HCPCS code G0101: Screening pelvic exam, pelvic and clinical breast exam2026 Medicare rate & RVUs in Ohio
Medicare screening pelvic and clinical breast examination for cervical or vaginal cancer, reported for asymptomatic patients at the covered 12- or 24-month screening interval.
In Ohio, Medicare pays $37.79 for G0101 in the office and $24.07 when it’s performed in a hospital or facility.
Check a contract rate as a % of Medicare · G0101 nationwide
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 11 sections
What G0101 covers
G0101 covers the hands-on pelvic and clinical breast examination furnished under Medicare's cervical and vaginal cancer screening benefit. Gynecologists, family physicians, internists, nurse practitioners, physician assistants, and certified nurse-midwives commonly perform it in office settings. The exam may occur during a well-woman appointment or alongside a Medicare annual wellness visit. Obtaining a screening Pap specimen is reported separately with Q0091 when that service is performed.
Medicare covers the screening exam every 24 months for most beneficiaries and every 12 months for patients at high risk for cervical or vaginal cancer, or of childbearing age with an abnormal Pap result in the preceding 3 years. Document the clinical breast exam and at least 7 of CMS's 11 specified examination elements, which include the breast, pelvic structures, anus and perineum, and digital rectal exam. The record and diagnosis coding should support screening intent and any claimed annual eligibility. The Part B deductible and coinsurance are waived for this screening service.
This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.
How Ohio compares for G0101
Across 109 of 109 payment localities, the office rate for G0101 runs from $35.41 in Arkansas to $50.32 in San Benito County, CA. Ohio pays $37.79. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Ohio · this page$37.79
- Los Angeles, CA · California$43.72+$5.93
- Washington, DC area · District of Columbia$44.85+$7.06
- Miami, FL · Florida$44.25+$6.46
- Chicago, IL · Illinois$42.99+$5.20
- Manhattan, NY · New York$45.74+$7.95
- Alaska · Alaska$47.52+$9.73
Other areas in Ohio first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $35.89 | $22.74 |
| ArkansasArkansas | $35.41 | $22.50 |
| ArizonaArizona | $38.71 | $24.14 |
| Bakersfield, CACalifornia | $41.29 | $24.82 |
| Chico, CACalifornia | $41.09 | $24.62 |
| El Centro, CACalifornia | $41.10 | $24.63 |
| Fresno, CACalifornia | $41.09 | $24.62 |
| Hanford, CACalifornia | $41.09 | $24.62 |
| Madera, CACalifornia | $41.09 | $24.62 |
| Merced, CACalifornia | $41.09 | $24.62 |
| Modesto, CACalifornia | $41.09 | $24.62 |
| Napa, CACalifornia | $46.75 | $26.94 |
| Oxnard, CACalifornia | $43.41 | $25.64 |
| Redding, CACalifornia | $41.09 | $24.62 |
| Rest of CaliforniaCalifornia | $41.09 | $24.62 |
| Riverside, CACalifornia | $41.85 | $25.37 |
| Sacramento, CACalifornia | $42.89 | $25.41 |
| Salinas, CACalifornia | $42.73 | $25.31 |
| San Diego, CACalifornia | $43.57 | $25.59 |
| Marin County, CACalifornia | $49.19 | $28.00 |
| San Francisco, CACalifornia | $49.11 | $27.92 |
| San Benito County, CACalifornia | $50.32 | $28.64 |
| Santa Clara County, CACalifornia | $49.99 | $28.32 |
| San Luis Obispo, CACalifornia | $42.07 | $24.95 |
| Santa Cruz, CACalifornia | $43.85 | $25.59 |
| Santa Maria, CACalifornia | $42.84 | $25.32 |
| Santa Rosa, CACalifornia | $44.28 | $25.82 |
