G9520

G9520 — Patient does not achieve final refraction (spherical equivalent) +/- 1.0 diopters of their planned refraction within 90 days of surgery

HCPCSActiveBETOS Z2

G9520 is a HCPCS Level II code for patient does not achieve final refraction (spherical equivalent) +/- 1.0 diopters of their planned refraction within 90 days of surgery. 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 G9520

Long descriptor: Patient does not achieve final refraction (spherical equivalent) +/- 1.0 diopters of their planned refraction within 90 days of surgery
Short descriptor: Refract not +/- 1.0 w/in 90d
Added: January 1, 2016
BETOS: Z2
Pricing indicator: 00 — Not priced by Part B

Codes adjacent to G9520

HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If G9520 is not quite right, the correct code is very often within a few positions of it.

G9512Individual had a pdc of 0.8 or greater
G9513Individual did not have a pdc of 0.8 or greater
G9514Patient required a return to the operating room within 90 days of surgery
G9515Patient did not require a return to the operating room within 90 days of surgery
G9516Patient achieved an improvement in visual acuity, from their preoperative level, within 90 days of surgery
G9517Patient did not achieve an improvement in visual acuity, from their preoperative level, within 90 days of surgery, reason not given
G9518Documentation of active injection drug use
G9519Patient achieves final refraction (spherical equivalent) +/- 1.0 diopters of their planned refraction within 90 days of surgery
G9521Total number of emergency department visits and inpatient hospitalizations less than two in the past 12 months
G9522Total number of emergency department visits and inpatient hospitalizations equal to or greater than two in the past 12 months or patient not screened, reason not given
G9523Patient discontinued from hemodialysis or peritoneal dialysisterminated
G9524Patient was referred to hospice careterminated
G9525Documentation of patient reason(s) for not referring to hospice care (e.g., patient declined, other patient reasons)terminated
G9526Patient was not referred to hospice care, reason not giventerminated
G9529Patient with minor blunt head trauma had an appropriate indication(s) for a head ct
G9530Patient presented with a minor blunt head trauma and had a head ct ordered for trauma by an emergency care provider

Questions about G9520

What is HCPCS code G9520?

G9520 is a HCPCS Level II code for patient does not achieve final refraction (spherical equivalent) +/- 1.0 diopters of their planned refraction within 90 days of surgery. It sits in the Procedures and Professional Services (Temporary) section.

Does Medicare cover G9520?

The CMS HCPCS file marks G9520 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 G9520 paid under the physician fee schedule?

G9520 carries PFS status code M. Measurement code. Used for reporting purposes only; never paid.