HCPCS G0455: Microbiota instillationMedicare rate & RVUs
Reports preparation and delivery of fecal microbiota, commonly for selected patients with recurrent Clostridioides difficile infection.
Medicare pays $146.30 for G0455 nationally in the office and $61.46 in a hospital or facility. Local office rates run $130.23–$192.20.
Medicare rate · G0455
Microbiota instillation
Swap in your local Medicare rate.
- Work RVUs
- 1.31
- Total RVUs
- 4.38
- Global days
- 000
National rate · 2026
$146.30
Office setting, before claim adjustments.
See every locality for G0455 → · 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.
On this page 10 sections
What G0455 covers
G0455 covers preparing fecal microbiota and instilling it into the patient by a delivery method such as colonoscopy, upper gastrointestinal access, or enema. Gastroenterologists commonly provide the service for selected patients with recurrent Clostridioides difficile infection. The code represents the microbiota preparation and delivery, not the colonoscopy or upper endoscopy used to reach the treatment site.
Report G0455 when both preparation and instillation are performed; document the clinical indication, preparation, delivery method, and procedure performed. The code has a 0-day global period, so same-day preoperative and postoperative care is included. Modifier 50 is inappropriate for this service. An assistant at surgery is payable only when medical necessity is documented; co-surgeons and team surgery are not permitted.
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 G0455 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
$130.23 to $192.20
109 of 109 payment localities
G0455 rates by state
Office rate range in each state. Select a state to see its payment localities.
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Local rates. Clear comparisons.
Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.
$130.23
$173.24
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $172.44 | 1 |
| AL | $132.03 | 1 |
| AR | $130.23 | 1 |
| AZ | $142.59 | 1 |
| CA | $154.27–$192.20 | 29 |
| CO | $152.06 | 1 |
| CT | $155.69 | 1 |
| DC | $166.61 | 1 |
| DE | $144.87 | 1 |
| FL | $144.34–$157.46 | 3 |
| GA | $136.62–$148.93 | 2 |
| GU | $157.73 | 1 |
| HI | $157.73 | 1 |
| IA | $135.16 | 1 |
| ID | $136.00 | 1 |
| IL | $140.41–$153.15 | 4 |
| IN | $136.75 | 1 |
| KS | $134.58 | 1 |
| KY | $135.04 | 1 |
| LA | $134.85–$141.16 | 2 |
| MA | $151.23–$166.56 | 2 |
| MD | $147.52–$166.61 | 3 |
| ME | $136.70–$143.69 | 2 |
| MI | $138.38–$146.08 | 2 |
| MN | $145.84 | 1 |
| MO | $132.67–$141.61 | 3 |
| MS | $131.47 | 1 |
| MT | $146.29 | 1 |
| NC | $138.05 | 1 |
| ND | $143.52 | 1 |
| NE | $135.85 | 1 |
| NH | $149.72 | 1 |
| NJ | $157.50–$165.03 | 2 |
| NM | $139.11 | 1 |
| NV | $145.61 | 1 |
| NY | $140.01–$171.60 | 5 |
| OH | $137.82 | 1 |
| OK | $134.78 | 1 |
| OR | $144.52–$156.66 | 2 |
| PA | $138.01–$152.00 | 2 |
| PR | $147.30 | 1 |
| RI | $149.85 | 1 |
| SC | $138.16 | 1 |
| SD | $143.19 | 1 |
| TN | $135.23 | 1 |
| TX | $137.16–$151.53 | 8 |
| UT | $139.95 | 1 |
| VA | $143.26–$166.61 | 2 |
| VI | $147.30 | 1 |
| VT | $143.01 | 1 |
| WA | $150.93–$169.84 | 2 |
| WI | $138.95 | 1 |
| WV | $135.49 | 1 |
| WY | $145.08 | 1 |
How the G0455 rate is calculated
Each of G0455’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 · G0455
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 1.31Practice expense 2.93Malpractice 0.14
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for G0455
The CMS indicators that decide how G0455 is paid alongside other services.
CMS payment indicators · G0455
Microbiota instillation
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is included. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
G0455 compared with similar codes
Compare codes
G0455 vs 44705 vs 45378 vs 43235: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 44705Prepare fecal microbiota
- 44705 describes preparation of fecal microbiota for instillation. G0455 covers preparation together with instillation.
- 45378Colonoscopy
- 45378 describes a diagnostic colonoscopy; it does not represent microbiota preparation and delivery. G0455 may be reported for the microbiota service when colonoscopic access is used.
- 43235Upper GI endoscopy
- 43235 describes a diagnostic upper endoscopy, not microbiota preparation and instillation. Use it for the endoscopic service when applicable, with G0455 describing the microbiota service.
G0455 billing questions
How does G0455 differ from billing code 44705?
G0455 covers preparation and instillation of fecal microbiota. billing code 44705 describes preparation for instillation, so distinguish the services by whether the microbiota is also delivered.
Can the endoscopic procedure be reported separately?
G0455 describes microbiota preparation and delivery, not the endoscopic access procedure. When a separately reportable colonoscopy or upper endoscopy is performed, report that procedure under its applicable code.
Should modifier 50 be appended for bilateral delivery?
No. CMS identifies bilateral adjustment as inappropriate for G0455.
Can an assistant, co-surgeon, or surgical team be reported?
An assistant at surgery is payable only with documentation of medical necessity. Co-surgeons and team surgery are not permitted for this code.
What care is included in the global period?
G0455 has a 0-day global period. Same-day preoperative and postoperative care is included.
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
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