $461.27 | $530.46 | Jan 1, 2026 | Contractor file |
| JH · Louisiana, Area 99 CMS 07202-99 | — | # | $385.54 | $366.26 | $421.20 | Jan 1, 2026 | Contractor file |
| JH · Mississippi, Area 00 CMS 07302-00 | — | — | $473.94 | $450.24 | $517.78 | Jan 1, 2026 | Contractor file |
| JH · Mississippi, Area 00 CMS 07302-00 | — | # | $376.12 | $357.31 | $410.91 | Jan 1, 2026 | Contractor file |
| JH · New Mexico, Area 05 CMS 04212-05 | — | — | $500.47 | $475.45 | $546.77 | Jan 1, 2026 | Contractor file |
| JH · New Mexico, Area 05 CMS 04212-05 | — | # | $397.40 | $377.53 | $434.16 | Jan 1, 2026 | Contractor file |
| JH · Oklahoma, Area 00 CMS 04312-00 | — | — | $486.53 | $462.20 | $531.53 | Jan 1, 2026 | Contractor file |
| JH · Oklahoma, Area 00 CMS 04312-00 | — | # | $385.11 | $365.85 | $420.73 | Jan 1, 2026 | Contractor file |
| JH · Texas, Area 09 CMS 04412-09 | — | — | $524.93 | $498.68 | $573.48 | Jan 1, 2026 | Contractor file |
| JH · Texas, Area 09 CMS 04412-09 | — | # | $412.15 | $391.54 | $450.27 | Jan 1, 2026 | Contractor file |
| JH · Texas, Area 11 CMS 04412-11 | — | — | $527.85 | $501.46 | $576.68 | Jan 1, 2026 | Contractor file |
| JH · Texas, Area 11 CMS 04412-11 | — | # | $414.70 | $393.97 | $453.07 | Jan 1, 2026 | Contractor file |
| JH · Texas, Area 15 CMS 04412-15 | — | — | $526.23 | $499.92 | $574.91 | Jan 1, 2026 | Contractor file |
| JH · Texas, Area 15 CMS 04412-15 | — | # | $413.35 | $392.68 | $451.58 | Jan 1, 2026 | Contractor file |
| JH · Texas, Area 18 CMS 04412-18 | — | — | $532.45 | $505.83 | $581.70 | Jan 1, 2026 | Contractor file |
| JH · Texas, Area 18 CMS 04412-18 | — | # | $421.04 | $399.99 | $459.99 | Jan 1, 2026 | Contractor file |
| JH · Texas, Area 20 CMS 04412-20 | — | — | $494.72 | $469.98 | $540.48 | Jan 1, 2026 | Contractor file |
| JH · Texas, Area 20 CMS 04412-20 | — | # | $391.74 | $372.15 | $427.97 | Jan 1, 2026 | Contractor file |
| JH · Texas, Area 28 CMS 04412-28 | — | — | $524.20 | $497.99 | $572.69 | Jan 1, 2026 | Contractor file |
| JH · Texas, Area 28 CMS 04412-28 | — | # | $412.25 | $391.64 | $450.39 | Jan 1, 2026 | Contractor file |
| JH · Texas, Area 31 CMS 04412-31 | — | — | $550.77 | $523.23 | $601.71 | Jan 1, 2026 | Contractor file |
| JH · Texas, Area 31 CMS 04412-31 | — | # | $430.51 | $408.98 | $470.33 | Jan 1, 2026 | Contractor file |
| JH · Texas, Area 99 CMS 04412-99 | — | — | $509.25 | $483.79 | $556.36 | Jan 1, 2026 | Contractor file |
| JH · Texas, Area 99 CMS 04412-99 | — | # | $401.67 | $381.59 | $438.83 | Jan 1, 2026 | Contractor file |
| JN · Florida, Area 03 CMS 09102-03 | — | — | $543.86 | $516.67 | $594.17 | Jan 1, 2026 | Contractor file |
| JN · Florida, Area 03 CMS 09102-03 | — | # | $431.28 | $409.72 | $471.18 | Jan 1, 2026 | Contractor file |
| JN · Florida, Area 04 CMS 09102-04 | — | — | $562.69 | $534.56 | $614.74 | Jan 1, 2026 | Contractor file |
| JN · Florida, Area 04 CMS 09102-04 | — | # | $448.79 | $426.35 | $490.30 | Jan 1, 2026 | Contractor file |
| JN · Florida, Area 99 CMS 09102-99 | — | — | $518.73 | $492.79 | $566.71 | Jan 1, 2026 | Contractor file |
| JN · Florida, Area 99 CMS 09102-99 | — | # | $411.94 | $391.34 | $450.04 | Jan 1, 2026 | Contractor file |
| JN · Puerto Rico, Area 20 CMS 09202-20 | — | — | $533.75 | $507.06 | $583.12 | Jan 1, 2026 | Contractor file |
| JN · Puerto Rico, Area 20 CMS 09202-20 | — | # | $419.21 | $398.25 | $457.99 | Jan 1, 2026 | Contractor file |
| JN · U.S. Virgin Islands, Area 50 CMS 09202-50 | — | — | $533.75 | $507.06 | $583.12 | Jan 1, 2026 | Contractor file |
| JN · U.S. Virgin Islands, Area 50 CMS 09202-50 | — | # | $419.21 | $398.25 | $457.99 | Jan 1, 2026 | Contractor file |
The authenticated MAC fees API returns the same source rows. ZIP5s that span localities are flagged and use only the crosswalk's dominant locality until ZIP+4 overrides are available.