| Stockton, CACalifornia | $41.09 | $24.62 |
| Vallejo, CACalifornia | $46.63 | $26.82 |
| Visalia, CACalifornia | $41.09 | $24.62 |
| Yuba City, CACalifornia | $41.09 | $24.62 |
| ColoradoColorado | $40.86 | $24.87 |
| ConnecticutConnecticut | $42.28 | $26.09 |
| DelawareDelaware | $39.31 | $24.46 |
| Fort Lauderdale, FLFlorida | $41.93 | $26.71 |
| Rest of FloridaFlorida | $39.92 | $25.55 |
| Atlanta, GAGeorgia | $40.62 | $25.35 |
| Rest of GeorgiaGeorgia | $37.74 | $24.34 |
| Hawaii, Guam, HIHawaii | $41.87 | $24.78 |
| IowaIowa | $36.41 | $22.65 |
| IdahoIdaho | $36.70 | $22.87 |
| East St. Louis, ILIllinois | $40.30 | $26.47 |
| Rest of IllinoisIllinois | $39.09 | $25.36 |
| Suburban Chicago, ILIllinois | $42.27 | $26.83 |
| IndianaIndiana | $36.89 | $22.95 |
| KansasKansas | $36.41 | $22.82 |
| KentuckyKentucky | $37.03 | $23.67 |
| New Orleans, LALouisiana | $38.73 | $24.58 |
| Rest of LouisianaLouisiana | $37.04 | $23.74 |
| Metropolitan Boston, MAMassachusetts | $44.50 | $26.55 |
| Rest of MassachusettsMassachusetts | $40.71 | $24.88 |
| Baltimore area, MDMaryland | $42.19 | $26.07 |
| Rest of MarylandMaryland | $39.97 | $24.76 |
| Rest of MaineMaine | $37.05 | $23.22 |
| Southern Maine, MEMaine | $38.68 | $23.78 |
| Detroit, MIMichigan | $40.56 | $26.05 |
| Rest of MichiganMichigan | $38.07 | $24.35 |
| MinnesotaMinnesota | $38.76 | $23.29 |
| Metropolitan Kansas City, MOMissouri | $38.31 | $24.19 |
| Metropolitan St. Louis, MOMissouri | $38.66 | $24.35 |
| Rest of MissouriMissouri | $36.55 | $23.60 |
| MississippiMississippi | $35.98 | $23.04 |
| MontanaMontana | $39.74 | $24.71 |
| North CarolinaNorth Carolina | $37.38 | $23.36 |
| North DakotaNorth Dakota | $38.36 | $23.33 |
| NebraskaNebraska | $36.54 | $22.67 |
| New HampshireNew Hampshire | $40.39 | $24.74 |
| Northern New JerseyNew Jersey | $44.47 | $27.03 |
| Rest of New JerseyNew Jersey | $42.65 | $26.24 |
| New MexicoNew Mexico | $38.33 | $24.55 |
| NevadaNevada | $39.38 | $24.33 |
| NYC suburbs and Long Island, NYNew York | $46.98 | $29.11 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $43.06 | $26.60 |
| Queens, NYNew York | $45.85 | $28.09 |
| Rest of New YorkNew York | $37.92 | $23.64 |
| OklahomaOklahoma | $36.80 | $23.37 |
| Portland, OROregon | $41.90 | $25.21 |
| Rest of OregonOregon | $38.96 | $23.99 |
| Metropolitan Philadelphia, PAPennsylvania | $41.39 | $25.75 |
| Rest of PennsylvaniaPennsylvania | $37.76 | $23.96 |
| Puerto RicoPuerto Rico | $39.96 | $24.77 |
| Rhode IslandRhode Island | $40.52 | $25.00 |
| South CarolinaSouth Carolina | $37.67 | $23.78 |
| South DakotaSouth Dakota | $38.19 | $23.16 |
| TennesseeTennessee | $36.60 | $22.94 |
| Austin, TXTexas | $40.83 | $24.93 |
| Beaumont, TXTexas | $37.54 | $23.86 |
| Brazoria, TXTexas | $39.15 | $24.25 |
| Dallas, TXTexas | $39.46 | $24.49 |
| Fort Worth, TXTexas | $39.26 | $24.44 |
| Galveston, TXTexas | $39.30 | $24.38 |
| Houston, TXTexas | $40.58 | $25.66 |
| Rest of TexasTexas | $38.36 | $24.10 |
| UtahUtah | $38.15 | $24.02 |
| VirginiaVirginia | $38.67 | $23.90 |
| Virgin Islands, VIUnited States Virgin Islands | $39.96 | $24.77 |
| VermontVermont | $38.36 | $23.48 |
| Rest of WashingtonWashington | $40.58 | $24.76 |
| King County, WAWashington | $45.21 | $26.77 |
| WisconsinWisconsin | $37.18 | $22.78 |
| West VirginiaWest Virginia | $37.78 | $24.72 |
| WyomingWyoming | $39.14 | $24.11 |
G0101 rates by state
Office rate range in each state. Select a state to see its payment localities.
