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

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, 2026One payment locality65.6K Medicare services in 2024

In Tennessee, Medicare pays $124.36 for G0423 in the office and $124.36 when it’s performed in a hospital or facility.

$124.36Office (non-facility)
$124.36Hospital or facility
−5.5%vs the national office rate ($131.60)

Check a contract rate as a % of Medicare · G0423 nationwide

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

We’ll open G0423 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Tennessee
  2. What G0423 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. 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.

How Tennessee compares for G0423

Across 109 of 109 payment localities, the office rate for G0423 runs from $121.32 in Arkansas to $167.88 in Alaska. Tennessee pays $124.36. The RVUs are the same everywhere; the geographic indexes change the dollars.

G0423 in Tennessee vs other payment areas
  1. Tennessee · this page$124.36
  2. Los Angeles, CA · California$143.88+$19.52
  3. Washington, DC area · District of Columbia$146.27+$21.91
  4. Miami, FL · Florida$140.15+$15.79
  5. Chicago, IL · Illinois$137.56+$13.20
  6. Manhattan, NY · New York$147.91+$23.55
  7. Alaska · Alaska$167.88+$43.52

Other areas in Tennessee first, then benchmark localities. Bars start at $0.

Every other payment area

G0423 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$122.47$122.47
ArkansasArkansas$121.32$121.32
ArizonaArizona$129.19$129.19
Bakersfield, CACalifornia$137.01$137.01
Chico, CACalifornia$136.58$136.58
El Centro, CACalifornia$136.60$136.60
Fresno, CACalifornia$136.58$136.58
Hanford, CACalifornia$136.58$136.58

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

See G0423 in every payment locality

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.

The exact Tennessee inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

15,251

Code
G0423
Physician work
2.05
Practice expense
1.77
Malpractice
0.12

GPCI2026.csv

95

Locality
Tennessee
Physician work
1.000
Practice expense
0.909
Malpractice
0.537
Office calculation for G0423 in Tennessee
ComponentRVULocality factorAdjusted
Physician work2.05× 1.0002.0500
Practice expense1.77× 0.9091.6089
Malpractice0.12× 0.5370.0644
Total RVUs3.7234
Conversion factor× 33.4009

Office rate, Tennessee$124.36

Office: (2.05 × 1 + 1.77 × 0.909 + 0.12 × 0.537) × $33.4009 = $124.36

Facility: (2.05 × 1 + 1.77 × 0.909 + 0.12 × 0.537) × $33.4009 = $124.36

Open G0423 in the RVU calculator

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.

How G0423 has changed in Tennessee

G0423 · Office / nonfacility

$124.36

Effective 2026-10-01

The base rate is $6.00 higher than on 2025-10-01, moving from $118.36 to $124.36 (5.1%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release
  1. January 1, 2026

    RVU26A

    $118.36changed to$124.36

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.99 changed to 2.05
    • Practice expense RVU 1.79 changed to 1.77
    • Practice expense GPCI 0.896 changed to 0.909
    • Malpractice GPCI 0.544 changed to 0.537

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $120.07changed to$118.36

    • Conversion factor 33.2875 changed to 32.3465
    • Work RVU 1.92 changed to 1.99
    • Practice expense RVU 1.81 changed to 1.79

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $118.11changed to$120.07

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $113.16changed to$118.11

    • Conversion factor 33.8872 changed to 32.7442
    • Work RVU 1.81 changed to 1.92
    • Practice expense RVU 1.67 changed to 1.81
    • Malpractice RVU 0.07 changed to 0.12
    • Practice expense GPCI 0.894 changed to 0.896
    • Malpractice GPCI 0.518 changed to 0.544
  5. January 1, 2023

    RVU23A

    $109.36changed to$113.16

    • Conversion factor 34.6062 changed to 33.8872
    • Work RVU 1.71 changed to 1.81
    • Practice expense RVU 1.51 changed to 1.67
    • Malpractice RVU 0.21 changed to 0.07
    • Practice expense GPCI 0.892 changed to 0.894
    • Malpractice GPCI 0.492 changed to 0.518

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $107.26changed to$109.36

    • Conversion factor 34.8931 changed to 34.6062
    • Work RVU 1.70 changed to 1.71
    • Practice expense RVU 1.43 changed to 1.51
    • Malpractice RVU 0.20 changed to 0.21

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $103.61changed to$107.26

    • Conversion factor 36.0896 changed to 34.8931
    • Work RVU 1.65 changed to 1.70
    • Practice expense RVU 1.31 changed to 1.43
    • Malpractice RVU 0.09 changed to 0.20
    • Practice expense GPCI 0.897 changed to 0.892
    • Malpractice GPCI 0.509 changed to 0.492

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $111.47changed to$103.61

    • Conversion factor 36.0391 changed to 36.0896
    • Work RVU 1.77 changed to 1.65
    • Practice expense RVU 1.41 changed to 1.31
    • Malpractice RVU 0.10 changed to 0.09
    • Practice expense GPCI 0.901 changed to 0.897
    • Malpractice GPCI 0.526 changed to 0.509

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $109.98changed to$111.47

    • Conversion factor 35.9996 changed to 36.0391
    • Work RVU 1.75 changed to 1.77
    • Practice expense RVU 1.39 changed to 1.41

    Held through RVU19B, RVU19C, RVU19D.

