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HCPCS code G0121: Screening colonoscopy, not high risk2026 Medicare rate & RVUs in Metropolitan Boston, MA

Report G0121 for a colorectal cancer screening colonoscopy performed for an individual who is not classified as high risk.

CMS RVU26DEffective Oct 1, 2026One payment locality301.6K Medicare services in 2024

In Metropolitan Boston, MA, Medicare pays $431.33 for G0121 in the office and $176.50 when it’s performed in a hospital or facility.

$431.33Office (non-facility)
$176.50Hospital or facility
+14.0%vs the national office rate ($378.43)

Check a contract rate as a % of Medicare · G0121 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 G0121 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Metropolitan Boston, MA
  2. What G0121 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 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.

How Metropolitan Boston, MA compares for G0121

Across 109 of 109 payment localities, the office rate for G0121 runs from $335.22 in Arkansas to $497.73 in San Benito County, CA. Metropolitan Boston, MA pays $431.33. The RVUs are the same everywhere; the geographic indexes change the dollars.

G0121 in Metropolitan Boston, MA vs other payment areas
  1. Metropolitan Boston, MA · this page$431.33
  2. Rest of Massachusetts · Massachusetts$390.97−$40.36
  3. Los Angeles, CA · California$425.32−$6.01
  4. Washington, DC area · District of Columbia$431.71+$0.38
  5. Miami, FL · Florida$410.47−$20.86
  6. Chicago, IL · Illinois$398.63−$32.70
  7. Manhattan, NY · New York$435.28+$3.95

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

Every other payment area

G0121 in every other Medicare payment locality
Payment localityOfficeFacility
AlaskaAlaska$442.02$214.72
AlabamaAlabama$340.07$153.32
ArkansasArkansas$335.22$151.89
ArizonaArizona$368.41$161.59
Bakersfield, CACalifornia$399.75$165.83
Chico, CACalifornia$398.51$164.59
El Centro, CACalifornia$398.58$164.66
Fresno, CACalifornia$398.51$164.59

G0121 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.

$335.22

$448.12

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

View every state and territory as a table
G0121 office rate range by state
State / territoryOffice rate rangeLocalities
AK$442.021
AL$340.071
AR$335.221
AZ$368.411
CA$398.51–$497.7329
CO$393.161
CT$403.381
DC$431.711
DE$374.451
FL$374.13–$410.473
GA$353.24–$385.702
GU$407.901
HI$407.901
IA$348.031
ID$350.381
IL$363.87–$398.634
IN$352.371
KS$346.691
KY$348.581
LA$348.15–$365.112
MA$390.97–$431.332
MD$381.44–$431.713
ME$352.47–$370.932
MI$357.78–$379.022
MN$376.041
MO$342.44–$366.073
MS$338.881
MT$378.401
NC$356.071
ND$370.101
NE$349.831
NH$387.261
NJ$407.79–$427.392
NM$359.821
NV$376.351
NY$361.36–$446.055
OH$356.081
OK$347.681
OR$373.23–$405.202
PA$356.49–$393.642
PR$381.061
RI$387.461
SC$356.711
SD$369.121
TN$348.441
TX$354.20–$392.028
UT$361.511
VA$369.92–$431.712
VI$381.061
VT$368.921
WA$390.14–$439.782
WI$357.881
WV$350.661
WY$374.781

See G0121 in every payment locality

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

Office or facility?

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.

The exact Metropolitan Boston, MA inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

15,093

Code
G0121
Physician work
3.18
Practice expense
7.73
Malpractice
0.42

GPCI2026.csv

62

Locality
Metropolitan Boston, MA
Physician work
1.041
Practice expense
1.194
Malpractice
0.890
Office calculation for G0121 in Metropolitan Boston, MA
ComponentRVULocality factorAdjusted
Physician work3.18× 1.0413.3104
Practice expense7.73× 1.1949.2296
Malpractice0.42× 0.8900.3738
Total RVUs12.9138
Conversion factor× 33.4009

Office rate, Metropolitan Boston, MA$431.33

Office: (3.18 × 1.041 + 7.73 × 1.194 + 0.42 × 0.89) × $33.4009 = $431.33

Facility: (3.18 × 1.041 + 1.34 × 1.194 + 0.42 × 0.89) × $33.4009 = $176.50

Open G0121 in the RVU calculator

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

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

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%).

