G0458 – Low dose rate (ldr) prostate brachytherapy services, composite rate
HCPCS Level II code · G codes: Procedures / Professional Services (Temporary)
HCPCS codeG0458
- Long description
- Low dose rate (ldr) prostate brachytherapy services, composite rate
- Short description
- Ldr prostate brachy comp rat
- Pricing indicator
00Not separately priced by Part B (bundled, not covered or Part A only)- Medicare coverage
CCarrier judgment – coverage decided by the Medicare contractor- BETOS category
P7AOncology - radiation therapy- Added
- January 1, 2013
- Last change
- January 1, 2018 – No change
Frequently asked questions
What is HCPCS code G0458?
G0458 is a HCPCS Level II code for low dose rate (ldr) prostate brachytherapy services, composite rate.
Does Medicare cover G0458?
The HCPCS file lists coverage code C: Carrier judgment – coverage decided by the Medicare contractor. Coverage and payment also depend on local coverage determinations and the patient’s plan.
Nearby G codes
- G0448 – Insertion or replacement of a permanent pacing cardioverter-defibrillator system with transvenous lead(s), single or dual chamber with insertion of pacing electrode, cardiac venous system, for left ventricular pacing
- G0451 – Development testing, with interpretation and report, per standardized instrument form
- G0452 – Molecular pathology procedure; physician interpretation and report
- G0453 – Continuous intraoperative neurophysiology monitoring, from outside the operating room (remote or nearby), per patient, (attention directed exclusively to one patient) each 15 minutes (list in addition to primary procedure)
- G0454 – Physician documentation of face-to-face visit for durable medical equipment determination performed by nurse practitioner, physician assistant or clinical nurse specialist
- G0455 – Preparation with instillation of fecal microbiota by any method, including assessment of donor specimen
- G0456 – Negative pressure wound therapy, (e.g. vacuum assisted drainage collection) using a mechanically-powered device, not durable medical equipment, including provision of cartridge and dressing(s), topical application(s), wound assessment, and instructions for ongoing care, per session; total wounds(s) surface area less than or equal to 50 square centimeters
- G0457 – Negative pressure wound therapy, (e.g. vacuum assisted drainage collection) using a mechanically-powered device, not durable medical equipment, including provision of cartridge and dressing(s), topical application(s), wound assessment, and instructions for ongoing care, per session; total wounds(s) surface area greater than 50 square centimeters
- G0459 – Inpatient telehealth pharmacologic management, including prescription, use, and review of medication with no more than minimal medical psychotherapy
- G0460 – Autologous platelet rich plasma or other blood-derived product for non-diabetic chronic wounds/ulcers, including as applicable phlebotomy, centrifugation or mixing, and all other preparatory procedures, administration and dressings, per treatment
- G0461 – Immunohistochemistry or immunocytochemistry, per specimen; first single or multiplex antibody stain
- G0462 – Immunohistochemistry or immunocytochemistry, per specimen; each additional single or multiplex antibody stain (list separately in addition to code for primary procedure)
- G0463 – Hospital outpatient clinic visit for assessment and management of a patient
- G0464 – Colorectal cancer screening; stool-based dna and fecal occult hemoglobin (e.g., kras, ndrg4 and bmp3)
- G0465 – Autologous platelet rich plasma (prp) or other blood-derived product for diabetic chronic wounds/ulcers, using an fda-cleared device for this indication, (includes as applicable administration, dressings, phlebotomy, centrifugation or mixing, and all other preparatory procedures, per treatment)
- G0466 – Federally qualified health center (fqhc) visit, new patient; a medically-necessary, face-to-face encounter (one-on-one) between a new patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a fqhc visit
Source: CMS HCPCS Level II quarterly file, October 2026. Reference only – check payer policy before billing.