G0405 Ekg interpret & report preve
What G0405 is
Electrocardiogram, routine ecg with 12 leads; interpretation and report only, 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 G0405 (CY2026)
| Work RVU | Practice expense RVU | Malpractice RVU | Total | Medicare rate | |
|---|---|---|---|---|---|
| Non-facility (office) | 0.17 | 0.07 | 0.01 | 0.25 | $8.35 |
| Facility (hospital, ASC) | 0.17 | 0.07 | 0.01 | 0.25 | $8.35 |
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.
Status: Active - payable under the Physician Fee Schedule. Global period: Global concept does not apply.
Medically Unlikely Edit (MUE)
Medicare caps G0405 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 G0405? These codes are bundled into it
G0405 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 |
G0405 is bundled into these codes
G0405 appears as a Column 2 code in 1 active edits. Reported with one of these Column 1 codes on the same date of service, G0405 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.