`G0404` Ekg tracing for initial prev

What G0404 is

Electrocardiogram, routine ecg with 12 leads; tracing only, without interpretation and report, performed as a screening for the initial preventive physical examination

HCPCS Level II long description, CMS October 2026 file. See the G codes page for the full section.

Medicare payment for G0404 (CY2026)

	Work RVU	Practice expense RVU	Malpractice RVU	Total	Medicare rate
Non-facility (office)	0.00	0.20	0.01	0.21	$7.01
Facility (hospital, ASC)	0.00	0.20	0.01	0.21	$7.01

National rates: total RVUs x the CY2026 conversion factor of 33.4009 (non-QP), before geographic adjustment. Actual Medicare payment is 80% of the rate shown after the deductible; the patient or secondary payer owes the 20% coinsurance.

Adjust for a Medicare locality:

Status: Active - payable under the Physician Fee Schedule. Global period: Global concept does not apply.

Medically Unlikely Edit (MUE)

Medicare caps G0404 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 G0404? These codes are bundled into it

G0404 is a Column 1 code in 12 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
`0903T`	Ecg alg 12 lead reduced i&r	0 - no modifier bypass	Check pair
`0904T`	Ecg alg 12 ld rdcd trcg only	0 - no modifier bypass	Check pair
`0905T`	Ecg alg 12 ld rdcd i&r only	0 - no modifier bypass	Check pair
`36591`	Draw blood off venous device	0 - no modifier bypass	Check pair
`36592`	Collect blood from picc	0 - no modifier bypass	Check pair
`93000`	Electrocardiogram complete	1 - modifier may bypass	Check pair
`93005`	Electrocardiogram tracing	1 - modifier may bypass	Check pair
`93010`	Electrocardiogram report	1 - modifier may bypass	Check pair
`93040`	Rhythm ecg with report	1 - modifier may bypass	Check pair
`93041`	Rhythm ecg tracing	1 - modifier may bypass	Check pair
`93042`	Rhythm ecg report	1 - modifier may bypass	Check pair
`96523`	Irrig drug delivery device	0 - no modifier bypass	Check pair

G0404 is bundled into these codes

G0404 appears as a Column 2 code in 1 active edits. Reported with one of these Column 1 codes on the same date of service, G0404 is the code that denies.

Column 1 code	Short description	Modifier indicator
`G0403`	Ekg for initial prevent exam	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.