HCPCS code G0101: Screening pelvic exam, pelvic and clinical breast exam2026 Medicare rate & RVUs in Dallas, TX

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.

CMS RVU26DEffective Oct 1, 2026One payment locality728.7K Medicare services in 2024

In Dallas, TX, Medicare pays $39.46 for G0101 in the office and $24.49 when it’s performed in a hospital or facility.

$39.46Office (non-facility)
$24.49Hospital or facility
−0.7%vs the national office rate ($39.75)

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.

We’ll open G0101 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Dallas, TX
  2. What G0101 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

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 Dallas, TX 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. Dallas, TX pays $39.46. The RVUs are the same everywhere; the geographic indexes change the dollars.

G0101 in Dallas, TX vs other payment areas
  1. Dallas, TX · this page$39.46
  2. Austin, TX · Texas$40.83+$1.37
  3. Beaumont, TX · Texas$37.54−$1.92
  4. Brazoria, TX · Texas$39.15−$0.31
  5. Fort Worth, TX · Texas$39.26−$0.20
  6. Galveston, TX · Texas$39.30−$0.16
  7. Houston, TX · Texas$40.58+$1.12

Other areas in Texas first, then benchmark localities. Bars start at $0.

Every other payment area

G0101 in every other Medicare payment locality
Payment localityOfficeFacility
Rest of TexasTexas$38.36$24.10
Los Angeles, CACalifornia$43.72$25.94
Washington, DC areaDistrict of Columbia$44.85$27.14
Miami, FLFlorida$44.25$28.61
Chicago, ILIllinois$42.99$27.89
Manhattan, NYNew York$45.74$28.27
AlaskaAlaska$47.52$31.51
AlabamaAlabama$35.89$22.74

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
G0101 office rate range by state
State / territoryOffice rate rangeLocalities
AK$47.521
AL$35.891
AR$35.411
AZ$38.711
CA$41.09–$50.3229
CO$40.861
CT$42.281
DC$44.851
DE$39.311
FL$39.92–$44.253
GA$37.74–$40.622
GU$41.871
HI$41.871
IA$36.411
ID$36.701
IL$39.09–$42.994
IN$36.891
KS$36.411
KY$37.031
LA$37.04–$38.732
MA$40.71–$44.502
MD$39.97–$44.853
ME$37.05–$38.682
MI$38.07–$40.562
MN$38.761
MO$36.55–$38.663
MS$35.981
MT$39.741
NC$37.381
ND$38.361
NE$36.541
NH$40.391
NJ$42.65–$44.472
NM$38.331
NV$39.381
NY$37.92–$46.985
OH$37.791
OK$36.801
OR$38.96–$41.902
PA$37.76–$41.392
PR$39.961
RI$40.521
SC$37.671
SD$38.191
TN$36.601
TX$37.54–$40.838
UT$38.151
VA$38.67–$44.852
VI$39.961
VT$38.361
WA$40.58–$45.212
WI$37.181
WV$37.781
WY$39.141

See G0101 in every payment locality

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

Office or facility?

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 Dallas, TX 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

99

Locality
Dallas, TX
Physician work
1.009
Practice expense
0.996
Malpractice
0.858
Office calculation for G0101 in Dallas, TX
ComponentRVULocality factorAdjusted
Physician work0.44× 1.0090.4440
Practice expense0.68× 0.9960.6773
Malpractice0.07× 0.8580.0601
Total RVUs1.1813
Conversion factor× 33.4009

Office rate, Dallas, TX$39.46

Office: (0.44 × 1.009 + 0.68 × 0.996 + 0.07 × 0.858) × $33.4009 = $39.46

Facility: (0.44 × 1.009 + 0.23 × 0.996 + 0.07 × 0.858) × $33.4009 = $24.49

Open G0101 in the RVU calculator

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 Dallas, TX

G0101 · Office / nonfacility

$39.46

Effective 2026-10-01

The base rate is $1.54 higher than on 2025-10-01, moving from $37.92 to $39.46 (4.1%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

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
  1. January 1, 2026

    RVU26A

    $37.92changed to$39.46

    • 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
    • Work GPCI 1.011 changed to 1.009
    • Practice expense GPCI 1.007 changed to 0.996
    • Malpractice GPCI 0.877 changed to 0.858

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $39.31changed to$37.92

    • Conversion factor 33.2875 changed to 32.3465
    • Malpractice RVU 0.07 changed to 0.06

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $38.67changed to$39.31

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $39.60changed to$38.67

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 0.65 changed to 0.66
    • Work GPCI 1.017 changed to 1.011
    • Practice expense GPCI 1.017 changed to 1.007
    • Malpractice GPCI 0.711 changed to 0.877
  5. January 1, 2023

    RVU23A

    $39.81changed to$39.60

    • 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
    • Work GPCI 1.023 changed to 1.017
    • Practice expense GPCI 1.026 changed to 1.017
    • Malpractice GPCI 0.546 changed to 0.711

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $39.76changed to$39.81

    • Conversion factor 34.8931 changed to 34.6062
    • Malpractice RVU 0.06 changed to 0.08

