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HCPCS code G0104: Flexible sigmoidoscopy, colorectal cancer screening2026 Medicare rate & RVUs in Iowa

Report G0104 for a Medicare colorectal cancer screening performed with a flexible sigmoidoscope to examine the rectum and distal colon.

CMS RVU26DEffective Oct 1, 2026One payment locality3.8K Medicare services in 2024

In Iowa, Medicare pays $196.94 for G0104 in the office and $49.32 when it’s performed in a hospital or facility.

$196.94Office (non-facility)
$49.32Hospital or facility
−8.3%vs the national office rate ($214.77)

Check a contract rate as a % of Medicare · G0104 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 G0104 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Iowa
  2. What G0104 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 G0104 covers

G0104 represents a colorectal cancer screening examination using a flexible scope to inspect the rectum and sigmoid colon. It is intended for screening rather than evaluation of symptoms. Gastroenterologists, colorectal surgeons, and other qualified physicians commonly perform the procedure in an outpatient endoscopy center or hospital department. The record should identify the screening purpose, the procedure performed, its findings, and any intervention.

Report one screening procedure, supported by documentation of the clinical indication and examination. The code has a 0-day global period, so routine same-day preoperative and postoperative care is included. When other procedures subject to the CMS multiple-procedure reduction occur in the same session, the highest-valued procedure is paid in full and the others at 50%. Modifier 50 is inappropriate for this single endoscopic service. Medicare does not pay an assistant at surgery for this code; co-surgeons and team surgery are not permitted.

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 Iowa compares for G0104

Across 109 of 109 payment localities, the office rate for G0104 runs from $187.08 in Arkansas to $297.27 in San Benito County, CA. Iowa pays $196.94. The RVUs are the same everywhere; the geographic indexes change the dollars.

G0104 in Iowa vs other payment areas
  1. Iowa · this page$196.94
  2. Los Angeles, CA · California$248.27+$51.33
  3. Washington, DC area · District of Columbia$249.36+$52.42
  4. Miami, FL · Florida$227.92+$30.98
  5. Chicago, IL · Illinois$220.64+$23.70
  6. Manhattan, NY · New York$248.43+$51.49
  7. Alaska · Alaska$238.75+$41.81

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

Every other payment area

G0104 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$190.21$49.05
ArkansasArkansas$187.08$48.50
ArizonaArizona$208.54$52.22
Bakersfield, CACalifornia$231.49$54.67
Chico, CACalifornia$231.16$54.35
El Centro, CACalifornia$231.18$54.37
Fresno, CACalifornia$231.16$54.35
Hanford, CACalifornia$231.16$54.35

G0104 rates by state

Office rate range in each state. Select a state to see its payment localities.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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.

$187.08

$264.22

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
G0104 office rate range by state
State / territoryOffice rate rangeLocalities
AK$238.751
AL$190.211
AR$187.081
AZ$208.541
CA$231.16–$297.2729
CO$226.051
CT$230.231
DC$249.361
DE$212.331
FL$208.53–$227.923
GA$195.63–$218.532
GU$238.391
HI$238.391
IA$196.941
ID$198.141
IL$200.85–$222.764
IN$199.471
KS$195.311
KY$194.061
LA$193.49–$204.432
MA$224.20–$251.132
MD$216.94–$249.363
ME$198.68–$211.762
MI$199.26–$210.862
MN$217.511
MO$189.32–$205.963
MS$188.271
MT$214.761
NC$201.131
ND$212.591
NE$198.341
NH$221.841
NJ$233.12–$246.142
NM$200.261
NV$214.341
NY$204.49–$254.395
OH$198.811
OK$194.291
OR$212.94–$234.662
PA$199.50–$223.502
PR$216.731
RI$220.951
SC$200.261
SD$212.331
TN$196.351
TX$197.97–$225.068
UT$203.371
VA$210.56–$249.362
VI$216.731
VT$211.121
WA$223.98–$257.172
WI$204.511
WV$192.291
WY$213.811

See G0104 in every payment locality

How the G0104 rate is calculated

Each of G0104’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 · G0104

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.82

0.82 RVUs× 1.000 GPCI

Practice expense5.50

5.50 RVUs× 1.000 GPCI

Malpractice0.11

0.11 RVUs× 1.000 GPCI

Adjusted RVUs

6.4300

Conversion factor

$33.4009

Medicare rate

$214.77

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Iowa inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

