G0104 Colorectal cancer screening; flexible sigmoidoscopy...
HCPCS Procedure & Supply Codes
G0104 - Ca screen;flexi sigmoidscope
Need more information about G0104? Get access to fees, crosswalks, billing policies, similar codes and much more.
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Additional Code Information includes:
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Save time with a Professional or Facility subscription! You will be able to see the most common modifiers billed to Medicare along with this code.
HCPCS Index Entries (Reverse Index Lookup) 
reverse_index/reverse_index_content.php?set=HCPCS&c=G0104
View historical information about the code including when it was added, changed, deleted, etc. Access to this feature is available in the following products:
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Subscribers may add their own notes as well as "Admin Notes" visible to all subscribers in their account. Access to this feature is available in the following products:
Subscribers may add their own notes as well as "Admin Notes" visible to all subscribers in their account. |
Medicare Processing Note #0010
THIS PROCESSING NOTE DELETED 1/1/97.
Medicare - Special Coverage Instructions
Subscribers will see related documentation, coding and billing tips. Access to this feature is available in the following products:
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DMEPOS Products (Durable Medical Equipment, Prosthetics, Orthotics, Supplies)
dmepos/dmepos_content.php?set=HCPCS&c=G0104
Calculated for National Unadjusted (00000)
* Note: Medicare may or may NOT reimburse you for this code. The fees provided below are based on values established by CMS/Medicare. Please check with your local Medicare contact on whether this code is eligible for reimbursement.
Medicare vs. My Fee Evaluation
| Modifier | Medicare Allowed | 150% | 200% | My Fee |
|---|---|---|---|---|
| (none) | $54.99 | $82.48 | $109.98 | (your fee) |
| (MPPR) | $27.49 | $41.24 | $54.99 | (your fee) |
Access to calculated fee values is available. Access to this feature is available in the following products:
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Medicare Participating - Assignment Accepted (Mandatory)
| Modifier | Allowed | Medicare 80% | Patient Pays |
|---|---|---|---|
| (none) | $54.99 | $##.## | $##.## |
| (MPPR) | $27.49 | $##.## | $##.## |
Medicare Non-Participating - Assignment Accepted (Check To Doctor)
| Modifier | Allowed | Medicare 80% | Patient Pays | Limiting Charge (Amount Billed) |
|---|---|---|---|---|
| (none) | $##.## | $##.## | $##.## | $##.## |
| (MPPR) | $##.## | $##.## | $##.## | $##.## |
Medicare Non-Participating - Assignment NOT Accepted (Check To Patient)
| Modifier | Allowed | Medicare 80% | Patient Pays | Limiting Charge (Amount Billed) |
|---|---|---|---|---|
| (none) | $##.## | $##.## | $##.## | $##.## |
| (MPPR) | $##.## | $##.## | $##.## | $##.## |
Medicare vs. My Fee Evaluation
| Modifier | Medicare Allowed | 150% | 200% | My Fee |
|---|---|---|---|---|
| (none) | $179.85 | $269.77 | $359.69 | (your fee) |
| (MPPR) | $89.92 | $134.88 | $179.85 | (your fee) |
Access to calculated fee values is available. Access to this feature is available in the following products:
Note: Subscribers will see the calculated values below. |
Medicare Participating - Assignment Accepted (Mandatory)
| Modifier | Allowed | Medicare 80% | Patient Pays |
|---|---|---|---|
| (none) | $179.85 | $##.## | $##.## |
| (MPPR) | $89.92 | $##.## | $##.## |
Medicare Non-Participating - Assignment Accepted (Check To Doctor)
| Modifier | Allowed | Medicare 80% | Patient Pays | Limiting Charge (Amount Billed) |
|---|---|---|---|---|
| (none) | $##.## | $##.## | $##.## | $##.## |
| (MPPR) | $##.## | $##.## | $##.## | $##.## |
Medicare Non-Participating - Assignment NOT Accepted (Check To Patient)
| Modifier | Allowed | Medicare 80% | Patient Pays | Limiting Charge (Amount Billed) |
|---|---|---|---|---|
| (none) | $##.## | $##.## | $##.## | $##.## |
| (MPPR) | $##.## | $##.## | $##.## | $##.## |
This section shows APC information including: Status Indicator, Relative Weight, Payment Rate, Crosswalks, and more. Access to this feature is available in the following products:
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View fees for this code from 4 different built-in fee schedules and from those you've added using the Compare-A-Fee™ tool. If you work with several fee schedules or would like to create custom fee comparison reports, you need our exclusive Compare-A-Fee™ tool.
