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

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 West Virginia, Medicare pays $125.58 for G0423 in the office and $125.58 when it’s performed in a hospital or facility.

$125.58Office (non-facility)
$125.58Hospital or facility
−4.6%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 West Virginia
  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 West Virginia 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. West Virginia pays $125.58. The RVUs are the same everywhere; the geographic indexes change the dollars.

G0423 in West Virginia vs other payment areas
  1. West Virginia · this page$125.58
  2. Los Angeles, CA · California$143.88+$18.30
  3. Washington, DC area · District of Columbia$146.27+$20.69
  4. Miami, FL · Florida$140.15+$14.57
  5. Chicago, IL · Illinois$137.56+$11.98
  6. Manhattan, NY · New York$147.91+$22.33
  7. Alaska · Alaska$167.88+$42.30

Other areas in West Virginia 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.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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 West Virginia 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

110

Locality
West Virginia
Physician work
1.000
Practice expense
0.869
Malpractice
1.431
Office calculation for G0423 in West Virginia
ComponentRVULocality factorAdjusted
Physician work2.05× 1.0002.0500
Practice expense1.77× 0.8691.5381
Malpractice0.12× 1.4310.1717
Total RVUs3.7598
Conversion factor× 33.4009

Office rate, West Virginia$125.58

Office: (2.05 × 1 + 1.77 × 0.869 + 0.12 × 1.431) × $33.4009 = $125.58

Facility: (2.05 × 1 + 1.77 × 0.869 + 0.12 × 1.431) × $33.4009 = $125.58

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.

Codes related to G0423

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to G0423
CodeHow it relatesOffice range, West Virginia
Same family
G0422Cardiac rehabilitation, intensive program with exerciseIntensive cardiac rehabilitation session that includes exercise.$125.58
Used instead
93797Cardiac rehab, without ECG monitoringConventional cardiac rehabilitation without continuous ECG monitoring, rather than an intensive program session.$16.36
93798Cardiac rehabilitation, continuous ECG monitoringConventional cardiac rehabilitation with continuous ECG monitoring, rather than an intensive program session.$24.24

How G0423 has changed in West Virginia

G0423 · Office / nonfacility

$125.58

Effective 2026-10-01

The base rate is $6.13 higher than on 2025-10-01, moving from $119.45 to $125.58 (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

    $119.45changed to$125.58

    • 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 0.862 changed to 0.869
    • Malpractice GPCI 1.333 changed to 1.431

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $121.17changed to$119.45

    • 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

    $119.19changed to$121.17

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $113.01changed to$119.19

    • 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 0.860 changed to 0.862
    • Malpractice GPCI 1.266 changed to 1.333

  5. January 1, 2023

    RVU23A

    $112.72changed to$113.01

    • 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 0.858 changed to 0.860
    • Malpractice GPCI 1.198 changed to 1.266

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $110.49changed to$112.72

    • 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

    $104.11changed to$110.49

    • 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 0.857 changed to 0.858
    • Malpractice GPCI 1.247 changed to 1.198

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $112.01changed to$104.11

    • 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
    • Malpractice GPCI 1.296 changed to 1.247

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $110.55changed to$112.01

    • 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. January 1, 2018

    RVU18AR1

    $103.86changed to$110.55

    • Conversion factor 35.8887 changed to 35.9996
    • Work RVU 1.66 changed to 1.75
    • Practice expense RVU 1.32 changed to 1.39
    • Malpractice RVU 0.09 changed to 0.10
    • Practice expense GPCI 0.847 changed to 0.857
    • Malpractice GPCI 1.289 changed to 1.296

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $97.10changed to$103.86

    • Conversion factor 35.8043 changed to 35.8887
    • Work RVU 1.56 changed to 1.66
    • Practice expense RVU 1.24 changed to 1.32
    • Practice expense GPCI 0.836 changed to 0.847
    • Malpractice GPCI 1.282 changed to 1.289

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $97.29changed to$97.10

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 1.25 changed to 1.24
    • Malpractice RVU 0.08 changed to 0.09