15,086

Code
G0104
Physician work
0.82
Practice expense
5.50
Malpractice
0.11

GPCI2026.csv

53

Locality
Iowa
Physician work
1.000
Practice expense
0.915
Malpractice
0.397
Office calculation for G0104 in Iowa
ComponentRVULocality factorAdjusted
Physician work0.82× 1.0000.8200
Practice expense5.50× 0.9155.0325
Malpractice0.11× 0.3970.0437
Total RVUs5.8962
Conversion factor× 33.4009

Office rate, Iowa$196.94

Office: (0.82 × 1 + 5.5 × 0.915 + 0.11 × 0.397) × $33.4009 = $196.94

Facility: (0.82 × 1 + 0.67 × 0.915 + 0.11 × 0.397) × $33.4009 = $49.32

Open G0104 in the RVU calculator

Payment rules and modifiers for G0104

The CMS indicators that decide how G0104 is paid alongside other services.

CMS payment indicators · G0104

Flexible sigmoidoscopy, colorectal cancer screening

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

G0104 without 51 · national office

$214.77

Flexible sigmoidoscopy, colorectal cancer screening

G0104-51 · Second procedure: 50%

$107.39

When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).

When to use modifier 51

Codes related to G0104

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to G0104
CodeHow it relatesOffice range, Iowa
Used instead
G0105Screening colonoscopy, high-risk individualColorectal screening by colonoscopy for a high-risk patient.$347.89
G0121Screening colonoscopy, not high riskColorectal screening by colonoscopy for a patient not classified as high risk.$348.03
45330Flexible sigmoidoscopy, diagnosticDiagnostic flexible sigmoidoscopy, rather than screening.$197.07
45331Sigmoidoscopy, with biopsyDiagnostic flexible sigmoidoscopy when biopsy is performed.$296.26

How G0104 has changed in Iowa

G0104 · Office / nonfacility

$196.94

Effective 2026-10-01

The base rate is $32.15 higher than on 2025-10-01, moving from $164.79 to $196.94 (19.5%).

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

    $164.79changed to$196.94

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 0.84 changed to 0.82
    • Practice expense RVU 4.60 changed to 5.50
    • Malpractice RVU 0.12 changed to 0.11
    • Practice expense GPCI 0.913 changed to 0.915
    • Malpractice GPCI 0.457 changed to 0.397

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $170.50changed to$164.79

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 4.63 changed to 4.60

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $167.72changed to$170.50

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $173.19changed to$167.72

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 4.64 changed to 4.63
    • Malpractice RVU 0.11 changed to 0.12
    • Practice expense GPCI 0.910 changed to 0.913
    • Malpractice GPCI 0.441 changed to 0.457

  5. January 1, 2023

    RVU23A

    $178.84changed to$173.19

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 4.72 changed to 4.64
    • Practice expense GPCI 0.907 changed to 0.910
    • Malpractice GPCI 0.425 changed to 0.441

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $178.10changed to$178.84

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 4.65 changed to 4.72

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $163.91changed to$178.10

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 4.03 changed to 4.65
    • Malpractice GPCI 0.424 changed to 0.425

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $160.24changed to$163.91

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 3.92 changed to 4.03
    • Malpractice RVU 0.12 changed to 0.11
    • Malpractice GPCI 0.423 changed to 0.424

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $157.78changed to$160.24

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 3.85 changed to 3.92

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $154.48changed to$157.78

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 3.78 changed to 3.85
    • Practice expense GPCI 0.902 changed to 0.907
    • Malpractice GPCI 0.458 changed to 0.423

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $153.46changed to$154.48

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense GPCI 0.896 changed to 0.902
    • Malpractice GPCI 0.493 changed to 0.458

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $127.30changed to$153.46

    • Conversion factor 35.9335 changed to 35.8043
    • Work RVU 0.96 changed to 0.84
    • Practice expense RVU 2.80 changed to 3.78
    • Malpractice RVU 0.15 changed to 0.12

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $126.67changed to$127.30

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $125.11changed to$126.67

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 2.77 changed to 2.80
    • Malpractice RVU 0.13 changed to 0.15
    • Practice expense GPCI 0.892 changed to 0.896
    • Malpractice GPCI 0.475 changed to 0.493

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $130.50changed to$125.11

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 3.17 changed to 2.77
    • Malpractice RVU 0.14 changed to 0.13
    • Practice expense GPCI 0.887 changed to 0.892
    • Malpractice GPCI 0.456 changed to 0.475

