GI · CMS status A
G0121
Screening colonoscopy avg risk
Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk.
Work RVU
3.36
2026 Medicare pays
$287.92
National GPCI · non-facility · CF $33.4009
RVU anatomyWork 3.36 + Practice 4.92 + Malpractice 0.34 = 8.62 total
Work (your effort)Practice expenseMalpractice
When to use it
Average-risk Medicare screening colonoscopy.
Full guidance
Once per 10 years.
Documentation checklist
- ✓Screening indication documented.
- ✓No personal or family history of polyps/CRC qualifying as high risk.
Common pitfalls
- !If a polyp is found and removed, the screening becomes diagnostic — use 45385 with modifier PT.
- !Patient cost share is waived for screening but may apply for the diagnostic conversion.
Common modifiers
PT (Medicare screening converted to diagnostic)33 (commercial)
Common ICD-10 pairings
Z12.11
Educational reference, not billing or legal advice. Verify against your payer contracts and your compliance team before submission.