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HCPCS code G0105: Screening colonoscopy, high-risk individual2026 Medicare rate & RVUs in Washington, DC area

Report G0105 for a screening colonoscopy in a Medicare beneficiary who meets high-risk criteria, such as a relevant personal or family history.

CMS RVU26DEffective Oct 1, 2026One payment locality410.5K Medicare services in 2024

In Washington, DC area, Medicare pays $431.34 for G0105 in the office and $179.92 when it’s performed in a hospital or facility.

$431.34Office (non-facility)
$179.92Hospital or facility
+14.1%vs the national office rate ($378.10)

Check a contract rate as a % of Medicare · G0105 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 G0105 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Washington, DC area
  2. What G0105 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 G0105 covers

G0105 represents a colonoscopic examination performed to screen an asymptomatic beneficiary who qualifies as high risk for colorectal cancer. A gastroenterologist, colorectal surgeon, or other qualified endoscopist examines the colon, typically in an ambulatory endoscopy center or hospital outpatient department. High-risk circumstances can include a personal history of colorectal cancer or adenomatous polyps, inflammatory bowel disease, or colorectal cancer in a first-degree relative. The indication should support screening rather than evaluation of current symptoms.

Document the screening purpose, the risk factor supporting high-risk status, and the endoscopy findings and extent. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. Modifier 53 is separately priced for a discontinued procedure. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Bilateral adjustment is inappropriate. Medicare does not pay an assistant at surgery, and co-surgeon and team-surgery billing 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 Washington, DC area compares for G0105

Across 109 of 109 payment localities, the office rate for G0105 runs from $335.05 in Arkansas to $497.55 in San Benito County, CA. Washington, DC area pays $431.34. The RVUs are the same everywhere; the geographic indexes change the dollars.

G0105 in Washington, DC area vs other payment areas
  1. Washington, DC area · this page$431.34
  2. Los Angeles, CA · California$425.10−$6.24
  3. Miami, FL · Florida$409.62−$21.72
  4. Chicago, IL · Illinois$397.87−$33.47
  5. Manhattan, NY · New York$434.75+$3.41
  6. Alaska · Alaska$441.84+$10.50
  7. Alabama · Alabama$339.88−$91.46

Other areas in District of Columbia first, then benchmark localities. Bars start at $0.

Every other payment area

G0105 in every other Medicare payment locality
Payment localityOfficeFacility
ArkansasArkansas$335.05$151.71
ArizonaArizona$368.12$161.31
Bakersfield, CACalifornia$399.55$165.63
Chico, CACalifornia$398.34$164.41
El Centro, CACalifornia$398.40$164.48
Fresno, CACalifornia$398.34$164.41
Hanford, CACalifornia$398.34$164.41
Madera, CACalifornia$398.34$164.41

G0105 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.

$335.05

$447.95

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

View every state and territory as a table
G0105 office rate range by state
State / territoryOffice rate rangeLocalities
AK$441.841
AL$339.881
AR$335.051
AZ$368.121
CA$398.34–$497.5529
CO$392.901
CT$402.981
DC$431.341
DE$374.151
FL$373.63–$409.623
GA$352.84–$385.302
GU$407.701
HI$407.701
IA$347.891
ID$350.231
IL$363.35–$397.874
IN$352.211
KS$346.521
KY$348.281
LA$347.83–$364.732
MA$390.70–$431.042
MD$381.14–$431.343
ME$352.27–$370.722
MI$357.40–$378.462
MN$375.941
MO$342.11–$365.733
MS$338.641
MT$378.071
NC$355.861
ND$369.961
NE$349.701
NH$386.971
NJ$407.43–$427.032
NM$359.421
NV$376.071
NY$361.12–$445.435
OH$355.751
OK$347.421
OR$373.00–$404.952
PA$356.17–$393.242
PR$380.731
RI$387.161
SC$356.421
SD$369.011
TN$348.261
TX$353.89–$391.728
UT$361.211
VA$369.68–$431.342
VI$380.731
VT$368.751
WA$389.89–$439.512
WI$357.781
WV$350.181
WY$374.541

See G0105 in every payment locality

How the G0105 rate is calculated

Each of G0105’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 · G0105

RVUs × geographic indexes × conversion factor

Office or facility?

Work3.18

3.18 RVUs× 1.000 GPCI

Practice expense7.73

7.73 RVUs× 1.000 GPCI

Malpractice0.41

0.41 RVUs× 1.000 GPCI

Adjusted RVUs

11.3200

Conversion factor

$33.4009

Medicare rate

$378.10

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

The exact Washington, DC area inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

15,087

Code
G0105
Physician work
3.18
Practice expense
7.73
Malpractice
0.41

GPCI2026.csv

39

Locality
Washington, DC area
Physician work
1.054
Practice expense
1.178
Malpractice
1.113
Office calculation for G0105 in Washington, DC area
ComponentRVULocality factorAdjusted
Physician work3.18× 1.0543.3517
Practice expense7.73× 1.1789.1059
Malpractice0.41× 1.1130.4563
Total RVUs12.9140
Conversion factor× 33.4009

Office rate, Washington, DC area$431.34

Office: (3.18 × 1.054 + 7.73 × 1.178 + 0.41 × 1.113) × $33.4009 = $431.34

Facility: (3.18 × 1.054 + 1.34 × 1.178 + 0.41 × 1.113) × $33.4009 = $179.92

Open G0105 in the RVU calculator

Payment rules and modifiers for G0105

The CMS indicators that decide how G0105 is paid alongside other services.

