HCPCS G0498
Chemo extend iv infus w/pump
No national payment amount
Your Medicare Administrative Contractor prices this code case by case, usually after reviewing documentation.
Did Medicare pay separately for HCPCS G0498 in Q2 2017? Copy link
Not at a published national rate. HCPCS G0498 carries status C (carrier-priced) in the Q2 2017 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 (Q2 2017) · effective April 2017 · materially updated Aug 4, 2026 · compact facts
Can you bill it with another code? Copy link
Enter a second CPT or HCPCS code billed the same date of service to check the current NCCI procedure-to-procedure edit between it and G0498.
Global period: what G0498'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.
Common questions Copy link
Why is there no payment amount for G0498?
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 G0498 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: restricted without documentation. 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. See 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? Copy link
For patientsWhat does HCPCS code G0498 mean?
HCPCS code G0498: Chemo extend iv infus w/pump.
Billing policy Copy link
What G0498'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 | 0 | Restricted without documentation. Payment for an assistant at surgery is restricted for this procedure unless supporting documentation establishes medical necessity. |
| 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 | 5 | Incident-to service. This code is billed incident to a physician’s professional service; the professional/technical split does not apply. |
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Source & method
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This is computed from CMS's Medicare Physician Fee Schedule Q2 2017 release (schedule pfs, effective April 2017). 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.
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 Q2 2017 figures, even after a newer release lands.
HCPCS G0498 Medicare Physician Fee Schedule rate (Q2 2017). Localis. https://localishealth.com/hcpcs/G0498/2017/B