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    v1.0.28
    OpenPayerBilling CodesProcedures / Professional ServicesHCPCS hcpcs-g0455-fecal-microbiota-instillation-preparation
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    HCPCS G0455: Preparation with Instillation of Fecal Microbiota

    HCPCS Level II code G0455 describes preparation with instillation of fecal microbiota by any method, including assessment of donor specimen; the service is a therapeutic microbiota transplant procedure (instillation of donor fecal material) typically performed in an outpatient or ambulatory clinical setting or endoscopy suite and involves preparation, testing/assessment of donor specimen, and delivery of microbiota to the recipient.

    For related coverage guidance, see recent payer policy updates: Esophagogastroduodenoscopy (EGD) Coverage Policy, Magnetic Sphincter Augmentation for the Treatment of Gastroesophageal Reflux Disease (GERD), Serum Testing for Hepatic Fibrosis in the Evaluation and Monitoring of Chronic Liver Disease.

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    Table of contents

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    • Billing CodesCPT, HCPCS, DRG & more
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    Clinical & Coding Specifications

    Clinical Context

    A typical patient is a 62-year-old adult with recurrent Clostridioides difficile infection who has failed multiple courses of appropriate antibiotic therapy. After infectious disease and gastroenterology evaluation, the patient is scheduled for fecal microbiota transplantation (FMT). The clinical workflow begins with donor screening and specimen preparation in the laboratory, including infectious disease testing and stool processing. On the day of treatment the patient is prepped in an outpatient endoscopy suite or ambulatory procedure room: informed consent is confirmed, baseline vital signs documented, and any procedural sedation or anesthesia is administered as indicated. The FMT material is instilled by colonoscopic infusion into the cecum or via retention enema depending on clinical judgment and patient factors. Post-procedure monitoring includes assessment for immediate adverse events, documentation of donor specimen testing, and follow-up visits to assess resolution of infection and any delayed complications. Typical sites of service include outpatient hospital endoscopy units, ambulatory surgical centers, or hospital inpatient units when the patient is already admitted.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    45378Colonoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)Often used when FMT is delivered via colonoscopic instillation; documents the colonoscopy portion of the encounter when billed separately under applicable payer rules.
    45380Colonoscopy, flexible; with biopsy, single or multipleMay be reported if mucosal biopsies are obtained during the same colonoscopic session as FMT instillation.
    99213Office or other outpatient visit for the evaluation and management of an established patient, typically 15 minutesCommonly used for pre-procedure evaluation or routine follow-up visits related to FMT when appropriate.
    96372Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intramuscularUse if any injection or instillation (non-endoscopic) approach is used and a payer requires a contemporaneous injection code (use per payer guidance).
    99152Moderate sedation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service, initial 15 minutesReport when moderate sedation is provided by the FMT-performing physician during the procedure and payer rules permit separate reporting.

    Related Modifiers

    11 rows

    ModifierDescriptionWhen to Use
    22Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
    23Modifier -23 (Unusual Anesthesia) is used on anesthesia service CPT codes when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia…- Use modifier -23 only on anesthesia CPT codes (00100–01999) when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia because of…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    59Modifier 59 indicates a distinct procedural service when two procedures that are not normally billed together are clinically and procedurally separate. The CPT definition (as reiterated by CMS)…- Use modifier -59 to report a distinct procedural service when documentation supports that the procedure reported is not normally billed together with another service on the same day because of a…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    66Modifier 66 (Surgical Team) is used when three or more surgeons act as primary surgeons on a single, highly complex procedure. The AMA defines it for use when a surgical team — often composed of…- Use modifier 66 when three or more surgeons act as primary surgeons working collaboratively as a surgical team on a single, highly complex or difficult procedure (for example organ…
    78CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
    80CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…
    81Modifier -81 indicates a physician served as a minimal assistant surgeon for part—not all—of an operative procedure. Use when a physician’s assisting role is limited and does not represent full…- Use CPT modifier -81 when a physician acts as a minimum assistant surgeon who assists during only part (a limited portion) of an operative procedure; append -81 to the primary surgical CPT code to…