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $40.52changed to$39.76

    • 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
    • Work GPCI 1.018 changed to 1.023
    • Practice expense GPCI 1.020 changed to 1.026
    • Malpractice GPCI 0.657 changed to 0.546

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $39.72changed to$40.52

    • Conversion factor 36.0391 changed to 36.0896
    • Malpractice RVU 0.05 changed to 0.08
    • Work GPCI 1.012 changed to 1.018
    • Practice expense GPCI 1.014 changed to 1.020
    • Malpractice GPCI 0.768 changed to 0.657

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $38.95changed to$39.72

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 0.58 changed to 0.60

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $39.20changed to$38.95

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 0.59 changed to 0.58
    • Work GPCI 1.015 changed to 1.012
    • Practice expense GPCI 1.012 changed to 1.014
    • Malpractice GPCI 0.770 changed to 0.768

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $38.74changed to$39.20

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 0.58 changed to 0.59
    • Work GPCI 1.018 changed to 1.015
    • Practice expense GPCI 1.009 changed to 1.012
    • Malpractice GPCI 0.772 changed to 0.770

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $38.88changed to$38.74

    • Conversion factor 35.9335 changed to 35.8043

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $38.68changed to$38.88

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $38.26changed to$38.68

    • Conversion factor 35.8228 changed to 35.7547
    • Malpractice RVU 0.03 changed to 0.05
    • Work GPCI 1.014 changed to 1.018
    • Practice expense GPCI 1.013 changed to 1.009
    • Malpractice GPCI 0.803 changed to 0.772

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $38.44changed to$38.26

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 0.64 changed to 0.58
    • Work GPCI 1.009 changed to 1.014
    • Practice expense GPCI 1.017 changed to 1.013
    • Malpractice GPCI 0.834 changed to 0.803

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $38.44

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$39.46$24.49RVU26D
2026-07-01$39.46$24.49RVU26C
2026-04-01$39.46$24.49RVU26B
2026-01-01$39.46$24.49RVU26A
2025-10-01$37.92$26.19RVU25D
2025-07-01$37.92$26.19RVU25C
2025-04-01$37.92$26.19RVU25B
2025-01-01$37.92$26.19RVU25A
2024-10-01$39.31$27.24RVU24D
2024-07-01$39.31$27.24RVU24C
2024-04-01$39.31$27.24RVU24B
2024-03-09$39.31$27.24RVU24AR
2024-01-01$38.67$26.80RVU24A
2023-10-01$39.60$27.53RVU23D
2023-07-01$39.60$27.53RVU23C
2023-04-01$39.60$27.53RVU23B
2023-01-01$39.60$27.53RVU23A
2022-10-01$39.81$27.74RVU22D
2022-07-01$39.81$27.74RVU22C
2022-04-01$39.81$27.74RVU22B
2022-01-01$39.81$27.74RVU22A
2021-10-01$39.76$27.59RVU21D
2021-07-01$39.76$27.59RVU21C
2021-04-01$39.76$27.59RVU21B
2021-01-01$39.76$27.59RVU21A
2020-10-01$40.52$28.74RVU20D
2020-07-01$40.52$28.74RVU20C
2020-04-01$40.52$28.74RVU20B
2020-01-01$40.52$28.74RVU20A
2019-10-01$39.72$28.03RVU19D
2019-07-01$39.72$28.03RVU19C
2019-04-01$39.72$28.03RVU19B
2019-01-01$39.72$28.03RVU19A
2018-10-01$38.95$28.36RVU18D
2018-07-01$38.95$28.36RVU18C
2018-04-01$38.95$28.36RVU18B
2018-01-01$38.95$28.36RVU18AR1
2017-10-01$39.20$28.67RVU17D
2017-07-01$39.20$28.67RVU17C
2017-04-01$39.20$28.67RVU17B
2017-01-01$39.20$28.67RVU17A
2016-10-01$38.74$28.26RVU16D
2016-07-01$38.74$28.26RVU16C
2016-04-01$38.74$28.26RVU16B
2016-01-01$38.74$28.26RVU16A
2015-10-01$38.88$28.36RVU15D
2015-07-01$38.88$28.36RVU15C
2015-04-01$38.68$28.22RVU15B
2015-01-01$38.68$28.22RVU15A
2014-10-01$38.26$27.73RVU14D
2014-07-01$38.26$27.73RVU14C
2014-04-01$38.26$27.73RVU14B
2014-01-01$38.26$27.73RVU14A
2013-10-01$38.44$27.37RVU13D
2013-07-01$38.44$27.37RVU13C
2013-04-01$38.44$27.37RVU13B
2013-01-01$38.44$27.37RVU13AR

Price G0101 for an earlier date of service

Where the Dallas, TX rate applies

Dallas, TX is a Medicare payment area, not a city. Our Census mapping connects it to 32 cities and communities in Texas. Some span more than one payment area; confirm with the service ZIP.

Browse all communities in Texas

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
RVUs for G0101PPRRVU2026_Oct_nonQPP.csv, line 15,083 (RVU26D)
Geographic factors for Dallas, TXGPCI2026.csv, line 99 (RVU26D)

Open CMS sourceHow we calculate rates

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