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View a table of UCR, Worker's Comp, and Medicare Fees here, as well as see UCR Fees in the charts below. Access to this feature is available in the following products:
Note: Subscribers will see the fee graphs below. |
View a chart showing the last 8+ years of Medicare denial rates, Medicare Allowed amounts, and Medicare billed amounts. Access to this feature is available in the following products:
Note: Subscribers will see the fee graphs below. |
Calculated for National Unadjusted (00000)
* Note: Medicare may or may NOT reimburse you for this code. The fees provided below are based on values established by CMS/Medicare. Please check with your local Medicare contact on whether this code is eligible for reimbursement.
RVU Components (by modifier)
| Modifier | Work | Practice Expense | Malpractice Expense | Total |
|---|---|---|---|---|
| (none) | 0.84 | 0.74 | 0.12 | 1.700 |
| (MPPR) | 0.42 | 0.37 | 0.06 | 0.850 |
Access to calculated fee values is available. Access to this feature is available in the following products:
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Practitioner Labor
| Pre-Service | Intra-Service | Post-Service | Total Time* |
|---|---|---|---|
| ## | ## | ## | ## min |
* Total Time may be greater than the displayed components.
Work RVU Components (by modifier)
| Modifier | National Unadjusted Work RVU | Work GPCI | Adjusted Work RVU |
|---|---|---|---|
| (none) | ##.## | ##.## | 0.84 |
| (MPPR) | ##.## | ##.## | 0.42 |
Clinical Labor - Direct Expense
| Staff | Staff Rate | Pre Time | Intra Time | Post Time | Total Time |
|---|---|---|---|---|---|
| RN/LPN/MTA | $0.54 / min | ## min | ## min | ## min | ## min |
Equipment - Direct Expense
| Item | Purchase Price | Expected Life | Total Time |
|---|---|---|---|
| table, exam | $##.## | ## years | ## min |
| light, fiberoptic headlight w-source | $##.## | ## years | ## min |
| cart, endoscopy imaging equipment | $##.## | ## years | ## min |
| multi-channeled flexible digital scope, flexible sigmoidoscopy | $##.## | ## years | ## min |
Supplies - Direct Expense
| Item | Unit Price | Quantity | Unit | Amount |
|---|---|---|---|---|
| cover, thermometer probe | $##.## | ## | item | $##.## |
| drape, non-sterile, sheet 40in x 60in | $##.## | ## | item | $##.## |
| gloves, non-sterile | $##.## | ## | pair | $##.## |
| gown, patient | $##.## | ## | item | $##.## |
| gown, staff, impervious | $##.## | ## | item | $##.## |
| mask, surgical | $##.## | ## | item | $##.## |
| paper, exam table | $##.## | ## | foot | $##.## |
| pillow case | $##.## | ## | item | $##.## |
| syringe 50-60ml | $##.## | ## | item | $##.## |
| cytology, brush | $##.## | ## | item | $##.## |
| tubing, suction, non-latex (6ft) with Yankauer tip (1) | $##.## | ## | item | $##.## |
| applicator, cotton-tipped, non-sterile 6in | $##.## | ## | item | $##.## |
| gauze, non-sterile 4in x 4in | $##.## | ## | item | $##.## |
| alcohol isopropyl 70% | $##.## | ## | ml | $##.## |
| basin, emesis | $##.## | ## | item | $##.## |
| lubricating jelly (K-Y) (5gm uou) | $##.## | ## | item | $##.## |
| water, distilled | $##.## | ## | oz | $##.## |
| cup, biopsy-specimen non-sterile 4oz | $##.## | ## | item | $##.## |
| cleaning brush, endoscope | $##.## | ## | item | $##.## |
| enzymatic detergent | $##.## | ## | oz | $##.## |
| glutaraldehyde 3.4% (Cidex, Maxicide, Wavicide) | $##.## | ## | oz | $##.## |
| glutaraldehyde test strips (Cidex, Metrex) | $##.## | ## | item | $##.## |
Indirect Expenses (clerical,overhead, and other) are also included in the practice expense.