Explore a state
Local rates. Clear comparisons.
Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.
$35.41
$47.52
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $47.52 | 1 |
| AL | $35.89 | 1 |
| AR | $35.41 | 1 |
| AZ | $38.71 | 1 |
| CA | $41.09–$50.32 | 29 |
| CO | $40.86 | 1 |
| CT | $42.28 | 1 |
| DC | $44.85 | 1 |
| DE | $39.31 | 1 |
| FL | $39.92–$44.25 | 3 |
| GA | $37.74–$40.62 | 2 |
| GU | $41.87 | 1 |
| HI | $41.87 | 1 |
| IA | $36.41 | 1 |
| ID | $36.70 | 1 |
| IL | $39.09–$42.99 | 4 |
| IN | $36.89 | 1 |
| KS | $36.41 | 1 |
| KY | $37.03 | 1 |
| LA | $37.04–$38.73 | 2 |
| MA | $40.71–$44.50 | 2 |
| MD | $39.97–$44.85 | 3 |
| ME | $37.05–$38.68 | 2 |
| MI | $38.07–$40.56 | 2 |
| MN | $38.76 | 1 |
| MO | $36.55–$38.66 | 3 |
| MS | $35.98 | 1 |
| MT | $39.74 | 1 |
| NC | $37.38 | 1 |
| ND | $38.36 | 1 |
| NE | $36.54 | 1 |
| NH | $40.39 | 1 |
| NJ | $42.65–$44.47 | 2 |
| NM | $38.33 | 1 |
| NV | $39.38 | 1 |
| NY | $37.92–$46.98 | 5 |
| OH | $37.79 | 1 |
| OK | $36.80 | 1 |
| OR | $38.96–$41.90 | 2 |
| PA | $37.76–$41.39 | 2 |
| PR | $39.96 | 1 |
| RI | $40.52 | 1 |
| SC | $37.67 | 1 |
| SD | $38.19 | 1 |
| TN | $36.60 | 1 |
| TX | $37.54–$40.83 | 8 |
| UT | $38.15 | 1 |
| VA | $38.67–$44.85 | 2 |
| VI | $39.96 | 1 |
| VT | $38.36 | 1 |
| WA | $40.58–$45.21 | 2 |
| WI | $37.18 | 1 |
| WV | $37.78 | 1 |
| WY | $39.14 | 1 |
How the G0101 rate is calculated
Each of G0101’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · G0101
RVUs × geographic indexes × conversion factor
Work0.44
0.44 RVUs× 1.000 GPCI
Practice expense0.68
0.68 RVUs× 1.000 GPCI
Malpractice0.07
0.07 RVUs× 1.000 GPCI
Adjusted RVUs
1.1900
Conversion factor
$33.4009
Medicare rate
$39.75
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Ohio inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
15,083
- Code
- G0101
- Physician work
- 0.44
- Practice expense
- 0.68
- Malpractice
- 0.07
GPCI2026.csv
85
- Locality
- Ohio
- Physician work
- 1.000
- Practice expense
- 0.913
- Malpractice
- 1.008
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.44 | × 1.000 | 0.4400 |
| Practice expense | 0.68 | × 0.913 | 0.6208 |
| Malpractice | 0.07 | × 1.008 | 0.0706 |
| Total RVUs | 1.1314 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Ohio$37.79
Office: (0.44 × 1 + 0.68 × 0.913 + 0.07 × 1.008) × $33.4009 = $37.79
Facility: (0.44 × 1 + 0.23 × 0.913 + 0.07 × 1.008) × $33.4009 = $24.07
Payment rules and modifiers for G0101
G0101 has no global surgery period, no multiple-procedure, bilateral or assistant-at-surgery adjustment, and no professional/technical split. What changes the payment is where the service happens: the place of service on the claim decides whether Medicare pays the office or the facility rate.
Place of service · G0101
Which rate does Medicare pay?
The POS code on the claim line (CMS-1500 box 24B).
POS 11 · non-facility rate · national
$39.75
- Non-facility (office)
- $39.75
- Facility
- $24.72
Higher because the practice carries its own overhead.
How G0101 has changed in Ohio
G0101 · Office / nonfacility
$37.79
Effective 2026-10-01
The base rate is $1.78 higher than on 2025-10-01, moving from $36.01 to $37.79 (4.9%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.
