G9676 HCPCS code: Patients aged 40 to 75 years at the beginning of the measurement period with type 1 or type 2 diabetes and with an ldl-c result of 70-189 mg/dl recorded as the highest fasting or direct laboratory test result in the measurement year or during the two years prior to the beginning of the measurement period
G9676 is the HCPCS Level II code for patients aged 40 to 75 years at the beginning of the measurement period with type 1 or type 2 diabetes and with an ldl-c result of 70-189 mg/dl recorded as the highest fasting or direct laboratory test result in the measurement year or during the two years prior to the beginning of the measurement period. 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 | Z2 |
| Added | 2016-01-01 |
| Last action effective | 2016-01-01 |
What changed for G9676
- 2016-01-01: G9676 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 G9676?
G9676 is the HCPCS Level II code for patients aged 40 to 75 years at the beginning of the measurement period with type 1 or type 2 diabetes and with an ldl-c result of 70-189 mg/dl recorded as the highest fasting or direct laboratory test result in the measurement year or during the two years prior to the beginning of the measurement period. Short descriptor: "40-75y w/type 1/2 w/ldl-c rs".
Does Medicare cover G9676?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
Related G96 codes
- G9600 — Symptomatic aaas that required urgent/emergent (non-elective) repair
- G9601 — Patient discharge to home no later than post-operative day #7
- G9602 — Patient not discharged to home by post-operative day #7
- G9603 — Patient survey score improved from baseline following treatment
- G9604 — Patient survey results not available
- G9605 — Patient survey score did not improve from baseline following treatment
- G9606 — Intraoperative cystoscopy performed to evaluate for lower tract injury
- G9607 — Documented medical reasons for not performing intraoperative cystoscopy (e.g., urethral pathology precluding cystoscopy, any patient who has a congenital or acquired absence of the urethra) or in the case of patient death
- G9608 — Intraoperative cystoscopy not performed to evaluate for lower tract injury
- G9609 — Documentation of an order for anti-platelet agents
- G9610 — Documentation of medical reason(s) in the patient's record for not ordering anti-platelet agents
- G9611 — Order for anti-platelet agents was not documented in the patient's record, reason not given
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Next steps
- Run a reimbursement report for a device billed under G9676
- Watch G9676 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for G9676
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.