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    v1.0.28
    OpenPayerBilling CodesProcedures / Professional ServicesHCPCS hcpcs-level-ii-g0460-autologous-prp-non-diabetic-chronic-wound-treatment
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    HCPCS G0460: Autologous Platelet-Rich Plasma for Chronic Wounds

    HCPCS Level II code G0460 describes provision of autologous platelet-rich plasma or other blood-derived products for treatment of non-diabetic chronic wounds or ulcers, including phlebotomy, centrifugation or mixing, preparatory procedures, administration and dressings per treatment; this is a wound care service typically performed in outpatient wound clinics, ambulatory surgery centers, or physician office settings and involves blood draw, processing, and application of the biologic product to promote chronic wound healing.

    For related coverage guidance, see recent payer policy updates: Esophagogastroduodenoscopy (EGD) Coverage Policy, Magnetic Sphincter Augmentation for the Treatment of Gastroesophageal Reflux Disease (GERD), Fecal Analysis in the Diagnosis of Intestinal Dysbiosis and Fecal Microbiota Transplant Testing.

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    Table of contents

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    Clinical & Coding Specifications

    Clinical Context

    A 67-year-old patient with a chronic non-healing venous leg ulcer present for 6 months despite standard wound care (compression therapy, debridement, topical dressings) presents to an outpatient wound care clinic. The wound measures 3.0 x 2.5 cm with granulation tissue but stalled healing. After clinical assessment and documentation of prior therapies and wound measurements, the treating clinician recommends autologous platelet-rich plasma (PRP) application. The clinical workflow includes informed consent, phlebotomy for autologous blood draw, centrifugation and preparation of the platelet-rich product in a sterile field, wound bed preparation and any necessary debridement, application of the PRP or blood-derived product to the wound, and placement of an appropriate dressing. The procedure is performed during an outpatient clinic visit or ambulatory surgical center encounter. Post-treatment instructions and scheduled wound follow-up visits for dressing changes and reassessment are documented. Billing uses G0460 per treatment, with documentation of diagnosis, prior conservative care, procedure steps (phlebotomy, centrifugation, application), and any supplies or dressings used.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    96372Therapeutic, prophylactic, or diagnostic injection (e.g., subcutaneous, intramuscular)May be used when an injectable blood-derived product is administered subcutaneously as part of wound therapy in certain workflows.
    11042Debridement, subcutaneous tissue (first 20 sq cm or less)Commonly performed immediately prior to G0460 to prepare the wound bed for application of PRP.
    11043Debridement, muscle and/or fascia (first 20 sq cm or less)Used when deeper debridement is clinically necessary before application of the blood-derived product.
    99406Smoking and tobacco use cessation counseling, intermediate, 3-10 minutesFrequently billed during clinic encounters when counseling on modifiable risk factors (e.g., smoking) occurs alongside wound care.
    99070Supplies and materials (except for those usually included with the procedure)Used to report additional dressings, specialized kits, or disposables associated with PRP preparation/application when not included in G0460 reimbursement.

    Related Modifiers

    9 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…
    55Modifier –55 indicates the billing provider furnished only postoperative management for a procedure that has a global surgical period. According to AAPC, this modifier is appended to the same CPT…- Use modifier -55 when billing the same CPT surgical code that has a 10- or 90-day global period and you, as a provider other than the original surgeon, furnished ONLY postoperative management (no…
    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…
    73Modifier 73 indicates a facility-level outpatient hospital or ASC procedure that was discontinued after the patient was prepared and taken to the procedure/operating room but before any anesthesia…- When to use: Apply CPT modifier 73 on the FACILITY (outpatient hospital or ASC) claim when the patient has been fully prepared and physically taken into the procedure/operating room but 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…
    82Modifier 82 is appended to a surgical CPT code to indicate that an attending physician acted as an assistant because a qualified resident surgeon was unavailable. In teaching hospitals it documents…- When to use: Append modifier 82 in teaching-hospital settings to indicate a physician served as an assistant surgeon because a qualified resident surgeon was unavailable (includes situations where…

    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…
    208800000XUrology PhysicianA urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has compreh…
    363A00000XPhysician AssistantA physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and…
    246QM0900XMicrobiology Specialist/TechnologistTechnologists, Technicians & Other Technical Service Providers · Specialist/Technologist, Pathology
    1835P0018XPharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistPharmacist Clinician/Clinical Pharmacy Specialist is a pharmacist with additional training and an expanded scope of practice that may include prescrip…
    207ZP0104XChemical Pathology PhysicianA chemical pathologist has expertise in the biochemistry of the human body as it applies to the understanding of the cause and progress of disease. Th…
    136A00000XRegistered Dietetic TechnicianA Dietetic Technician, Registered (DTR)/Nutrition and Dietetics Technician, Registered (NDTR) is an individual holding a nationally protected title is…

    Related ICD-10-CM Codes

    26 rows

    ICD-10-CM CodeDescription
    E11.621Type 2 diabetes mellitus with foot ulcer
    E11.622Type 2 diabetes mellitus with other skin ulcer
    I83.011Varicose veins of right lower extremity with ulcer of thigh
    I83.019Varicose veins of right lower extremity with ulcer of unspecified site
    I87.2Venous insufficiency (chronic) (peripheral)
    L97.101Non-pressure chronic ulcer of unspecified thigh limited to breakdown of skin
    L97.102Non-pressure chronic ulcer of unspecified thigh with fat layer exposed
    L97.103Non-pressure chronic ulcer of unspecified thigh with necrosis of muscle
    L97.109Non-pressure chronic ulcer of unspecified thigh with unspecified severity
    L97.311Non-pressure chronic ulcer of right ankle limited to breakdown of skin

    Showing 1–10 of 26

    Related Payer Policy Updates

    Specialty: Gastroenterology1 / 3

    7 rows

    PolicyPayerEffective Date
    Esophagogastroduodenoscopy (EGD) Coverage Policyevicore2026-11-05
    Magnetic Sphincter Augmentation for the Treatment of Gastroesophageal Reflux Disease (GERD)univerahealthcare2026-10-15
    Fecal Analysis in the Diagnosis of Intestinal Dysbiosis and Fecal Microbiota Transplant TestingOscar Health2026-10-01
    Serum Testing for Hepatic Fibrosis in the Evaluation and Monitoring of Chronic Liver DiseaseOscar Health2026-10-01
    Pancreatic Enzyme Testing for Acute PancreatitisOscar Health2026-10-01
    Helicobacter pylori TestingOscar Health2026-10-01
    Celiac Disease TestingOscar Health2026-10-01

    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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