| HCPCS Code: |
G0340 |
| Long Description: |
Image-guided robotic linear accelerator-based stereotactic radiosurgery, delivery including collimator changes and custom plugging, fractionated treatment, all lesions, per session, second through fifth sessions, maximum five sessions per course of treatment |
| Short Description: |
Robt lin-radsurg fractx 2-5 |
| Pricing Indicator 1: |
13 (Price established by carriers (e.G., not otherwise classified, individual determination, carrier discretion)) |
| Multiple Pricing Code: |
A (Not applicable as HCPCS priced under one methodology) |
| Statute Number: |
|
| Coverage Code: |
C (Carrier judgment) |
| ASC Payment Group Code: |
|
| Processing Note Number: |
|
| Berenson-Eggers Type of Service (BETOS) Code: |
P5E (Ambulatory procedures - other) |
| Type of Service Code 1: |
1 (Medical care) |
| Anesthesia Base Unit Quality: |
0 |
| Code Added: |
01-01-2004 |
| Action Effective Date: |
01-01-2014 |
| Action Code: |
P (Payment change (MOG, pricing indicator codes, anesthesia base units,Ambulatory Surgical Centers)) |
