G8876

G8876 — Documentation of reason(s) for not performing minimally invasive biopsy to diagnose breast cancer preoperatively (e.g., lesion too close to skin, implant, chest wall, etc., lesion could not be adequately visualized for needle biopsy, patient condition prevents needle biopsy [weight, breast thickness, etc.], duct excision without imaging abnormality, prophylactic mastectomy, reduction mammoplasty, excisional biopsy performed by another physician)

HCPCSActiveBETOS M5B

G8876 is a HCPCS Level II code for documentation of reason(s) for not performing minimally invasive biopsy to diagnose breast cancer preoperatively (e.g., lesion too close to skin, implant, chest wall, etc., lesion could not be adequately visualized for needle biopsy, patient condition prevents needle biopsy [weight, breast thickness, etc.], duct excision without imaging abnormality, prophylactic mastectomy, reduction mammoplasty, excisional biopsy performed by another physician). 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 G8876

Long descriptor: Documentation of reason(s) for not performing minimally invasive biopsy to diagnose breast cancer preoperatively (e.g., lesion too close to skin, implant, chest wall, etc., lesion could not be adequately visualized for needle biopsy, patient condition prevents needle biopsy [weight, breast thickness, etc.], duct excision without imaging abnormality, prophylactic mastectomy, reduction mammoplasty, excisional biopsy performed by another physician)
Short descriptor: Doc reas no min inv dx
Added: January 1, 2012
BETOS: M5B
Pricing indicator: 00 — Not priced by Part B

Codes adjacent to G8876

HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If G8876 is not quite right, the correct code is very often within a few positions of it.

G8868Patients receiving a first course of anti-tnf therapyterminated
G8869Patient has documented immunity to hepatitis b and initiating anti-tnf therapy
G8870Hepatitis b vaccine injection administered or previously received and is receiving a first course of anti-tnf therapyterminated
G8871Patient not receiving a first course of anti-tnf therapyterminated
G8872Excised tissue evaluated by imaging intraoperatively to confirm successful inclusion of targeted lesionterminated
G8873Patients with needle localization specimens which are not amenable to intraoperative imaging such as mri needle wire localization, or targets which are tentatively identified on mammogram or ultrasound which do not contain a biopsy marker but which can be verified on intraoperative inspection or pathology (e.g., needle biopsy site where the biopsy marker is remote from the actual biopsy site)terminated
G8874Excised tissue not evaluated by imaging intraoperatively to confirm successful inclusion of targeted lesionterminated
G8875Clinician diagnosed breast cancer preoperatively by a minimally invasive biopsy method
G8877Clinician did not attempt to achieve the diagnosis of breast cancer preoperatively by a minimally invasive biopsy method, reason not given
G8878Sentinel lymph node biopsy procedure performed
G8879Clinically node negative (t1n0m0 or t2n0m0) invasive breast cancerterminated
G8880Documentation of reason(s) sentinel lymph node biopsy not performed (e.g., reasons could include but not limited to; non-invasive cancer, incidental discovery of breast cancer on prophylactic mastectomy, incidental discovery of breast cancer on reduction mammoplasty, pre-operative biopsy proven lymph node (ln) metastases, inflammatory carcinoma, stage 3 locally advanced cancer, recurrent invasive breast cancer, clinically node positive after neoadjuvant systemic therapy, patient refusal after informed consent, patient with significant age, comorbidities, or limited life expectancy and favorable tumor; adjuvant systemic therapy unlikely to change)
G8881Stage of breast cancer is greater than t1n0m0 or t2n0m0
G8882Sentinel lymph node biopsy procedure not performed, reason not given
G8883Biopsy results reviewed, communicated, tracked and documentedterminated
G8884Clinician documented reason that patient's biopsy results were not reviewedterminated

Questions about G8876

What is HCPCS code G8876?

G8876 is a HCPCS Level II code for documentation of reason(s) for not performing minimally invasive biopsy to diagnose breast cancer preoperatively (e.g., lesion too close to skin, implant, chest wall, etc., lesion could not be adequately visualized for needle biopsy, patient condition prevents needle biopsy [weight, breast thickness, etc.], duct excision without imaging abnormality, prophylactic mastectomy, reduction mammoplasty, excisional biopsy performed by another physician). It sits in the Procedures and Professional Services (Temporary) section.

Does Medicare cover G8876?

The CMS HCPCS file marks G8876 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 G8876 paid under the physician fee schedule?

G8876 carries PFS status code M. Measurement code. Used for reporting purposes only; never paid.