What changed, release by release
January 1, 2026
RVU26A
$36.01changed to$37.79
- Conversion factor 32.3465 changed to 33.4009
- Work RVU 0.45 changed to 0.44
- Practice expense RVU 0.66 changed to 0.68
- Malpractice RVU 0.06 changed to 0.07
- Practice expense GPCI 0.911 changed to 0.913
- Malpractice GPCI 1.033 changed to 1.008
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$37.40changed to$36.01
- Conversion factor 33.2875 changed to 32.3465
- Malpractice RVU 0.07 changed to 0.06
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$36.79changed to$37.40
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$37.86changed to$36.79
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 0.65 changed to 0.66
- Practice expense GPCI 0.912 changed to 0.911
- Malpractice GPCI 1.063 changed to 1.033
January 1, 2023
RVU23A
$38.51changed to$37.86
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 0.63 changed to 0.65
- Malpractice RVU 0.08 changed to 0.07
- Practice expense GPCI 0.913 changed to 0.912
- Malpractice GPCI 1.094 changed to 1.063
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$38.06changed to$38.51
- Conversion factor 34.8931 changed to 34.6062
- Malpractice RVU 0.06 changed to 0.08
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$39.08changed to$38.06
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 0.60 changed to 0.63
- Malpractice RVU 0.08 changed to 0.06
- Practice expense GPCI 0.915 changed to 0.913
- Malpractice GPCI 1.049 changed to 1.094
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$37.86changed to$39.08
- Conversion factor 36.0391 changed to 36.0896
- Malpractice RVU 0.05 changed to 0.08
- Practice expense GPCI 0.917 changed to 0.915
- Malpractice GPCI 1.005 changed to 1.049
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$37.16changed to$37.86
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 0.58 changed to 0.60
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$37.38changed to$37.16
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 0.59 changed to 0.58
- Practice expense GPCI 0.918 changed to 0.917
- Malpractice GPCI 0.999 changed to 1.005
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$36.95changed to$37.38
- Conversion factor 35.8043 changed to 35.8887
- Practice expense RVU 0.58 changed to 0.59
- Malpractice GPCI 0.993 changed to 0.999
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$37.09changed to$36.95
- Conversion factor 35.9335 changed to 35.8043
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$36.90changed to$37.09
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$36.50changed to$36.90
- Conversion factor 35.8228 changed to 35.7547
- Malpractice RVU 0.03 changed to 0.05
- Practice expense GPCI 0.923 changed to 0.918
- Malpractice GPCI 1.117 changed to 0.993
Held through RVU15B.
January 1, 2014
RVU14A
$36.76changed to$36.50
- Conversion factor 34.0230 changed to 35.8228
- Practice expense RVU 0.64 changed to 0.58
- Practice expense GPCI 0.927 changed to 0.923
- Malpractice GPCI 1.240 changed to 1.117
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $36.76
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $37.79 | $24.07 | RVU26D |
| 2026-07-01 | $37.79 | $24.07 | RVU26C |
| 2026-04-01 | $37.79 | $24.07 | RVU26B |
| 2026-01-01 | $37.79 | $24.07 | RVU26A |
| 2025-10-01 | $36.01 | $25.40 | RVU25D |
| 2025-07-01 | $36.01 | $25.40 | RVU25C |
| 2025-04-01 | $36.01 | $25.40 | RVU25B |
| 2025-01-01 | $36.01 | $25.40 | RVU25A |
| 2024-10-01 | $37.40 | $26.48 | RVU24D |
| 2024-07-01 | $37.40 | $26.48 | RVU24C |
| 2024-04-01 | $37.40 | $26.48 | RVU24B |
| 2024-03-09 | $37.40 | $26.48 | RVU24AR |
| 2024-01-01 | $36.79 | $26.05 | RVU24A |
| 2023-10-01 | $37.86 | $27.04 | RVU23D |
| 2023-07-01 | $37.86 | $27.04 | RVU23C |
| 2023-04-01 | $37.86 | $27.04 | RVU23B |
