HCPCS code G0423: Cardiac rehabilitation, without exercise2026 Medicare rate & RVUs

Reports an exercise-free session of an intensive cardiac rehabilitation program, with structured risk-factor education and support for eligible cardiac patients.

CMS RVU26DEffective Oct 1, 2026109 payment localities65.6K Medicare services in 2024

Medicare pays $131.60 for G0423 nationally in the office and $131.60 in a hospital or facility. Local office rates run $121.32–$167.88.

Medicare rate · G0423

Cardiac rehabilitation, without exercise

Office or facility?

Work RVUs
2.05
Total RVUs
3.94
Global days
XXX

National rate · 2026

$131.60

Office setting, before claim adjustments.

See every locality for G0423 →Billed by an NP, PA or therapist? →

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

Your location

Medicare pays by the payment locality where the service is performed.

On this page 10 sections
  1. Medicare rate
  2. What G0423 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What G0423 covers

G0423 represents a session in an intensive cardiac rehabilitation program when exercise is not part of that session. The service is part of a structured cardiac recovery program, not simply a counseling visit. Cardiac rehabilitation staff deliver the program’s non-exercise components, which may include education and support addressing cardiovascular risk factors and behavior change. Sessions are typically furnished in an outpatient rehabilitation setting to patients participating in an intensive program.

Report G0423 for each qualifying session delivered without exercise; do not use it for a session that includes exercise. The record should support the patient’s participation in the intensive program, the date and delivery of the session, and the non-exercise services provided. The code is session-based rather than reported as timed units.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

Where G0423 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 payment localities

$121.32 to $167.88

$121.32$144.60$167.88
One dot per payment locality, office / nonfacility. Hover a dot to see the locality; select it to open that rate.

109 of 109 payment localities

G0423 office and facility rates by payment locality
Payment localityOfficeFacility
Alabama$122.47$122.47
Alaska$167.88$167.88
Arizona$129.19$129.19
Arkansas$121.32$121.32
Atlanta, GA$133.56$133.56
Austin, TX$134.71$134.71
Bakersfield, CA$137.01$137.01
Baltimore area, MD$137.96$137.96
Beaumont, TX$125.99$125.99
Brazoria, TX$130.73$130.73

G0423 rates by state

Office rate range in each state. Select a state to see its payment localities.

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$121.32

$167.88

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
G0423 office rate range by state
State / territoryOffice rate rangeLocalities
AK$167.881
AL$122.471
AR$121.321
AZ$129.191
CA$136.58–$163.4029
CO$135.331
CT$138.361
DC$146.271
DE$130.831
FL$131.01–$140.153
GA$125.98–$133.562
GU$138.011
HI$138.011
IA$124.161
ID$124.761
IL$128.71–$137.564
IN$125.221
KS$123.941
KY$124.701
LA$124.63–$128.662
MA$135.01–$145.442
MD$132.67–$146.273
ME$125.35–$129.592
MI$126.97–$132.282
MN$130.491
MO$123.34–$128.773
MS$122.341
MT$131.591
NC$126.191
ND$129.221
NE$124.551
NH$133.521
NJ$140.17–$145.642
NM$127.501
NV$130.991
NY$127.45–$150.595
OH$126.491
OK$124.381
OR$130.17–$138.232
PA$126.53–$136.032
PR$132.191
RI$134.421
SC$126.511
SD$128.941
TN$124.361
TX$125.99–$134.718
UT$127.641
VA$129.42–$146.272
VI$132.191
VT$129.031
WA$134.67–$147.712
WI$126.341
WV$125.581
WY$130.561

How the G0423 rate is calculated

Each of G0423’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · G0423

RVUs × geographic indexes × conversion factor

Office or facility?

Work2.05

2.05 RVUs× 1.000 GPCI

Practice expense1.77

1.77 RVUs× 1.000 GPCI

Malpractice0.12

0.12 RVUs× 1.000 GPCI

Adjusted RVUs

3.9400

Conversion factor

$33.4009

Medicare rate

$131.60

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for G0423

G0423 has no global surgery period, no multiple-procedure, bilateral or assistant-at-surgery adjustment, and no professional/technical split. What changes the payment is where the service happens: the place of service on the claim decides whether Medicare pays the office or the facility rate.

Place of service · G0423

Which rate does Medicare pay?

The POS code on the claim line (CMS-1500 box 24B).

POS 11 · non-facility rate · national

$131.60

Non-facility (office)
$131.60
Facility
$131.60

Higher because the practice carries its own overhead.

G0423 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • G0423

    Cardiac rehabilitation, without exercise2.05 wRVU

    $131.60

  • G0422

    Cardiac rehabilitation, intensive program with exercise2.05 wRVU

    $131.60+$0.00

  • 93797

    Cardiac rehab, without ECG monitoring0.18 wRVU

    $17.70−$113.90

  • 93798

    Cardiac rehabilitation, continuous ECG monitoring0.28 wRVU

    $26.05−$105.55

How to choose

G0422Cardiac rehabilitationIntensive program with exercise
Both identify intensive cardiac rehabilitation sessions; G0423 is for a session without exercise, while G0422 is for one that includes exercise.
93797Cardiac rehabWithout ECG monitoring
93797 represents conventional cardiac rehabilitation without continuous ECG monitoring. G0423 is for an exercise-free session in an intensive cardiac rehabilitation program.
93798Cardiac rehabilitationContinuous ECG monitoring
93798 represents conventional cardiac rehabilitation with continuous ECG monitoring. Use G0423 when the service is an exercise-free intensive-program session instead.

G0423 billing questions

When should G0423 be chosen instead of G0422?

Use G0423 for an intensive cardiac rehabilitation session without exercise. Use G0422 when exercise is included in the session.

Is G0423 reported by time or by session?

It is reported per session, not as timed units. Document the session date and the services furnished.

Can G0423 be used for ordinary cardiac rehabilitation?

G0423 identifies intensive cardiac rehabilitation. Conventional cardiac rehabilitation is represented by codes such as 93797 and 93798, depending on the service and monitoring.

What documentation supports G0423?

Document the patient’s participation in the intensive program and the non-exercise services delivered during that session. The record should distinguish the session from one that includes exercise.

Does G0423 describe only education?

No. It identifies an exercise-free session within an intensive cardiac rehabilitation program; the record should reflect the program services actually provided, not just a generic counseling encounter.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Show the CMS file lines behind this rate
RVUs for G0423PPRRVU2026_Oct_nonQPP.csv, line 15,251 (RVU26D)

Open CMS sourceHow we calculate rates

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