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G0105 Colorectal cancer screening; colonoscopy on individual at high risk...
HCPCS Procedure & Supply Codes
G0105 - Colorectal scrn; hi risk ind
Need more information about G0105? Get access to fees, crosswalks, billing policies, similar codes and much more.
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Additional Code Information includes:
Access to this feature is available in the following products:
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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=G0105
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=G0105
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) | $177.26 | $265.89 | $354.52 | (your fee) |
| (MPPR) | $88.63 | $132.94 | $177.26 | (your fee) |
| 53 | $88.63 | $132.94 | $177.26 | (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) | $177.26 | $##.## | $##.## |
| (MPPR) | $88.63 | $##.## | $##.## |
| 53 | $88.63 | $##.## | $##.## |
Medicare Non-Participating - Assignment Accepted (Check To Doctor)
| Modifier | Allowed | Medicare 80% | Patient Pays | Limiting Charge (Amount Billed) |
|---|---|---|---|---|
| (none) | $##.## | $##.## | $##.## | $##.## |
| (MPPR) | $##.## | $##.## | $##.## | $##.## |
| 53 | $##.## | $##.## | $##.## | $##.## |
Medicare Non-Participating - Assignment NOT Accepted (Check To Patient)
| Modifier | Allowed | Medicare 80% | Patient Pays | Limiting Charge (Amount Billed) |
|---|---|---|---|---|
| (none) | $##.## | $##.## | $##.## | $##.## |
| (MPPR) | $##.## | $##.## | $##.## | $##.## |
| 53 | $##.## | $##.## | $##.## | $##.## |
Medicare vs. My Fee Evaluation
| Modifier | Medicare Allowed | 150% | 200% | My Fee |
|---|---|---|---|---|
| (none) | $327.67 | $491.51 | $655.34 | (your fee) |
| (MPPR) | $164.00 | $246.00 | $327.99 | (your fee) |
| 53 | $163.67 | $245.51 | $327.35 | (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) | $327.67 | $##.## | $##.## |
| (MPPR) | $164.00 | $##.## | $##.## |
| 53 | $163.67 | $##.## | $##.## |
Medicare Non-Participating - Assignment Accepted (Check To Doctor)
| Modifier | Allowed | Medicare 80% | Patient Pays | Limiting Charge (Amount Billed) |
|---|---|---|---|---|
| (none) | $##.## | $##.## | $##.## | $##.## |
| (MPPR) | $##.## | $##.## | $##.## | $##.## |
| 53 | $##.## | $##.## | $##.## | $##.## |
Medicare Non-Participating - Assignment NOT Accepted (Check To Patient)
| Modifier | Allowed | Medicare 80% | Patient Pays | Limiting Charge (Amount Billed) |
|---|---|---|---|---|
| (none) | $##.## | $##.## | $##.## | $##.## |
| (MPPR) | $##.## | $##.## | $##.## | $##.## |
| 53 | $##.## | $##.## | $##.## | $##.## |
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.
Access to this feature is available in the following products:
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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) | 3.26 | 1.79 | 0.43 | 5.480 |
| (MPPR) | 1.63 | 0.89 | 0.22 | 2.740 |
| 53 | 1.63 | 0.9 | 0.21 | 2.740 |
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) | ##.## | ##.## | 3.26 |
| (MPPR) | ##.## | ##.## | 1.63 |
| 53 | ##.## | ##.## | 1.63 |
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 |
| RN | $0.76 / min | ## min | ## min | ## min | ## min |
Equipment - Direct Expense
| Item | Purchase Price | Expected Life | Total Time |
|---|---|---|---|
| table, exam | $##.## | ## years | ## min |
| light, exam | $##.## | ## years | ## min |
| scope video system (monitor, processor, digital capture, cart, printer, LED light) | $##.## | ## years | ## min |
| multi-channeled flexible digital scope, colonoscopy | $##.## | ## years | ## min |
Supplies - Direct Expense
| Item | Unit Price | Quantity | Unit | Amount |
