HCPCS G0105

Colorectal cancer screening; colonoscopy on individual at high risk (CMS descriptor)

Other services Work RVU per service 3.26 (2022 fee schedule)

8,623
97th percentile among 6,326 codes billed · 2022
$99M
98th percentile among 6,326 codes billed · 2022
381K
92nd percentile among 6,326 codes billed · 2022
27
55th percentile among 6,326 codes billed · 2022
137
62nd percentile among 6,326 codes billed · 2022
+2.0%
Medicare payment on the code vs 2021; billers +1.7% · 2022

Trend

Medicare payment on the code

$0$50M$100M2020: $72M paid20202021: $97M paid20212022: $99M paid20222023: $105M paid20232024: $105M paid2024$105M$0$50M$100M2020: $72M paid20202021: $97M paid20212022: $99M paid20222023: $105M paid20232024: $105M paid2024$105M$0$50M$100M2020: $72M paid20202021: $97M paid20212022: $99M paid20222023: $105M paid20232024: $105M paid2024$105M$0$50M$100M2020: $72M paid20202021: $97M paid20212022: $99M paid20222023: $105M paid20232024: $105M paid2024$105M

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). Data years 2020–2024.

Billers

05,0002020: 7,238 providers20202021: 8,482 providers20212022: 8,623 providers20222023: 8,773 providers20232024: 8,537 providers20248,53705,0002020: 7,238 providers20202021: 8,482 providers20212022: 8,623 providers20222023: 8,773 providers20232024: 8,537 providers20248,53705,0002020: 7,238 providers20202021: 8,482 providers20212022: 8,623 providers20222023: 8,773 providers20232024: 8,537 providers20248,53705,0002020: 7,238 providers20202021: 8,482 providers20212022: 8,623 providers20222023: 8,773 providers20232024: 8,537 providers20248,537

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). Data years 2020–2024.

observed calculated calculated calculated calculated calculated reported
20248,537$105,008,876-0%364,912261323.26
20238,773$105,087,294+7%384,059271363.26
20228,623$98,638,928+2%380,903271373.26
20218,482$96,750,545+35%372,353271363.26
20207,238$71,579,724first year in data279,730241173.26

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). Data years 2020–2024.

By state

observed calculated calculated calculated calculated calculated
Florida707$9,393,57236,76930173
California587$8,188,27125,99328132
Texas607$6,495,27426,20026130
Pennsylvania504$6,390,75224,24727160
North Carolina333$4,152,19715,90329147
New York325$3,755,33112,83925126
New Jersey265$3,560,12911,84426143
Maryland214$3,498,25512,50033209
Georgia305$3,421,65813,21827130
Massachusetts287$3,282,30412,84425155
Ohio320$3,015,98612,00125119
Arizona190$2,918,90411,08535202
Illinois284$2,681,74610,9502795
Tennessee205$2,622,04311,18634154
South Carolina177$2,578,33110,66636180

Not listed: 3 states with fewer than 11 billers (small cells).

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). Providers placed by practice address. Data year 2022.

Top metro areas

observed calculated calculated calculated calculated
New York-Newark-Jersey City, NY-NJ365$4,938,35315,63425
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD240$3,407,47612,12327
Washington-Arlington-Alexandria, DC-VA-MD-WV180$2,310,7838,42529
Boston-Cambridge-Newton, MA-NH221$2,245,8858,94824
Phoenix-Mesa-Chandler, AZ139$2,170,6017,97233
Los Angeles-Long Beach-Anaheim, CA168$2,053,0926,95628
Dallas-Fort Worth-Arlington, TX194$2,015,7887,86226
Atlanta-Sandy Springs-Roswell, GA167$1,934,9307,18026
Miami-Fort Lauderdale-West Palm Beach, FL158$1,878,5277,25125
Chicago-Naperville-Elgin, IL-IN204$1,803,7037,44827
Baltimore-Columbia-Towson, MD92$1,638,4995,87435
San Francisco-Oakland-Fremont, CA99$1,558,6844,35928
Detroit-Warren-Dearborn, MI109$1,238,2784,87731
Seattle-Tacoma-Bellevue, WA119$1,224,0654,41524
Jacksonville, FL84$1,086,3414,39626

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 96 areas with the most payment among those with at least 11 billers; non-metro parts of each state are one area. Data year 2022.

Specialties billing G0105 nationally

Ambulatory Surgical Center accounts for 57% of payment for G0105 nationally in 2022, across 6 specialties on claims.

observed calculated calculated calculated calculated calculated
Ambulatory Surgical Center1,40616%$56,022,86257%150,714107
Gastroenterology5,78267%$35,643,16336%192,15433
General Surgery7188.3%$2,904,4592.9%16,34523
Colorectal Surgery (Proctology)3504.1%$2,165,0702.2%11,47133
Internal Medicine2903.4%$1,595,6201.6%8,55730
Family Practice470.55%$159,5080.16%91920

Not listed: 14 specialties with fewer than 11 billers (small cells).

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). Provider-level lines (fewer than 11 beneficiaries suppressed by CMS); specialty is the provider type on claims. Data year 2022.

Top billers of G0105 nationally

Named top billers are a Pro figure, and Pro is not available to buy, so this list is not shown to any account. The counts and totals by state, metro area and specialty on this page are free.

Original Medicare Part B fee-for-service only; CMS suppresses provider lines with fewer than 11 beneficiaries. How these figures are computed · Limitations