HCPCS G0460
Autologous prp for ulcers
No national payment amount
Carrier-priced: no national payment amount.
Did Medicare pay separately for HCPCS G0460 in Q4 2021?
Not at a published national rate. HCPCS G0460 carries status C (carrier-priced) in the Q4 2021 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 (Q4 2021) · effective October 2021 · materially updated Aug 4, 2026 · compact facts
Common questions
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?
Each item below comes from a CMS indicator 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
- Assistant at surgery: never separately payable. See billing policy
- Co-surgeons: not permitted. See billing policy
- Team surgery: not permitted. 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.
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.
Saw this code on your bill?
What is a G0460 visit in patient-friendly terms?
In plain terms: Autologous prp for ulcers You'll typically see HCPCS G0460 on a bill or explanation of benefits (EOB) when a clinician performs or bills for this service.
How this amount is computed
amount = (work RVU × work GPCI + PE RVU × PE GPCI + MP RVU × MP GPCI) × conversion factor. National amounts use GPCI = 1.000. To price an RVU figure of your own, use the RVU-to-dollars converter.
| Component | RVU |
|---|---|
| Work RVU | blank |
| Practice expense RVU (non-facility) | blank |
| Practice expense RVU (facility) | blank |
| Malpractice RVU | blank |
Every rate combines three parts: work (the clinician’s time, skill and effort), practice expense (office overhead — higher when the service is done in a doctor’s own office), and malpractice (the share of liability-insurance cost). A blank means CMS publishes no national number for that part. Read it as unknown, and never as zero.
Billing policy
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. |
| Assistant at surgery | 1 | Never separately payable. An assistant at surgery may never be separately paid for this procedure — a statutory restriction. |
| 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 | 2 | Standard reduction applies. The same standard ranking-and-reduction rule as indicator 1 applies to this procedure when billed with others on the same date. |
| 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. |
Rate history by release
National non-facility amount for G0460 across quarterly releases. Up 9.9% since Q3 2018 · high $217.68 in Q1 2019
| Release | Status | Non-facility | Facility |
|---|---|---|---|
| Q3 2026 Jun 30, 2026 – present | C | — | — |
| Q2 2026 Mar 10, 2026 – Jun 29, 2026 | C | — | — |
| Q1 2026 Dec 29, 2025 – Mar 9, 2026 | C | — | — |
| Q4 2025 Sep 11, 2025 – Dec 28, 2025 | C | — | — |
| Q3 2025 Jun 5, 2025 – Sep 10, 2025 | C | — | — |
| Q2 2025 Jun 5, 2025 – Jun 4, 2025 | C | — | — |
| Q1 2025 Dec 23, 2024 – Jun 4, 2025 | C | — | — |
| Q4 2024 Aug 9, 2024 – Dec 22, 2024 | C | — | — |
| Q3 2024 May 3, 2024 – Aug 8, 2024 | C | — | — |
| Q2 2024 Mar 15, 2024 – May 2, 2024 | C | — | — |
| Q1 2024 Mar 11, 2023 – Mar 14, 2024 | C | — | — |
| Q4 2023 Aug 1, 2023 – Mar 10, 2023 | C | — | — |
| Q3 2023 May 10, 2023 – Jul 31, 2023 | C | — | — |
