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See a sample rate comparisonHCPCS G0104 Fee Schedule
Medicare rates as of October 2026
HCPCS G0104 is classified under Procedures / Professional Services, in the Screening Examinations and Disease Management Training subgroup.
Colorectal cancer screening; flexible sigmoidoscopy
| Key Fact | Detail |
|---|---|
| Service Type | Procedures / Professional Services Screening Examinations and Disease Management Training |
| Complexity Level | Low |
| Medicare Fee Schedule | $214.77 national non-facility rate (2026) · View Medicare rates for G0104 |
| Medicaid Fee Schedule | $166.87 median of the 8 states in the free preview · View Medicaid rates for G0104 |
National average reimbursement for HCPCS G0104 by major payers:
$183.20
BCBS / Anthem
$212.41
UnitedHealthcare
$201.82
Aetna
$201.88
Cigna
Compare published rates across providers.
Choose a payer to see a sample of rates for HCPCS G0104.
HCPCS G0104
5 of 25 sample ratesHigher to lower in this preview
Kevin Comar
Borland-Groover Clinic, P.A.
$657.84Published rateSilvia Fernandez Perez
Florida Hospital Medical Group Inc
$261.26Published rateSaud El-Sayed Suleiman
$181.41Published rateSovi Joseph Md PA
Sovi Joseph, M.D., P.A.
$116.43Published rateRaouf Hilal
$46.70Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS G0104 vs. Other Screening Examinations and Disease Management Training Codes
The table lists codes related to G0104. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| G0103-HCPCS | Low | Prostate cancer screening; prostate specific antigen test (PSA) |
| G0104-HCPCS | Low | Colorectal cancer screening; flexible sigmoidoscopy |
| G0105-HCPCS | Moderate | Colorectal cancer screening; colonoscopy on individual at high risk |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS G0104. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the G0104 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
FREE SAMPLE MARKET COMPARISON
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Bring your top codes (like HCPCS G0104) and we'll show you how you compare in 15 minutes or less.