HCPCS code G0423: Cardiac rehabilitation, without exercise2026 Medicare rate & RVUs in Michigan
Reports an exercise-free session of an intensive cardiac rehabilitation program, with structured risk-factor education and support for eligible cardiac patients.
Medicare pays $126.97–$132.28 for G0423 in the office in Michigan, from Rest of Michigan to Detroit, MI. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 9 sections
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 in Michigan
| Payment locality | Office | Facility |
|---|---|---|
| Detroit, MI | $132.28 | $132.28 |
| Rest of Michigan | $126.97 | $126.97 |
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
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
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
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