CMS payment indicators · G0105

Screening colonoscopy, high-risk individual

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

G0105 without 51 · national office

$378.10

Screening colonoscopy, high-risk individual

G0105-51 · Second procedure: 50%

$189.05

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 G0105

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

Codes related to G0105
CodeHow it relatesOffice range, Washington, DC area
Used instead
G0121Screening colonoscopy, not high riskScreening colonoscopy for an individual who does not meet high-risk criteria.$431.71
G0104Flexible sigmoidoscopy, colorectal cancer screeningColorectal cancer screening performed by flexible sigmoidoscopy.$249.36
45378Colonoscopy, diagnostic, no tissue removalColonoscopy code used for a diagnostic examination rather than high-risk screening.$431.34
Often billed with
00812Colonoscopy anesthesia, screening colonoscopyAnesthesia service commonly reported for a screening colonoscopy encounter.No office rate

How G0105 has changed in Washington, DC area

G0105 · Office / nonfacility

$431.34

Effective 2026-10-01

The base rate is $55.33 higher than on 2025-10-01, moving from $376.01 to $431.34 (14.7%).

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

    $376.01changed to$431.34

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 3.26 changed to 3.18
    • Practice expense RVU 6.44 changed to 7.73
    • Malpractice RVU 0.43 changed to 0.41
    • Work GPCI 1.057 changed to 1.054
    • Practice expense GPCI 1.192 changed to 1.178
    • Malpractice GPCI 1.168 changed to 1.113

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $389.34changed to$376.01

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 6.51 changed to 6.44
    • Malpractice RVU 0.42 changed to 0.43

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $382.99changed to$389.34

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $401.99changed to$382.99

    • Conversion factor 33.8872 changed to 32.7442
    • Work GPCI 1.056 changed to 1.057
    • Practice expense GPCI 1.214 changed to 1.192
    • Malpractice GPCI 1.231 changed to 1.168

  5. January 1, 2023

    RVU23A

    $421.69changed to$401.99

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 6.66 changed to 6.51
    • Malpractice RVU 0.40 changed to 0.42
    • Work GPCI 1.054 changed to 1.056
    • Practice expense GPCI 1.236 changed to 1.214
    • Malpractice GPCI 1.294 changed to 1.231

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $421.33changed to$421.69

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 6.56 changed to 6.66
    • Malpractice RVU 0.41 changed to 0.40

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $395.23changed to$421.33

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 5.75 changed to 6.56
    • Malpractice RVU 0.40 changed to 0.41
    • Work GPCI 1.049 changed to 1.054
    • Practice expense GPCI 1.221 changed to 1.236
    • Malpractice GPCI 1.277 changed to 1.294

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $380.34changed to$395.23

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 5.46 changed to 5.75
    • Malpractice RVU 0.45 changed to 0.40
    • Work GPCI 1.045 changed to 1.049
    • Practice expense GPCI 1.205 changed to 1.221
    • Malpractice GPCI 1.261 changed to 1.277

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $373.00changed to$380.34

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 5.29 changed to 5.46
    • Malpractice RVU 0.46 changed to 0.45

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $370.61changed to$373.00

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 5.26 changed to 5.29
    • Malpractice RVU 0.45 changed to 0.46
    • Work GPCI 1.048 changed to 1.045
    • Malpractice GPCI 1.271 changed to 1.261

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $446.97changed to$370.61

    • Conversion factor 35.8043 changed to 35.8887
    • Work RVU 3.36 changed to 3.26
    • Practice expense RVU 6.93 changed to 5.26
    • Malpractice RVU 0.47 changed to 0.45
    • Work GPCI 1.051 changed to 1.048
    • Malpractice GPCI 1.280 changed to 1.271

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $459.99changed to$446.97

    • Conversion factor 35.9335 changed to 35.8043
    • Work RVU 3.69 changed to 3.36
    • Practice expense RVU 6.81 changed to 6.93
    • Malpractice RVU 0.56 changed to 0.47

    Held through RVU16B, RVU16C, RVU16D.

  13. October 1, 2015

    RVU15D

    $447.52changed to$459.99

    • Work RVU 3.36 changed to 3.69

  14. July 1, 2015

    RVU15C

    $445.30changed to$447.52

    • Conversion factor 35.7547 changed to 35.9335

  15. January 1, 2015

    RVU15A

    $454.91changed to$445.30

    • Conversion factor 35.8228 changed to 35.7547
    • Work RVU 3.69 changed to 3.36
    • Practice expense RVU 6.78 changed to 6.81
    • Work GPCI 1.050 changed to 1.051
    • Practice expense GPCI 1.202 changed to 1.205
    • Malpractice GPCI 1.205 changed to 1.280

    Held through RVU15B.

