S0117: Tretinoin, topical, 5 grams
S0117 is a HCPCS Level II code for tretinoin, topical, 5 grams. It belongs to the Temporary National Codes (Non-Medicare) section. Medicare does not pay it: see the coverage note below before you bill it.
Medicare coverage: Not payable by Medicare
Medicare does not pay this code. It may still be valid for another payer, but a Medicare claim carrying it will not be reimbursed.
From the coverage field of the CMS Alpha-Numeric HCPCS File, release 2026Q4-Oct. This states Medicare’s position on the code, not on your particular claim.
Physician fee schedule statusI
Not valid for Medicare purposes. Medicare uses another code.
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 S0117
- Long descriptor
- Tretinoin, topical, 5 grams
- Short descriptor
- Tretinoin topical 5 g
- Added
- July 1, 2004
- 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 S0117
HCPCS has no hierarchy: related items simply sit next to each other in the numbering. If S0117 is not quite right, the correct code is very often within a few positions of it.
- S0090Sildenafil citrate, 25 mg
- S0091Granisetron hydrochloride, 1 mg (for circumstances falling under the medicare statute, use q0166)
- S0092Injection, hydromorphone hydrochloride, 250 mg (loading dose for infusion pump)
- S0093Injection, morphine sulfate, 500 mg (loading dose for infusion pump)
- S0104Zidovudine, oral, 100 mg
- S0106Bupropion hcl sustained release tablet, 150 mg, per bottle of 60 tablets
- S0108Mercaptopurine, oral, 50 mg
- S0109Methadone, oral, 5 mg
- S0119Ondansetron, oral, 4 mg (for circumstances falling under the medicare statute, use hcpcs q code)
- S0122Injection, menotropins, 75 iu
- S0126Injection, follitropin alfa, 75 iu
- S0128Injection, follitropin beta, 75 iu
- S0132Injection, ganirelix acetate, 250 mcg
- S0136Clozapine, 25 mg
- S0137Didanosine (ddi), 25 mg
- S0138Finasteride, 5 mg