G4004 — Endocrinology mips specialty set
G4004 is a HCPCS Level II code for endocrinology mips specialty set. It belongs to the Procedures and Professional Services (Temporary) section. Whether Medicare pays it depends on the coverage rule below.
Medicare coverage: Carrier judgment
Coverage is decided by your Medicare contractor, not by national policy. Whether this is paid depends on the LCD for your jurisdiction and on what the documentation supports.
From the coverage field of the CMS Alpha-Numeric HCPCS File, release 2026Q3-Jul. This states Medicare’s position on the code, not on your particular claim.
Physician fee schedule statusM
Measurement code. Used for reporting purposes only; never paid.
Global period: XXX
Want the dollar amount for your locality? The fee calculator applies your GPCI and the current conversion factor.
The CMS record for G4004
- Long descriptor
- Endocrinology mips specialty set
- Short descriptor
- Endocrinology ss
- Added
- January 1, 2022
- BETOS
- Z2
- Pricing indicator
- 00 — Not priced by Part B
The official wording. This is what the code means.
CMS's 28-character form, which is what shows up on a remittance advice.
When CMS introduced the code.
Berenson-Eggers Type of Service — CMS's own analytic grouping.
Service not separately priced by Part B — not covered, bundled into another service, or used by Part A only.
Codes adjacent to G4004
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If G4004 is not quite right, the correct code is very often within a few positions of it.
- G2252Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related e/m service provided within the previous 7 days nor leading to an e/m service or procedure within the next 24 hours or soonest available appointment; 11-20 minutes of medical discussion
- G3001Administration and supply of tositumomab, 450 mgterminated
- G3002Chronic pain management and treatment, monthly bundle including, diagnosis; assessment and monitoring; administration of a validated pain rating scale or tool; the development, implementation, revision, and/or maintenance of a person-centered care plan that includes strengths, goals, clinical needs, and desired outcomes; overall treatment management; facilitation and coordination of any necessary behavioral health treatment; medication management; pain and health literacy counseling; any necessary chronic pain related crisis care; and ongoing communication and care coordination between relevant practitioners furnishing care, e.g. physical therapy and occupational therapy, complementary and integrative approaches, and community-based care, as appropriate. required initial face-to-face visit at least 30 minutes provided by a physician or other qualified health professional; first 30 minutes personally provided by physician or other qualified health care professional, per calendar month. (when using g3002, 30 minutes must be met or exceeded.)
- G3003Each additional 15 minutes of chronic pain management and treatment by a physician or other qualified health care professional, per calendar month. (list separately in addition to code for g3002. when using g3003, 15 minutes must be met or exceeded.)
- G4000Dermatology mips specialty set
- G4001Diagnostic radiology mips specialty set
- G4002Electrophysiology cardiac specialist mips specialty set
- G4003Emergency medicine mips specialty set
- G4005Family medicine mips specialty set
- G4006Gastro-enterology mips specialty set
- G4007General surgery mips specialty set
- G4008Geriatrics mips specialty set
- G4009Hospitalists mips specialty set
- G4010Infectious disease mips specialty set
- G4011Internal medicine mips specialty set
- G4012Interventional radiology mips specialty set
Questions about G4004
What is HCPCS code G4004?
G4004 is a HCPCS Level II code for endocrinology mips specialty set. It sits in the Procedures and Professional Services (Temporary) section.
Does Medicare cover G4004?
The CMS HCPCS file marks G4004 as "Carrier judgment". Coverage is decided by your Medicare contractor, not by national policy. Whether this is paid depends on the LCD for your jurisdiction and on what the documentation supports.
How is G4004 paid under the physician fee schedule?
G4004 carries PFS status code M. Measurement code. Used for reporting purposes only; never paid.