LEVEL II Modifiers G1, G2,G3, G4,G5,G6

G1    Most Recent URR of less than 60%
G2    Most Recent URR of 60% to 64.9%
G3    Most Recent URR of 65% to 69.9%
G4    Most Recent URR of 70% to 74.9%
G5    Most Recent URR of 75% or Greater
G6    ESRD Patient for Whom less than 7 Dialysis Sessions have been provided in a Month
GA    Waiver of liability on file
GC    Service Performed, in part, by a Resident under the Direction of a Teaching Physician
GF    non-physician services in a critical access hospital (CAH) electing the All-Inclusive payment method.
GG    Performance and payment of screening & diagnostic mammogram same day/same patient
GH    Diagnostic mammogram converted to a screening mammogram on the same day
GN    Services delivered under an outpatient speech-language pathology
GO    Services delivered under an outpatient occupational therapy
GP    Services delivered under an outpatient physical therapy
GY    Item/Service is statutorily excluded or does not meet the definition of a Medicare benefit
GZ    No signed ABN on file