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $96.81changed to$97.29

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $95.90changed to$96.81

    • Conversion factor 35.8228 changed to 35.7547
    • Work RVU 1.47 changed to 1.56
    • Practice expense RVU 1.33 changed to 1.25
    • Practice expense GPCI 0.832 changed to 0.836
    • Malpractice GPCI 1.256 changed to 1.282

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $77.56changed to$95.90

    • Conversion factor 34.0230 changed to 35.8228
    • Work RVU 1.20 changed to 1.47
    • Practice expense RVU 1.20 changed to 1.33
    • Malpractice RVU 0.07 changed to 0.08
    • Practice expense GPCI 0.828 changed to 0.832
    • Malpractice GPCI 1.229 changed to 1.256

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $77.56

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$125.58$125.58RVU26D
2026-07-01$125.58$125.58RVU26C
2026-04-01$125.58$125.58RVU26B
2026-01-01$125.58$125.58RVU26A
2025-10-01$119.45$119.45RVU25D
2025-07-01$119.45$119.45RVU25C
2025-04-01$119.45$119.45RVU25B
2025-01-01$119.45$119.45RVU25A
2024-10-01$121.17$121.17RVU24D
2024-07-01$121.17$121.17RVU24C
2024-04-01$121.17$121.17RVU24B
2024-03-09$121.17$121.17RVU24AR
2024-01-01$119.19$119.19RVU24A
2023-10-01$113.01$113.01RVU23D
2023-07-01$113.01$113.01RVU23C
2023-04-01$113.01$113.01RVU23B
2023-01-01$113.01$113.01RVU23A
2022-10-01$112.72$112.72RVU22D
2022-07-01$112.72$112.72RVU22C
2022-04-01$112.72$112.72RVU22B
2022-01-01$112.72$112.72RVU22A
2021-10-01$110.49$110.49RVU21D
2021-07-01$110.49$110.49RVU21C
2021-04-01$110.49$110.49RVU21B
2021-01-01$110.49$110.49RVU21A
2020-10-01$104.11$104.11RVU20D
2020-07-01$104.11$104.11RVU20C
2020-04-01$104.11$104.11RVU20B
2020-01-01$104.11$104.11RVU20A
2019-10-01$112.01$112.01RVU19D
2019-07-01$112.01$112.01RVU19C
2019-04-01$112.01$112.01RVU19B
2019-01-01$112.01$112.01RVU19A
2018-10-01$110.55$110.55RVU18D
2018-07-01$110.55$110.55RVU18C
2018-04-01$110.55$110.55RVU18B
2018-01-01$110.55$110.55RVU18AR1
2017-10-01$103.86$103.86RVU17D
2017-07-01$103.86$103.86RVU17C
2017-04-01$103.86$103.86RVU17B
2017-01-01$103.86$103.86RVU17A
2016-10-01$97.10$97.10RVU16D
2016-07-01$97.10$97.10RVU16C
2016-04-01$97.10$97.10RVU16B
2016-01-01$97.10$97.10RVU16A
2015-10-01$97.29$97.29RVU15D
2015-07-01$97.29$97.29RVU15C
2015-04-01$96.81$96.81RVU15B
2015-01-01$96.81$96.81RVU15A
2014-10-01$95.90$95.90RVU14D
2014-07-01$95.90$95.90RVU14C
2014-04-01$95.90$95.90RVU14B
2014-01-01$95.90$95.90RVU14A
2013-10-01$77.56$77.56RVU13D
2013-07-01$77.56$77.56RVU13C
2013-04-01$77.56$77.56RVU13B
2013-01-01$77.56$77.56RVU13AR

Price G0423 for an earlier date of service

Where the West Virginia rate applies

West Virginia is a Medicare payment area, not a city. Our Census mapping connects it to 439 cities and communities in West Virginia. Some span more than one payment area; confirm with the service ZIP.

  • Accoville
  • Addison (Webster Springs)
  • Adrian
  • Albright
  • Alderson
  • Alum Creek
  • Amherstdale
  • Anawalt

Browse all communities in West Virginia

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 West VirginiaGPCI2026.csv, line 110 (RVU26D)

Open CMS sourceHow we calculate rates

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