HCPCS code G0121: Screening colonoscopy, not high risk2026 Medicare rate & RVUs in Louisiana
Report G0121 for a colorectal cancer screening colonoscopy performed for an individual who is not classified as high risk.
Medicare pays $348.15–$365.11 for G0121 in the office in Louisiana, from Rest of Louisiana to New Orleans, LA. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 9 sections
What G0121 covers
G0121 represents a colonoscopy performed for colorectal cancer screening when the patient is not classified as high risk. A gastroenterologist, surgeon, or other qualified practitioner advances a colonoscope through the large bowel to examine the colon for abnormalities. The service may be performed in a physician office or a facility, such as an ambulatory surgery center or hospital outpatient department.
Select G0121 based on the screening indication and the patient’s risk classification, not simply because a colonoscopy occurred. The record should support screening intent and include the procedure findings and extent of examination. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. Modifier 53 has separate pricing treatment. When multiple procedures occur in one session, the highest-valued procedure is paid in full and others at 50%. Do not report modifier 50; assistant-at-surgery payment is restricted, and 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.
Where G0121 pays more and less in Louisiana
| Payment locality | Office | Facility |
|---|---|---|
| New Orleans, LA | $365.11 | $164.27 |
| Rest of Louisiana | $348.15 | $159.26 |
How the G0121 rate is calculated
Each of G0121’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 · G0121
RVUs × geographic indexes × conversion factor
Work3.18
3.18 RVUs× 1.000 GPCI
Practice expense7.73
7.73 RVUs× 1.000 GPCI
Malpractice0.42
0.42 RVUs× 1.000 GPCI
Adjusted RVUs
11.3300
Conversion factor
$33.4009
Medicare rate
$378.43
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for G0121
The CMS indicators that decide how G0121 is paid alongside other services.
CMS payment indicators · G0121
Screening colonoscopy, not high risk
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
G0121 without 51 · national office
$378.43
Screening colonoscopy, not high risk
G0121-51 · Second procedure: 50%
$189.22
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%).
G0121 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- G0105Screening colonoscopyHigh-risk individual
- Both describe screening colonoscopy, but G0105 is for patients classified as high risk; G0121 is for those not classified as high risk.
- G0104Flexible sigmoidoscopyColorectal cancer screening
- G0104 reports screening by flexible sigmoidoscopy. G0121 reports screening by colonoscopy, which examines the colon more extensively.
- 45378ColonoscopyDiagnostic, no tissue removal
- G0121 identifies a screening colonoscopy for a patient who is not high risk. CPT 45378 is used for a diagnostic colonoscopy when the clinical indication is diagnostic rather than screening.
G0121 billing questions
When should G0121 be selected instead of G0105?
Use G0121 for a screening colonoscopy when the patient is not classified as high risk. G0105 is the corresponding screening code for a high-risk individual.
How does G0121 differ from G0104?
G0121 is for screening by colonoscopy. G0104 represents screening by flexible sigmoidoscopy, which examines a more limited portion of the colon.
What documentation supports G0121?
Document that the examination was for colorectal cancer screening and support the patient’s not-high-risk classification. The procedure report should describe the examination and its findings.
What does modifier 53 mean for this code?
Modifier 53 identifies a discontinued procedure, and CMS assigns it separate pricing treatment for G0121. The record should explain why the colonoscopy was discontinued.
Can G0121 be billed with modifier 50?
No. Do not append modifier 50 to this colonoscopy service.
How are multiple procedures in the same session paid?
CMS pays the highest-valued procedure in full and pays other procedures at 50% when multiple procedures are performed in the same session.
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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