G0105 Colorectal scrn; hi risk ind
What G0105 is
Colorectal cancer screening; colonoscopy on individual at high risk
HCPCS Level II long description, CMS October 2026 file. See the G codes page for the full section.
Medicare payment for G0105 (CY2026)
| Work RVU | Practice expense RVU | Malpractice RVU | Total | Medicare rate | |
|---|---|---|---|---|---|
| Non-facility (office) | 3.18 | 7.73 | 0.41 | 11.32 | $378.10 |
| Facility (hospital, ASC) | 3.18 | 1.34 | 0.41 | 4.93 | $164.67 |
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 (endoscopic or minor procedure: global period is the day of the procedure).
Medically Unlikely Edit (MUE)
Medicare caps G0105 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 G0105? These codes are bundled into it
G0105 is a Column 1 code in 310 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 | |
|---|---|---|---|
0091U | 0 - no modifier bypass | Check pair | |
0163U | 0 - no modifier bypass | Check pair | |
0213T | Njx paravert w/us cer/thor | 0 - no modifier bypass | Check pair |
0216T | Njx paravert w/us lumb/sac | 0 - no modifier bypass | Check pair |
0405U | 1 - modifier may bypass | Check pair | |
0421U | 0 - no modifier bypass | Check pair | |
0460U | 1 - modifier may bypass | Check pair | |
0461U | 1 - modifier may bypass | Check pair | |
0464U | 0 - no modifier bypass | Check pair | |
0501U | 0 - no modifier bypass | Check pair | |
0596T | Temp fml iu vlv-pmp 1st insj | 1 - modifier may bypass | Check pair |
0597T | Temp fml iu valve-pmp rplcmt | 1 - modifier may bypass | Check pair |
0708T | Id ca immntx prep & 1st njx | 1 - modifier may bypass | Check pair |
0709T | Id ca immntx each addl njx | 1 - modifier may bypass | Check pair |
0903T | Ecg alg 12 lead reduced i&r | 1 - modifier may bypass | Check pair |
0904T | Ecg alg 12 ld rdcd trcg only | 1 - modifier may bypass | Check pair |
0905T | Ecg alg 12 ld rdcd i&r only | 1 - modifier may bypass | Check pair |
12001 | Rpr s/n/ax/gen/trnk 2.5cm/< | 1 - modifier may bypass | Check pair |
12002 | Rpr s/n/ax/gen/trnk2.6-7.5cm | 1 - modifier may bypass | Check pair |
12004 | Rpr s/n/ax/gen/trk7.6-12.5cm | 1 - modifier may bypass | Check pair |
12005 | Rpr s/n/a/gen/trk12.6-20.0cm | 1 - modifier may bypass | Check pair |
12006 | Rpr s/n/a/gen/trk20.1-30.0cm | 1 - modifier may bypass | Check pair |
12007 | Rpr s/n/ax/gen/trnk >30.0 cm | 1 - modifier may bypass | Check pair |
12011 | Rpr f/e/e/n/l/m 2.5 cm/< | 1 - modifier may bypass | Check pair |
12013 | Rpr f/e/e/n/l/m 2.6-5.0 cm | 1 - modifier may bypass | Check pair |
12014 | Rpr f/e/e/n/l/m 5.1-7.5 cm | 1 - modifier may bypass | Check pair |
12015 | Rpr f/e/e/n/l/m 7.6-12.5 cm | 1 - modifier may bypass | Check pair |
12016 | Rpr fe/e/en/l/m 12.6-20.0 cm | 1 - modifier may bypass | Check pair |
12017 | Rpr fe/e/en/l/m 20.1-30.0 cm | 1 - modifier may bypass | Check pair |
12018 | Rpr f/e/e/n/l/m >30.0 cm | 1 - modifier may bypass | Check pair |
Showing 30 of 310 column 2 codes. Use the pair checker for any specific combination.
G0105 is bundled into these codes
G0105 appears as a Column 2 code in 20 active edits. Reported with one of these Column 1 codes on the same date of service, G0105 is the code that denies.
| Column 1 code | Short description | Modifier indicator | |
|---|---|---|---|
0885T | Colsc flx 1st tndsc dilat | 0 | Check pair |
0886T | Sgmdsc flx 1st tndsc dilat | 1 | Check pair |
45349 | Sigmoidoscopy w/resection | 0 | Check pair |
45378 | Diagnostic colonoscopy | 0 | Check pair |
45379 | Colonoscopy w/fb removal | 0 | Check pair |
45380 | Colonoscopy and biopsy | 0 | Check pair |
45381 | Colonoscopy submucous njx | 0 | Check pair |
45382 | Colonoscopy w/control bleed | 0 | Check pair |
45384 | Colonoscopy w/lesion removal | 0 | Check pair |
45385 | Colonoscopy w/lesion removal | 0 | Check pair |
45386 | Colonoscopy w/balloon dilat | 0 | Check pair |
45388 | Colonoscopy w/ablation | 0 | Check pair |
45389 | Colonoscopy w/stent plcmt | 0 | Check pair |
45390 | Colonoscopy w/resection | 0 | Check pair |
45393 | Colonoscopy w/decompression | 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.