When to use modifier 51

Codes related to G0121

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

Codes related to G0121
CodeHow it relatesOffice range, Metropolitan Boston, MA
Same family
G0105Screening colonoscopy, high-risk individualScreening colonoscopy for an individual classified as high risk.$431.04
Used instead
G0104Flexible sigmoidoscopy, colorectal cancer screeningColorectal screening by flexible sigmoidoscopy rather than colonoscopy.$251.13
45378Colonoscopy, diagnostic, no tissue removalDiagnostic colonoscopy when the clinical indication is not screening.$431.04

How G0121 has changed in Metropolitan Boston, MA

G0121 · Office / nonfacility

$431.33

Effective 2026-10-01

The base rate is $59.38 higher than on 2025-10-01, moving from $371.95 to $431.33 (16.0%).

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

    $371.95changed to$431.33

    • 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 0.44 changed to 0.42
    • Work GPCI 1.042 changed to 1.041
    • Practice expense GPCI 1.197 changed to 1.194
    • Malpractice GPCI 0.894 changed to 0.890

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $385.26changed to$371.95

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 6.51 changed to 6.44
    • Malpractice RVU 0.43 changed to 0.44

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $378.98changed to$385.26

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $392.82changed to$378.98

    • Conversion factor 33.8872 changed to 32.7442
    • Work GPCI 1.045 changed to 1.042
    • Practice expense GPCI 1.200 changed to 1.197
    • Malpractice GPCI 0.868 changed to 0.894

  5. January 1, 2023

    RVU23A

    $407.56changed to$392.82

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 6.66 changed to 6.51
    • Malpractice RVU 0.41 changed to 0.43
    • Work GPCI 1.049 changed to 1.045
    • Practice expense GPCI 1.203 changed to 1.200
    • Malpractice GPCI 0.842 changed to 0.868

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $407.03changed to$407.56

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 6.56 changed to 6.66
    • Malpractice RVU 0.42 changed to 0.41

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $384.06changed to$407.03

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 5.75 changed to 6.56
    • Work GPCI 1.041 changed to 1.049
    • Practice expense GPCI 1.191 changed to 1.203
    • Malpractice GPCI 0.952 changed to 0.842

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $370.95changed to$384.06

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 5.46 changed to 5.75
    • Malpractice RVU 0.46 changed to 0.42
    • Work GPCI 1.033 changed to 1.041
    • Practice expense GPCI 1.179 changed to 1.191
    • Malpractice GPCI 1.061 changed to 0.952

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $363.71changed to$370.95

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 5.29 changed to 5.46
    • Malpractice RVU 0.47 changed to 0.46

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $355.13changed to$363.71

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 5.26 changed to 5.29
    • Work GPCI 1.025 changed to 1.033
    • Practice expense GPCI 1.171 changed to 1.179
    • Malpractice GPCI 0.839 changed to 1.061

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $421.52changed to$355.13

    • 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 0.48 changed to 0.47
    • Work GPCI 1.017 changed to 1.025
    • Practice expense GPCI 1.163 changed to 1.171
    • Malpractice GPCI 0.617 changed to 0.839

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $431.86changed to$421.52

    • 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 0.48

    Held through RVU16B, RVU16C, RVU16D.

  13. October 1, 2015

    RVU15D

    $419.80changed to$431.86

    • Work RVU 3.36 changed to 3.69

  14. July 1, 2015

    RVU15C

    $417.71changed to$419.80

    • Conversion factor 35.7547 changed to 35.9335

  15. January 1, 2015

    RVU15A

    $429.19changed to$417.71

    • 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 1.016 changed to 1.017
    • Practice expense GPCI 1.156 changed to 1.163
    • Malpractice GPCI 0.704 changed to 0.617

    Held through RVU15B.