Payment considerations Copy link
Here are the inputs and payment rules that apply to this code. Each link takes you to the detail below.
Other payment indicators (3)
Facility/non-facility: Not determined, Professional/technical component: Does not apply, Other fee-schedule routing: Does not apply.
Why would a Medicare claim for G0186 be denied or paid less?
These come from CMS indicators on this page, not general billing advice.
- Its status indicator is C (carrier-priced)—Your Medicare Administrative Contractor prices this code case by case, usually after reviewing documentation. See status indicators
- 10 codes form NCCI pairs with G0186 carrying modifier indicator 0—no NCCI-associated modifier bypasses the edit, so billed together on the same date of service, a line of the pair denies. See billing together
- 20 codes pair with G0186 under modifier indicator 1—separately payable only when an NCCI-associated modifier (59, or a more specific XE, XS, XP, or XU) is clinically appropriate and the documentation supports a distinct service; without one, a line of the pair denies. See billing together
- More than 1 unit per patient per date of service exceeds G0186's Medically Unlikely Edit (MUE) limit. See billing together
- Assistant at surgery: restricted without documentation. See billing policy
- Co-surgeons: payable with documentation. See billing policy
- Team surgery: payable with documentation. See billing policy
- Multiple procedures: standard reduction applies. See billing policy
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.
Reconciling a contractor-priced payment for G0186 Copy link
There is no national allowed amount for G0186, so every reconciliation of this line runs against the MAC fee schedule that was in force for the date of service rather than against a national baseline.
What to check
- Compare the paid amount against the MAC fee schedule in force for the date of service; there is no national allowed amount here to reconcile against.
- Ask the MAC which global period it assigned: the contractor sets the follow-up window for this code, so whether a post-operative visit should have paid depends on the contractor that priced it.
- Rank the claim’s procedure lines before calling a reduced line short-paid—under the standard multiple-procedure rule only the highest-valued one prices in full.
- Look for modifier 50 or a second-side line before comparing: billed for both sides, this procedure should price at 150% of the single-side amount.
- Reprice the line against the release, locality, setting, modifier and participation status that applied to the date of service before treating any difference as an underpayment.
Codes to compare
National Q4 2026 amounts at GPCI 1.000. A blank means this schedule does not publish a payable PFS amount.
Sources: CMS Medicare Physician Fee Schedule Relative Value Files; CMS Medicare Physician Fee Schedule Relative Value Files (status indicator field); CMS Medicare Claims Processing Manual (Pub. 100-04).
Which billing rules and modifiers apply? Copy link
Global period: what G0186's fee already covers Copy link
Your Medicare Administrative Contractor decides whether a global period applies and sets its length when it prices the code. The result is 0, 10, or 90 days.
Billing policy Copy link
These billing-policy indicators explain how G0186 is treated. They apply whether the code is nationally priced or carrier-priced: a restriction like "bilateral not allowed" still matters on a carrier-priced code.
| Policy | Value | What it means |
|---|---|---|
| Bilateral surgery | 1 | 150% bilateral adjustment applies. Billed bilaterally (modifier 50, or on both sides), Medicare pays 150% of the single-side fee schedule amount. |
| Assistant at surgery | 0 | Restricted without documentation. Payment for an assistant at surgery is restricted for this procedure unless supporting documentation establishes medical necessity. |
| Co-surgeons | 1 | Payable with documentation. Co-surgeons may be paid, but only with supporting documentation establishing the medical necessity of two surgeons. |
| Team surgery | 1 | Payable with documentation. A surgical team may be paid, but only with supporting documentation establishing medical necessity. |
| Multiple procedures | 2 | Standard reduction applies. When billed with other procedures on the same date, the highest-valued one is paid at 100% and the next four at 50% each. |
| Professional/technical split | 0 | No PC/TC split. This is a physician service code; the professional/technical split does not apply, and the code is billed as a single service. |
Can you bill it with another code? Copy link
Check a pair of codes 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 for the pair.
Billing together (NCCI edits) Copy link
NCCI Q4 2026Based on CMS's National Correct Coding Initiative (NCCI). A few examples appear here; use the complete edit page to check a specific pair.
Not separately payable with G0186 on the same date of service—no modifier bypasses the edit (modifier indicator 0)
Showing 3 of 10.
Separately payable with G0186 only when an NCCI-associated modifier is appropriate and documented (modifier indicator 1)
Showing 3 of 20.
Modifier 59 and the X modifiers are not a universal bypass—CMS expects the most specific applicable modifier, and which one that is depends on the pair and the documented circumstances.
Check a paired code or view all 30 NCCI pairs →
Medically Unlikely Edit (MUE) limit: 1 unit per patient per date of service.
How has it changed? Copy link
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.
Usage and related codes Copy link
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Source & method
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Contractor amounts come from the MAC-published schedules and effective dates shown above. The PFS file shows this code is priced by the contractor. Past releases are never edited, so these sources stay valid after CMS publishes a newer one. CMS owns the code description shown for HCPCS Level II codes. Our methodology explains sourcing, parsing, versioning, and how we cross-check claims before we publish them.
Use the (i) buttons next to each amount above for the exact row, columns, and math.
Cite this rate
The citation names the release, so anyone can check it even after CMS publishes a newer one.
HCPCS G0186 National PFS baseline: No national PFS rate (Q4 2026; participating; whole service; GPCI 1.000; sequestration excluded). Localis. https://localishealth.com/hcpcs/G0186/2026/D