G9881 HCPCS code: The mdpp beneficiary achieved at least 9% weight loss (wl) from his/her baseline weight in months 1-24 under the mdpp expanded model (em). this is a one-time payment available when a beneficiary first achieves at least 9% weight loss from baseline as measured by an in-person weight measurement at a core session, core maintenance session, or ongoing maintenance session
G9881 is the HCPCS Level II code for the mdpp beneficiary achieved at least 9% weight loss (wl) from his/her baseline weight in months 1-24 under the mdpp expanded model (em). this is a one-time payment available when a beneficiary first achieves at least 9% weight loss from baseline as measured by an in-person weight measurement at a core session, core maintenance session, or ongoing maintenance session. In 2024 Medicare paid an average of $24.50 per service for G9881 across 149 services. Its Medicare coverage code is C (Carrier judgment): Coverage is decided by the Medicare contractor (MAC) case by case. Medicare volume rose 19% from 2022 to 2024 (125 to 149 services). In 2024, about 46 clinicians billed Medicare for G9881 for 149 beneficiaries.
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 | Y1 |
| Added | 2018-04-01 |
| Last action effective | 2018-04-01 |
Who bills G9881 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 46 |
| Medicare beneficiaries | 149 |
| States with claims | 3 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for G9881, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 125 | 125 | $33.66 | $33.66 |
| 2023 | 116 | 116 | $36.22 | $36.22 |
| 2024 | 149 | 149 | $24.50 | $24.50 |
States with the most G9881 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Maryland | 23 | $24.50 |
| Oregon | 15 | $24.50 |
| Illinois | 13 | $24.50 |
What changed for G9881
- 2018-04-01: G9881 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 G9881?
G9881 is the HCPCS Level II code for the mdpp beneficiary achieved at least 9% weight loss (wl) from his/her baseline weight in months 1-24 under the mdpp expanded model (em). this is a one-time payment available when a beneficiary first achieves at least 9% weight loss from baseline as measured by an in-person weight measurement at a core session, core maintenance session, or ongoing maintenance session. Short descriptor: "Em 9 percent wl".
How much does Medicare pay for G9881?
In 2024, the average Medicare payment was $24.50 per service (average allowed $24.50).
Does Medicare cover G9881?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
Related G98 codes
- G9800 — Patients who are identified as having an intolerance or allergy to beta-blocker therapy
- G9801 — Hospitalizations in which the patient was transferred directly to a non-acute care facility for any diagnosis
- G9802 — Patients who use hospice services any time during the measurement period
- G9803 — Patient prescribed at least a 135 day treatment within the 180-day measurement interval with beta-blockers post-discharge for ami
- G9804 — Patient was not prescribed at least a 135 day treatment within the 180-day measurement interval with beta-blockers post-discharge for ami
- G9805 — Patients who use hospice services any time during the measurement period
- G9806 — Patients who received cervical cytology or an hpv test
- G9807 — Patients who did not receive cervical cytology or an hpv test
- G9808 — Any patients who had no asthma controller medications dispensed during the measurement year
- G9809 — Patients who use hospice services any time during the measurement period
- G9810 — Patient achieved a pdc of at least 75% for their asthma controller medication
- G9811 — Patient did not achieve a pdc of at least 75% for their asthma controller medication
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 G9881
- Watch G9881 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for G9881
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.