  16. January 1, 2014

    RVU14A

    $471.90changed to$454.91

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 7.79 changed to 6.78
    • Malpractice RVU 0.59 changed to 0.56
    • Work GPCI 1.049 changed to 1.050
    • Practice expense GPCI 1.198 changed to 1.202
    • Malpractice GPCI 1.130 changed to 1.205

    Held through RVU14B, RVU14C, RVU14D.

  17. January 1, 2013

    RVU13AR

    Earliest loaded release: $471.90

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$431.34$179.92RVU26D
2026-07-01$431.34$179.92RVU26C
2026-04-01$431.34$179.92RVU26B
2026-01-01$431.34$179.92RVU26A
2025-10-01$376.01$196.72RVU25D
2025-07-01$376.01$196.72RVU25C
2025-04-01$376.01$196.72RVU25B
2025-01-01$376.01$196.72RVU25A
2024-10-01$389.34$201.26RVU24D
2024-07-01$389.34$201.26RVU24C
2024-04-01$389.34$201.26RVU24B
2024-03-09$389.34$201.26RVU24AR
2024-01-01$382.99$197.98RVU24A
2023-10-01$401.99$205.76RVU23D
2023-07-01$401.99$205.76RVU23C
2023-04-01$401.99$205.76RVU23B
2023-01-01$401.99$205.76RVU23A
2022-10-01$421.69$211.25RVU22D
2022-07-01$421.69$211.25RVU22C
2022-04-01$421.69$211.25RVU22B
2022-01-01$421.69$211.25RVU22A
2021-10-01$421.33$213.02RVU21D
2021-07-01$421.33$213.02RVU21C
2021-04-01$421.33$213.02RVU21B
2021-01-01$421.33$213.02RVU21A
2020-10-01$395.23$215.88RVU20D
2020-07-01$395.23$215.88RVU20C
2020-04-01$395.23$215.88RVU20B
2020-01-01$395.23$215.88RVU20A
2019-10-01$380.34$216.62RVU19D
2019-07-01$380.34$216.62RVU19C
2019-04-01$380.34$216.62RVU19B
2019-01-01$380.34$216.62RVU19A
2018-10-01$373.00$217.70RVU18D
2018-07-01$373.00$217.70RVU18C
2018-04-01$373.00$217.70RVU18B
2018-01-01$373.00$217.70RVU18AR1
2017-10-01$370.61$217.09RVU17D
2017-07-01$370.61$217.09RVU17C
2017-04-01$370.61$217.09RVU17B
2017-01-01$370.61$217.09RVU17A
2016-10-01$446.97$223.05RVU16D
2016-07-01$446.97$223.05RVU16C
2016-04-01$446.97$223.05RVU16B
2016-01-01$446.97$223.05RVU16A
2015-10-01$459.99$249.12RVU15D
2015-07-01$447.52$236.65RVU15C
2015-04-01$445.30$235.48RVU15B
2015-01-01$445.30$235.48RVU15A
2014-10-01$454.91$246.50RVU14D
2014-07-01$454.91$246.50RVU14C
2014-04-01$454.91$246.50RVU14B
2014-01-01$454.91$246.50RVU14A
2013-10-01$471.90$244.05RVU13D
2013-07-01$471.90$244.05RVU13C
2013-04-01$471.90$244.05RVU13B
2013-01-01$471.90$244.05RVU13AR

Price G0105 for an earlier date of service

Where the Washington, DC area rate applies

Washington, DC area is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in District of Columbia. Some span more than one payment area; confirm with the service ZIP.

  • Washington

Browse all communities in District of Columbia

G0105 billing questions

How is G0105 different from G0121?

G0105 is for a screening colonoscopy when the beneficiary meets Medicare high-risk criteria. G0121 is the screening colonoscopy code for an individual who is not high risk.

When should G0104 be considered instead?

G0104 describes colorectal cancer screening by flexible sigmoidoscopy. G0105 is for screening by colonoscopy in a high-risk individual.

What documentation supports high-risk screening?

Record that the service was for screening and identify the history or other qualifying risk factor supporting high-risk status. The procedure report should document the examination and findings.

What does modifier 53 mean for G0105?

Modifier 53 identifies a procedure that was discontinued. CMS separately prices this modifier for G0105.

How does the multiple-procedure rule affect G0105?

When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others are subject to the standard 50% reduction.

Can an assistant surgeon or co-surgeon be billed?

Medicare does not pay an assistant at surgery for G0105. Co-surgeon and team-surgery billing are not permitted.

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 G0105PPRRVU2026_Oct_nonQPP.csv, line 15,087 (RVU26D)
Geographic factors for Washington, DC areaGPCI2026.csv, line 39 (RVU26D)

Open CMS sourceHow we calculate rates

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