G0563 HCPCS code: Stereotactic body radiation therapy, treatment delivery, per fraction to 1 or more lesions, including image guidance and real-time positron emissions-based delivery adjustments to 1 or more lesions, entire course not to exceed 5 fractions

G0563 is the HCPCS Level II code for stereotactic body radiation therapy, treatment delivery, per fraction to 1 or more lesions, including image guidance and real-time positron emissions-based delivery adjustments to 1 or more lesions, entire course not to exceed 5 fractions. 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.

Code details

FieldValue
SectionG codes — Procedures and professional services (temporary)
Coverage codeC — Carrier judgment
Pricing indicator13
BETOS categoryP7A
Added2025-01-01
Last action effective2025-01-01

NCCI unit limits (MUE)

Claim typeMax units per dayRationale
outpatient hospital claims1Nature of Service/Procedure
practitioner claims1Nature of Service/Procedure

Medicare policy articles for this code

Covered diagnoses (239 ICD-10-CM codes)

The diagnoses most often listed as covered in the policy articles above:

ICD-10-CMDiagnosisArticles listing it
C00.0Malignant neoplasm of external upper lip1
C00.1Malignant neoplasm of external lower lip1
C00.2Malignant neoplasm of external lip, unspecified1
C00.3Malignant neoplasm of upper lip, inner aspect1
C00.4Malignant neoplasm of lower lip, inner aspect1
C00.5Malignant neoplasm of lip, unspecified, inner aspect1
C00.6Malignant neoplasm of commissure of lip, unspecified1
C00.8Malignant neoplasm of overlapping sites of lip1
C00.9Malignant neoplasm of lip, unspecified1
C01Malignant neoplasm of base of tongue1

Showing 10 of 239. The full list, non-covered diagnoses and CSV export are in Caduvo.

What changed for G0563

Frequently asked questions

What is HCPCS code G0563?

G0563 is the HCPCS Level II code for stereotactic body radiation therapy, treatment delivery, per fraction to 1 or more lesions, including image guidance and real-time positron emissions-based delivery adjustments to 1 or more lesions, entire course not to exceed 5 fractions. Short descriptor: "Sbrt w/positron emission del".

Does Medicare cover G0563?

Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.

Which diagnoses support coverage for G0563?

Medicare policy articles that cite G0563 list 239 covered ICD-10-CM diagnosis codes across 1 article. The most cited include C00.0 (Malignant neoplasm of external upper lip), C00.1 (Malignant neoplasm of external lower lip), C00.2 (Malignant neoplasm of external lip, unspecified). A listed diagnosis is necessary but not sufficient; the policy's other criteria still apply.

How many units of G0563 can be billed per day?

1 on outpatient hospital claims; 1 on practitioner claims (NCCI medically unlikely edits).

Related G05 codes

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Next steps

Sources: CMS HCPCS Level II release October 2025; 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.

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