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Describe a service in plain words, or type a CPT/HCPCS code.

HCPCS G0219

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Excluded from PFS — out of payment scope by statute, regulation, non-coverage, or reporting-only status.

HCPCS Level II

No national payment amount

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

Did Medicare pay separately for HCPCS G0219 in Q3 2023? Copy link

Not at a published national rate. HCPCS G0219 carries status N (non-covered) in the Q3 2023 release. Medicare covers no part of this service. Treat the blank amount as unpriced, not as $0.

Source: Physician relative value file (Q3 2023) · effective July 2023 · materially updated Aug 4, 2026 · compact facts

Why isn't there a national PFS amount?

  • Status 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.

CMS evidence · 2 sources

Open evidence
Physician relative value file (Q3 2023) · rvu23c.zip (PPRRVU23_JUL.csv row 1,767)

See full source & method below

Common questions Copy link

Why is there no payment amount for G0219?

Its status indicator is N (non-covered). Medicare covers no part of this service. 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 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.

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.

Payment rules

Applicable payment rules Copy link

Only the rules that can matter for G0219, each linking to its detail on this page.

Facility/non-facility Not determined Professional/technical component Applies
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

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

XXX Does not apply

The global surgery concept does not apply to this code.

Modifiers that report work outside G0219's global period
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.

Billing policy Copy link

What G0219's billing-policy indicators mean. These show for every code, priced or not: 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

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 G0219.

See every current NCCI pair for G0219 →

History

Rate history by release Copy link

National non-facility amount for G0219 across quarterly releases.

Release Status Non-facility Facility
Q3 2026 Jul 1, 2026 – present N — —
Q2 2026 Apr 1, 2026 – Jun 30, 2026 N — —
Q1 2026 Jan 1, 2026 – Mar 31, 2026 N — —

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Source & method

Show sources

This is computed from CMS's Medicare Physician Fee Schedule Q3 2023 release (schedule pfs, effective July 2023). 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.

Physician relative value file (Q3 2023) · rvu23c.zip (PPRRVU23_JUL.csv row 1,767)

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 Q3 2023 figures, even after a newer release lands.

HCPCS G0219 Medicare Physician Fee Schedule rate (Q3 2023). Localis. https://localishealth.com/hcpcs/G0219/2023/C