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G9838 HCPCS Level II code: Patient has metastatic disease at diagnosis

G9838 is the HCPCS code for “Patient has metastatic disease at diagnosis” in CMS’s October 2026 release, in effect from Oct 1, 2026.

Official description

G9838

Patient has metastatic disease at diagnosis

Short description: Pt met dis at dx

HCPCS · United States

Medicare details

The indicators CMS publishes with G9838 in its October 2026 file. They describe Medicare’s handling, not another payer’s.

Medicare coverage
Carrier judgment
Medicare pricing
Service not separately priced by Part B (e.g., services not covered, bundled, used by Part A only, etc.)
Type of service
Medical care
BETOS category
Undefined codes
Added
Jan 1, 2017

Where G9838 sits

  1. 1G codesProcedures and professional services
  2. 2Active code G9838Patient has metastatic disease at diagnosis

Source and release

Data release
HCPCS Level II · October 2026
Effective date
Oct 1, 2026
Publisher
CMS

This page is built from the HCPCS Level II catalog that Vero Codes reads when it suggests codes: Centers for Medicare & Medicaid Services’s October 2026 release, imported from the publisher’s file and checked against it. The description, notes and structured data come from the same record.

See G9838 in the CMS source

Frequently asked questions

What does HCPCS code G9838 mean?

G9838 is the HCPCS code for “Patient has metastatic disease at diagnosis” in CMS’s HCPCS Level II October 2026 release.

Does Medicare cover G9838?

CMS lists G9838’s Medicare coverage as “Carrier judgment” and its pricing as “Service not separately priced by Part B (e.g., services not covered, bundled, used by Part A only, etc.)”. Coverage and payment still depend on the patient, the setting, the documentation and the payer.

Which HCPCS Level II release does this page use?

It uses CMS’s October 2026 release, in effect from Oct 1, 2026 to Dec 31, 2026. It is a reference: confirm the code against the current list and the payer’s rules before you submit it.

Codes beside G9838

G9832Ajcc stage at breast cancer diagnosis = i (ia or ib) and t-stage at breast cancer diagnosis = t1cG9833Patient transfer to practice after initiation of chemotherapyG9834Patient has metastatic disease at diagnosisG9835Trastuzumab administered within 12 months of diagnosisG9836Reason for not administering trastuzumab documented (e.g. patient declined, patient died, patient transferred, contraindication or other clinical exclusion, neoadjuvant…G9837Trastuzumab not administered within 12 months of diagnosisG9839Anti-egfr monoclonal antibody therapyG9840Ras (kras and nras) gene mutation testing performed before initiation of anti-egfr moabG9841Ras (kras and nras) gene mutation testing not performed before initiation of anti-egfr moabG9842Patient has metastatic disease at diagnosisG9843Ras (kras or nras) gene mutationG9844Patient did not receive anti-egfr monoclonal antibody therapy