RxDoctor Payments Data

HCPCS G0121

Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk

$295.44Medicare-allowed amount per service, averaged across 245,280 services
Providers submitted
$1736.49

Asking price, not received

Medicare allowed
$295.44

The fee schedule figure

Medicare paid
$295.44

Balance is patient coinsurance

Providers submitted an average of $1736.49 for this code and Medicare allowed $295.445.9× 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 $295.44 (100%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility
$244.18
Hospital / facility
$296.97

The facility rate is higher for this code, which is unusual and generally means the service depends on equipment or staffing a hospital carries. 7,126 services were billed in an office setting and 238,154 in a facility.

Services
245,280

Medicare Part B, 2024

Beneficiaries
244,439
Providers billing it
7,705
Total allowed
$72,465,523

Services × allowed amount

What Medicare pays for HCPCS G0121

Across 245,280 services billed by 7,705 providers to 244,439 beneficiaries, Medicare allowed an average of $295.44 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 G0121

SpecialtyServicesBeneficiariesAvg allowedProviders
Gastroenterology113,031112,679$178.364,698
Ambulatory Surgical Center100,948100,549$464.111,532
General Surgery18,18518,143$170.97874
Internal Medicine5,8245,796$177.86269
Colorectal Surgery (Proctology)5,3635,354$179.04239
Family Practice1,1801,173$185.6160
Emergency Medicine152152$183.176
Hospitalist132130$160.755
Vascular Surgery9494$170.193
Osteopathic Manipulative Medicine8181$169.383
General Practice6160$194.104
Thoracic Surgery4847$173.352
Gynecological Oncology3737$190.631
Cardiology2323$166.581
Nurse Practitioner2222$0.011

G0121 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.

StateServicesAllowedStandardized pmtProviders
California26,947$364.94$312.53713
Florida21,985$300.57$310.34600
Texas19,293$295.07$304.49591
Pennsylvania11,191$284.70$289.62378
New Jersey9,463$354.25$328.04264
Ohio9,268$256.24$269.87328
New York8,641$355.50$315.98284
Maryland8,110$312.77$308.86219
Georgia7,367$292.86$300.41247
North Carolina7,111$298.81$313.99245
Arizona6,931$304.17$309.75180
Illinois6,759$269.29$266.32253
South Carolina6,146$269.36$284.71160
Michigan6,015$278.80$286.44202
Tennessee5,907$268.71$292.13182
Massachusetts5,795$271.74$260.77177
Missouri5,451$249.87$262.97174
Virginia5,419$259.69$259.38196
Indiana4,884$255.83$267.77186
Colorado4,461$310.19$312.23145
Oklahoma3,908$241.54$252.03114
Mississippi3,853$259.74$289.8097
Louisiana3,716$264.13$286.53129
Kansas3,693$264.14$283.23106
Washington3,675$315.70$297.19143
Kentucky3,033$234.73$246.63123
Wisconsin3,001$245.51$256.73129
Iowa2,812$258.11$278.5584
Nevada2,539$332.10$323.9969
Arkansas2,498$234.87$256.3582
Oregon2,312$309.86$294.9382
Utah2,311$263.62$274.2863
Nebraska2,017$279.50$291.3170
Alabama1,976$256.18$288.2083
Delaware1,947$320.97$315.8945
Connecticut1,927$312.62$292.2180
Minnesota1,677$285.35$285.2469
Idaho1,313$254.54$270.0955
New Hampshire1,303$263.10$264.1047
New Mexico1,256$265.56$270.6739
Montana1,155$232.19$238.7934
South Dakota988$227.59$243.7734
Alaska855$377.23$316.7721
Wyoming664$281.55$289.7523
West Virginia662$188.19$196.0533
Rhode Island604$281.84$281.4426
Vermont583$214.66$222.1220
Hawaii494$343.89$316.1919
North Dakota393$204.44$213.1316
District of Columbia391$242.53$218.7317
Maine366$250.08$249.7318
Guam125$324.28$332.345
U.S. Virgin Islands64$288.88$331.734
ZZ13$156.87$170.841
Puerto Rico12$176.16$177.631

Related codes

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.