G2204 — Patients between 45 and 85 years of age who received a screening colonoscopy during the performance period
G2204 is a HCPCS Level II code for patients between 45 and 85 years of age who received a screening colonoscopy during the performance period. It belongs to the Procedures and Professional Services (Temporary) section. Whether Medicare pays it depends on the coverage rule below.
Medicare coverage: Carrier judgment
Coverage is decided by your Medicare contractor, not by national policy. Whether this is paid depends on the LCD for your jurisdiction and on what the documentation supports.
From the coverage field of the CMS Alpha-Numeric HCPCS File, release 2026Q3-Jul. This states Medicare’s position on the code, not on your particular claim.
Physician fee schedule statusM
Measurement code. Used for reporting purposes only; never paid.
Global period: XXX
Want the dollar amount for your locality? The fee calculator applies your GPCI and the current conversion factor.
The CMS record for G2204
- Long descriptor
- Patients between 45 and 85 years of age who received a screening colonoscopy during the performance period
- Short descriptor
- Pt 45-85 w/ scope
- Added
- January 1, 2021
- BETOS
- Z2
- Pricing indicator
- 00 — Not priced by Part B
The official wording. This is what the code means.
CMS's 28-character form, which is what shows up on a remittance advice.
When CMS introduced the code.
Berenson-Eggers Type of Service — CMS's own analytic grouping.
Service not separately priced by Part B — not covered, bundled into another service, or used by Part A only.
Codes adjacent to G2204
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If G2204 is not quite right, the correct code is very often within a few positions of it.
- G2196Patient identified as an unhealthy alcohol user when screened for unhealthy alcohol use using a systematic screening method
- G2197Patient screened for unhealthy alcohol use using a systematic screening method and not identified as an unhealthy alcohol user
- G2198Documentation of medical reason(s) for not screening for unhealthy alcohol use using a systematic screening method (e.g., limited life expectancy, other medical reasons)terminated
- G2199Patient not screened for unhealthy alcohol use using a systematic screening method
- G2200Patient identified as an unhealthy alcohol user received brief counseling
- G2201Documentation of medical reason(s) for not providing brief counseling (e.g., limited life expectancy, other medical reasons)terminated
- G2202Patient did not receive brief counseling if identified as an unhealthy alcohol user
- G2203Documentation of medical reason(s) for not providing brief counseling if identified as an unhealthy alcohol user (e.g., limited life expectancy, other medical reasons)terminated
- G2205Patients with pregnancy during adjuvant treatment course
- G2206Patient received adjuvant treatment course including both chemotherapy and her2-targeted therapy
- G2207Reason 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)
- G2208Patient did not receive adjuvant treatment course including both chemotherapy and her2-targeted therapy
- G2209Patient refused to participate
- G2210Residual 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
- G2211Visit 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 home or residence or office/outpatient evaluation and management service, new or established)
- G2212Prolonged 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)
Questions about G2204
What is HCPCS code G2204?
G2204 is a HCPCS Level II code for patients between 45 and 85 years of age who received a screening colonoscopy during the performance period. It sits in the Procedures and Professional Services (Temporary) section.
Does Medicare cover G2204?
The CMS HCPCS file marks G2204 as "Carrier judgment". Coverage is decided by your Medicare contractor, not by national policy. Whether this is paid depends on the LCD for your jurisdiction and on what the documentation supports.
How is G2204 paid under the physician fee schedule?
G2204 carries PFS status code M. Measurement code. Used for reporting purposes only; never paid.