|---|---|---|---|---|
| gloves, non-sterile | $##.## | ## | pair | $##.## |
| gloves, sterile | $##.## | ## | pair | $##.## |
| gown, patient | $##.## | ## | item | $##.## |
| gown, staff, impervious | $##.## | ## | item | $##.## |
| mask, surgical, with face shield | $##.## | ## | item | $##.## |
| paper, exam table | $##.## | ## | foot | $##.## |
| shoe covers, surgical | $##.## | ## | pair | $##.## |
| iv tubing (extension) | $##.## | ## | foot | $##.## |
| needle, 18-27g | $##.## | ## | item | $##.## |
| syringe 10-12ml | $##.## | ## | item | $##.## |
| syringe 20ml | $##.## | ## | item | $##.## |
| syringe 50-60ml | $##.## | ## | item | $##.## |
| canister, suction | $##.## | ## | item | $##.## |
| catheter, suction | $##.## | ## | item | $##.## |
| electrode, ECG (single) | $##.## | ## | item | $##.## |
| tubing, suction, non-latex (6ft) with Yankauer tip (1) | $##.## | ## | item | $##.## |
| cautery, patient ground pad w-cord | $##.## | ## | item | $##.## |
| tape, elastic, 2in (Elastoplast, Elasticon) (5yd uou) | $##.## | ## | item | $##.## |
| swab-pad, alcohol | $##.## | ## | 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) | ##.## | ##.## | 1.790 |
| (MPPR) | ##.## | ##.## | 0.890 |
| 53 | ##.## | ##.## | 0.900 |
RVU Components (by modifier)
| Modifier | Work | Practice Expense | Malpractice Expense | Total |
|---|---|---|---|---|
| (none) | 3.26 | 6.44 | 0.43 | 10.130 |
| (MPPR) | 1.63 | 3.22 | 0.22 | 5.070 |
| 53 | 1.63 | 3.22 | 0.21 | 5.060 |
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) | ##.## | ##.## | 3.26 |
| (MPPR) | ##.## | ##.## | 1.63 |
| 53 | ##.## | ##.## | 1.63 |
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 |
| RN | $0.76 / min | ## min | ## min | ## min | ## min |
Equipment (Non-Facility)- Direct Expense
| Item | Purchase Price | Expected Life | Total Time |
|---|---|---|---|
| table, exam | $##.## | ## years | ## min |
| light, exam | $##.## | ## years | ## min |
| scope video system (monitor, processor, digital capture, cart, printer, LED light) | $##.## | ## years | ## min |
| multi-channeled flexible digital scope, colonoscopy | $##.## | ## years | ## min |
Supplies (Non-Facility)- Direct Expense
| Item | Unit Price | Quantity | Unit | Amount |
|---|---|---|---|---|
| gloves, non-sterile | $##.## | ## | pair | $##.## |
| gloves, sterile | $##.## | ## | pair | $##.## |
| gown, patient | $##.## | ## | item | $##.## |
| gown, staff, impervious | $##.## | ## | item | $##.## |
| mask, surgical, with face shield | $##.## | ## | item | $##.## |
| paper, exam table | $##.## | ## | foot | $##.## |
| shoe covers, surgical | $##.## | ## | pair | $##.## |
| iv tubing (extension) | $##.## | ## | foot | $##.## |
| needle, 18-27g | $##.## | ## | item | $##.## |
| syringe 10-12ml | $##.## | ## | item | $##.## |
| syringe 20ml | $##.## | ## | item | $##.## |
| syringe 50-60ml | $##.## | ## | item | $##.## |
| canister, suction | $##.## | ## | item | $##.## |
| catheter, suction | $##.## | ## | item | $##.## |
| electrode, ECG (single) | $##.## | ## | item | $##.## |
| tubing, suction, non-latex (6ft) with Yankauer tip (1) | $##.## | ## | item | $##.## |
| cautery, patient ground pad w-cord | $##.## | ## | item | $##.## |
| tape, elastic, 2in (Elastoplast, Elasticon) (5yd uou) | $##.## | ## | item | $##.## |
| swab-pad, alcohol | $##.## | ## | 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) | ##.## | ##.## | 6.440 |
| (MPPR) | ##.## | ##.## | 3.220 |
| 53 | ##.## | ##.## | 3.220 |
Cross-A-Code™ (ICD-9/10, CPT, Modifiers, NCCI, NDC, ASA CROSSWALK®)
crosswalks/crosswalk_content.php?set=HCPCS&c=G0105
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=G0105
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