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See a sample rate comparisonHCPCS G0105 Fee Schedule
Last Verified: September 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
Colorectal cancer screening; colonoscopy on individual at high risk
| Key Fact | Detail |
|---|---|
| Service Type | Procedures / Professional Services Screening Examinations and Disease Management Training |
| Complexity Level | Moderate |
| Medicaid Fee Schedule | View Medicaid rates for G0105 |
National average reimbursement for HCPCS G0105 by major payers:
$406.59
$472.91
$441.44
$370.08
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HCPCS G0105
5 of 25 sample ratesHigher to lower in this preview
Jennifer Romanowicz
University Physicians Incorporated
$1,365.18Published ratePaul Rochon
University Physicians Incorporated
$1,171.61Published ratePadmini Palat
University Physicians Incorporated
$1,093.51Published rateGeorge Marzloff
University Physicians Incorporated
$933.90Published rateMichelle West
University Physicians Incorporated
$215.69Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS G0105 vs. Other Screening Examinations and Disease Management Training Codes
The HCPCS G0105 code is part of the Procedures / Professional Services services used for Screening Examinations and Disease Management Training. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The HCPCS G0105 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 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 G0105. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the G0105 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.
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