HCPCS G0422: Cardiac rehabilitationMedicare rate & RVUs in Utah
Reports a session of intensive cardiac rehabilitation that includes supervised exercise and structured lifestyle intervention for an eligible patient.
Medicare pays $127.64 for G0422 in the office in Utah (Utah). 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.
On this page 9 sections
What G0422 covers
G0422 identifies a session in an intensive cardiac rehabilitation program that includes supervised exercise alongside structured lifestyle intervention. The program serves eligible patients with cardiac disease and is delivered by a multidisciplinary rehabilitation team, commonly in an outpatient cardiac rehabilitation setting, with medical oversight. Exercise is integrated with education and behavior-change support addressing cardiovascular risk factors.
Report G0422 for each intensive cardiac rehabilitation session that includes exercise; use G0423 when the session is conducted without exercise. Documentation should identify the patient's qualifying cardiac indication, participation in the intensive program, services provided that day, exercise activity, and clinical oversight. The code is reported by session, not by exercise minutes. The CMS fee schedule assigns resources to this service; the clinical record should support the session reported.
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.
G0422 in Utah
| Payment locality | Office | Facility |
|---|---|---|
| Utah | $127.64 | $127.64 |
How the G0422 rate is calculated
Each of G0422’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 · G0422
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 G0422
G0422 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 · G0422
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.
G0422 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- G0423Cardiac rehabilitation
- Both represent intensive cardiac rehabilitation; G0422 includes exercise in the session, while G0423 is used when the session is conducted without exercise.
- 93798Cardiac rehabilitation
- 93798 describes conventional cardiac rehabilitation with exercise. G0422 is for the exercise-inclusive session within an intensive cardiac rehabilitation program.
- 93797Cardiac rehab
- 93797 describes conventional cardiac rehabilitation without exercise. G0422 requires an intensive program and an exercise-inclusive session.
G0422 billing questions
When should G0422 be used instead of G0423?
Use G0422 for an intensive cardiac rehabilitation session that includes exercise. Use G0423 for an intensive session conducted without exercise.
How does G0422 differ from 93798?
G0422 represents intensive cardiac rehabilitation, while 93798 represents conventional cardiac rehabilitation with exercise. The program type, not exercise alone, distinguishes the codes.
Is G0422 counted by minutes or sessions?
It is reported per session, rather than by the number of exercise minutes.
What documentation supports G0422?
Record the patient's qualifying cardiac indication and intensive-program participation, along with the services and supervised exercise provided during that session.
Can G0422 be used for any supervised cardiac exercise?
No. It identifies an exercise-inclusive session in an intensive cardiac rehabilitation program, not exercise alone or conventional cardiac rehabilitation.
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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