G9540 — Patient alive 3 months post procedure
G9540 is a HCPCS Level II code for patient alive 3 months post procedure. 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 G9540
- Long descriptor
- Patient alive 3 months post procedure
- Short descriptor
- Pt alive 3 mos post proc
- Added
- January 1, 2016
- BETOS
- Z2
- 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 G9540
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If G9540 is not quite right, the correct code is very often within a few positions of it.
- G9532Patient had a head ct for trauma ordered by someone other than an emergency care provider or was ordered for a reason other than traumaterminated
- G9533Patient with minor blunt head trauma did not have an appropriate indication(s) for a head ct
- G9534Advanced brain imaging (cta, ct, mra or mri) was not orderedterminated
- G9535Patients with a normal neurological examinationterminated
- G9536Documentation of medical reason(s) for ordering an advanced brain imaging study (i.e., patient has an abnormal neurological examination; patient has the coexistence of seizures, or both; recent onset of severe headache; change in the type of headache; signs of increased intracranial pressure (e.g., papilledema, absent venous pulsations on funduscopic examination, altered mental status, focal neurologic deficits, signs of meningeal irritation); hiv-positive patients with a new type of headache; immunocompromised patient with unexplained headache symptoms; patient on coagulopathy/anti-coagulation or anti-platelet therapy; very young patients with unexplained headache symptoms)terminated
- G9537Imaging needed as part of a clinical trial; or other clinician ordered the study
- G9538Advanced brain imaging (cta, ct, mra or mri) was orderedterminated
- G9539Intent for potential removal at time of placement
- G9541Filter removed within 3 months of placement
- G9542Documented re-assessment for the appropriateness of filter removal within 3 months of placement
- G9543Documentation of at least two attempts to reach the patient to arrange a clinical re-assessment for the appropriateness of filter removal within 3 months of placement
- G9544Patients that do not have the filter removed, documented re-assessment for the appropriateness of filter removal, or documentation of at least two attempts to reach the patient to arrange a clinical re-assessment for the appropriateness of filter removal within 3 months of placement
- G9547Cystic renal lesion that is simple appearing (bosniak i or ii) , or adrenal lesion less than or equal to 1.0 cm or adrenal lesion greater than 1.0 cm but less than or equal to 4.0 cm classified as likely benign by unenhanced ct or washout protocol ct, or mri with in- and opposed-phase sequences or other equivalent institutional imaging protocols
- G9548Final reports for imaging studies stating no follow-up imaging is recommended
- G9549Documentation of medical reason(s) that follow-up imaging is indicated (e.g., patient has lymphadenopathy, signs of metastasis or an active diagnosis or history of cancer, and other medical reason(s))
- G9550Final reports for imaging studies with follow-up imaging recommended, or final reports that do not include a specific recommendation of no follow-up
Questions about G9540
What is HCPCS code G9540?
G9540 is a HCPCS Level II code for patient alive 3 months post procedure. It sits in the Procedures and Professional Services (Temporary) section.
Does Medicare cover G9540?
The CMS HCPCS file marks G9540 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 G9540 paid under the physician fee schedule?
G9540 carries PFS status code M. Measurement code. Used for reporting purposes only; never paid.