G0429 Dermal filler injection(s)Dermal filler injection(s) for the treatment of facial lipodystrophy syndrome (lds) (e.g., as a result of highly active antiretroviral therapy)
Status A: active, paid separately under the PFS if covered. National amounts: non-facility $99.53, facility $56.11 (total RVUs 2.98 / 1.68 × $33.4009 conversion factor). Work RVU 1.16, practice expense RVU 1.69 non-facility and 0.39 facility, malpractice RVU 0.13. Global period 000. Qualifying APM participants are paid at a $33.5675 conversion factor.
2 of 2 payer prior-auth lists that name G0429 require prior authorization or set conditions: Rocky Mountain Health Plans, UnitedHealthcare.
| Payer | Plan | State | Prior auth | Conditions | Since | Source |
|---|---|---|---|---|---|---|
| Rocky Mountain Health Plans | Rocky Mountain Medicare Advantage D-SNP | CO | prior auth required | Feb 1, 2025 | Rocky Mountain Health Plans Medicare Advantage Dual-Special Needs Plans – prior authorization Effective February 1, 2025 | |
| UnitedHealthcare | UnitedHealthcare Individual Exchange plans | All | prior auth required | Oct 1, 2026 | Prior authorization requirements for UnitedHealthcare Individual Exchange plans Effective October 1, 2026 |
G0429 appears in 15 coverage policies from Aetna, Anthem, Capital Blue Cross, Centene, Health Care Service Corporation (BCBS IL, TX, OK, NM, MT), UnitedHealthcare.
| Payer | Policy | Role in policy | Reviewed | Document |
|---|---|---|---|---|
| Aetna | Cosmetic Surgery and Procedures (0031) | covered if criteria are met | Jun 25, 2026 | payer document |
| Anthem | Autologous Fat Grafting and Injectable Soft Tissue Fillers (CG-SURG-123) | covered if criteria are met | Nov 6, 2025 | payer document |
| Capital Blue Cross | Cosmetic and Reconstructive Surgery (MP 1.004) Procedure codes | covered if criteria are met | Sep 1, 2026 | payer document |
| Centene | Cosmetic and Reconstructive Procedures Reference Number: CP.MP.31 (CP.MP.31) | covered if criteria are met | Aug 1, 2026 | payer document |
| Health Care Service Corporation (BCBS IL, TX, OK, NM, MT) | Cosmetic and Reconstructive Procedures (SUR716.001) CPT Codes 11200, 11201, 11920, 11921, 11922, 11950, 11951, 11952, 11954, 11960, | listed, no stance | Jan 1, 2026 | payer document |
| UnitedHealthcare | Injectable Dermal Fillers and Bulking Agents (CS371.C) | listed, no stance | Jan 1, 2026 | payer document |
| UnitedHealthcare | Injectable Dermal Fillers and Bulking Agents (2026T0650F) | listed, no stance | Jan 1, 2026 | payer document |
| UnitedHealthcare | Injectable Dermal Fillers and Bulking Agents (for Idaho Only) (CS371ID.C) | listed, no stance | May 1, 2026 | payer document |
| UnitedHealthcare | Injectable Dermal Fillers and Bulking Agents (for Kansas Only) (CS371KS.02) | listed, no stance | Jan 1, 2026 | payer document |
| UnitedHealthcare | Injectable Dermal Fillers and Bulking Agents (for Kentucky Only) (CS371KY.03) | listed, no stance | Jan 1, 2026 | payer document |
| UnitedHealthcare | Injectable Dermal Fillers and Bulking Agents (for Nebraska Only) (CS371NE.C) | listed, no stance | Jan 1, 2026 | payer document |
| UnitedHealthcare | Injectable Dermal Fillers and Bulking Agents (for New Mexico Only) (CS371NM.C) | listed, no stance | Jan 1, 2026 | payer document |
| UnitedHealthcare | Injectable Dermal Fillers and Bulking Agents (for Ohio Only) (CS371OH.C) | listed, no stance | Jan 1, 2026 | payer document |
| UnitedHealthcare | Injectable Dermal Fillers and Bulking Agents (for Pennsylvania Only) (CS371PA.C) | listed, no stance | Jan 1, 2026 | payer document |
| UnitedHealthcare | Injectable Dermal Fillers and Bulking Agents (for Tennessee Only) (CS371TN.C) | listed, no stance | Jan 1, 2026 | payer document |
Prior authorization required or conditional in IN, VT.
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.