HCPCS G0105

Across 364,912 services billed by 8,537 providers to 363,739 beneficiaries, Medicare allowed an average of $287.76 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.

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.

• 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
• G0101Cervical or vaginal cancer screening; pelvic and clinical breast exami$37.86
• G0181Physician or allowed practitioner supervision of a patient receiving m$103.01
• G0179Physician or allowed practitioner re-certification for medicare-covere$40.20
• 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

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.

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