G0268 HCPCS code: Removal of impacted cerumen (one or both ears) by physician on same date of service as audiologic function testing
G0268 is the HCPCS Level II code for removal of impacted cerumen (one or both ears) by physician on same date of service as audiologic function testing. In 2024 Medicare paid an average of $36.31 per service for G0268 across 155,444 services. Its Medicare coverage code is C (Carrier judgment): Coverage is decided by the Medicare contractor (MAC) case by case. The NCCI unit limit is 1 per day on outpatient hospital claims. Medicare volume fell 1% from 2022 to 2024 (157,053 to 155,444 services). In 2024, about 5,048 clinicians billed Medicare for G0268 for 147,389 beneficiaries; New York, Florida, Pennsylvania accounted for 42% of services.
Code details
| Field | Value |
|---|---|
| Section | G codes — Procedures and professional services (temporary) |
| Coverage code | C — Carrier judgment |
| Pricing indicator | 11 — Priced using national relative value units (Physician Fee Schedule) |
| BETOS category | P6C |
| Added | 2003-01-01 |
| Last action effective | 2003-01-01 |
Who bills G0268 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 5,048 |
| Medicare beneficiaries | 147,389 |
| States with claims | 50 |
| Share of services in top 3 states (New York, Florida, Pennsylvania) | 42% |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for G0268, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 157,053 | 147,560 | $51.26 | $37.54 |
| 2023 | 159,508 | 150,151 | $50.88 | $37.52 |
| 2024 | 155,444 | 147,389 | $49.50 | $36.31 |
States with the most G0268 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| New York | 34,049 | $40.51 |
| Florida | 18,922 | $35.13 |
| Pennsylvania | 12,121 | $34.62 |
| New Jersey | 11,695 | $41.03 |
| Texas | 10,752 | $34.25 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 1 | Code Descriptor / CPT Instruction |
| practitioner claims | 1 | Code Descriptor / CPT Instruction |
Medicare policy articles for this code
- A56454: Billing and Coding: Cerumen (Earwax) Removal (CGS Administrators, LLC (MAC - Part A, MAC - Part B))
Covered diagnoses (3 ICD-10-CM codes)
The diagnoses most often listed as covered in the policy articles above:
| ICD-10-CM | Diagnosis | Articles listing it |
|---|---|---|
| H61.21 | Impacted cerumen, right ear | 1 |
| H61.22 | Impacted cerumen, left ear | 1 |
| H61.23 | Impacted cerumen, bilateral | 1 |
What changed for G0268
- 2003-01-01: G0268 added to HCPCS Level II
- Next scheduled CMS quarterly update (HCPCS and DMEPOS fee schedule): 2027-01-01
Frequently asked questions
What is HCPCS code G0268?
G0268 is the HCPCS Level II code for removal of impacted cerumen (one or both ears) by physician on same date of service as audiologic function testing. Short descriptor: "Removal of impacted wax md".
How much does Medicare pay for G0268?
In 2024, the average Medicare payment was $36.31 per service (average allowed $49.50).
Does Medicare cover G0268?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
Which diagnoses support coverage for G0268?
Medicare policy articles that cite G0268 list 3 covered ICD-10-CM diagnosis codes across 1 article. The most cited include H61.21 (Impacted cerumen, right ear), H61.22 (Impacted cerumen, left ear), H61.23 (Impacted cerumen, bilateral). A listed diagnosis is necessary but not sufficient; the policy's other criteria still apply.
How many units of G0268 can be billed per day?
1 on outpatient hospital claims; 1 on practitioner claims (NCCI medically unlikely edits).
Related G02 codes
- G0202 — Screening mammography, bilateral (2-view study of each breast), including computer-aided detection (cad) when performed
- G0204 — Diagnostic mammography, including computer-aided detection (cad) when performed; bilateral
- G0206 — Diagnostic mammography, including computer-aided detection (cad) when performed; unilateral
- G0219 — Pet imaging whole body; melanoma for non-covered indications
- G0235 — Pet imaging, any site, not otherwise specified
- G0237 — Therapeutic procedures to increase strength or endurance of respiratory muscles, face to face, one on one, each 15 minutes (includes monitoring)
- G0238 — Therapeutic procedures to improve respiratory function, other than described by g0237, one on one, face to face, per 15 minutes (includes monitoring)
- G0239 — Therapeutic procedures to improve respiratory function or increase strength or endurance of respiratory muscles, two or more individuals (includes monitoring)
- G0245 — Initial physician evaluation and management of a diabetic patient with diabetic sensory neuropathy resulting in a loss of protective sensation (lops) which must include: (1) the diagnosis of lops, (2) a patient history, (3) a physical examination that consists of at least the following elements: (a) visual inspection of the forefoot, hindfoot and toe web spaces, (b) evaluation of a protective sensation, (c) evaluation of foot structure and biomechanics, (d) evaluation of vascular status and skin integrity, and (e) evaluation and recommendation of footwear and (4) patient education
- G0246 — Follow-up physician evaluation and management of a diabetic patient with diabetic sensory neuropathy resulting in a loss of protective sensation (lops) to include at least the following: (1) a patient history, (2) a physical examination that includes: (a) visual inspection of the forefoot, hindfoot and toe web spaces, (b) evaluation of protective sensation, (c) evaluation of foot structure and biomechanics, (d) evaluation of vascular status and skin integrity, and (e) evaluation and recommendation of footwear, and (3) patient education
- G0247 — Routine foot care by a physician of a diabetic patient with diabetic sensory neuropathy resulting in a loss of protective sensation (lops) to include, the local care of superficial wounds (i.e. superficial to muscle and fascia) and at least the following if present: (1) local care of superficial wounds, (2) debridement of corns and calluses, and (3) trimming and debridement of nails
- G0248 — Demonstration, prior to initiation of home inr monitoring, for patient with either mechanical heart valve(s), chronic atrial fibrillation, or venous thromboembolism who meets medicare coverage criteria, under the direction of a physician; includes: face-to-face demonstration of use and care of the inr monitor, obtaining at least one blood sample, provision of instructions for reporting home inr test results, and documentation of patient's ability to perform testing and report results
Building a device that would bill under a code like this? Caduvo matches a device description to HCPCS/CPT codes, Medicare coverage and payment, and the FDA pathway in one report.
Next steps
- Run a reimbursement report for a device billed under G0268
- Watch G0268 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for G0268
Sources: CMS HCPCS Level II release October 2026; CMS DMEPOS fee schedule; CMS NCCI MUE tables; CMS Medicare utilization (physician and DME supplier files); CMS Medicare Coverage Database articles. Fees are Medicare allowables, not commercial rates. Not billing or legal advice.