G0428 — Collagen meniscus implant procedure for filling meniscal defects (e.g., cmi, collagen scaffold, menaflex)
G0428 is a HCPCS Level II code for collagen meniscus implant procedure for filling meniscal defects (e.g., cmi, collagen scaffold, menaflex). It belongs to the Procedures and Professional Services (Temporary) section. Medicare does not pay it — see the coverage note below before you bill it.
Medicare coverage: Non-covered by Medicare
Medicare does not cover the item or service this code describes.
From the coverage field of the CMS Alpha-Numeric HCPCS File, release 2026Q3-Jul. This states Medicare’s position on the code, not on your particular claim.
Physician fee schedule statusN
Non-covered service. Medicare does not cover it.
Global period: XXX
Want the dollar amount for your locality? The fee calculator applies your GPCI and the current conversion factor.
Medically Unlikely Edits — units per day
The most units of G0428 Medicare will pay on one date of service. Bill more on a single line and it is denied. The limit is not the same in every setting, so the row that matters is the one matching the claim you are building.
- practitioner
- 0 — never payable MAI 3 — Date of Service Edit: Clinical · CMS Policy
- outpatient
- 0 — never payable MAI 3 — Date of Service Edit: Clinical · CMS Policy
The adjudication indicator decides whether exceeding the limit is worth appealing at all: MAI 1 is a line edit you can support with documentation, MAI 3 is a date-of-service edit that is also appealable, and MAI 2 is absolute — no documentation overrides it. CMS MUE 2026Q3.
The CMS record for G0428
- Long descriptor
- Collagen meniscus implant procedure for filling meniscal defects (e.g., cmi, collagen scaffold, menaflex)
- Short descriptor
- Collagen meniscus implant
- Added
- May 25, 2010
- BETOS
- P1G
- Pricing indicator
- 00 — Not priced by Part B
The official wording. This is what the code means.
CMS's 28-character form, which is what shows up on a remittance advice.
When CMS introduced the code.
Berenson-Eggers Type of Service — CMS's own analytic grouping.
Service not separately priced by Part B — not covered, bundled into another service, or used by Part A only.
Codes adjacent to G0428
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If G0428 is not quite right, the correct code is very often within a few positions of it.
- G0420Face-to-face educational services related to the care of chronic kidney disease; individual, per session, per one hour
- G0421Face-to-face educational services related to the care of chronic kidney disease; group, per session, per one hour
- G0422Intensive cardiac rehabilitation; with or without continuous ecg monitoring with exercise, per session
- G0423Intensive cardiac rehabilitation; with or without continuous ecg monitoring; without exercise, per session
- G0424Pulmonary rehabilitation, including exercise (includes monitoring), one hour, per session, up to two sessions per dayterminated
- G0425Telehealth consultation, emergency department or initial inpatient, typically 30 minutes communicating with the patient via telehealth
- G0426Telehealth consultation, emergency department or initial inpatient, typically 50 minutes communicating with the patient via telehealth
- G0427Telehealth consultation, emergency department or initial inpatient, typically 70 minutes or more communicating with the patient via telehealth
- G0429Dermal filler injection(s) for the treatment of facial lipodystrophy syndrome (lds) (e.g., as a result of highly active antiretroviral therapy)
- G0431Drug screen, qualitative; multiple drug classes by high complexity test method (e.g., immunoassay, enzyme assay), per patient encounterterminated
- G0432Infectious agent antibody detection by enzyme immunoassay (eia) technique, hiv-1 and/or hiv-2, screening
- G0433Infectious agent antibody detection by enzyme-linked immunosorbent assay (elisa) technique, hiv-1 and/or hiv-2, screening
- G0434Drug screen, other than chromatographic; any number of drug classes, by clia waived test or moderate complexity test, per patient encounterterminated
- G0435Infectious agent antibody detection by rapid antibody test, hiv-1 and/or hiv-2, screening
- G0436Smoking and tobacco cessation counseling visit for the asymptomatic patient; intermediate, greater than 3 minutes, up to 10 minutesterminated
- G0437Smoking and tobacco cessation counseling visit for the asymptomatic patient; intensive, greater than 10 minutesterminated
Questions about G0428
What is HCPCS code G0428?
G0428 is a HCPCS Level II code for collagen meniscus implant procedure for filling meniscal defects (e.g., cmi, collagen scaffold, menaflex). It sits in the Procedures and Professional Services (Temporary) section.
Does Medicare cover G0428?
The CMS HCPCS file marks G0428 as "Non-covered by Medicare". Medicare does not cover the item or service this code describes.
How is G0428 paid under the physician fee schedule?
G0428 carries PFS status code N. Non-covered service. Medicare does not cover it.