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G9280

G9280Pneumococcal vaccination not administered prior to discharge, reason not specified

HCPCSActiveBETOS M5B

G9280 is a HCPCS Level II code for pneumococcal vaccination not administered prior to discharge, reason not specified. 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 G9280

Long descriptor
Pneumococcal vaccination not administered prior to discharge, reason not specified

The official wording. This is what the code means.

Short descriptor
Pne not given norsn

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

Added
January 1, 2014

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 G9280

HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If G9280 is not quite right, the correct code is very often within a few positions of it.

  • G9272Ldl value >= 100terminated
  • G9273Blood pressure has a systolic value of < 140 and a diastolic value of < 90
  • G9274Blood pressure has a systolic value of =140 and a diastolic value of = 90 or systolic value < 140 and diastolic value = 90 or systolic value = 140 and diastolic value < 90
  • G9275Documentation that patient is a current non-tobacco user
  • G9276Documentation that patient is a current tobacco user
  • G9277Documentation that the patient is on daily aspirin or anti-platelet or has documentation of a valid contraindication or exception to aspirin/anti-platelet; contraindications/exceptions include anti-coagulant use, allergy to aspirin or anti-platelets, history of gastrointestinal bleed and bleeding disorder; additionally, the following exceptions documented by the physician as a reason for not taking daily aspirin or anti-platelet are acceptable (use of non-steroidal anti-inflammatory agents, documented risk for drug interaction, uncontrolled hypertension defined as >180 systolic or >110 diastolic or gastroesophageal reflux)
  • G9278Documentation that the patient is not on daily aspirin or anti-platelet regimen
  • G9279Pneumococcal screening performed and documentation of vaccination received prior to discharge
  • G9281Screening performed and documentation that vaccination not indicated/patient refusal
  • G9282Documentation of medical reason(s) for not reporting the histological type or nsclc-nos classification with an explanation (e.g., biopsy taken for other purposes in a patient with a history of non-small cell lung cancer or other documented medical reasons)
  • G9283Non small cell lung cancer biopsy and cytology specimen report documents classification into specific histologic type or classified as nsclc-nos with an explanation
  • G9284Non small cell lung cancer biopsy and cytology specimen report does not document classification into specific histologic type or classified as nsclc-nos with an explanation
  • G9285Specimen site other than anatomic location of lung or is not classified as non small cell lung cancer
  • G9286Antibiotic regimen prescribed within 10 days after onset of symptoms
  • G9287Antibiotic regimen not prescribed within 10 days after onset of symptoms
  • G9288Documentation of medical reason(s) for not reporting the histological type or nsclc-nos classification with an explanation (e.g., a solitary fibrous tumor in a person with a history of non-small cell carcinoma or other documented medical reasons)

Questions about G9280

What is HCPCS code G9280?

G9280 is a HCPCS Level II code for pneumococcal vaccination not administered prior to discharge, reason not specified. It sits in the Procedures and Professional Services (Temporary) section.

Does Medicare cover G9280?

The CMS HCPCS file marks G9280 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 G9280 paid under the physician fee schedule?

G9280 carries PFS status code M. Measurement code. Used for reporting purposes only; never paid.

HCPCS Level II2026Q3-Jul· effective July 1, 2026