G8721 — Pt category (primary tumor), pn category (regional lymph nodes), and histologic grade were documented in pathology report
G8721 is a HCPCS Level II code for pt category (primary tumor), pn category (regional lymph nodes), and histologic grade were documented in pathology report. 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 G8721
- Long descriptor
- Pt category (primary tumor), pn category (regional lymph nodes), and histologic grade were documented in pathology report
- Short descriptor
- Pt, pn, hist grade doc
- 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 G8721
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If G8721 is not quite right, the correct code is very often within a few positions of it.
- 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
- G8722Documentation of medical reason(s) for not including the pt category, the pn category or the histologic grade in the pathology report (e.g., re-excision without residual tumor; non-carcinomasanal canal)
- G8723Specimen site is other than anatomic location of primary tumor
- G8724Pt category, pn category and histologic grade were not documented in the pathology report, reason not given
- G8725Fasting lipid profile performed (triglycerides, ldl-c, hdl-c and total cholesterol)terminated
- G8726Clinician has documented reason for not performing fasting lipid profile (e.g., patient declined, other patient reasons)terminated
- G8728Fasting lipid profile not performed, reason not giventerminated
- G8730Pain assessment documented as positive using a standardized tool and a follow-up plan is documentedterminated
- G8731Pain assessment using a standardized tool is documented as negative, no follow-up plan requiredterminated
Questions about G8721
What is HCPCS code G8721?
G8721 is a HCPCS Level II code for pt category (primary tumor), pn category (regional lymph nodes), and histologic grade were documented in pathology report. It sits in the Procedures and Professional Services (Temporary) section.
Does Medicare cover G8721?
The CMS HCPCS file marks G8721 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 G8721 paid under the physician fee schedule?
G8721 carries PFS status code M. Measurement code. Used for reporting purposes only; never paid.