G0101 HCPCS code: Cervical or vaginal cancer screening; pelvic and clinical breast examination
G0101 is the HCPCS Level II code for cervical or vaginal cancer screening; pelvic and clinical breast examination. In 2024 Medicare paid an average of $37.59 per service for G0101 across 728,665 services. Its Medicare coverage code is D (Special coverage instructions apply): Medicare covers it when its national or local coverage criteria are met. The NCCI unit limit is 1 per day on outpatient hospital claims. Medicare volume fell 4% from 2022 to 2024 (762,198 to 728,665 services). In 2024, about 41,289 clinicians billed Medicare for G0101 for 728,665 beneficiaries; New York, Florida, Pennsylvania accounted for 27% of services.
Code details
| Field | Value |
|---|---|
| Section | G codes — Procedures and professional services (temporary) |
| Coverage code | D — Special coverage instructions apply |
| Pricing indicator | 11 — Priced using national relative value units (Physician Fee Schedule) |
| BETOS category | M1A |
| Added | 1998-01-01 |
| Last action effective | 1998-01-01 |
Who bills G0101 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 41,289 |
| Medicare beneficiaries | 728,665 |
| States with claims | 54 |
| Share of services in top 3 states (New York, Florida, Pennsylvania) | 27% |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for G0101, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 762,198 | 762,179 | $39.00 | $39.00 |
| 2023 | 760,312 | 760,311 | $38.17 | $38.17 |
| 2024 | 728,665 | 728,665 | $37.59 | $37.59 |
States with the most G0101 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| New York | 81,584 | $41.74 |
| Florida | 62,188 | $37.95 |
| Pennsylvania | 56,495 | $36.54 |
| California | 51,292 | $41.48 |
| New Jersey | 45,786 | $41.93 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 1 | Anatomic Consideration |
| practitioner claims | 1 | Anatomic Consideration |
What changed for G0101
- 1998-01-01: G0101 added to HCPCS Level II
- Next scheduled CMS quarterly update (HCPCS and DMEPOS fee schedule): 2027-01-01
Frequently asked questions
What is HCPCS code G0101?
G0101 is the HCPCS Level II code for cervical or vaginal cancer screening; pelvic and clinical breast examination. Short descriptor: "Ca screen;pelvic/breast exam".
How much does Medicare pay for G0101?
In 2024, the average Medicare payment was $37.59 per service (average allowed $37.59).
Does Medicare cover G0101?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
How many units of G0101 can be billed per day?
1 on outpatient hospital claims; 1 on practitioner claims (NCCI medically unlikely edits).
Related G01 codes
- G0102 — Prostate cancer screening; digital rectal examination
- G0103 — Prostate cancer screening; prostate specific antigen test (PSA)
- G0104 — Colorectal cancer screening; flexible sigmoidoscopy
- G0105 — Colorectal cancer screening; colonoscopy on individual at high risk
- G0106 — Colorectal cancer screening; alternative to g0104, screening sigmoidoscopy, barium enema
- G0108 — Diabetes outpatient self-management training services, individual, per 30 minutes
- G0109 — Diabetes outpatient self-management training services, group session (2 or more), per 30 minutes
- G0117 — Glaucoma screening for high risk patients furnished by an optometrist or ophthalmologist
- G0118 — Glaucoma screening for high risk patient furnished under the direct supervision of an optometrist or ophthalmologist
- G0120 — Colorectal cancer screening; alternative to g0105, screening colonoscopy, barium enema.
- G0121 — Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk
- G0122 — Colorectal cancer screening; barium enema
Building a device that would bill under a code like this? Caduvo matches a device description to HCPCS/CPT codes, Medicare coverage and payment, and the FDA pathway in one report.
Next steps
- Run a reimbursement report for a device billed under G0101
- Watch G0101 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for G0101
Sources: CMS HCPCS Level II release October 2025; CMS DMEPOS fee schedule; CMS NCCI MUE tables; CMS Medicare utilization (physician and DME supplier files); CMS Medicare Coverage Database articles. Fees are Medicare allowables, not commercial rates. Not billing or legal advice.