PE RVU Components (by modifier)
| Modifier | National Unadjusted PE RVU | PE GPCI | Adjusted PE RVU |
|---|---|---|---|
| (none) | ##.## | ##.## | 0.740 |
| (MPPR) | ##.## | ##.## | 0.370 |
RVU Components (by modifier)
| Modifier | Work | Practice Expense | Malpractice Expense | Total |
|---|---|---|---|---|
| (none) | 0.84 | 4.6 | 0.12 | 5.560 |
| (MPPR) | 0.42 | 2.3 | 0.06 | 2.780 |
Access to calculated fee values is available. Access to this feature is available in the following products:
Note: Subscribers will see the calculated values below. |
Practitioner Labor
| Pre-Service | Intra-Service | Post-Service | Total Time* |
|---|---|---|---|
| ## | ## | ## | ## min |
* Total Time may be greater than the displayed components.
Work RVU Components (by modifier)
| Modifier | National Unadjusted Work RVU | Work GPCI | Adjusted Work RVU |
|---|---|---|---|
| (none) | ##.## | ##.## | 0.84 |
| (MPPR) | ##.## | ##.## | 0.42 |
Clinical Labor (Non-Facility)- Direct Expense
| Staff | Staff Rate | Pre Time | Intra Time | Post Time | Total Time |
|---|---|---|---|---|---|
| RN/LPN/MTA | $0.54 / min | ## min | ## min | ## min | ## min |
Equipment (Non-Facility)- Direct Expense
| Item | Purchase Price | Expected Life | Total Time |
|---|---|---|---|
| table, exam | $##.## | ## years | ## min |
| light, fiberoptic headlight w-source | $##.## | ## years | ## min |
| cart, endoscopy imaging equipment | $##.## | ## years | ## min |
| multi-channeled flexible digital scope, flexible sigmoidoscopy | $##.## | ## years | ## min |
Supplies (Non-Facility)- Direct Expense
| Item | Unit Price | Quantity | Unit | Amount |
|---|---|---|---|---|
| cover, thermometer probe | $##.## | ## | item | $##.## |
| drape, non-sterile, sheet 40in x 60in | $##.## | ## | item | $##.## |
| gloves, non-sterile | $##.## | ## | pair | $##.## |
| gown, patient | $##.## | ## | item | $##.## |
| gown, staff, impervious | $##.## | ## | item | $##.## |
| mask, surgical | $##.## | ## | item | $##.## |
| paper, exam table | $##.## | ## | foot | $##.## |
| pillow case | $##.## | ## | item | $##.## |
| syringe 50-60ml | $##.## | ## | item | $##.## |
| cytology, brush | $##.## | ## | item | $##.## |
| tubing, suction, non-latex (6ft) with Yankauer tip (1) | $##.## | ## | item | $##.## |
| applicator, cotton-tipped, non-sterile 6in | $##.## | ## | item | $##.## |
| gauze, non-sterile 4in x 4in | $##.## | ## | item | $##.## |
| alcohol isopropyl 70% | $##.## | ## | ml | $##.## |
| basin, emesis | $##.## | ## | item | $##.## |
| lubricating jelly (K-Y) (5gm uou) | $##.## | ## | item | $##.## |
| water, distilled | $##.## | ## | oz | $##.## |
| cup, biopsy-specimen non-sterile 4oz | $##.## | ## | item | $##.## |
| cleaning brush, endoscope | $##.## | ## | item | $##.## |
| enzymatic detergent | $##.## | ## | oz | $##.## |
| glutaraldehyde 3.4% (Cidex, Maxicide, Wavicide) | $##.## | ## | oz | $##.## |
| glutaraldehyde test strips (Cidex, Metrex) | $##.## | ## | item | $##.## |
Indirect Expenses (clerical,overhead, and other) are also included in the practice expense.
PE RVU Components (by modifier)
| Modifier | National Unadjusted PE RVU | PE GPCI | Adjusted PE RVU |
|---|---|---|---|
| (none) | ##.## | ##.## | 4.600 |
| (MPPR) | ##.## | ##.## | 2.300 |
Cross-A-Code™ (ICD-9/10, CPT, Modifiers, NCCI, NDC, ASA CROSSWALK®)
crosswalks/crosswalk_content.php?set=HCPCS&c=G0104
View relationships (or crosswalks) between code sets. Access to this feature is available in the following products:
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Medicare Policies & Guidelines (Articles, LCDs, NCDs)
coverage/coverage_content.php?set=HCPCS&c=G0104
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