G8721 HCPCS code: Pt category (primary tumor), pn category (regional lymph nodes), and histologic grade were documented in pathology report
G8721 is the HCPCS Level II code for pt category (primary tumor), pn category (regional lymph nodes), and histologic grade were documented in pathology report. 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 | M5B |
| Added | 2012-01-01 |
| Last action effective | 2012-01-01 |
What changed for G8721
- 2012-01-01: G8721 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 G8721?
G8721 is the HCPCS Level II code for pt category (primary tumor), pn category (regional lymph nodes), and histologic grade were documented in pathology report. Short descriptor: "Pt, pn, hist grade doc".
Does Medicare cover G8721?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
Related G87 codes
- G8700 — Rehabilitation services (occupational, physical or speech) not indicated at or prior to discharge
- G8701 — Rehabilitation services were not ordered, reason not otherwise specified
- G8702 — Documentation that prophylactic antibiotics were given within 4 hours prior to surgical incision or intraoperatively
- G8703 — Documentation that prophylactic antibiotics were neither given within 4 hours prior to surgical incision nor intraoperatively
- G8704 — 12-lead electrocardiogram (ECG) performed
- G8705 — Documentation of medical reason(s) for not performing a 12-lead electrocardiogram (ECG)
- G8706 — Documentation of patient reason(s) for not performing a 12-lead electrocardiogram (ECG)
- G8707 — 12-lead electrocardiogram (ECG) not performed, reason not given
- G8708 — Patient not prescribed antibiotic
- G8709 — Uri episodes when the patient had competing diagnoses on or three days after the episode date (e.g., intestinal infection, pertussis, bacterial infection, lyme disease, otitis media, acute sinusitis, acute pharyngitis, acute tonsillitis, chronic sinusitis, infection of the pharynx/larynx/tonsils/adenoids, prostatitis, cellulitis, mastoiditis, or bone infections, acute lymphadenitis, impetigo, skin staph infections, pneumonia/gonococcal infections, venereal disease (syphilis, chlamydia, inflammatory diseases [female reproductive organs]), infections of the kidney, cystitis or uti, and acne)
- G8710 — Patient prescribed antibiotic
- G8711 — Prescribed antibiotic on or within 3 days after the episode date
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Next steps
- Run a reimbursement report for a device billed under G8721
- Watch G8721 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for G8721
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.