`G0500` Mod sedat endo service >5yrs

What G0500 is

Moderate sedation services provided by the same physician or other qualified health care professional performing a gastrointestinal endoscopic service that sedation supports, requiring the presence of an independent trained observer to assist in the monitoring of the patient's level of consciousness and physiological status; initial 15 minutes of intra-service time; patient age 5 years or older (additional time may be reported with 99153, as appropriate)

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

Medicare payment for G0500 (CY2026)

	Work RVU	Practice expense RVU	Malpractice RVU	Total	Medicare rate
Non-facility (office)	0.10	1.86	0.03	1.99	$66.47
Facility (hospital, ASC)	0.10	0.03	0.03	0.16	$5.34

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 G0500 at 1 unit 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: Code Descriptor / CPT Instruction. Units above the cap are denied unless the edit's adjudication rules allow an appeal with documentation.

Billed with G0500? These codes are bundled into it

G0500 is a Column 1 code in 105 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
`0708T`	Id ca immntx prep & 1st njx	1 - modifier may bypass	Check pair
`0709T`	Id ca immntx each addl njx	1 - modifier may bypass	Check pair
`0903T`	Ecg alg 12 lead reduced i&r	1 - modifier may bypass	Check pair
`0904T`	Ecg alg 12 ld rdcd trcg only	1 - modifier may bypass	Check pair
`0905T`	Ecg alg 12 ld rdcd i&r only	1 - modifier may bypass	Check pair
`36000`	Place needle in vein	1 - modifier may bypass	Check pair
`36400`	Vnpnxr<3yrs phy/qhp fem/jug	1 - modifier may bypass	Check pair
`36405`	Vnpnxr<3yrs phy/qhp scalp vn	1 - modifier may bypass	Check pair
`36406`	Vnpnxr<3yrs phy/qhp other vn	1 - modifier may bypass	Check pair
`36410`	Vnpnxr 3yr/> phy/qhp dx/ther	1 - modifier may bypass	Check pair
`36420`	Venipuncture cutdown < 1 yr	1 - modifier may bypass	Check pair
`36425`	Venipuncture cutdown 1 yr/>	1 - modifier may 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
`94760`	N-invas ear/pls oximetry 1	0 - no modifier bypass	Check pair
`94761`	N-invas ear/pls oximetry mlt	0 - no modifier bypass	Check pair
`94762`	N-invas ear/pls oximtry cont	1 - modifier may bypass	Check pair
`96360`	Hydration iv infusion init	1 - modifier may bypass	Check pair
`96365`	Ther/proph/diag iv inf init	1 - modifier may bypass	Check pair
`96372`	Ther/proph/diag inj sc/im	1 - modifier may bypass	Check pair
`96373`	Ther/proph/diag inj ia	1 - modifier may bypass	Check pair
`96374`	Ther/proph/diag inj iv push	1 - modifier may bypass	Check pair
`96375`	Tx/pro/dx inj new drug addon	1 - modifier may bypass	Check pair
`96376`	Tx/pro/dx inj same drug adon	1 - modifier may bypass	Check pair

Showing 30 of 105 column 2 codes. Use the pair checker for any specific combination.

G0500 is bundled into these codes

G0500 appears as a Column 2 code in 337 active edits. Reported with one of these Column 1 codes on the same date of service, G0500 is the code that denies.

Column 1 code	Short description
`00100`	Anes px salivary gland w/bx	Check pair
`00102`	Anes px plstc rpr cleft lip	Check pair
`00103`	Anes rcnstv px eyelid	Check pair
`00104`	Anes electroconvulsive ther	Check pair
`00120`	Anes px ear w/bx nos	Check pair
`00124`	Anes px ear otoscopy	Check pair
`00126`	Anes px ear tympanotomy	Check pair
`00140`	Anes procedures on eye nos	Check pair
`00142`	Anes px on eye lens surgery	Check pair
`00144`	Anes px eye corneal trnspl	Check pair
`00145`	Anes px eye vitreortnl surg	Check pair
`00147`	Anes px on eye iridectomy	Check pair
`00148`	Anes px eye ophthalmoscopy	Check pair
`00160`	Anes px nose&sinus nos	Check pair
`00162`	Anes px nose&sinus rad surg	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.