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G0559 Post-operative follow-up visit complexity inherent to evaluation and management services addressing surgical procedure(s), provided...
HCPCS Procedure & Supply Codes
Code Added 2025-01-01
G0559 - Post-operative follow-up visit complexity inherent to evaluation and management services addressing surgical procedure(s), provided by a physician or qualified health care professional who is not the practitioner who performed the procedure (or in the same group practice) and is of the same or of a different specialty than the practitioner who performed the procedure, within the 90-day global period of the procedure(s), once per 90-day global period, when there has not been a formal transfer of care and requires the following required elements, when possible and applicable: reading available surgical note to understand the relative success of the procedure, the anatomy that was affected, and potential complications that could have arisen due to the unique circumstances of the patient's operation. research the procedure to determine expected post-operative course and potential complications (in the case of doing a post-op for a procedure outside the specialty). evaluate and physically examine the patient to determine whether the post-operative course is progressing appropriately. communicate with the practitioner who performed the procedure if any questions or concerns arise. (list separately in addition to office/outpatient evaluation and management visit, new or established)
The above description is abbreviated. This code description may also have Includes, Excludes, Notes, Guidelines, Examples and other information.
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The above description is abbreviated. This code description may also have Includes, Excludes, Notes, Guidelines, Examples and other information.
Additional Code Information includes:
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HCPCS Index Entries (Reverse Index Lookup) 
reverse_index/reverse_index_content.php?set=hcpcs&c=G0559
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DMEPOS Products (Durable Medical Equipment, Prosthetics, Orthotics, Supplies)
dmepos/dmepos_content.php?set=hcpcs&c=G0559
Calculated for National Unadjusted (00000)
* Note: Medicare may or may NOT reimburse you for this code. The fees provided below are based on values established by CMS/Medicare. Please check with your local Medicare contact on whether this code is eligible for reimbursement.
Medicare vs. My Fee Evaluation
| Modifier | Medicare Allowed | 150% | 200% | My Fee |
|---|---|---|---|---|
| (none) | $8.73 | $13.10 | $17.47 | (your fee) |
Access to calculated fee values is available. Access to this feature is available in the following products:
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Medicare Participating - Assignment Accepted (Mandatory)
| Modifier | Allowed | Medicare 80% | Patient Pays |
|---|---|---|---|
| (none) | $8.73 | $##.## | $##.## |
Medicare Non-Participating - Assignment Accepted (Check To Doctor)
| Modifier | Allowed | Medicare 80% | Patient Pays | Limiting Charge (Amount Billed) |
|---|---|---|---|---|
| (none) | $##.## | $##.## | $##.## | $##.## |
Medicare Non-Participating - Assignment NOT Accepted (Check To Patient)
| Modifier | Allowed | Medicare 80% | Patient Pays | Limiting Charge (Amount Billed) |
|---|---|---|---|---|
| (none) | $##.## | $##.## | $##.## | $##.## |
Medicare vs. My Fee Evaluation
| Modifier | Medicare Allowed | 150% | 200% | My Fee |
|---|---|---|---|---|
| (none) | $8.73 | $13.10 | $17.47 | (your fee) |
Access to calculated fee values is available. Access to this feature is available in the following products:
Note: Subscribers will see the calculated values below. |
Medicare Participating - Assignment Accepted (Mandatory)
| Modifier | Allowed | Medicare 80% | Patient Pays |
|---|---|---|---|
| (none) | $8.73 | $##.## | $##.## |
Medicare Non-Participating - Assignment Accepted (Check To Doctor)
| Modifier | Allowed | Medicare 80% | Patient Pays | Limiting Charge (Amount Billed) |
|---|---|---|---|---|
| (none) | $##.## | $##.## | $##.## | $##.## |
Medicare Non-Participating - Assignment NOT Accepted (Check To Patient)
| Modifier | Allowed | Medicare 80% | Patient Pays | Limiting Charge (Amount Billed) |
|---|---|---|---|---|
| (none) | $##.## | $##.## | $##.## | $##.## |
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Calculated for National Unadjusted (00000)
* Note: Medicare may or may NOT reimburse you for this code. The fees provided below are based on values established by CMS/Medicare. Please check with your local Medicare contact on whether this code is eligible for reimbursement.
RVU Components (by modifier)
| Modifier | Work | Practice Expense | Malpractice Expense | Total |
|---|---|---|---|---|
| (none) | 0.16 | 0.08 | 0.03 | 0.270 |
Calculated fee values are available. Access to this feature is available in the following products:
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Practitioner Labor
| Pre-Service | Intra-Service | Post-Service | Total Time* |
|---|---|---|---|
| ## | ## | ## | ## min |
* Total Time may be greater than the displayed components.
Work RVU Components (by modifier)
| Modifier | National Unadjusted Work RVU | Work GPCI | Adjusted Work RVU |
|---|---|---|---|
| (none) | ##.## | ##.## | 0.16 |
Clinical Labor - Direct Expense
| Staff | Staff Rate | Pre Time | Intra Time | Post Time | Total Time |
|---|---|---|---|---|---|
| $0.00 / min | ## min | ## min | ## min | ## min |
Equipment - Direct Expense
| Item | Purchase Price | Expected Life | Total Time |
|---|---|---|---|
| $##.## | ## years | ## min |
Supplies - Direct Expense
| Item | Unit Price | Quantity | Unit | Amount |
|---|
Indirect Expenses (clerical,overhead, and other) are also included in the practice expense.
PE RVU Components (by modifier)
| Modifier | National Unadjusted PE RVU | PE GPCI | Adjusted PE RVU |
|---|---|---|---|
| (none) | ##.## | ##.## | 0.080 |
RVU Components (by modifier)
| Modifier | Work | Practice Expense | Malpractice Expense | Total |
|---|---|---|---|---|
| (none) | 0.16 | 0.08 | 0.03 | 0.270 |
Calculated fee values are available. Access to this feature is available in the following products:
|
Practitioner Labor
| Pre-Service | Intra-Service | Post-Service | Total Time* |
|---|---|---|---|
| ## | ## | ## | ## min |
* Total Time may be greater than the displayed components.
Work RVU Components (by modifier)
| Modifier | National Unadjusted Work RVU | Work GPCI | Adjusted Work RVU |
|---|---|---|---|
| (none) | ##.## | ##.## | 0.16 |
Clinical Labor (Non-Facility)- Direct Expense
| Staff | Staff Rate | Pre Time | Intra Time | Post Time | Total Time |
|---|---|---|---|---|---|
| $0.00 / min | ## min | ## min | ## min | ## min |
Equipment (Non-Facility)- Direct Expense
| Item | Purchase Price | Expected Life | Total Time |
|---|---|---|---|
| $##.## | ## years | ## min |
Supplies (Non-Facility)- Direct Expense
| Item | Unit Price | Quantity | Unit | Amount |
|---|
Indirect Expenses (clerical,overhead, and other) are also included in the practice expense.
PE RVU Components (by modifier)
| Modifier | National Unadjusted PE RVU | PE GPCI | Adjusted PE RVU |
|---|---|---|---|
| (none) | ##.## | ##.## | 0.080 |
Cross-A-Code™ (ICD-9/10, CPT, Modifiers, NCCI, NDC, ASA CROSSWALK®)
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View relationships (or crosswalks) between code sets. Access to this feature is available in the following products:
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Medicare Policies & Guidelines (Articles, LCDs, NCDs)
coverage/coverage_content.php?set=hcpcs&c=G0559
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