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G0102 Prostate ca screening; dre

What G0102 is

Prostate cancer screening; digital rectal examination

HCPCS Level II long description, CMS October 2026 file. See the G codes page for the full section.

Medicare payment for G0102 (CY2026)

Work RVUPractice expense RVUMalpractice RVUTotalMedicare rate
Non-facility (office)0.180.540.010.73$24.38
Facility (hospital, ASC)0.180.040.010.23$7.68

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.

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Medically Unlikely Edit (MUE)

Medicare caps G0102 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 G0102? These codes are bundled into it

G0102 is a Column 1 code in 11 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 codeShort descriptionModifier indicator
0403U1 - modifier may bypassCheck pair
36591Draw blood off venous device0 - no modifier bypassCheck pair
36592Collect blood from picc0 - no modifier bypassCheck pair
96523Irrig drug delivery device0 - no modifier bypassCheck pair
99446Ntrprof ph1/ntrnet/ehr 5-100 - no modifier bypassCheck pair
99447Ntrprof ph1/ntrnet/ehr 11-200 - no modifier bypassCheck pair
99448Ntrprof ph1/ntrnet/ehr 21-300 - no modifier bypassCheck pair
99449Ntrprof ph1/ntrnet/ehr 31/>0 - no modifier bypassCheck pair
99451Ntrprof ph1/ntrnet/ehr 5/>0 - no modifier bypassCheck pair
99452Ntrprof ph1/ntrnet/ehr rfrl0 - no modifier bypassCheck pair
99463Same day nb discharge0 - no modifier bypassCheck pair

G0102 is bundled into these codes

G0102 appears as a Column 2 code in 90 active edits. Reported with one of these Column 1 codes on the same date of service, G0102 is the code that denies.

Column 1 codeShort descriptionModifier indicator
0495U1Check pair
99202Office o/p new sf 15 min0Check pair
99203Office o/p new low 30 min0Check pair
99204Office o/p new mod 45 min0Check pair
99205Office o/p new hi 60 min0Check pair
99211Off/op est may x req phy/qhp0Check pair
99212Office o/p est sf 10 min0Check pair
99213Office o/p est low 20 min0Check pair
99214Office o/p est mod 30 min0Check pair
99215Office o/p est hi 40 min0Check pair
992211st hosp ip/obs sf/low 400Check pair
992221st hosp ip/obs moderate 550Check pair
992231st hosp ip/obs high 750Check pair
99231Sbsq hosp ip/obs sf/low 250Check pair
99232Sbsq hosp ip/obs moderate 350Check 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.