HCPCS G0491
Priced under CLFS
G0491 · PFS Q4 2026
Status X is not separately payable under the PFS.
HCPCS G0491 has no published national rate. It carries status X (statutory exclusion) in the Q4 2026 release. The statutory definition of physician services does not include this item. The blank amount means unpriced, not $0.
PFS status evidence
Inspect PFS status evidence
- Code
- G0491
- Release
- Q4 2026, revision 2
- Result
- Priced under CLFS
Citations
-
Shows this code’s PFS status (X). Result: Priced under CLFS.
Physician relative value file (PPRRVU)Q4 2026 · revision 2
Latest revision of this release
Release period: October 1 – December 31, 2026
This PFS record alone does not establish a $0 allowance or a coverage determination. Any amount from another schedule needs its own evidence.
Record details
PPRRVU2026_Oct_nonQPP.csv in rvu26d-updated-08-26-2026.zip (row 15,296)- hcpcs (col 1)
- G0491
- modifier (col 2)
- blank
- status_code (col 4)
- X
SHA-256: 4d0d3f19bd954ffc0f5b8439169d267da023d4f6911f4539bb6e98723cb1a626
Why is there no national PFS amount for G0491?
Its status indicator is X (statutory exclusion). The statutory definition of physician services does not include this item. Status X is not separately payable under the PFS.
About this code
Dialysis acu kidney no esrd
Payment considerations Copy link
Here are the inputs and payment rules that apply to this code. Each link takes you to the detail below.
Other payment indicators (7)
Facility/non-facility: Not determined, Professional/technical component: Does not apply, Bilateral adjustment: Does not apply, Multiple-procedure reduction: Does not apply, Assistant/co-surgeon treatment: Does not apply, Global surgery: Does not apply, Contractor pricing: Does not apply.
Why would a Medicare claim for G0491 be denied or paid less?
These come from CMS indicators on this page, not general billing advice.
- Its status indicator is X (statutory exclusion)—The statutory definition of physician services does not include this item. See status indicators
- 126 codes form NCCI pairs with G0491 carrying modifier indicator 0—no NCCI-associated modifier bypasses the edit, so billed together on the same date of service, a line of the pair denies. See billing together
- 164 codes pair with G0491 under modifier indicator 1—separately payable only when an NCCI-associated modifier (59, or a more specific XE, XS, XP, or XU) is clinically appropriate and the documentation supports a distinct service; without one, a line of the pair denies. See billing together
- More than 1 unit per patient per date of service exceeds G0491's Medically Unlikely Edit (MUE) limit. See billing together
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 G0491's fee already covers Copy link
The global surgery concept does not apply to this code.
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.
Billing together (NCCI edits) Copy link
NCCI Q4 2026Based on CMS's National Correct Coding Initiative (NCCI). A few examples appear here; use the complete edit page to check a specific pair.
Not separately payable with G0491 on the same date of service—no modifier bypasses the edit (modifier indicator 0)
Showing 3 of 126.
Separately payable with G0491 only when an NCCI-associated modifier is appropriate and documented (modifier indicator 1)
Showing 3 of 164.
Modifier 59 and the X modifiers are not a universal bypass—CMS expects the most specific applicable modifier, and which one that is depends on the pair and the documented circumstances.
Check a paired code or view all 290 NCCI pairs →
Medically Unlikely Edit (MUE) limit: 1 unit per patient per date of service.
