G8398 HCPCS code: Dilated macular or fundus exam not performed
G8398 is the HCPCS Level II code for dilated macular or fundus exam not performed. CMS terminated G8398 on 2020-12-31; do not bill it for later dates of service. Its Medicare coverage code is C (Carrier judgment): Coverage is decided by the Medicare contractor (MAC) case by case.
Code details
| Field | Value |
|---|---|
| Section | G codes — Procedures and professional services (temporary) |
| Coverage code | C — Carrier judgment |
| Pricing indicator | 00 — Not separately priced by Medicare |
| BETOS category | M5D |
| Added | 2008-01-01 |
| Last action effective | 2021-01-01 |
| Terminated | 2020-12-31 |
What changed for G8398
- 2008-01-01: G8398 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 G8398?
G8398 is the HCPCS Level II code for dilated macular or fundus exam not performed. Short descriptor: "Dil macular/fundus not perfo".
Does Medicare cover G8398?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
Related G83 codes
- G8395 — Left ventricular ejection fraction (lvef) >= 40% or documentation as normal or mildly depressed left ventricular systolic function
- G8396 — Left ventricular ejection fraction (lvef) not performed or documented
- G8397 — Dilated macular or fundus exam performed, including documentation of the presence or absence of macular edema and level of severity of retinopathy
- G8399 — Patient with documented results of a central dual-energy x-ray absorptiometry (dxa) ever being performed
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Next steps
- Run a reimbursement report for a device billed under G8398
- Watch G8398 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for G8398
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.