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See a sample rate comparisonHCPCS G0423 Fee Schedule
Medicare rates as of October 2026
HCPCS G0423 is classified under Procedures / Professional Services, in the Cardiac and Pulmonary Rehabilitation Services subgroup.
Intensive cardiac rehabilitation; with or without continuous ECG monitoring; without exercise, per session
| Key Fact | Detail |
|---|---|
| Service Type | Procedures / Professional Services Cardiac and Pulmonary Rehabilitation Services |
| Hospital Outpatient Group (APC) | APC 5771 - Cardiac Rehabilitation |
| Common Revenue Codes | 0943 |
| Medicare Fee Schedule | $131.60 national non-facility rate (2026)View Medicare rates for G0423 |
| Medicaid Fee Schedule | $56.17 median of the 7 states in the free previewView Medicaid rates for G0423 |
National average reimbursement for HCPCS G0423 by major payers:
$136.88
BCBS / Anthem
$118.98
UnitedHealthcare
$113.84
Aetna
$137.97
Cigna
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HCPCS G0423
5 of 25 sample ratesHigher to lower in this preview
Arthur M. Blank Hospital, Inc., Arthur M. Blank Hospital
Childrens Healthcare Of Atlanta Inc
$355.20Published rateEmory Crawford Long Hospital
Emory University
$226.86Published rateBradley Smith
Emergeortho, P.A.
$120.80Published rateThe Hospital Authority Of Monroe County, Georgia, Monroe County Hospital
The Hospital Authority Of Monroe County Georgia
$72.75Published rateNorthside Hospital, Inc., Northside Hospital Duluth
$55.02Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS G0423 vs. Other Cardiac and Pulmonary Rehabilitation Services Codes
The table lists codes related to G0423. Select one to see its fee schedule.
| Code | Description |
|---|---|
| G0422-HCPCS | Intensive cardiac rehabilitation; with or without continuous ECG monitoring with exercise, per session |
| G0423-HCPCS | Intensive cardiac rehabilitation; with or without continuous ECG monitoring; without exercise, per session |
| G0425-HCPCS | Telehealth consultation, emergency department or initial inpatient, typically 30 minutes communicating with the patient via telehealth |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS G0423. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the G0423 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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Frequently Asked Questions
What APC is HCPCS G0423 assigned to?
Medicare's hospital outpatient payment system (OPPS) assigns HCPCS G0423 to APC 5771 (Cardiac Rehabilitation). An APC groups outpatient services that Medicare pays at the same base rate.
Which revenue codes are billed with HCPCS G0423?
Hospital price transparency files list HCPCS G0423 under these revenue codes: 0943. A revenue code names the hospital department or charge category for the line; it does not change what the service is.