HCPCS G0105 Fee Schedule
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.
| Key Fact | Detail |
|---|---|
| Service Type | • Procedures / Professional Services • Screening Examinations and Disease Management Training |
| Complexity Level | Moderate |
National average reimbursement for HCPCS G0105 by major payers:

$406.59

$472.91

$441.44

$370.08
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for HCPCS G0105 | ||||||
United | G0105 | $957.66 | 1851608616 - CLAY QUINT | 742161737 - UNIVERSITY PHYSICIANS INCORPORATED | CO | Vascular Surgery Physician (2086S0129X) |
United | G0105 | $957.66 | 1275995524 - HEIKO YANG | 742161737 - UNIVERSITY PHYSICIANS INCORPORATED | CO | Urology Physician (208800000X) |
United | G0105 | $1195.05 | 1306284898 - JANELL KIERSTEIN | 742161737 - UNIVERSITY PHYSICIANS INCORPORATED | CO | Genetic Counselor (M.S.) (170300000X) |
United | G0105 | $1171.61 | 1407065188 - BENJAMIN STEINBERG | 742161737 - UNIVERSITY PHYSICIANS INCORPORATED | CO | Clinical Cardiac Electrophysiology Physician (207RC0001X) |
United | G0105 | $1120.68 | 1619346855 - AMY REED | 742161737 - UNIVERSITY PHYSICIANS INCORPORATED | CO | Family Nurse Practitioner (363LF0000X) |
United | G0105 | $543.35 | 1003895293 - IAN BACH | 800348943 - POUDRE VALLEY MEDICAL GROUP LLC | CO | Family Medicine Physician (207Q00000X) |
United | G0105 | $705.25 | 1497106637 - BETHANY MENSINK | 840405257 - CATHOLIC HEALTH INITIATIVES COLORADO | MI | Surgery Physician (208600000X) |
United | G0105 | $1120.68 | 1093883860 - SANDRA MOON | 742161737 - UNIVERSITY PHYSICIANS INCORPORATED | CO | Pediatric Emergency Medicine (Pediatrics) Physician (2080P0204X) |
United | G0105 | $1171.61 | 1598913980 - PAUL ROCHON | 742161737 - UNIVERSITY PHYSICIANS INCORPORATED | CO | Vascular & Interventional Radiology Physician (2085R0204X) |
United | G0105 | $1093.51 | 1144363862 - PADMINI PALAT | 742161737 - UNIVERSITY PHYSICIANS INCORPORATED | CO | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | G0105 | $1093.51 | 1700961430 - ROBIN DETERDING | 742161737 - UNIVERSITY PHYSICIANS INCORPORATED | CO | Pediatric Pulmonology Physician (2080P0214X) |
United | G0105 | $933.90 | 1508270851 - GEORGE MARZLOFF | 742161737 - UNIVERSITY PHYSICIANS INCORPORATED | CO | Physical Medicine & Rehabilitation Physician (208100000X) |
United | G0105 | $215.69 | 1013450501 - MICHELLE WEST | 742161737 - UNIVERSITY PHYSICIANS INCORPORATED | CO | Clinical Psychologist (103TC0700X) |
United | G0105 | $705.25 | 1700063732 - RYAN EARNEST | 840405257 - CATHOLIC HEALTH INITIATIVES COLORADO | TX | Trauma Surgery Physician (2086S0127X) |
United | G0105 | $1195.05 | 1356728166 - RYAN MURPHY | 742161737 - UNIVERSITY PHYSICIANS INCORPORATED | CO | Emergency Medicine Physician (207P00000X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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HCPCS 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 |
| G0106-HCPCS | Moderate | Colorectal cancer screening; alternative to G0104, screening sigmoidoscopy, barium enema |
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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