G8465 — High or very high risk of recurrence of prostate cancer
G8465 is a HCPCS Level II code for high or very high risk of recurrence of prostate cancer. It belongs to the Procedures and Professional Services (Temporary) section. Whether Medicare pays it depends on the coverage rule below.
Medicare coverage: Carrier judgment
Coverage is decided by your Medicare contractor, not by national policy. Whether this is paid depends on the LCD for your jurisdiction and on what the documentation supports.
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 statusM
Measurement code. Used for reporting purposes only; never paid.
Global period: XXX
Want the dollar amount for your locality? The fee calculator applies your GPCI and the current conversion factor.
The CMS record for G8465
- Long descriptor
- High or very high risk of recurrence of prostate cancer
- Short descriptor
- High risk recurrence pro ca
- Added
- January 1, 2008
- BETOS
- M5D
- 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 G8465
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If G8465 is not quite right, the correct code is very often within a few positions of it.
- G8442Pain assessment not documented as being performed, documentation the patient is not eligible for a pain assessment using a standardized tool at the time of the encounterterminated
- G8450Beta-blocker therapy prescribed
- G8451Beta-blocker therapy for lvef <=40% not prescribed for reasons documented by the clinician (e.g., low blood pressure, fluid overload, asthma, patients recently treated with an intravenous positive inotropic agent, allergy, intolerance, other medical reasons, patient declined, other patient reasons)
- G8452Beta-blocker therapy not prescribed
- G8458Clinician documented that patient is not an eligible candidate for genotype testing; patient not receiving antiviral treatment for hepatitis c during the measurement period (e.g. genotype test done prior to the reporting period, patient declines, patient not a candidate for antiviral treatment)terminated
- G8460Clinician documented that patient is not an eligible candidate for quantitative rna testing at week 12; patient not receiving antiviral treatment for hepatitis cterminated
- G8461Patient receiving antiviral treatment for hepatitis c during the measurement periodterminated
- G8464Clinician documented that prostate cancer patient is not an eligible candidate for adjuvant hormonal therapy; low or intermediate risk of recurrence or risk of recurrence not determinedterminated
- G8473Angiotensin converting enzyme (ace) inhibitor or angiotensin receptor blocker (arb) therapy prescribed
- G8474Angiotensin converting enzyme (ace) inhibitor or angiotensin receptor blocker (arb) therapy not prescribed for reasons documented by the clinician (e.g., allergy, intolerance, pregnancy, renal failure due to ace inhibitor, diseases of the aortic or mitral valve, other medical reasons) or (e.g., patient declined, other patient reasons)
- G8475Angiotensin converting enzyme (ace) inhibitor or angiotensin receptor blocker (arb) therapy not prescribed, reason not given
- G8476Most recent blood pressure has a systolic measurement of < 140 mmhg and a diastolic measurement of < 90 mmhg
- G8477Most recent blood pressure has a systolic measurement of >= 140 mmhg and/or a diastolic measurement of >= 90 mmhg
- G8478Blood pressure measurement not performed or documented, reason not given
- G8482Influenza immunization administered or previously receivedterminated
- G8483Influenza immunization was not administered for reasons documented by clinician (e.g., patient allergy or other medical reasons, patient declined or other patient reasons, vaccine not available or other system reasons)terminated
Questions about G8465
What is HCPCS code G8465?
G8465 is a HCPCS Level II code for high or very high risk of recurrence of prostate cancer. It sits in the Procedures and Professional Services (Temporary) section.
Does Medicare cover G8465?
The CMS HCPCS file marks G8465 as "Carrier judgment". Coverage is decided by your Medicare contractor, not by national policy. Whether this is paid depends on the LCD for your jurisdiction and on what the documentation supports.
How is G8465 paid under the physician fee schedule?
G8465 carries PFS status code M. Measurement code. Used for reporting purposes only; never paid.