G0455 Fecal microbiota prep instil
What G0455 is
Preparation with instillation of fecal microbiota by any method, including assessment of donor specimen
HCPCS Level II long description, CMS October 2026 file. See the G codes page for the full section.
Medicare payment for G0455 (CY2026)
| Work RVU | Practice expense RVU | Malpractice RVU | Total | Medicare rate | |
|---|---|---|---|---|---|
| Non-facility (office) | 1.31 | 2.93 | 0.14 | 4.38 | $146.30 |
| Facility (hospital, ASC) | 1.31 | 0.39 | 0.14 | 1.84 | $61.46 |
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 (endoscopic or minor procedure: global period is the day of the procedure).
Medically Unlikely Edit (MUE)
Medicare caps G0455 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 G0455? These codes are bundled into it
G0455 is a Column 1 code in 71 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 | |
|---|---|---|---|
64461 | Pvb thoracic single inj site | 0 - no modifier bypass | Check pair |
64462 | Pvb thoracic 2nd+ inj site | 0 - no modifier bypass | Check pair |
64463 | Pvb thoracic cont infusion | 0 - no modifier bypass | Check pair |
64466 | Thrc fascial pln blk uni njx | 1 - modifier may bypass | Check pair |
64467 | Thrc fascial pln blk uni nfs | 1 - modifier may bypass | Check pair |
64468 | Thrc fascial pln blk bi njx | 1 - modifier may bypass | Check pair |
64469 | Thrc fascial pln blk bi nfs | 1 - modifier may bypass | Check pair |
64473 | Lwr xtr fscl pln blk uni njx | 1 - modifier may bypass | Check pair |
64474 | Lwr xtr fscl pln blk uni nfs | 1 - modifier may bypass | Check pair |
64486 | Tap block unil by injection | 0 - no modifier bypass | Check pair |
64487 | Tap block uni by infusion | 0 - no modifier bypass | Check pair |
64488 | Tap block bi injection | 0 - no modifier bypass | Check pair |
64489 | Tap block bi by infusion | 0 - no modifier bypass | Check pair |
92012 | Intrm oph exam est patient | 1 - modifier may bypass | Check pair |
92014 | Compre oph exam est pt 1/> | 1 - modifier may bypass | Check pair |
96361 | Hydrate iv infusion add-on | 1 - modifier may bypass | Check pair |
96366 | Ther/proph/diag iv inf addon | 1 - modifier may bypass | Check pair |
96367 | Tx/proph/dg addl seq iv inf | 1 - modifier may bypass | Check pair |
96368 | Ther/diag concurrent inf | 1 - modifier may bypass | Check pair |
99211 | Off/op est may x req phy/qhp | 1 - modifier may bypass | Check pair |
99212 | Office o/p est sf 10 min | 1 - modifier may bypass | Check pair |
99213 | Office o/p est low 20 min | 1 - modifier may bypass | Check pair |
99214 | Office o/p est mod 30 min | 1 - modifier may bypass | Check pair |
99215 | Office o/p est hi 40 min | 1 - modifier may bypass | Check pair |
99221 | 1st hosp ip/obs sf/low 40 | 1 - modifier may bypass | Check pair |
99222 | 1st hosp ip/obs moderate 55 | 1 - modifier may bypass | Check pair |
99223 | 1st hosp ip/obs high 75 | 1 - modifier may bypass | Check pair |
99231 | Sbsq hosp ip/obs sf/low 25 | 1 - modifier may bypass | Check pair |
99232 | Sbsq hosp ip/obs moderate 35 | 1 - modifier may bypass | Check pair |
99233 | Sbsq hosp ip/obs high 50 | 1 - modifier may bypass | Check pair |
Showing 30 of 71 column 2 codes. Use the pair checker for any specific combination.
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.