  10. April 1, 2018

    RVU18B

    No ratechanged to$109.98

    Held through RVU18C, RVU18D.

  11. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C, RVU13D, RVU14A, RVU14B, RVU14C, RVU14D, RVU15A, RVU15B, RVU15C, RVU15D, RVU16A, RVU16B, RVU16C, RVU16D, RVU17A, RVU17B, RVU17C, RVU17D, RVU18AR1.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$124.36$124.36RVU26D
2026-07-01$124.36$124.36RVU26C
2026-04-01$124.36$124.36RVU26B
2026-01-01$124.36$124.36RVU26A
2025-10-01$118.36$118.36RVU25D
2025-07-01$118.36$118.36RVU25C
2025-04-01$118.36$118.36RVU25B
2025-01-01$118.36$118.36RVU25A
2024-10-01$120.07$120.07RVU24D
2024-07-01$120.07$120.07RVU24C
2024-04-01$120.07$120.07RVU24B
2024-03-09$120.07$120.07RVU24AR
2024-01-01$118.11$118.11RVU24A
2023-10-01$113.16$113.16RVU23D
2023-07-01$113.16$113.16RVU23C
2023-04-01$113.16$113.16RVU23B
2023-01-01$113.16$113.16RVU23A
2022-10-01$109.36$109.36RVU22D
2022-07-01$109.36$109.36RVU22C
2022-04-01$109.36$109.36RVU22B
2022-01-01$109.36$109.36RVU22A
2021-10-01$107.26$107.26RVU21D
2021-07-01$107.26$107.26RVU21C
2021-04-01$107.26$107.26RVU21B
2021-01-01$107.26$107.26RVU21A
2020-10-01$103.61$103.61RVU20D
2020-07-01$103.61$103.61RVU20C
2020-04-01$103.61$103.61RVU20B
2020-01-01$103.61$103.61RVU20A
2019-10-01$111.47$111.47RVU19D
2019-07-01$111.47$111.47RVU19C
2019-04-01$111.47$111.47RVU19B
2019-01-01$111.47$111.47RVU19A
2018-10-01$109.98$109.98RVU18D
2018-07-01$109.98$109.98RVU18C
2018-04-01$109.98$109.98RVU18B
2018-01-01Rate data unavailableRate data unavailableRVU18AR1
2017-10-01Rate data unavailableRate data unavailableRVU17D
2017-07-01Rate data unavailableRate data unavailableRVU17C
2017-04-01Rate data unavailableRate data unavailableRVU17B
2017-01-01Rate data unavailableRate data unavailableRVU17A
2016-10-01Rate data unavailableRate data unavailableRVU16D
2016-07-01Rate data unavailableRate data unavailableRVU16C
2016-04-01Rate data unavailableRate data unavailableRVU16B
2016-01-01Rate data unavailableRate data unavailableRVU16A
2015-10-01Rate data unavailableRate data unavailableRVU15D
2015-07-01Rate data unavailableRate data unavailableRVU15C
2015-04-01Rate data unavailableRate data unavailableRVU15B
2015-01-01Rate data unavailableRate data unavailableRVU15A
2014-10-01Rate data unavailableRate data unavailableRVU14D
2014-07-01Rate data unavailableRate data unavailableRVU14C
2014-04-01Rate data unavailableRate data unavailableRVU14B
2014-01-01Rate data unavailableRate data unavailableRVU14A
2013-10-01Rate data unavailableRate data unavailableRVU13D
2013-07-01Rate data unavailableRate data unavailableRVU13C
2013-04-01Rate data unavailableRate data unavailableRVU13B
2013-01-01Rate data unavailableRate data unavailableRVU13AR

Price G0423 for an earlier date of service

Where the Tennessee rate applies

Tennessee is a Medicare payment area, not a city. Our Census mapping connects it to 504 cities and communities in Tennessee. Some span more than one payment area; confirm with the service ZIP.

  • Adams
  • Adamsville
  • Alamo
  • Alcoa
  • Alexandria
  • Algood
  • Allardt
  • Altamont

Browse all communities in Tennessee

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)
Geographic factors for TennesseeGPCI2026.csv, line 95 (RVU26D)

Open CMS sourceHow we calculate rates

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