G9911 — Clinically node negative (t1n0m0 or t2n0m0) invasive breast cancer before or after neoadjuvant systemic therapy
G9911 is a HCPCS Level II code for clinically node negative (t1n0m0 or t2n0m0) invasive breast cancer before or after neoadjuvant systemic therapy. 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 G9911
- Long descriptor
- Clinically node negative (t1n0m0 or t2n0m0) invasive breast cancer before or after neoadjuvant systemic therapy
- Short descriptor
- Node neg pre/post syst ther
- Added
- January 1, 2018
- 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 G9911
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If G9911 is not quite right, the correct code is very often within a few positions of it.
- G9903Patient screened for tobacco use and identified as a tobacco non-user
- G9904Documentation of medical reason(s) for not screening for tobacco use (e.g., limited life expectancy, other medical reason)terminated
- G9905Patient not screened for tobacco use
- G9906Patient identified as a tobacco user received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling and/or pharmacotherapy)
- G9907Documentation of medical reason(s) for not providing tobacco cessation intervention on the date of the encounter or within the previous 12 months (e.g., limited life expectancy, other medical reason)terminated
- G9908Patient identified as tobacco user did not receive tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling and/or pharmacotherapy)
- G9909Documentation of medical reason(s) for not providing tobacco cessation intervention on the date of the encounter or within the previous 12 months if identified as a tobacco user (e.g., limited life expectancy, other medical reason)terminated
- G9910Patients age 66 or older in institutional special needs plans (snp) or residing in long-term care with pos code 32, 33, 34, 54 or 56 for more than 90 consecutive days during the measurement period
- G9912Hepatitis b virus (hbv) status assessed and results interpreted prior to initiating anti-tnf (tumor necrosis factor) therapy
- G9913Hepatitis b virus (hbv) status not assessed and results interpreted prior to initiating anti-tnf (tumor necrosis factor) therapy, reason not otherwise specified
- G9914Patient initiated an anti-tnf agent
- G9915No record of hbv results documented
- G9916Functional status performed once in the last 12 months
- G9917Documentation of advanced stage dementia and caregiver knowledge is limited
- G9918Functional status not performed, reason not otherwise specified
- G9919Screening performed and positive and provision of recommendations
Questions about G9911
What is HCPCS code G9911?
G9911 is a HCPCS Level II code for clinically node negative (t1n0m0 or t2n0m0) invasive breast cancer before or after neoadjuvant systemic therapy. It sits in the Procedures and Professional Services (Temporary) section.
Does Medicare cover G9911?
The CMS HCPCS file marks G9911 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 G9911 paid under the physician fee schedule?
G9911 carries PFS status code M. Measurement code. Used for reporting purposes only; never paid.