S0117 – Tretinoin, topical, 5 grams
HCPCS Level II code · S codes: Temporary National Codes (Non-Medicare)
HCPCS codeS0117
- Long description
- Tretinoin, topical, 5 grams
- Short description
- Tretinoin topical 5 g
- Pricing indicator
00Not separately priced by Part B (bundled, not covered or Part A only)- Medicare coverage
INot payable by Medicare- BETOS category
Z2Undefined codes- Added
- July 1, 2004
- Last change
- July 1, 2004 – No change
Frequently asked questions
What is HCPCS code S0117?
S0117 is a HCPCS Level II code for tretinoin, topical, 5 grams.
Does Medicare cover S0117?
The HCPCS file lists coverage code I: Not payable by Medicare. Coverage and payment also depend on local coverage determinations and the patient’s plan.
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Source: CMS HCPCS Level II quarterly file, October 2026. Reference only – check payer policy before billing.