| Q2 2023 Feb 3, 2023 – May 9, 2023 | C | — | — |
| Q1 2023 Jan 30, 2023 – Feb 2, 2023 | C | — | — |
| Q4 2022 Jul 29, 2022 – Jan 29, 2023 | C | — | — |
| Q3 2022 Jun 17, 2022 – Jul 28, 2022 | C | — | — |
| Q2 2022 Feb 14, 2022 – Jun 16, 2022 | C | — | — |
| Q1 2022 Dec 15, 2021 – Feb 13, 2022 | C | — | — |
| Q4 2021 Aug 3, 2021 – Dec 14, 2021 | C | — | — |
| Q3 2021 Jun 10, 2021 – Aug 2, 2021 | C | — | — |
| Q2 2021 Feb 26, 2021 – Jun 9, 2021 | C | — | — |
| Q1 2021 Dec 29, 2020 – Feb 25, 2021 | C | — | — |
| Q4 2020 Oct 21, 2020 – Dec 28, 2020 | A | $216.90 (0.0%) | $130.28 (0.0%) |
| Q3 2020 Jun 18, 2020 – Oct 20, 2020 | A | $216.90 (0.0%) | $130.28 (0.0%) |
| Q2 2020 Apr 30, 2020 – Jun 17, 2020 | A | $216.90 (0.0%) | $130.28 (0.0%) |
| Q1 2020 Nov 8, 2019 – Apr 29, 2020 | A | $216.90 (-0.4%) | $130.28 (-1.8%) |
| Q4 2019 Aug 2, 2019 – Nov 7, 2019 | A | $217.68 (0.0%) | $132.62 (0.0%) |
| Q3 2019 May 3, 2019 – Aug 1, 2019 | A | $217.68 (0.0%) | $132.62 (0.0%) |
| Q2 2019 Mar 1, 2019 – May 2, 2019 | A | $217.68 (0.0%) | $132.62 (0.0%) |
| Q1 2019 Dec 13, 2018 – Feb 28, 2019 | A | $217.68 (+10.3%) | $132.62 (+4.4%) |
| Q4 2018 Aug 3, 2018 – Dec 12, 2018 | A | $197.28 (0.0%) | $127.08 (0.0%) |
| Q3 2018 Apr 30, 2018 – Aug 2, 2018 | A | $197.28 | $127.08 |
| Q2 2018 Feb 12, 2018 – Apr 29, 2018 | C | — | — |
| Q1 2018 Feb 9, 2018 – Feb 11, 2018 | C | — | — |
| Q4 2017 Aug 18, 2017 – Feb 8, 2018 | C | — | — |
| Q3 2017 May 3, 2017 – Aug 17, 2017 | C | — | — |
| Q2 2017 Feb 9, 2017 – May 2, 2017 | C | — | — |
| Q1 2017 Nov 14, 2016 – Feb 8, 2017 | C | — | — |
| Q4 2016 Aug 5, 2016 – Nov 13, 2016 | C | — | — |
| Q3 2016 May 17, 2016 – Aug 4, 2016 | C | — | — |
| Q2 2016 Feb 2, 2016 – May 16, 2016 | C | — | — |
| Q1 2016 Jan 21, 2016 – Feb 1, 2016 | C | — | — |
| Q4 2015 Oct 2, 2015 – Jan 20, 2016 | C | — | — |
| Q3 2015 May 15, 2015 – Oct 1, 2015 | C | — | — |
| Q2 2015 Feb 13, 2015 – May 14, 2015 | C | — | — |
| Q1 2015 Dec 23, 2014 – Feb 12, 2015 | C | — | — |
| Q4 2014 Aug 19, 2014 – Dec 22, 2014 | C | — | — |
| Q3 2014 May 15, 2014 – Aug 18, 2014 | C | — | — |
| Q2 2014 Mar 24, 2014 – May 14, 2014 | C | — | — |
Did this answer your question about HCPCS G0460?
We're building this out in the open. Tell us what you were actually trying to work out and we'll either answer you directly or build the page that does.
Source & method
Show sources
Hide
This is computed from CMS's Medicare Physician Fee Schedule Q4 2021 release (schedule pfs, effective October 2021). 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. Commercial and cash-pay figures anywhere on this page are arithmetic on the Medicare amount, using commonly cited reimbursement ranges. They're illustrative, and no nationwide claims database stands behind them. Our methodology covers all of this in depth — sourcing, parsing, versioning, and how claims are cross-checked before they ship.
Conversion factor $34.8931 read from the same file, row 11, column 25.
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 Q4 2021 figures, even after a newer release lands.
HCPCS G0460 Medicare Physician Fee Schedule rate (Q4 2021). Localis. https://localishealth.com/hcpcs/G0460/2021/D