  16. January 1, 2014

    RVU14A

    No ratechanged to$429.19

    Held through RVU14B, RVU14C, RVU14D.

  17. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$431.33$176.50RVU26D
2026-07-01$431.33$176.50RVU26C
2026-04-01$431.33$176.50RVU26B
2026-01-01$431.33$176.50RVU26A
2025-10-01$371.95$191.91RVU25D
2025-07-01$371.95$191.91RVU25C
2025-04-01$371.95$191.91RVU25B
2025-01-01$371.95$191.91RVU25A
2024-10-01$385.26$196.40RVU24D
2024-07-01$385.26$196.40RVU24C
2024-04-01$385.26$196.40RVU24B
2024-03-09$385.26$196.40RVU24AR
2024-01-01$378.98$193.19RVU24A
2023-10-01$392.82$198.85RVU23D
2023-07-01$392.82$198.85RVU23C
2023-04-01$392.82$198.85RVU23B
2023-01-01$392.82$198.85RVU23A
2022-10-01$407.56$202.73RVU22D
2022-07-01$407.56$202.73RVU22C
2022-04-01$407.56$202.73RVU22B
2022-01-01$407.56$202.73RVU22A
2021-10-01$407.03$204.28RVU21D
2021-07-01$407.03$204.28RVU21C
2021-04-01$407.03$204.28RVU21B
2021-01-01$407.03$204.28RVU21A
2020-10-01$384.06$209.12RVU20D
2020-07-01$384.06$209.12RVU20C
2020-04-01$384.06$209.12RVU20B
2020-01-01$384.06$209.12RVU20A
2019-10-01$370.95$210.76RVU19D
2019-07-01$370.95$210.76RVU19C
2019-04-01$370.95$210.76RVU19B
2019-01-01$370.95$210.76RVU19A
2018-10-01$363.71$211.76RVU18D
2018-07-01$363.71$211.76RVU18C
2018-04-01$363.71$211.76RVU18B
2018-01-01$363.71$211.76RVU18AR1
2017-10-01$355.13$205.94RVU17D
2017-07-01$355.13$205.94RVU17C
2017-04-01$355.13$205.94RVU17B
2017-01-01$355.13$205.94RVU17A
2016-10-01$421.52$205.41RVU16D
2016-07-01$421.52$205.41RVU16C
2016-04-01$421.52$205.41RVU16B
2016-01-01$421.52$205.41RVU16A
2015-10-01$431.86$228.34RVU15D
2015-07-01$419.80$216.28RVU15C
2015-04-01$417.71$215.20RVU15B
2015-01-01$417.71$215.20RVU15A
2014-10-01$429.19$228.76RVU14D
2014-07-01$429.19$228.76RVU14C
2014-04-01$429.19$228.76RVU14B
2014-01-01$429.19$228.76RVU14A
2013-10-01Rate data unavailableRate data unavailableRVU13D
2013-07-01Rate data unavailableRate data unavailableRVU13C
2013-04-01Rate data unavailableRate data unavailableRVU13B
2013-01-01Rate data unavailableRate data unavailableRVU13AR

Price G0121 for an earlier date of service

Where the Metropolitan Boston, MA rate applies

Metropolitan Boston, MA is a Medicare payment area, not a city. Our Census mapping connects it to 60 cities and communities in Massachusetts. Some span more than one payment area; confirm with the service ZIP.

  • Boston
  • Arlington
  • Ayer
  • Bellingham
  • Belmont
  • Braintree Town
  • Brookline
  • Burlington

Browse all communities in Massachusetts

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
RVUs for G0121PPRRVU2026_Oct_nonQPP.csv, line 15,093 (RVU26D)
Geographic factors for Metropolitan Boston, MAGPCI2026.csv, line 62 (RVU26D)

Open CMS sourceHow we calculate rates

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