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<strong>CMS</strong>-1403-FC<br />

TABLE 7: G Codes for Prostate Biopsy<br />

G Code Descriptor<br />

G0416 Surgical pathology, gross and microscopic<br />

examination for prostate needle saturation<br />

biopsy sampling, 1-20 specimens<br />

G0417 Surgical pathology, gross and microscopic<br />

examination for prostate needle saturation<br />

biopsy sampling, 21-40 specimens<br />

G0418 Surgical pathology, gross and microscopic<br />

examination for prostate needle saturation<br />

biopsy sampling, 41-60 specimen<br />

G0419 Surgical pathology, gross and microscopic<br />

examination for prostate needle saturation<br />

biopsy sampling, greater than 60 specimens<br />

The following is a summary of the comments we received<br />

and our responses.<br />

Comment: Some commenters expressed opposition to this<br />

proposal, while others supported it but recommended<br />

modifications to the proposed G codes. All commenters were<br />

opposed to Medicare contractor pricing the G codes and<br />

stated that <strong>CMS</strong>, rather than the Medicare contractor,<br />

should assign an appropriate work value for each specimen<br />

level to capture the expertise, skill, time, and resources<br />

used to determine if prostate cancer is present.<br />

Response: First, for CY 2009, the CPT Editorial Panel<br />

changed Category III code (0137T) to a Category I code,<br />

55706, Biopsies, prostate; needle, transperineal,<br />

stereotactic template guided saturation sampling including<br />

image guidance, which the AMA RUC valued at 6.15 work RVUs.<br />

140

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