| 2023-01-01 | $37.86 | $27.04 | RVU23A |
| 2022-10-01 | $38.51 | $27.76 | RVU22D |
| 2022-07-01 | $38.51 | $27.76 | RVU22C |
| 2022-04-01 | $38.51 | $27.76 | RVU22B |
| 2022-01-01 | $38.51 | $27.76 | RVU22A |
| 2021-10-01 | $38.06 | $27.23 | RVU21D |
| 2021-07-01 | $38.06 | $27.23 | RVU21C |
| 2021-04-01 | $38.06 | $27.23 | RVU21B |
| 2021-01-01 | $38.06 | $27.23 | RVU21A |
| 2020-10-01 | $39.08 | $28.52 | RVU20D |
| 2020-07-01 | $39.08 | $28.52 | RVU20C |
| 2020-04-01 | $39.08 | $28.52 | RVU20B |
| 2020-01-01 | $39.08 | $28.52 | RVU20A |
| 2019-10-01 | $37.86 | $27.28 | RVU19D |
| 2019-07-01 | $37.86 | $27.28 | RVU19C |
| 2019-04-01 | $37.86 | $27.28 | RVU19B |
| 2019-01-01 | $37.86 | $27.28 | RVU19A |
| 2018-10-01 | $37.16 | $27.58 | RVU18D |
| 2018-07-01 | $37.16 | $27.58 | RVU18C |
| 2018-04-01 | $37.16 | $27.58 | RVU18B |
| 2018-01-01 | $37.16 | $27.58 | RVU18AR1 |
| 2017-10-01 | $37.38 | $27.83 | RVU17D |
| 2017-07-01 | $37.38 | $27.83 | RVU17C |
| 2017-04-01 | $37.38 | $27.83 | RVU17B |
| 2017-01-01 | $37.38 | $27.83 | RVU17A |
| 2016-10-01 | $36.95 | $27.42 | RVU16D |
| 2016-07-01 | $36.95 | $27.42 | RVU16C |
| 2016-04-01 | $36.95 | $27.42 | RVU16B |
| 2016-01-01 | $36.95 | $27.42 | RVU16A |
| 2015-10-01 | $37.09 | $27.52 | RVU15D |
| 2015-07-01 | $37.09 | $27.52 | RVU15C |
| 2015-04-01 | $36.90 | $27.38 | RVU15B |
| 2015-01-01 | $36.90 | $27.38 | RVU15A |
| 2014-10-01 | $36.50 | $26.91 | RVU14D |
| 2014-07-01 | $36.50 | $26.91 | RVU14C |
| 2014-04-01 | $36.50 | $26.91 | RVU14B |
| 2014-01-01 | $36.50 | $26.91 | RVU14A |
| 2013-10-01 | $36.76 | $26.67 | RVU13D |
| 2013-07-01 | $36.76 | $26.67 | RVU13C |
| 2013-04-01 | $36.76 | $26.67 | RVU13B |
| 2013-01-01 | $36.76 | $26.67 | RVU13AR |
Where the Ohio rate applies
Ohio is a Medicare payment area, not a city. Our Census mapping connects it to 1265 cities and communities in Ohio. Some span more than one payment area; confirm with the service ZIP.
- Aberdeen
- Ada
- Adamsville
- Addyston
- Adelphi
- Adena
- Ai
- Akron
G0101 billing questions
How is this code billed alongside a preventive visit such as 99397 for a Medicare patient?
Traditional Medicare does not cover the routine preventive medicine visit described by 99397. Report G0101 for the eligible screening pelvic and breast exam, and Q0091 if a screening Pap specimen is collected; avoid counting those services twice in any separately billed visit.
Does this code include obtaining the Pap smear?
No. Collecting and conveying the screening Pap specimen to the laboratory is reported separately with Q0091. Screening cytology is a separate laboratory service.
What documentation supports the exam?
The record should document the clinical breast exam and at least 7 of the 11 CMS-listed examination elements. It should also support screening intent and any high-risk status used for annual eligibility.
Can a problem-oriented E/M be billed on the same date?
Yes, if the clinician performs a significant, separately identifiable evaluation and management of a problem beyond the screening exam. Append modifier 25 to the E/M code, and do not count the screening work toward that service.
When does the annual frequency apply instead of every 24 months?
The 12-month interval applies with documented high-risk factors for cervical or vaginal cancer, or when a patient of childbearing age had an abnormal Pap result in the preceding 3 years. The claim should include a diagnosis supporting the qualifying status.
Can it be billed for a patient who has had a hysterectomy?
Yes, when an eligible screening pelvic and breast exam is performed, including screening for vaginal cancer after hysterectomy. The applicable screening interval still governs coverage.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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