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $130.50

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$196.94$49.32RVU26D
2026-07-01$196.94$49.32RVU26C
2026-04-01$196.94$49.32RVU26B
2026-01-01$196.94$49.32RVU26A
2025-10-01$164.79$50.80RVU25D
2025-07-01$164.79$50.80RVU25C
2025-04-01$164.79$50.80RVU25B
2025-01-01$164.79$50.80RVU25A
2024-10-01$170.50$51.97RVU24D
2024-07-01$170.50$51.97RVU24C
2024-04-01$170.50$51.97RVU24B
2024-03-09$170.50$51.97RVU24AR
2024-01-01$167.72$51.12RVU24A
2023-10-01$173.19$51.70RVU23D
2023-07-01$173.19$51.70RVU23C
2023-04-01$173.19$51.70RVU23B
2023-01-01$173.19$51.70RVU23A
2022-10-01$178.84$52.34RVU22D
2022-07-01$178.84$52.34RVU22C
2022-04-01$178.84$52.34RVU22B
2022-01-01$178.84$52.34RVU22A
2021-10-01$178.10$52.15RVU21D
2021-07-01$178.10$52.15RVU21C
2021-04-01$178.10$52.15RVU21B
2021-01-01$178.10$52.15RVU21A
2020-10-01$163.91$53.60RVU20D
2020-07-01$163.91$53.60RVU20C
2020-04-01$163.91$53.60RVU20B
2020-01-01$163.91$53.60RVU20A
2019-10-01$160.24$54.00RVU19D
2019-07-01$160.24$54.00RVU19C
2019-04-01$160.24$54.00RVU19B
2019-01-01$160.24$54.00RVU19A
2018-10-01$157.78$54.27RVU18D
2018-07-01$157.78$54.27RVU18C
2018-04-01$157.78$54.27RVU18B
2018-01-01$157.78$54.27RVU18AR1
2017-10-01$154.48$54.13RVU17D
2017-07-01$154.48$54.13RVU17C
2017-04-01$154.48$54.13RVU17B
2017-01-01$154.48$54.13RVU17A
2016-10-01$153.46$53.69RVU16D
2016-07-01$153.46$53.69RVU16C
2016-04-01$153.46$53.69RVU16B
2016-01-01$153.46$53.69RVU16A
2015-10-01$127.30$60.33RVU15D
2015-07-01$127.30$60.33RVU15C
2015-04-01$126.67$60.03RVU15B
2015-01-01$126.67$60.03RVU15A
2014-10-01$125.11$59.61RVU14D
2014-07-01$125.11$59.61RVU14C
2014-04-01$125.11$59.61RVU14B
2014-01-01$125.11$59.61RVU14A
2013-10-01$130.50$59.58RVU13D
2013-07-01$130.50$59.58RVU13C
2013-04-01$130.50$59.58RVU13B
2013-01-01$130.50$59.58RVU13AR

Price G0104 for an earlier date of service

Where the Iowa rate applies

Iowa is a Medicare payment area, not a city. Our Census mapping connects it to 1026 cities and communities in Iowa. Some span more than one payment area; confirm with the service ZIP.

  • Ackley
  • Ackworth
  • Adair
  • Adel
  • Afton
  • Agency
  • Ainsworth
  • Akron

Browse all communities in Iowa

G0104 billing questions

How is G0104 different from a diagnostic flexible sigmoidoscopy?

G0104 is for a colorectal cancer screening examination. Use a diagnostic sigmoidoscopy code, such as 45330, when the procedure is performed to investigate a symptom or other diagnostic indication.

Should modifier 50 be reported?

No. This is a single endoscopic screening service, not a bilateral procedure; modifier 50 is inappropriate.

Is routine same-day evaluation separately included?

Routine same-day preoperative and postoperative care is included under the 0-day global period.

What happens when another procedure is performed in the same session?

Under the CMS multiple-procedure reduction, the highest-valued procedure is paid in full and the other qualifying procedures are paid at 50%.

What documentation supports G0104?

Document the screening purpose, the flexible sigmoidoscopy performed, its findings, and any intervention. If the procedure is diagnostic rather than screening, select the code that represents the diagnostic service.

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 G0104PPRRVU2026_Oct_nonQPP.csv, line 15,086 (RVU26D)
Geographic factors for IowaGPCI2026.csv, line 53 (RVU26D)

Open CMS sourceHow we calculate rates

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