G0458 – Low dose rate (ldr) prostate brachytherapy services, composite rate

HCPCS Level II code · G codes: Procedures / Professional Services (Temporary)

Active code Carrier judgment

HCPCS codeG0458
Long description
Low dose rate (ldr) prostate brachytherapy services, composite rate
Short description
Ldr prostate brachy comp rat
Pricing indicator
00 Not separately priced by Part B (bundled, not covered or Part A only)
Medicare coverage
C Carrier judgment – coverage decided by the Medicare contractor
BETOS category
P7A Oncology - 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

Source: CMS HCPCS Level II quarterly file, October 2026. Reference only – check payer policy before billing.