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Medicare Physician Fee Schedule Effective CMS RVU21D Updated

HCPCS G0219 Medicare payment status

Excluded from PFS

G0219 · PFS Q4 2021 · Historical

Status N: non-covered. Medicare covers no part of this service, so the PFS produces no payment amount.

View applicable payment rules
View CMS source and method

CMS RVU21DOctober 1 – December 31, 2021

PFS status evidence

Physician relative value file (Q4 2021) · rvu21d.zip (PPRRVU21_OCT.csv row 1,528)
Inspect PFS status evidence
Code
G0219
Release
Q4 2021, revision 1
Result
Excluded from PFS

Citations

  • Shows this code’s PFS status (N). Result: Excluded from PFS.

    Physician relative value file (PPRRVU)CMS RVU21DOctober 1 – December 31, 2021

    This PFS record alone does not establish a $0 allowance or a coverage determination. Any amount from another schedule needs its own evidence.

    PPRRVU21_OCT.csv row 1,528 in rvu21d.zip

    In the CMS file

    Loading rows 1,526–1,530 of PPRRVU21_OCT.csv…

    Download rvu21d.zip from CMS File fingerprint f1972bd23bdc51795ceba7d536bb413a0ba0b47fad8c2ed594e7ee7799877297

Plain-text summaryReport a problem

HCPCS G0219 has no published national rate. It carries status N (non-covered) in the Q4 2021 release. Medicare covers no part of this service. The blank amount means unpriced, not $0.

Why is there no national PFS amount for G0219?

Its status indicator is N (non-covered). Medicare covers no part of this service. Status N: non-covered. Medicare covers no part of this service, so the PFS produces no payment amount.

About this code

Pet img wholbod melano nonco

Payment considerations Copy link

Here are the inputs and payment rules that apply to this code. Each link takes you to the detail below.

Professional/technical component Applies
Other payment indicators (9)
Facility/non-facility: Not determined, Bilateral adjustment: Does not apply, Multiple-procedure reduction: Does not apply, Assistant/co-surgeon treatment: Does not apply, Global surgery: Does not apply, NCCI same-day edits: Not determined, MUE behavior: Not determined, Other fee-schedule routing: Does not apply, Contractor pricing: Does not apply.
Why would a Medicare claim for G0219 be denied or paid less?

These come from CMS indicators on this page, not general billing advice.

  • Its status indicator is N (non-covered)—Medicare covers no part of this service. See status indicators
  • G0219 splits into a professional component (modifier 26) and a technical component (modifier TC)—a claim for only one part needs that modifier to price correctly. 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.

Which billing rules and modifiers apply? Copy link

Global period: what G0219's fee already covers Copy link

XXX Does not apply

The global surgery concept does not apply to this code.

Billing policy Copy link

These billing-policy indicators explain how G0219 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
Professional/technical split 1 Splits into professional and technical. This procedure splits into a professional component (modifier 26) and a technical component (modifier TC), each separately payable.

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.

See every current NCCI pair for G0219 →

Why a G0219 line may not pay separately Copy link

CMS publishes no separately payable amount for G0219 in this release, so reconciling the line means establishing which status governed the date of service rather than chasing a fee-schedule difference.

What to check

  • Confirm the status that governed the date of service before working this line as a short payment—CMS publishes no separately payable fee-schedule amount for it in this release.
  • Confirm which component the line carried before comparing anything: the same code prices three ways—globally, as a professional component with modifier 26, and as a technical component with modifier TC.
  • 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.

Compare against G0235, G0237 and G0238: their amounts are in Related codes.

Check an actual payment Model this code in a contract

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).

How has it changed? Copy link

Rate history by release Copy link

National Office (non-facility) amount for G0219 across quarterly releases.

Release Status Office Facility
Q4 2026 Oct 1, 2026 – present N — —
Q3 2026 Jul 1, 2026 – Sep 30, 2026 N — —
Q2 2026 Apr 1, 2026 – Jun 30, 2026 N — —
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

Show sources

This page uses CMS's Medicare Physician Fee Schedule Q4 2021 release (effective October 2021). National baselines use GPCI 1.000 and exclude sequestration. Whether a national amount exists depends on the status and CMS’s payment instructions; blank RVUs are never treated as zero. 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.

Physician relative value file (Q4 2021) · rvu21d.zip (PPRRVU21_OCT.csv row 1,528)

Cite this rate

The citation names the release, so anyone can check it even after CMS publishes a newer one.

HCPCS G0219 National PFS baseline: No national PFS rate (Q4 2021; participating physician; whole service; GPCI 1.000; sequestration excluded). CMS RVU21D, PPRRVU21_OCT.csv row 1,528. Localis. https://localishealth.com/hcpcs/G0219/2021/D