HCPCS Level II modifier
Modifier G5
Modifier G5 is a HCPCS Level II modifier. CMS describes it as: Most recent urr reading of 75 or greater.
Source: CMS HCPCS Level II, October 2026 file dated September 23, 2026. Publisher page
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- Modifier
- G5
- Type
- HCPCS Level II modifier, maintained by CMS
- CMS description
- Most recent urr reading of 75 or greater
- Claim form
- CMS-1500 item 24D, up to four modifiers per line. 837P SV101-3 to SV101-6.
- Guidance
- CMS HCPCS quarterly update
Related modifiers
- G6ESRD patient for whom less than six dialysis sessions have been provided in a month
- G4Most recent urr reading of 70 to 74.9
- G7Pregnancy resulted from rape or incest or pregnancy certified by physician as life threatening
- G3Most recent urr reading of 65 to 69.9
- G8Monitored anesthesia care (MAC) for deep complex, complicated, or markedly invasive surgical procedure
- G2Most recent urr reading of 60 to 64.9
- G9Monitored anesthesia care for patient who has history of severe cardio-pulmonary condition
- G1Most recent urr reading of less than 60
Related pages
Questions
What does modifier G5 mean?
Modifier G5 is a HCPCS Level II modifier. CMS describes it as: Most recent urr reading of 75 or greater.
Is modifier G5 a CPT or a HCPCS modifier?
G5 is a HCPCS Level II modifier from the CMS quarterly HCPCS file. Two-digit numeric modifiers, such as 25 or 59, are CPT modifiers.
Where does modifier G5 go on a claim?
On the CMS-1500 it goes in item 24D next to the procedure code. Each line holds up to four modifiers. On an 837P it goes in SV101-3 to SV101-6.
What denial comes back when a modifier is wrong?
A missing or mismatched modifier often comes back as CARC 4. A modifier that was not valid on the date of service comes back as CARC 182. A bundling edit the modifier should have bypassed comes back as CARC 97 or 236.