S0117 HCPCS code: Tretinoin, topical, 5 grams
S0117 is the HCPCS Level II code for tretinoin, topical, 5 grams. Its Medicare coverage code is I (Not payable by Medicare): Medicare does not pay separately under this code; another code applies.
Code details
| Field | Value |
|---|---|
| Section | S codes — Temporary national codes (non-Medicare) |
| Coverage code | I — Not payable by Medicare |
| Pricing indicator | 00 — Not separately priced by Medicare |
| BETOS category | Z2 |
| Added | 2004-07-01 |
| Last action effective | 2004-07-01 |
What changed for S0117
- 2004-07-01: S0117 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 S0117?
S0117 is the HCPCS Level II code for tretinoin, topical, 5 grams. Short descriptor: "Tretinoin topical 5 g".
Does Medicare cover S0117?
Coverage code I — Not payable by Medicare. Medicare does not pay separately under this code; another code applies.
Related S01 codes
- S0104 — Zidovudine, oral, 100 mg
- S0106 — Bupropion hcl sustained release tablet, 150 mg, per bottle of 60 tablets
- S0108 — Mercaptopurine, oral, 50 mg
- S0109 — Methadone, oral, 5 mg
- S0119 — Ondansetron, oral, 4 mg (for circumstances falling under the medicare statute, use hcpcs q code)
- S0122 — Injection, menotropins, 75 iu
- S0126 — Injection, follitropin alfa, 75 iu
- S0128 — Injection, follitropin beta, 75 iu
- S0132 — Injection, ganirelix acetate, 250 mcg
- S0136 — Clozapine, 25 mg
- S0137 — Didanosine (ddi), 25 mg
- S0138 — Finasteride, 5 mg
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Next steps
- Run a reimbursement report for a device billed under S0117
- Watch S0117 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for S0117
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.