HCPCS G0457
Neg pres wound >50 sq cm
Contractor-priced — your Medicare Administrative Contractor sets the amount, not a national fee schedule.
No national payment amount
Your Medicare Administrative Contractor prices this code case by case, usually after reviewing documentation.
Did Medicare pay separately for HCPCS G0457 in Q3 2014? Copy link
Not at a published national rate. HCPCS G0457 carries status C (carrier-priced) in the Q3 2014 release. Your Medicare Administrative Contractor prices this code case by case, usually after reviewing documentation. Treat the blank amount as unpriced, not as $0.
Source: Physician relative value file (Q3 2014) · effective July 2014 · materially updated Aug 4, 2026 · compact facts
Why isn't there a national PFS amount?
- Status C (Carrier-priced): Your Medicare Administrative Contractor prices this code case by case, usually after reviewing documentation.
- Carrier-priced: no national payment amount.
CMS evidence · 2 sources
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Common questions Copy link
Why is there no payment amount for G0457?
Its status indicator is C (carrier-priced). Your Medicare Administrative Contractor prices this code case by case, usually after reviewing documentation. 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 G0457 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
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 G0457, each linking to its detail on this page.
Global period: what G0457'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.
| 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 G0457.
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Source & method
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This is computed from CMS's Medicare Physician Fee Schedule Q3 2014 release (schedule pfs, effective July 2014). 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 Q3 2014 figures, even after a newer release lands.
HCPCS G0457 Medicare Physician Fee Schedule rate (Q3 2014). Localis. https://localishealth.com/hcpcs/G0457/2014/C