S0613 — Annual gynecological examination; clinical breast examination without pelvic evaluation
S0613 is a HCPCS Level II code for annual gynecological examination; clinical breast examination without pelvic evaluation. 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 2026Q3-Jul. 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 S0613
- Long descriptor
- Annual gynecological examination; clinical breast examination without pelvic evaluation
- Short descriptor
- Ann breast exam
- Added
- July 1, 2005
- 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 S0613
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If S0613 is not quite right, the correct code is very often within a few positions of it.
- S0581Nonstandard lens (list this code in addition to the basic code for the lens)
- S0590Integral lens service, miscellaneous services reported separately
- S0592Comprehensive contact lens evaluation
- S0595Dispensing new spectacle lenses for patient supplied frame
- S0596Phakic intraocular lens for correction of refractive error
- S0601Screening proctoscopy
- S0610Annual gynecological examination, new patient
- S0612Annual gynecological examination, established patient
- S0618Audiometry for hearing aid evaluation to determine the level and degree of hearing loss
- S0620Routine ophthalmological examination including refraction; new patient
- S0621Routine ophthalmological examination including refraction; established patient
- S0622Physical exam for college, new or established patient (list separately in addition to appropriate evaluation and management code)
- S0630Removal of sutures; by a physician other than the physician who originally closed the wound
- S0800Laser in situ keratomileusis (lasik)
- S0810Photorefractive keratectomy (prk)
- S0812Phototherapeutic keratectomy (ptk)
Questions about S0613
What is HCPCS code S0613?
S0613 is a HCPCS Level II code for annual gynecological examination; clinical breast examination without pelvic evaluation. It sits in the Temporary National Codes (Non-Medicare) section.
Does Medicare cover S0613?
The CMS HCPCS file marks S0613 as "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.
How is S0613 paid under the physician fee schedule?
S0613 carries PFS status code I. Not valid for Medicare purposes. Medicare uses another code.