2024 HCPCS Code G0465

Autologous platelet rich plasma (prp) or other blood-derived product for diabetic chronic wounds/ulcers, using an fda-cleared device for this indication, (includes as applicable administration, dressings, phlebotomy, centrifugation or mixing, and all other preparatory procedures, per treatment)

Short Description	Autolog prp diab wound ulcer
HCPCS Coverage Code	C - Carrier judgment
HCPCS Action Code	N - No maintenance for this code
HCPCS Action Effective Date	July 01, 2023
HCPCS Code Added Date	April 13, 2021
HCPCS Pricing Indicator Code	13 - Price established by carriers (e.G., not otherwise classified, individual determination, carrier discretion)
HCPCS Multiple Pricing Indicator Code	A - Not applicable as HCPCS priced under one methodology
HCPCS Coverage Issues Manual Reference Section Number
HCPCS Type Of Service Code	1 - Medical care
HCPCS Anesthesia Base Unit Quantity	0