G0101 Ca screen;pelvic/breast exam
What G0101 is
Cervical or vaginal cancer screening; pelvic and clinical breast examination
HCPCS Level II long description, CMS October 2026 file. See the G codes page for the full section.
Medicare payment for G0101 (CY2026)
| Work RVU | Practice expense RVU | Malpractice RVU | Total | Medicare rate | |
|---|---|---|---|---|---|
| Non-facility (office) | 0.44 | 0.68 | 0.07 | 1.19 | $39.75 |
| Facility (hospital, ASC) | 0.44 | 0.23 | 0.07 | 0.74 | $24.72 |
National rates: total RVUs x the CY2026 conversion factor of 33.4009 (non-QP), before geographic adjustment. Actual Medicare payment is 80% of the rate shown after the deductible; the patient or secondary payer owes the 20% coinsurance.
Status: Active - payable under the Physician Fee Schedule. Global period: Global concept does not apply.
Medically Unlikely Edit (MUE)
Medicare caps G0101 at 1 unit per date of service for practitioner claims (MAI 2 - date of service edit (absolute): units above the MUE never pay), rationale: Anatomic Consideration. Units above the cap are denied unless the edit's adjudication rules allow an appeal with documentation.
Billed with G0101? These codes are bundled into it
G0101 is a Column 1 code in 98 active NCCI PTP edits. When one of these Column 2 codes is reported on the same date of service, it is denied as bundled - unless the edit's modifier indicator is 1 and documentation supports a distinct service with an NCCI-associated modifier.
| Column 2 code | Short description | Modifier indicator | |
|---|---|---|---|
36591 | Draw blood off venous device | 0 - no modifier bypass | Check pair |
36592 | Collect blood from picc | 0 - no modifier bypass | Check pair |
57410 | Pelvic examination | 1 - modifier may bypass | Check pair |
96523 | Irrig drug delivery device | 0 - no modifier bypass | Check pair |
99202 | Office o/p new sf 15 min | 1 - modifier may bypass | Check pair |
99203 | Office o/p new low 30 min | 1 - modifier may bypass | Check pair |
99204 | Office o/p new mod 45 min | 1 - modifier may bypass | Check pair |
99205 | Office o/p new hi 60 min | 1 - modifier may bypass | Check pair |
99211 | Off/op est may x req phy/qhp | 1 - modifier may bypass | Check pair |
99212 | Office o/p est sf 10 min | 1 - modifier may bypass | Check pair |
99213 | Office o/p est low 20 min | 1 - modifier may bypass | Check pair |
99214 | Office o/p est mod 30 min | 1 - modifier may bypass | Check pair |
99215 | Office o/p est hi 40 min | 1 - modifier may bypass | Check pair |
99221 | 1st hosp ip/obs sf/low 40 | 1 - modifier may bypass | Check pair |
99222 | 1st hosp ip/obs moderate 55 | 1 - modifier may bypass | Check pair |
99223 | 1st hosp ip/obs high 75 | 1 - modifier may bypass | Check pair |
99231 | Sbsq hosp ip/obs sf/low 25 | 1 - modifier may bypass | Check pair |
99232 | Sbsq hosp ip/obs moderate 35 | 1 - modifier may bypass | Check pair |
99233 | Sbsq hosp ip/obs high 50 | 1 - modifier may bypass | Check pair |
99234 | Hosp ip/obs sm dt sf/low 45 | 1 - modifier may bypass | Check pair |
99235 | Hosp ip/obs same date mod 70 | 1 - modifier may bypass | Check pair |
99236 | Hosp ip/obs same date hi 85 | 1 - modifier may bypass | Check pair |
99238 | Hosp ip/obs dschrg mgmt 30/< | 1 - modifier may bypass | Check pair |
99239 | Hosp ip/obs dschrg mgmt >30 | 1 - modifier may bypass | Check pair |
99281 | Emr dpt vst mayx req phy/qhp | 1 - modifier may bypass | Check pair |
99282 | Emergency dept visit sf mdm | 1 - modifier may bypass | Check pair |
99283 | Emergency dept visit low mdm | 1 - modifier may bypass | Check pair |
99284 | Emergency dept visit mod mdm | 1 - modifier may bypass | Check pair |
99285 | Emergency dept visit hi mdm | 1 - modifier may bypass | Check pair |
99291 | Critical care first hour | 1 - modifier may bypass | Check pair |
Showing 30 of 98 column 2 codes. Use the pair checker for any specific combination.
G0101 is bundled into these codes
G0101 appears as a Column 2 code in 2 active edits. Reported with one of these Column 1 codes on the same date of service, G0101 is the code that denies.
| Column 1 code | Short description | Modifier indicator | |
|---|---|---|---|
99170 | Anogenital exam child w imag | 1 | Check pair |
G0337 | Hospice evaluation preelecti | 0 | Check pair |
Data: CMS CY2026 Physician Fee Schedule RVU file (October release, RVU26D) and Medicare NCCI PTP practitioner edits v32.3 (2026 Q4). Verify against the official files before billing or contracting decisions.