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HCPCS G0105 Fee Schedule

Last Verified: January 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 FactDetail
Service Type

Procedures / Professional Services

Screening Examinations and Disease Management Training

Complexity LevelModerate

National average reimbursement for HCPCS G0105 by major payers:

bcbs

$406.59

uhc

$472.91

aetna

$441.44

cigna

$370.08

Preview provider-level rates for...
For billing codeHCPCS G0105
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for HCPCS G0105

United
G0105$957.661851608616 - CLAY QUINT742161737 - UNIVERSITY PHYSICIANS INCORPORATEDCOVascular Surgery Physician (2086S0129X)
United
G0105$957.661275995524 - HEIKO YANG742161737 - UNIVERSITY PHYSICIANS INCORPORATEDCOUrology Physician (208800000X)
United
G0105$1195.051306284898 - JANELL KIERSTEIN742161737 - UNIVERSITY PHYSICIANS INCORPORATEDCOGenetic Counselor (M.S.) (170300000X)
United
G0105$1171.611407065188 - BENJAMIN STEINBERG742161737 - UNIVERSITY PHYSICIANS INCORPORATEDCOClinical Cardiac Electrophysiology Physician (207RC0001X)
United
G0105$1120.681619346855 - AMY REED742161737 - UNIVERSITY PHYSICIANS INCORPORATEDCOFamily Nurse Practitioner (363LF0000X)
United
G0105$543.351003895293 - IAN BACH800348943 - POUDRE VALLEY MEDICAL GROUP LLCCOFamily Medicine Physician (207Q00000X)
United
G0105$705.251497106637 - BETHANY MENSINK840405257 - CATHOLIC HEALTH INITIATIVES COLORADOMISurgery Physician (208600000X)
United
G0105$1120.681093883860 - SANDRA MOON742161737 - UNIVERSITY PHYSICIANS INCORPORATEDCOPediatric Emergency Medicine (Pediatrics) Physician (2080P0204X)
United
G0105$1171.611598913980 - PAUL ROCHON742161737 - UNIVERSITY PHYSICIANS INCORPORATEDCOVascular & Interventional Radiology Physician (2085R0204X)
United
G0105$1093.511144363862 - PADMINI PALAT742161737 - UNIVERSITY PHYSICIANS INCORPORATEDCONeurology with Special Qualifications in Child Neurology Physician (2084N0402X)
United
G0105$1093.511700961430 - ROBIN DETERDING742161737 - UNIVERSITY PHYSICIANS INCORPORATEDCOPediatric Pulmonology Physician (2080P0214X)
United
G0105$933.901508270851 - GEORGE MARZLOFF742161737 - UNIVERSITY PHYSICIANS INCORPORATEDCOPhysical Medicine & Rehabilitation Physician (208100000X)
United
G0105$215.691013450501 - MICHELLE WEST742161737 - UNIVERSITY PHYSICIANS INCORPORATEDCOClinical Psychologist (103TC0700X)
United
G0105$705.251700063732 - RYAN EARNEST840405257 - CATHOLIC HEALTH INITIATIVES COLORADOTXTrauma Surgery Physician (2086S0127X)
United
G0105$1195.051356728166 - RYAN MURPHY742161737 - UNIVERSITY PHYSICIANS INCORPORATEDCOEmergency Medicine Physician (207P00000X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

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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.

CodeComplexityDescription
G0104-HCPCSLowColorectal cancer screening; flexible sigmoidoscopy
G0105-HCPCSModerateColorectal cancer screening; colonoscopy on individual at high risk
G0106-HCPCSModerateColorectal 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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