S0613 HCPCS code: Annual gynecological examination; clinical breast examination without pelvic evaluation
S0613 is the HCPCS Level II code for annual gynecological examination; clinical breast examination without pelvic evaluation. 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 | 2005-07-01 |
| Last action effective | 2005-07-01 |
What changed for S0613
- 2005-07-01: S0613 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 S0613?
S0613 is the HCPCS Level II code for annual gynecological examination; clinical breast examination without pelvic evaluation. Short descriptor: "Ann breast exam".
Does Medicare cover S0613?
Coverage code I — Not payable by Medicare. Medicare does not pay separately under this code; another code applies.
Related S06 codes
- S0601 — Screening proctoscopy
- S0610 — Annual gynecological examination, new patient
- S0612 — Annual gynecological examination, established patient
- S0618 — Audiometry for hearing aid evaluation to determine the level and degree of hearing loss
- S0620 — Routine ophthalmological examination including refraction; new patient
- S0621 — Routine ophthalmological examination including refraction; established patient
- S0622 — Physical exam for college, new or established patient (list separately in addition to appropriate evaluation and management code)
- S0630 — Removal of sutures; by a physician other than the physician who originally closed the wound
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Next steps
- Run a reimbursement report for a device billed under S0613
- Watch S0613 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for S0613
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.