hcpcs data

G0043

Patients with mechanical prosthetic heart valve

Medicare: Carrier judgmentG seriesAdded January 01, 2022

What G0043 means

G0043 (Pt mech pros ht valv) belongs to the HCPCS Level II G series (Procedures / Professional Services (Temporary)). Its Medicare coverage status is Carrier judgment. Medicare coverage is left to the judgment of the local Medicare Administrative Contractor (MAC), so check your MAC's local coverage determinations.

Part B pricing: Service not separately priced by Part B (e.g., services not covered, bundled, used by part a only, etc.).

Code details

Short description
Pt mech pros ht valv
Coverage code
C = Carrier judgment
Pricing indicator
00 = Service not separately priced by Part B (e.g., services not covered, bundled, used by part a only, etc.)
Multiple pricing indicator
9 = Not applicable as HCPCS not priced separately by part B (pricing indicator is 00) or value is not established(pricing indicator is '99')
Type of service
1 = Medical care
Action code
N = No maintenance for this code
Action effective date
January 01, 2022
Code added date
January 01, 2022
Data year
2026

Questions about G0043

What is HCPCS code G0043?

HCPCS code G0043 is a Level II code in the G series (Procedures / Professional Services (Temporary)). Its full description is: "Patients with mechanical prosthetic heart valve"

Is G0043 a CPT code?

No. G0043 is a HCPCS Level II code maintained by CMS, not a CPT (Level I) code from the American Medical Association. People often search for it as a CPT code because both code sets are reported on the same claims.

Does Medicare cover HCPCS code G0043?

The Medicare coverage code for G0043 is "Carrier judgment". Medicare coverage is left to the judgment of the local Medicare Administrative Contractor (MAC), so check your MAC's local coverage determinations.

When was HCPCS code G0043 added?

G0043 was added to the HCPCS code set on January 01, 2022. The most recent action on it (No maintenance for this code) took effect on January 01, 2022.

All G codes