HCPCS code G0412 — Open tx iliac spine uni/bil. Status: Active. Effective Jan 1, 2026. Source: CMS HCPCS Level II.

G0412

Active

Open tx iliac spine uni/bil

Open treatment of iliac spine(s), tuberosity avulsion, or iliac wing fracture(s), unilateral or bilateral for pelvic bone fracture patterns which do not disrupt the pelvic ring includes internal fixation, when performed

Category: Procedures
Section: G-codes: Procedures / Professional Services
Effective: Jan 1, 2026
Code type: alphanumeric
OPPS Status: J1 — Hospital Part B services paid through a comprehensive APC (C-APC)
OPPS APC: 5114

MUE — Medically Unlikely Edits

Maximum units of G0412 Medicare will pay for one beneficiary on one date of service. Claims exceeding the MUE are denied or returned for review.

Service Type Max Units / Day
Outpatient Hospital 1
Practitioner Services 1

Source: CMS Medicare NCCI Medically Unlikely Edits

NCCI Edits

The following codes cannot be billed together with G0412 without appropriate documentation.

Column 2 Code Modifier
G0463 Modifier may bypass edit
G0471 Modifier may bypass edit

Source: CMS National Correct Coding Initiative (NCCI)

Change History

Quarterly changes published by CMS. Revisions may affect the code description, coverage, or rate — review each quarter's changes before submitting claims.

  • New Code 2026-Q1
    Open tx iliac spine uni/bil