G8815 — Documented reason in the medical records for why the statin therapy was not prescribed (i.e., lower extremity bypass was for a patient with non-artherosclerotic disease)
G8815 is a HCPCS Level II code for documented reason in the medical records for why the statin therapy was not prescribed (i.e., lower extremity bypass was for a patient with non-artherosclerotic disease). 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 G8815
- Long descriptor
- Documented reason in the medical records for why the statin therapy was not prescribed (i.e., lower extremity bypass was for a patient with non-artherosclerotic disease)
- Short descriptor
- Doc reas no statin therapy
- 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 G8815
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If G8815 is not quite right, the correct code is very often within a few positions of it.
- G8797Specimen site other than anatomic location of esophagus
- G8798Specimen site other than anatomic location of prostate
- G8806Performance of trans-abdominal or trans-vaginal ultrasound and pregnancy location documented
- G8807Trans-abdominal or trans-vaginal ultrasound not performed for reasons documented by clinician (e.g., patient has a documented intrauterine pregnancy [iup])
- G8808Trans-abdominal or trans-vaginal ultrasound not performed, reason not given
- G8809Rh-immunoglobulin (rhogam) orderedterminated
- G8810Rh-immunoglobulin (rhogam) not ordered for reasons documented by clinician (e.g., patient had prior documented receipt of rhogam within 12 weeks, patient refusal)terminated
- G8811Documentation rh-immunoglobulin (rhogam) was not ordered, reason not giventerminated
- G8816Statin medication prescribed at discharge
- G8817Statin therapy not prescribed at discharge, reason not given
- G8818Patient discharge to home no later than post-operative day #7terminated
- G8825Patient not discharged to home by post-operative day #7terminated
- G8826Patient discharged to home no later than post-operative day #2 following evar
- G8833Patient not discharged to home by post-operative day #2 following evar
- G8834Patient discharged to home no later than post-operative day #2 following cea
- G8838Patient not discharged to home by post-operative day #2 following cea
Questions about G8815
What is HCPCS code G8815?
G8815 is a HCPCS Level II code for documented reason in the medical records for why the statin therapy was not prescribed (i.e., lower extremity bypass was for a patient with non-artherosclerotic disease). It sits in the Procedures and Professional Services (Temporary) section.
Does Medicare cover G8815?
The CMS HCPCS file marks G8815 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 G8815 paid under the physician fee schedule?
G8815 carries PFS status code M. Measurement code. Used for reporting purposes only; never paid.