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See a sample rate comparisonHCPCS G0423 Fee Schedule
Last Verified: September 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
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 |
| Complexity Level | Low |
| Medicaid Fee Schedule | View Medicaid rates for G0423 |
National average reimbursement for HCPCS G0423 by major payers:
$136.88
$118.98
$113.84
$137.97
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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 HCPCS G0423 code is part of the Procedures / Professional Services services used for Cardiac and Pulmonary Rehabilitation Services. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The HCPCS G0423 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| G0422-HCPCS | Low | Intensive cardiac rehabilitation; with or without continuous ECG monitoring with exercise, per session |
| G0423-HCPCS | Low | Intensive cardiac rehabilitation; with or without continuous ECG monitoring; without exercise, per session |
| G0425-HCPCS | Low | 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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