HCPCS G0460
Autologous prp for ulcers
Contractor-priced — your Medicare Administrative Contractor sets the amount, not a national fee schedule.
No national payment amount in Q1 2018
Your Medicare Administrative Contractor prices this code case by case, usually after reviewing documentation.
Contractor amounts on file today
$121.59–$847.01
We hold no contractor-published amount for G0460 in Q1 2018. The figures above are what contractors publish now , across 63 of 119 payment localities on file — not what your contractor paid in Q1 2018.
Reading an old claim? Keep this page for Q1 2018 and open the current G0460 page for today’s.
Did Medicare pay separately for HCPCS G0460 in Q1 2018? Copy link
Not at a published national rate. HCPCS G0460 carries status C (carrier-priced) in the Q1 2018 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 (Q1 2018) · effective January 2018 · 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 G0460?
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 G0460 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
- Bilateral surgery: no bilateral adjustment. See billing policy
- Co-surgeons: not permitted. See billing policy
- Team surgery: not permitted. 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. The G0460 rate last moved in Q1 2020 (-0.4% non-facility) — see its rate history or 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 G0460, each linking to its detail on this page.
Global period: what G0460'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.
Billing policy Copy link
What G0460'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 |
|---|---|---|
| Bilateral surgery | 0 | No bilateral adjustment. The 150% bilateral payment adjustment does not apply to this procedure. |
| Co-surgeons | 0 | Not permitted. Medicare does not recognize co-surgeons (modifier 62) for this procedure. |
| Team surgery | 0 | Not permitted. Medicare does not recognize a surgical team (modifier 66) for this procedure. |
| Multiple procedures | 0 | No reduction. No payment reduction applies when this procedure is billed with other procedures on the same date — each is treated as unrelated. |
| 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
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 G0460.
Did this answer your question about HCPCS G0460?
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Source & method
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This is computed from CMS's Medicare Physician Fee Schedule Q1 2018 release (schedule pfs, effective January 2018). 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 Q1 2018 figures, even after a newer release lands.
HCPCS G0460 Medicare Physician Fee Schedule rate (Q1 2018). Localis. https://localishealth.com/hcpcs/G0460/2018/A