How has it changed? Copy link
Rate history by release Copy link
National Office (non-facility) amount for G0491 across quarterly releases.
| Release | Status | Office | Facility |
|---|---|---|---|
| Q4 2026 Oct 1, 2026 – present | X | — | — |
| Q3 2026 Jul 1, 2026 – Sep 30, 2026 | X | — | — |
| Q2 2026 Apr 1, 2026 – Jun 30, 2026 | X | — | — |
| Q1 2026 Jan 1, 2026 – Mar 31, 2026 | X | — | — |
| Q4 2025 Oct 1, 2025 – Dec 31, 2025 | X | — | — |
| Q3 2025 Jul 1, 2025 – Sep 30, 2025 | X | — | — |
| Q2 2025 Apr 1, 2025 – Jun 30, 2025 | X | — | — |
| Q1 2025 Jan 1, 2025 – Mar 31, 2025 | X | — | — |
| Q4 2024 Oct 1, 2024 – Dec 31, 2024 | X | — | — |
| Q3 2024 Jul 1, 2024 – Sep 30, 2024 | X | — | — |
| Q2 2024 Apr 1, 2024 – Jun 30, 2024 | X | — | — |
| Q1 2024 Mar 9, 2024 – Mar 31, 2024 | X | — | — |
| Q1 2024 Jan 1, 2024 – Mar 8, 2024 | X | — | — |
| Q4 2023 Oct 1, 2023 – Dec 31, 2023 | X | — | — |
| Q3 2023 Jul 1, 2023 – Sep 30, 2023 | X | — | — |
| Q2 2023 Apr 1, 2023 – Jun 30, 2023 | X | — | — |
| Q1 2023 Jan 1, 2023 – Mar 31, 2023 | X | — | — |
| Q4 2022 Oct 1, 2022 – Dec 31, 2022 | X | — | — |
| Q3 2022 Jul 1, 2022 – Sep 30, 2022 | X | — | — |
| Q2 2022 Apr 1, 2022 – Jun 30, 2022 | X | — | — |
| Q1 2022 Jan 1, 2022 – Mar 31, 2022 | X | — | — |
| Q4 2021 Oct 1, 2021 – Dec 31, 2021 | X | — | — |
| Q3 2021 Jul 1, 2021 – Sep 30, 2021 | X | — | — |
| Q2 2021 Apr 1, 2021 – Jun 30, 2021 | X | — | — |
| Q1 2021 Jan 1, 2021 – Mar 31, 2021 | X | — | — |
| Q4 2020 Oct 1, 2020 – Dec 31, 2020 | X | — | — |
| Q3 2020 Jul 1, 2020 – Sep 30, 2020 | X | — | — |
| Q2 2020 Apr 1, 2020 – Jun 30, 2020 | X | — | — |
| Q1 2020 Jan 1, 2020 – Mar 31, 2020 | X | — | — |
| Q4 2019 Oct 1, 2019 – Dec 31, 2019 | X | — | — |
| Q3 2019 Jul 1, 2019 – Sep 30, 2019 | X | — | — |
| Q2 2019 Apr 1, 2019 – Jun 30, 2019 | X | — | — |
| Q1 2019 Jan 1, 2019 – Mar 31, 2019 | X | — | — |
| Q4 2018 Oct 1, 2018 – Dec 31, 2018 | X | — | — |
| Q3 2018 Jul 1, 2018 – Sep 30, 2018 | X | — | — |
| Q2 2018 Apr 1, 2018 – Jun 30, 2018 | X | — | — |
| Q1 2018 Jan 1, 2018 – Mar 31, 2018 | X | — | — |
| Q4 2017 Oct 1, 2017 – Dec 31, 2017 | X | — | — |
| Q3 2017 Jul 1, 2017 – Sep 30, 2017 | X | — | — |
| Q2 2017 Apr 1, 2017 – Jun 30, 2017 | X | — | — |
| Q1 2017 Jan 1, 2017 – Mar 31, 2017 | X | — | — |
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.
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Source & method
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This page uses CMS's Medicare Physician Fee Schedule Q4 2026 release (effective October 2026). 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.
Use the (i) buttons next to each amount above for the exact row, columns, and math.
Cite this rate
The citation names the release, so anyone can check it even after CMS publishes a newer one.
HCPCS G0491 National PFS baseline: No national PFS rate (Q4 2026; participating; whole service; GPCI 1.000; sequestration excluded). Localis. https://localishealth.com/hcpcs/G0491/2026/D