    Showing 1–10 of 11

    Related Provider Taxonomies

    8 rows

    Taxonomy CodeSpecialtyNotes
    207Q00000XFamily Medicine PhysicianFamily Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadt…
    207L00000XAnesthesiology PhysicianAn anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an opera…
    208600000XSurgery PhysicianA general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of s…
    207K00000XAllergy & Immunology PhysicianAn allergist-immunologist is trained in evaluation, physical and laboratory diagnosis, and management of disorders involving the immune system. Select…
    207R00000XInternal Medicine PhysicianA physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults…
    2081P0010XPediatric Rehabilitation Medicine PhysicianA physiatrist who utilizes an interdisciplinary approach and addresses the prevention, diagnosis, treatment and management of congenital and childhood…
    163W00000XRegistered Nurse(1) A registered nurse is a person qualified by graduation from an accredited nursing school (depending upon schooling, a registered nurse may receive…
    174N00000XLactation Consultant (Non-RN)An individual trained to provide breastfeeding assistance services to both mothers and infants. Lactation Consultants are not required to be nurses an…

    Related ICD-10-CM Codes

    26 rows

    ICD-10-CM CodeDescription
    A04.72Enterocolitis due to Clostridium difficile, not specified as recurrent
    A04.8Other specified bacterial intestinal infections
    A04.9Bacterial intestinal infection, unspecified
    A06.9Amebiasis, unspecified
    A07.1Giardiasis [lambliasis]
    A07.2Cryptosporidiosis
    A09Infectious gastroenteritis and colitis, unspecified
    K52.89Other specified noninfective gastroenteritis and colitis
    K52.9Noninfective gastroenteritis and colitis, unspecified
    K57.20Diverticulitis of large intestine with perforation and abscess without bleeding

    Showing 1–10 of 26

    Related Payer Policy Updates

    Specialty: Gastroenterology1 / 3

    10 rows

    PolicyPayerEffective Date
    Esophagogastroduodenoscopy (EGD) Coverage Policyevicore2026-11-05
    Magnetic Sphincter Augmentation for the Treatment of Gastroesophageal Reflux Disease (GERD)univerahealthcare2026-10-15
    Serum Testing for Hepatic Fibrosis in the Evaluation and Monitoring of Chronic Liver DiseaseOscar Health2026-10-01
    Fecal Analysis in the Diagnosis of Intestinal Dysbiosis and Fecal Microbiota Transplant TestingOscar Health2026-10-01
    Pancreatic Enzyme Testing for Acute PancreatitisOscar Health2026-10-01
    Helicobacter pylori TestingOscar Health2026-10-01
    Celiac Disease TestingOscar Health2026-10-01
    Laboratory Testing for the Diagnosis of Inflammatory Bowel DiseaseOscar Health2026-10-01
    Percutaneous Electrical Nerve Field Stimulation (PENFS)Cigna2026-09-15
    Colorectal Cancer ScreeningBlue Cross Blue Shield - New Mexico2026-09-04

    Related Codes

    HCPCS-G9490-HOME-ASSESSMENT-NON-HOMEBOUND

    HCPCS G9490: Home Visit Patient Assessment for Non-Homebound Beneficiary

    HCPCS-G0008-INFLUENZA-VACCINE-ADMINISTRATION

    HCPCS G0008: Administration of Influenza Virus Vaccine

    HCPCS-G0009-PNEUMOCOCCAL-VACCINE-ADMINISTRATION

    HCPCS G0009: Administration of Pneumococcal Vaccine

    HCPCS-G0010-HEPATITIS-B-VACCINE-ADMINISTRATION

    HCPCS G0010: Administration of Hepatitis B Vaccine

    HCPCS-G0011-PREP-COUNSELING-HIV-RISK-REDUCTION-ADHERENCE

    HCPCS G0011: Individual PrEP Counseling, HIV Risk Assessment

    HCPCS-G0012-PRE-EXPOSURE-PROPHYLAXIS-INJECTION-HIV-PREVENTION

    HCPCS G0012: Injection of PrEP Drug for HIV Prevention

    HCPCS-G0013-PREP-INDIVIDUAL-COUNSELING-HIV-RISK-REDUCTION

    HCPCS G0013: Individual PrEP Counseling by Clinical Staff

    HCPCS-G0017-PSYCHOTHERAPY-CRISIS-FIRST-60-MINUTES-NON-OFFICE

    HCPCS G0017: Psychotherapy for Crisis, First 60 Minutes

    HCPCS-G0018-PSYCHOTHERAPY-CRISIS-ADDITIONAL-30-MINUTES-NON-OFFICE

    HCPCS G0018: Psychotherapy for Crisis, Additional 30 Minutes

    HCPCS-G0019-COMMUNITY-HEALTH-INTEGRATION-SDOH-CARE-COORDINATION

    HCPCS G0019: Community Health Integration, Person-Centered Assessment

    Showing 1–10 of 1996

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    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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