How much does Medicare pay for HCPCS G0101?

Medicare allowed an average of $37.86 per service and paid $37.86 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $105.31, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is HCPCS code G0101?

Cervical or vaginal cancer screening; pelvic and clinical breast examination. It was billed 646,399 times to 646,399 Medicare beneficiaries by 14,958 providers in 2024.

Does G0101 pay differently in an office than a hospital?

Yes. The allowed amount averaged $38.19 in an office setting and $25.49 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills G0101 most?

Obstetrics & Gynecology, with 521,364 services from 11,140 clinicians. Next are Nurse Practitioner, Physician Assistant, Certified Nurse Midwife.

HCPCS G0101

Cervical or vaginal cancer screening; pelvic and clinical breast examination

$37.86Medicare-allowed amount per service, averaged across 646,399 services

Providers submitted

$105.31

Asking price, not received

Medicare allowed

$37.86

The fee schedule figure

Medicare paid

$37.86

Balance is patient coinsurance

Providers submitted an average of $105.31 for this code and Medicare allowed $37.86 — 2.8× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $37.86 (100%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $38.19
Hospital / facility: $25.49

The office rate is higher because the practice supplies the room, staff and equipment out of that payment. In a hospital the facility bills those separately, so the clinician's share is smaller — the total cost to Medicare is usually higher, not lower. 629,559 services were billed in an office setting and 16,840 in a facility.

Services: 646,399
Beneficiaries: 646,399
Providers billing it: 14,958
Total allowed: $24,472,666

What Medicare pays for HCPCS G0101

Across 646,399 services billed by 14,958 providers to 646,399 beneficiaries, Medicare allowed an average of $37.86 per service. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills G0101

Specialty	Services	Beneficiaries	Avg allowed	Providers
Obstetrics & Gynecology	521,364	521,364	$39.06	11,140
Nurse Practitioner	83,836	83,836	$31.62	2,506
Physician Assistant	18,333	18,333	$31.74	540
Certified Nurse Midwife	8,017	8,017	$38.12	298
Family Practice	6,042	6,042	$37.90	228
Internal Medicine	5,064	5,064	$38.68	178
Gynecological Oncology	2,813	2,813	$38.79	42
General Practice	186	186	$36.80	6
Hospitalist	145	145	$41.80	5
Certified Clinical Nurse Specialist	129	129	$33.33	2
Osteopathic Manipulative Medicine	98	98	$39.78	4
General Surgery	96	96	$37.58	3
Endocrinology	78	78	$45.67	1
Otolaryngology	68	68	$41.29	1
Emergency Medicine	47	47	$35.82	1

G0101 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
New York	76,797	$42.06	$36.83	1,385
Florida	56,439	$38.05	$37.15	1,036
Pennsylvania	52,174	$36.72	$36.48	1,012
California	45,293	$41.63	$37.37	999
New Jersey	43,673	$42.02	$37.78	720
Texas	30,965	$37.01	$37.50	892
Virginia	25,198	$37.57	$37.18	512
Ohio	24,818	$34.72	$35.96	717
Maryland	22,396	$39.28	$36.68	427
Illinois	19,863	$37.99	$36.35	550
Massachusetts	18,234	$38.73	$36.60	445
Georgia	17,893	$36.70	$37.76	454
North Carolina	16,373	$35.42	$37.09	494
Tennessee	16,287	$34.23	$36.93	382
Louisiana	13,755	$32.59	$35.04	325
Connecticut	13,112	$41.45	$37.83	327
South Carolina	13,019	$35.64	$37.41	303
Missouri	12,284	$34.93	$36.32	350
Michigan	12,068	$38.26	$37.23	366
Indiana	11,010	$34.13	$36.68	337
Alabama	10,813	$33.73	$37.49	278
Mississippi	10,632	$34.11	$37.40	186
Arizona	8,887	$35.76	$36.55	210
Kentucky	8,151	$34.16	$35.78	237
Delaware	6,593	$36.80	$36.67	90
Arkansas	6,450	$33.16	$37.09	153
Oklahoma	5,253	$34.36	$36.97	153
Kansas	3,884	$33.73	$36.42	128
Hawaii	3,825	$38.63	$37.23	70
Colorado	3,423	$38.16	$37.52	137
New Hampshire	3,418	$34.51	$33.89	112
Nevada	3,372	$35.83	$36.86	121
Nebraska	3,248	$33.50	$36.85	97
West Virginia	3,058	$32.24	$33.63	76
Rhode Island	2,850	$39.19	$38.12	65
Iowa	2,799	$29.87	$32.45	106
Oregon	2,678	$36.32	$36.33	118
Wisconsin	2,271	$33.61	$35.78	113
Washington	1,956	$35.71	$34.55	81
District of Columbia	1,828	$42.61	$37.38	47
New Mexico	1,446	$34.93	$36.20	44
Vermont	1,336	$30.17	$31.05	35
Maine	1,078	$31.86	$32.64	39
Minnesota	1,006	$36.32	$37.51	52
Idaho	890	$29.87	$32.33	38
Montana	871	$33.46	$33.44	35
Utah	692	$36.90	$37.60	17
Wyoming	555	$35.18	$35.79	20
Puerto Rico	434	$36.14	$38.34	20
Alaska	370	$43.67	$36.36	17
South Dakota	364	$28.38	$29.63	18
North Dakota	304	$29.89	$30.79	11
U.S. Virgin Islands	13	$31.21	$32.68	1

Related codes

G0103Prostate cancer screening; prostate specific antigen test (psa)$18.89
G0127Trimming of dystrophic nails$17.81
G0180Physician or allowed practitioner certification for medicare-covered h$52.34
G0181Physician or allowed practitioner supervision of a patient receiving m$103.01
G0179Physician or allowed practitioner re-certification for medicare-covere$40.20
G0105Colorectal cancer screening; colonoscopy on individual at high risk$287.76
G0145Screening cytopathology$25.95
G0121Colorectal cancer screening; colonoscopy on individual not meeting cri$295.44
G0136Administration of a standardized$16.63
G0108Diabetes outpatient self-management training services$53.63
G0123Screening cytopathology$19.83
G0109Diabetes outpatient self-management training services$15.50

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.