$129.42–$146.27
Both identify intensive cardiac rehabilitation sessions; G0423 is for a session without exercise, while G0422 is for one that includes exercise.
On this page
CMS RVU26D · Effective 2026-10-01
G0423 Cardiac rehabilitation Medicare reimbursement rates in Virginia
Reports an exercise-free session of an intensive cardiac rehabilitation program, with structured risk-factor education and support for eligible cardiac patients. Compare G0423 office and facility rates across CMS payment localities in Virginia.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for G0423 in Virginia?
Virginia has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
$129.42–$146.27
2 of 2 localities have a supported rate.
Facility setting
$129.42–$146.27
2 of 2 localities have a supported rate.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Cardiac rehabilitation
About G0423: Intensive cardiac rehabilitation without exercise
Reports an exercise-free session of an intensive cardiac rehabilitation program, with structured risk-factor education and support for eligible cardiac patients.
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. CMS lists no special payment rules for this code in the supplied facts.
Where the value comes from
- Work RVU2.05 · 52%
- Practice expense (office) RVU1.77 · 45%
- Malpractice RVU0.12 · 3%
65.6K
Medicare services in 2024 · #692 by national volume
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.
G0423 compared with similar codes
Office rates for Virginia, from the same CMS release.
$17.41–$20.09
93797 represents conventional cardiac rehabilitation without continuous ECG monitoring. G0423 is for an exercise-free session in an intensive cardiac rehabilitation program.
$25.58–$29.49
93798 represents conventional cardiac rehabilitation with continuous ECG monitoring. Use G0423 when the service is an exercise-free intensive-program session instead.
Compare G0423 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
2 of 2 payment localities
Dc + Md/Va Suburbs →
Office / nonfacility
$146.27
Facility
$146.27
Virginia →
Office / nonfacility
$129.42
Facility
$129.42
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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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
15,248G0420,,Ed svc ckd ind per session,A,,2.12,1.15,,1.15,NA,0.13,3.40,3.40,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
15,249G0421,,Ed svc ckd grp per session,A,,0.50,0.29,,0.29,NA,0.03,0.82,0.82,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
15,250G0422,,Intens cardiac rehab w/exerc,A,,2.05,1.77,,1.77,,0.12,3.94,3.94,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
15,251G0423,,Intens cardiac rehab no exer,A,,2.05,1.77,,1.77,,0.12,3.94,3.94,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
15,252G0425,,Inpt/ed teleconsult30,A,,1.92,0.41,NA,0.41,,0.19,2.52,2.52,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
15,253G0426,,Inpt/ed teleconsult50,A,,2.61,0.67,NA,0.67,,0.23,3.51,3.51,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
15,254G0427,,Inpt/ed teleconsult70,A,,3.86,0.90,NA,0.90,,0.28,5.04,5.04,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00