G8709 — Uri episodes when the patient had competing diagnoses on or three days after the episode date (e.g., intestinal infection, pertussis, bacterial infection, lyme disease, otitis media, acute sinusitis, acute pharyngitis, acute tonsillitis, chronic sinusitis, infection of the pharynx/larynx/tonsils/adenoids, prostatitis, cellulitis, mastoiditis, or bone infections, acute lymphadenitis, impetigo, skin staph infections, pneumonia/gonococcal infections, venereal disease (syphilis, chlamydia, inflammatory diseases [female reproductive organs]), infections of the kidney, cystitis or uti, and acne)
G8709 is a HCPCS Level II code for uri episodes when the patient had competing diagnoses on or three days after the episode date (e.g., intestinal infection, pertussis, bacterial infection, lyme disease, otitis media, acute sinusitis, acute pharyngitis, acute tonsillitis, chronic sinusitis, infection of the pharynx/larynx/tonsils/adenoids, prostatitis, cellulitis, mastoiditis, or bone infections, acute lymphadenitis, impetigo, skin staph infections, pneumonia/gonococcal infections, venereal disease (syphilis, chlamydia, inflammatory diseases [female reproductive organs]), infections of the kidney, cystitis or uti, and acne). 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 G8709
- Long descriptor
- Uri episodes when the patient had competing diagnoses on or three days after the episode date (e.g., intestinal infection, pertussis, bacterial infection, lyme disease, otitis media, acute sinusitis, acute pharyngitis, acute tonsillitis, chronic sinusitis, infection of the pharynx/larynx/tonsils/adenoids, prostatitis, cellulitis, mastoiditis, or bone infections, acute lymphadenitis, impetigo, skin staph infections, pneumonia/gonococcal infections, venereal disease (syphilis, chlamydia, inflammatory diseases [female reproductive organs]), infections of the kidney, cystitis or uti, and acne)
- Short descriptor
- Uri ep compete diag
- Added
- January 1, 2012
- BETOS
- M5B
- 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 G8709
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If G8709 is not quite right, the correct code is very often within a few positions of it.
- G8701Rehabilitation services were not ordered, reason not otherwise specifiedterminated
- G8702Documentation that prophylactic antibiotics were given within 4 hours prior to surgical incision or intraoperativelyterminated
- G8703Documentation that prophylactic antibiotics were neither given within 4 hours prior to surgical incision nor intraoperativelyterminated
- G870412-lead electrocardiogram (ecg) performedterminated
- G8705Documentation of medical reason(s) for not performing a 12-lead electrocardiogram (ecg)terminated
- G8706Documentation of patient reason(s) for not performing a 12-lead electrocardiogram (ecg)terminated
- G870712-lead electrocardiogram (ecg) not performed, reason not giventerminated
- G8708Patient not prescribed antibiotic
- G8710Patient prescribed antibiotic
- G8711Prescribed antibiotic on or within 3 days after the episode date
- G8712Antibiotic not prescribed or dispensed
- G8713Spkt/v greater than or equal to 1.2 (single-pool clearance of urea [kt] / volume [v])terminated
- G8714Hemodialysis treatment performed exactly three times per week for > 90 daysterminated
- G8717Spkt/v less than 1.2 (single-pool clearance of urea [kt] / volume [v]), reason not giventerminated
- G8718Total kt/v greater than or equal to 1.7 per week (total clearance of urea [kt] / volume [v])terminated
- G8720Total kt/v less than 1.7 per week (total clearance of urea [kt] / volume [v])terminated
Questions about G8709
What is HCPCS code G8709?
G8709 is a HCPCS Level II code for uri episodes when the patient had competing diagnoses on or three days after the episode date (e.g., intestinal infection, pertussis, bacterial infection, lyme disease, otitis media, acute sinusitis, acute pharyngitis, acute tonsillitis, chronic sinusitis, infection of the pharynx/larynx/tonsils/adenoids, prostatitis, cellulitis, mastoiditis, or bone infections, acute lymphadenitis, impetigo, skin staph infections, pneumonia/gonococcal infections, venereal disease (syphilis, chlamydia, inflammatory diseases [female reproductive organs]), infections of the kidney, cystitis or uti, and acne). It sits in the Procedures and Professional Services (Temporary) section.
Does Medicare cover G8709?
The CMS HCPCS file marks G8709 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 G8709 paid under the physician fee schedule?
G8709 carries PFS status code M. Measurement code. Used for reporting purposes only; never paid.