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

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 Montana, Medicare pays $378.07 for G0105 in the office and $164.64 when it’s performed in a hospital or facility.

$378.07Office (non-facility)
$164.64Hospital or facility
−0.0%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 Montana
  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 Montana 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. Montana pays $378.07. The RVUs are the same everywhere; the geographic indexes change the dollars.

G0105 in Montana vs other payment areas
  1. Montana · this page$378.07
  2. Los Angeles, CA · California$425.10+$47.03
  3. Washington, DC area · District of Columbia$431.34+$53.27
  4. Miami, FL · Florida$409.62+$31.55
  5. Chicago, IL · Illinois$397.87+$19.80
  6. Manhattan, NY · New York$434.75+$56.68
  7. Alaska · Alaska$441.84+$63.77

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

Every other payment area

G0105 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$339.88$153.13
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

G0105 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.

$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 Montana 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

71

Locality
Montana
Physician work
1.000
Practice expense
1.000
Malpractice
0.998
Office calculation for G0105 in Montana
ComponentRVULocality factorAdjusted
Physician work3.18× 1.0003.1800
Practice expense7.73× 1.0007.7300
Malpractice0.41× 0.9980.4092
Total RVUs11.3192
Conversion factor× 33.4009

Office rate, Montana$378.07

Office: (3.18 × 1 + 7.73 × 1 + 0.41 × 0.998) × $33.4009 = $378.07

Facility: (3.18 × 1 + 1.34 × 1 + 0.41 × 0.998) × $33.4009 = $164.64

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

How G0105 has changed in Montana

G0105 · Office / nonfacility

$378.07

Effective 2026-10-01

The base rate is $50.71 higher than on 2025-10-01, moving from $327.36 to $378.07 (15.5%).

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

    $327.36changed to$378.07

    • 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
    • Malpractice GPCI 0.978 changed to 0.998

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $338.89changed to$327.36

    • 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

    $333.36changed to$338.89

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $345.00changed to$333.36

    • Conversion factor 33.8872 changed to 32.7442
  5. January 1, 2023

    RVU23A

    $356.82changed to$345.00

    • 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
    • Malpractice GPCI 0.977 changed to 0.978

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $356.63changed to$356.82

    • 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

    $343.99changed to$356.63

    • 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
    • Malpractice GPCI 1.304 changed to 0.977

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $340.71changed to$343.99

    • 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
    • Malpractice GPCI 1.631 changed to 1.304

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $334.81changed to$340.71

    • 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

    $328.85changed to$334.81

    • 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
    • Malpractice GPCI 1.429 changed to 1.631

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $389.06changed to$328.85

    • 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
    • Malpractice GPCI 1.226 changed to 1.429

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $401.97changed to$389.06

    • 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

    $390.11changed to$401.97

    • Work RVU 3.36 changed to 3.69
  14. July 1, 2015

    RVU15C

    $388.17changed to$390.11

    • Conversion factor 35.7547 changed to 35.9335
  15. January 1, 2015

    RVU15A

    $398.44changed to$388.17

    • 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
    • Malpractice GPCI 1.165 changed to 1.226

    Held through RVU15B.

  16. January 1, 2014

    RVU14A

    $412.73changed to$398.44

    • 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
    • Malpractice GPCI 1.103 changed to 1.165

    Held through RVU14B, RVU14C, RVU14D.

  17. January 1, 2013

    RVU13AR

    Earliest loaded release: $412.73

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$378.07$164.64RVU26D
2026-07-01$378.07$164.64RVU26C
2026-04-01$378.07$164.64RVU26B
2026-01-01$378.07$164.64RVU26A
2025-10-01$327.36$176.95RVU25D
2025-07-01$327.36$176.95RVU25C
2025-04-01$327.36$176.95RVU25B
2025-01-01$327.36$176.95RVU25A
2024-10-01$338.89$181.11RVU24D
2024-07-01$338.89$181.11RVU24C
2024-04-01$338.89$181.11RVU24B
2024-03-09$338.89$181.11RVU24AR
2024-01-01$333.36$178.15RVU24A
2023-10-01$345.00$183.36RVU23D
2023-07-01$345.00$183.36RVU23C
2023-04-01$345.00$183.36RVU23B
2023-01-01$345.00$183.36RVU23A
2022-10-01$356.82$186.56RVU22D
2022-07-01$356.82$186.56RVU22C
2022-04-01$356.82$186.56RVU22B
2022-01-01$356.82$186.56RVU22A
2021-10-01$356.63$188.09RVU21D
2021-07-01$356.63$188.09RVU21C
2021-04-01$356.63$188.09RVU21B
2021-01-01$356.63$188.09RVU21A
2020-10-01$343.99$197.11RVU20D
2020-07-01$343.99$197.11RVU20C
2020-04-01$343.99$197.11RVU20B
2020-01-01$343.99$197.11RVU20A
2019-10-01$340.71$204.84RVU19D
2019-07-01$340.71$204.84RVU19C
2019-04-01$340.71$204.84RVU19B
2019-01-01$340.71$204.84RVU19A
2018-10-01$334.81$205.93RVU18D
2018-07-01$334.81$205.93RVU18C
2018-04-01$334.81$205.93RVU18B
2018-01-01$334.81$205.93RVU18AR1
2017-10-01$328.85$201.45RVU17D
2017-07-01$328.85$201.45RVU17C
2017-04-01$328.85$201.45RVU17B
2017-01-01$328.85$201.45RVU17A
2016-10-01$389.06$203.23RVU16D
2016-07-01$389.06$203.23RVU16C
2016-04-01$389.06$203.23RVU16B
2016-01-01$389.06$203.23RVU16A
2015-10-01$401.97$226.98RVU15D
2015-07-01$390.11$215.12RVU15C
2015-04-01$388.17$214.05RVU15B
2015-01-01$388.17$214.05RVU15A
2014-10-01$398.44$225.05RVU14D
2014-07-01$398.44$225.05RVU14C
2014-04-01$398.44$225.05RVU14B
2014-01-01$398.44$225.05RVU14A
2013-10-01$412.73$222.54RVU13D
2013-07-01$412.73$222.54RVU13C
2013-04-01$412.73$222.54RVU13B
2013-01-01$412.73$222.54RVU13AR

Price G0105 for an earlier date of service

Where the Montana rate applies

Montana is a Medicare payment area, not a city. Our Census mapping connects it to 497 cities and communities in Montana. Some span more than one payment area; confirm with the service ZIP.

  • Absarokee
  • Acton
  • Alberton
  • Alder
  • Alzada
  • Amsterdam
  • Anaconda-Deer Lodge County
  • Antelope

Browse all communities in Montana

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 MontanaGPCI2026.csv, line 71 (RVU26D)

Open CMS sourceHow we calculate rates

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