MCMCB Pro
G8694

G8694Current or prior left ventricular ejection fraction (lvef) < = 40% or documentation of moderate or severe lvsd

HCPCSActiveBETOS M5B

G8694 is a HCPCS Level II code for current or prior left ventricular ejection fraction (lvef) < = 40% or documentation of moderate or severe lvsd. 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 G8694

Long descriptor
Current or prior left ventricular ejection fraction (lvef) < = 40% or documentation of moderate or severe lvsd

The official wording. This is what the code means.

Short descriptor
Lvef <=40%

CMS's 28-character form, which is what shows up on a remittance advice.

Added
January 1, 2012

When CMS introduced the code.

BETOS
M5B

Berenson-Eggers Type of Service — CMS's own analytic grouping.

Pricing indicator
00 — Not priced by Part B

Service not separately priced by Part B — not covered, bundled into another service, or used by Part A only.

Codes adjacent to G8694

HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If G8694 is not quite right, the correct code is very often within a few positions of it.

  • G8670Residual score for the elbow, wrist or hand impairment not measured because the patient did not complete the elbow/wrist/hand fs prom at initial evaluation and/or near discharge, reason not given
  • G8671Risk-adjusted functional status change residual score for the neck, cranium, mandible, thoracic spine, ribs or other general orthopedic impairment successfully calculated and the score was equal to zero (0) or greater than zero (> 0)terminated
  • G8672Risk-adjusted functional status change residual score for the neck, cranium, mandible, thoracic spine, ribs or other general orthopedic impairment successfully calculated and the score was less than zero (< 0)terminated
  • G8673Risk-adjusted functional status change residual score for the neck, cranium, mandible, thoracic spine, ribs or other general orthopedic impairment not measured because the patient did not complete the fs status survey near discharge, patient not appropriateterminated
  • G8674Risk-adjusted functional status change residual score for the neck, cranium, mandible, thoracic spine, ribs or other general orthopedic impairment not measured because the patient did not complete the general orthopedic fs prom at initial evaluation and/or near discharge, reason not giventerminated
  • G8682Lvf testing documented as being performed prior to discharge or in the previous 12 monthsterminated
  • G8683Lvf testing not performed prior to discharge or in the previous 12 months for a medical or patient documented reasonterminated
  • G8685Lvf testing not documented as being performed prior to discharge or in the previous 12 months, reason not giventerminated
  • G8696Antithrombotic therapy prescribed at dischargeterminated
  • G8697Antithrombotic therapy not prescribed for documented reasons (e.g., patient had stroke during hospital stay, patient expired during inpatient stay, other medical reason(s)); (e.g., patient left against medical advice, other patient reason(s))terminated
  • G8698Antithrombotic therapy was not prescribed at discharge, reason not giventerminated
  • G8699Rehabilitation services (occupational, physical or speech) ordered at or prior to dischargeterminated
  • G8700Rehabilitation services (occupational, physical or speech) not indicated at or prior to dischargeterminated
  • G8701Rehabilitation services were not ordered, reason not otherwise specifiedterminated
  • G8702Documentation that prophylactic antibiotics were given within 4 hours prior to surgical incision or intraoperativelyterminated
  • G8703Documentation that prophylactic antibiotics were neither given within 4 hours prior to surgical incision nor intraoperativelyterminated

Questions about G8694

What is HCPCS code G8694?

G8694 is a HCPCS Level II code for current or prior left ventricular ejection fraction (lvef) < = 40% or documentation of moderate or severe lvsd. It sits in the Procedures and Professional Services (Temporary) section.

Does Medicare cover G8694?

The CMS HCPCS file marks G8694 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 G8694 paid under the physician fee schedule?

G8694 carries PFS status code M. Measurement code. Used for reporting purposes only; never paid.

HCPCS Level II2026Q3-Jul· effective July 1, 2026