G2204 HCPCS code: Patients between 45 and 85 years of age who received a screening colonoscopy during the performance period

G2204 is the HCPCS Level II code for patients between 45 and 85 years of age who received a screening colonoscopy during the performance period. Its Medicare coverage code is C (Carrier judgment): Coverage is decided by the Medicare contractor (MAC) case by case.

Code details

Medicare policy articles for this code

• A55069: Billing and Coding: Screening Colonoscopy Converted to a Diagnostic and/or Therapeutic Colonoscopy (Palmetto GBA (MAC - Part A, MAC - Part B))

Covered diagnoses (3 ICD-10-CM codes)

The diagnoses most often listed as covered in the policy articles above:

What changed for G2204

• 2021-01-01: G2204 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 G2204?

G2204 is the HCPCS Level II code for patients between 45 and 85 years of age who received a screening colonoscopy during the performance period. Short descriptor: "Pt 45-85 w/ scope".

Does Medicare cover G2204?

Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.

Which diagnoses support coverage for G2204?

Medicare policy articles that cite G2204 list 3 covered ICD-10-CM diagnosis codes across 1 article. The most cited include Z12.11 (Encounter for screening for malignant neoplasm of colon), Z15.060 (Genetic susceptibility to colorectal cancer), Z80.0 (Family history of malignant neoplasm of digestive organs). A listed diagnosis is necessary but not sufficient; the policy's other criteria still apply.

Related G22 codes

• G2200 — Patient identified as an unhealthy alcohol user received brief counseling
• G2201 — Documentation of medical reason(s) for not providing brief counseling (e.g., limited life expectancy, other medical reasons)
• G2202 — Patient did not receive brief counseling if identified as an unhealthy alcohol user
• G2203 — Documentation of medical reason(s) for not providing brief counseling if identified as an unhealthy alcohol user (e.g., limited life expectancy, other medical reasons)
• G2205 — Patients with pregnancy during adjuvant treatment course
• G2206 — Patient received adjuvant treatment course including both chemotherapy and her2-targeted therapy
• G2207 — Reason for not administering adjuvant treatment course including both chemotherapy and her2-targeted therapy (e.g. poor performance status (ecog 3-4; karnofsky <=50), cardiac contraindications, insufficient renal function, insufficient hepatic function, other active or secondary cancer diagnoses, other medical contraindications, patients who died during initial treatment course or transferred during or after initial treatment course)
• G2208 — Patient did not receive adjuvant treatment course including both chemotherapy and her2-targeted therapy
• G2209 — Patient refused to participate
• G2210 — Residual score for the neck impairment not measured because the patient did not complete the neck fs prom at initial evaluation and/or near discharge, reason not given
• G2211 — Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established)
• G2212 — Prolonged office or other outpatient evaluation and management service(s) beyond the maximum required time of the primary procedure which has been selected using total time on the date of the primary service; each additional 15 minutes by the physician or qualified healthcare professional, with or without direct patient contact (list separately in addition to cpt codes 99205, 99215, 99483 for office or other outpatient evaluation and management services) (do not report g2212 on the same date of service as 99358, 99359, 99415, 99416). (do not report g2212 for any time unit less than 15 minutes)

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 G2204
• Watch G2204 for fee, coverage and descriptor changes
• Build a full Medicare revenue model for G2204

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.

All G codes · HCPCS lookup