G0303 Pre-op service lvrs 10-15dos

Pre-operative pulmonary surgery services for preparation for lvrs, 10 to 15 days of services

Medically Unlikely Edits (effective October 1, 2026)

Medicare pricing for G0303

Physician Fee Schedule (CY 2026, RVU26D)

Status X: statutory exclusion, not paid under the PFS.

Payer policies and prior authorization for G0303

Payer coverage policies that name G0303

G0303 appears in 5 coverage policies from Aetna, Anthem, Blue Cross Blue Shield of Massachusetts, BlueCross BlueShield of South Carolina.

PayerPolicyRole in policyReviewedDocument
AetnaLung Denervation Therapy and Lung Volume Reduction Surgery (0160)
Spiration Valve System		covered if criteria are metMar 26, 2026payer document
AnthemPulmonary Rehabilitation (CG-REHAB-03)covered if criteria are met (range G0302-G0304)May 14, 2026payer document
Blue Cross Blue Shield of MassachusettsLung Volume Reduction Surgery for Severe Emphysema (364)listed, no stancepayer document
Blue Cross Blue Shield of MassachusettsOutpatient Pulmonary Rehabilitation (136)listed, no stancepayer document
BlueCross BlueShield of South CarolinaLung Volume Reduction Surgery for Severe Emphysema (CAM 70171)listed, no stanceJul 1, 2026payer document

Medicaid fee-for-service

Prior authorization required or conditional in IN.

  • AZ: $191.73 (outpatient_hospital), effective Oct 1, 2021
  • ND: $0.00 (physician), effective Aug 1, 2026
  • VT: $167.66 (outpatient_hospital_opps), effective Feb 1, 2026
  • WY: $95.49 (outpatient_hospital_apc, Ambulatory Surgical Centers), effective Apr 1, 2026

From payers' published prior-auth lists, coverage policies and state Medicaid fee schedules, updated Oct 16, 2026. The role is what the policy's own code table or text says about the code. Not a guarantee of coverage or payment; verify with the payer. CPT® is a registered trademark of the American Medical Association.