G0428 Collagen meniscus implant

What G0428 is

Collagen meniscus implant procedure for filling meniscal defects (e.g., cmi, collagen scaffold, menaflex)

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

Medicare payment for G0428 (CY2026)

This code has no Physician Fee Schedule rate: Non-covered by Medicare. 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 G0428 at 0 units per date of service for practitioner claims (MAI 3 - date of service edit (clinical): units above the MUE may pay with documentation on appeal), rationale: CMS Policy. Units above the cap are denied unless the edit's adjudication rules allow an appeal with documentation.

Billed with G0428? These codes are bundled into it

G0428 is a Column 1 code in 140 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.

Showing 30 of 140 column 2 codes. Use the pair checker for any specific combination.

G0428 is bundled into these codes

G0428 appears as a Column 2 code in 26 active edits. Reported with one of these Column 1 codes on the same date of service, G0428 is the code that denies.

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.