HCPCS code Q0091: Pap collection, screening specimen2026 Medicare rate & RVUs in Illinois
Q0091 reports obtaining and preparing a cervical or vaginal specimen for a screening Pap test and sending it to the laboratory.
Medicare pays $43.78–$47.84 for Q0091 in the office in Illinois, from Rest of Illinois to Suburban Chicago, IL. 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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What Q0091 covers
Q0091 represents the clinician’s work to obtain a cervical or vaginal specimen for a screening Pap test, prepare it, and send it to the laboratory. It is commonly reported when a physician or other qualified practitioner collects the sample during a preventive gynecologic visit. The code covers specimen acquisition and handling, not cytology interpretation or a separately performed pelvic examination.
Report Q0091 when the collection is for screening, rather than evaluation of symptoms or a known abnormality. Documentation should identify the screening purpose, record that the specimen was collected, and support its preparation and conveyance to the laboratory. G0101 may describe a screening pelvic examination performed at the same visit; the laboratory reports cytology under the code matching its preparation and screening method. CMS assigns physician work and practice-expense values to Q0091, with separate office and facility practice-expense inputs.
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 Q0091 pays more and less in Illinois
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
4 payment localities
$43.78 to $47.84
| Payment locality | Office | Facility |
|---|---|---|
| Chicago, IL | $47.64 | $17.09 |
| East St. Louis, IL | $44.46 | $16.50 |
| Rest of Illinois | $43.78 | $16.03 |
| Suburban Chicago, IL | $47.84 | $16.63 |
How the Q0091 rate is calculated
Each of Q0091’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 · Q0091
RVUs × geographic indexes × conversion factor
Work0.36
0.36 RVUs× 1.000 GPCI
Practice expense0.99
0.99 RVUs× 1.000 GPCI
Malpractice0.03
0.03 RVUs× 1.000 GPCI
Adjusted RVUs
1.3800
Conversion factor
$33.4009
Medicare rate
$46.09
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for Q0091
Q0091 has no global surgery period, no multiple-procedure, bilateral or assistant-at-surgery adjustment, and no professional/technical split. What changes the payment is where the service happens: the place of service on the claim decides whether Medicare pays the office or the facility rate.
Place of service · Q0091
Which rate does Medicare pay?
The POS code on the claim line (CMS-1500 box 24B).
POS 11 · non-facility rate · national
$46.09
- Non-facility (office)
- $46.09
- Facility
- $15.70
Higher because the practice carries its own overhead.
Q0091 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- G0101Screening pelvic examPelvic and clinical breast exam
- Choose Q0091 for collection and handling of the screening Pap specimen. Choose G0101 for a screening pelvic examination; both services may occur at one visit.
- 88142Pap testPreservative fluid, manual screening
- Q0091 covers obtaining and sending the specimen. 88142 describes the laboratory cytology service performed on a cervical or vaginal specimen.
- G0123Pap cytologyCytotechnologist-screened thin layer
- Q0091 reports specimen collection. G0123 reports the laboratory’s screening cytology service using thin-layer preparation.
Q0091 billing questions
How is Q0091 different from G0101?
Q0091 represents collection and handling of the screening Pap specimen. G0101 represents a screening pelvic examination when that examination is performed and documented.
Does Q0091 include the laboratory's cytology interpretation?
No. Q0091 covers obtaining, preparing, and sending the specimen; the laboratory reports its cytology service under the applicable laboratory code.
Can Q0091 be reported for a diagnostic Pap test?
Q0091 is for obtaining a specimen for screening. When testing is performed to evaluate symptoms or a known abnormality, do not characterize that collection as screening.
What documentation supports Q0091?
Document the screening purpose, the cervical or vaginal specimen collection, and preparation and conveyance of the specimen to the laboratory.
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
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