G0027 Semen analysis
What G0027 is
Semen analysis; presence and/or motility of sperm excluding huhner
HCPCS Level II long description, CMS October 2026 file. See the G codes page for the full section.
Medicare payment for G0027 (CY2026)
This code has no Physician Fee Schedule rate: Statutory exclusion - not payable under the Physician Fee Schedule. It may be paid under a different fee schedule (clinical laboratory, DMEPOS, anesthesia) or not paid at all - check the relevant CMS schedule.
Medically Unlikely Edit (MUE)
Medicare caps G0027 at 1 unit per date of service for practitioner claims (MAI 2 - date of service edit (absolute): units above the MUE never pay), rationale: Code Descriptor / CPT Instruction. Units above the cap are denied unless the edit's adjudication rules allow an appeal with documentation.
Billed with G0027? These codes are bundled into it
G0027 is a Column 1 code in 5 active NCCI PTP edits. When one of these Column 2 codes is reported on the same date of service, it is denied as bundled - unless the edit's modifier indicator is 1 and documentation supports a distinct service with an NCCI-associated modifier.
| Column 2 code | Short description | Modifier indicator | |
|---|---|---|---|
80503 | Path clin consltj sf 5-20 | 1 - modifier may bypass | Check pair |
80504 | Path clin consltj mod 21-40 | 1 - modifier may bypass | Check pair |
80505 | Path clin consltj high 41-60 | 1 - modifier may bypass | Check pair |
80506 | Path clin consltj prolng svc | 1 - modifier may bypass | Check pair |
89321 | Semen anal sperm detection | 0 - no modifier bypass | Check pair |
G0027 is bundled into these codes
G0027 appears as a Column 2 code in 6 active edits. Reported with one of these Column 1 codes on the same date of service, G0027 is the code that denies.
| Column 1 code | Short description | Modifier indicator | |
|---|---|---|---|
89260 | Sperm isolation simple | 0 | Check pair |
89261 | Sperm isolation complex | 0 | Check pair |
89300 | Semen analysis w/huhner | 0 | Check pair |
89310 | Semen analysis w/count | 0 | Check pair |
89320 | Semen anal vol/count/mot | 0 | Check pair |
89322 | Semen anal strict criteria | 0 | Check pair |
Data: CMS CY2026 Physician Fee Schedule RVU file (October release, RVU26D) and Medicare NCCI PTP practitioner edits v32.3 (2026 Q4). Verify against the official files before billing or contracting decisions.