HCPCS code G0415 — Open tx post pelvic fxcture.
Status: Active.
Effective Jan 1, 2026.
Source: CMS HCPCS Level II.
G0415
ActiveOpen tx post pelvic fxcture
Open treatment of posterior pelvic bone fracture and/or dislocation, for fracture patterns which disrupt the pelvic ring, unilateral or bilateral, includes internal fixation, when performed (includes ilium, sacroiliac joint and/or sacrum)
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:
5113
MUE — Medically Unlikely Edits
Maximum units of G0415 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 G0415 without appropriate documentation.
| Column 2 Code | Modifier |
|---|---|
| G0413 | Modifier may bypass edit |
| 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.
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New Code 2026-Q1Open tx post pelvic fxcture