G0102 HCPCS code: Prostate cancer screening; digital rectal examination
G0102 is the HCPCS Level II code for prostate cancer screening; digital rectal examination. In 2024 Medicare paid an average of $12.67 per service for G0102 across 7,317 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 45% from 2022 to 2024 (13,311 to 7,317 services). In 2024, about 941 clinicians billed Medicare for G0102 for 7,317 beneficiaries; California, Texas, New York accounted for 34% 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 | Y1 |
| Added | 2000-01-01 |
| Last action effective | 2000-01-01 |
Who bills G0102 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 941 |
| Medicare beneficiaries | 7,317 |
| States with claims | 35 |
| Share of services in top 3 states (California, Texas, New York) | 34% |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for G0102, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 13,311 | 13,311 | $22.94 | $12.76 |
| 2023 | 10,522 | 10,522 | $22.85 | $13.21 |
| 2024 | 7,317 | 7,317 | $22.46 | $12.67 |
States with the most G0102 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| California | 848 | $15.27 |
| Texas | 838 | $11.02 |
| New York | 747 | $15.96 |
| Massachusetts | 518 | $12.62 |
| Illinois | 442 | $13.37 |
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 G0102
- 2000-01-01: G0102 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 G0102?
G0102 is the HCPCS Level II code for prostate cancer screening; digital rectal examination. Short descriptor: "Prostate ca screening; dre".
How much does Medicare pay for G0102?
In 2024, the average Medicare payment was $12.67 per service (average allowed $22.46).
Does Medicare cover G0102?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
How many units of G0102 can be billed per day?
1 on outpatient hospital claims; 1 on practitioner claims (NCCI medically unlikely edits).
Related G01 codes
- G0101 — Cervical or vaginal cancer screening; pelvic and clinical breast 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 G0102
- Watch G0102 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for G0102
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.