HCPCS G0105

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

Other services Work RVU per service 3.26 (2023 fee schedule)

8,773
97th percentile among 6,405 codes billed · 2023
$105M
98th percentile among 6,405 codes billed · 2023
384K
92nd percentile among 6,405 codes billed · 2023
27
55th percentile among 6,405 codes billed · 2023
136
61st percentile among 6,405 codes billed · 2023
+6.5%
Medicare payment on the code vs 2022; billers +1.7% · 2023

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
Florida701$10,221,33436,73630176
California651$9,615,40828,05027131
Texas605$7,238,88326,66127128
Pennsylvania497$6,153,61422,71427152
North Carolina336$4,151,59315,16628149
New York336$3,959,68613,00922131
New Jersey277$3,846,32212,00226145
Maryland222$3,840,74112,72633183
Georgia296$3,487,23412,77827122
Massachusetts284$3,434,80113,30327154
Ohio344$3,335,19012,95024119
Arizona198$3,074,29911,13933180
Illinois306$3,054,71011,8972695
South Carolina172$2,758,52010,54640199
Tennessee203$2,668,76610,74135142

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 2023.

Top metro areas

observed calculated calculated calculated calculated
New York-Newark-Jersey City, NY-NJ377$5,428,35416,20725
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD245$3,295,17611,24726
Los Angeles-Long Beach-Anaheim, CA205$2,494,8677,65124
Boston-Cambridge-Newton, MA-NH220$2,411,5379,43426
Washington-Arlington-Alexandria, DC-VA-MD-WV185$2,387,0288,03227
Dallas-Fort Worth-Arlington, TX201$2,352,7078,39927
Phoenix-Mesa-Chandler, AZ143$2,213,1917,62829
Miami-Fort Lauderdale-West Palm Beach, FL167$2,159,7947,42623
Chicago-Naperville-Elgin, IL-IN220$2,070,3538,07924
Atlanta-Sandy Springs-Roswell, GA162$2,056,8797,06026
Baltimore-Columbia-Towson, MD101$1,884,5746,33435
San Francisco-Oakland-Fremont, CA96$1,637,1074,07027
Detroit-Warren-Dearborn, MI105$1,419,0525,17729
Seattle-Tacoma-Bellevue, WA116$1,232,5334,18523
Charlotte-Concord-Gastonia, NC-SC98$1,209,9904,37825

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 2023.

Specialties billing G0105 nationally

Ambulatory Surgical Center accounts for 60% of payment for G0105 nationally in 2023, across 6 specialties on claims.

observed calculated calculated calculated calculated calculated
Ambulatory Surgical Center1,44116%$62,703,22760%149,841104
Gastroenterology5,83466%$35,259,70834%194,62733
General Surgery7348.4%$2,936,3652.8%16,91223
Colorectal Surgery (Proctology)3764.3%$2,199,9222.1%11,85532
Internal Medicine3133.6%$1,695,2921.6%9,27930
Family Practice440.50%$138,7680.13%75117

Not listed: 12 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 2023.

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