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Medicare Physician Fee Schedule · Q3 2026 release

HCPCS G0121 in Phoenix, AZ 03102-00

Colon ca scrn not hi rsk ind in ZIPs including 85004, 85251, and 85016

G0121 2026 C · Phoenix, AZ flag03102-00 A Active
Allowed amount
$368.41
in a doctor’s own office or clinic

97.4% of the $378.43 national baseline

Medicare payment
$294.73
Patient / secondary
$73.68
Expected total to provider
$368.41

Patient / secondary and expected total to provider assume the Part B annual deductible is already met. If it isn't, the patient owes more than the amount shown here.

Locality-adjusted Physician Fee Schedule pricing

How much does Medicare allow for HCPCS G0121 in Phoenix, AZ? Copy link

The Medicare allowed amount is $368.41 in the office (non-facility) setting and $161.59 in a facility, under the Q3 2026 Physician Fee Schedule. The office amount is 2.6% below the national baseline, and the facility amount is 2.1% below the national baseline. This is the fee schedule amount before sequestration and before any deductible or coinsurance is applied — not necessarily what a specific claim pays.

What Medicare locality is Phoenix, AZ in? Copy link

CMS prices all of Arizona as one Medicare payment locality, so this amount applies statewide, including Tucson, Mesa, Scottsdale and Chandler — not only in Phoenix, AZ.

Why Phoenix, AZ differs from the national amount Copy link

Phoenix, AZ (this locality)
$368.41
National PFS baseline (GPCI 1.000)
$378.43

The national figure is a baseline, not an amount any provider is paid. This locality's geographic practice cost indices scale each RVU component before the conversion factor is applied, which puts Phoenix, AZ at 2.6% below the national baseline.

Work GPCI
1.000
Practice expense GPCI
0.969
Malpractice GPCI
0.856
2026 conversion factor
$33.4009

Formula and inputs Copy link

The office (non-facility) amount for G0121 in Phoenix, AZ: each component's RVU times its GPCI, summed, then multiplied by the conversion factor.

RVU and GPCI components of the Phoenix, AZ allowed amount for G0121
Component RVU × GPCI = Adjusted RVU
Work 3.18 1.000 3.1800
Practice expense 7.73 0.969 7.4904
Malpractice 0.42 0.856 0.3595
Sum of adjusted RVUs 11.0299
× $33.4009 2026 conversion factor $368.41

Facility vs. Office (non-facility) Copy link

In a facility (hospital outpatient or ASC), Phoenix, AZ allows $161.59 for G0121, versus $368.41 in the office. Only the practice-expense RVU changes with the setting. In a facility, the hospital bills its own fee, so the professional payment is lower. Which setting applies to your place of service.

Participating, non-participating and limiting charge Copy link

All figures are for the office (non-facility) setting in Phoenix, AZ. The allowed amount is not the program payment — the rows below separate them. See how the limiting charge and sequestration are derived.

Participation and payment-split amounts for G0121 in Phoenix, AZ
Participating allowed amount The fee schedule amount a participating provider accepts as payment in full. $368.41
Non-participating allowed amount 95% of the participating amount. $349.99
Limiting charge Ceiling a non-participating provider may bill the patient on an unassigned claim — 115% of the non-participating amount. $402.49
Medicare program payment 80% of the allowed amount, once the annual Part B deductible is met. $294.73
Beneficiary coinsurance The remaining 20%. $73.68
Sequestration adjustment Reduces Medicare's share only — never the allowed amount, and never the patient's share. $5.89
Medicare pays after sequestration Program payment net of the sequestration reduction. $288.84

Contracted rate: % of Medicare in Phoenix, AZ Copy link

Commercial contracts are usually written as a percentage of the Medicare fee schedule. Which Medicare amount they mean is the part that gets misread: a contract benchmarked to the fee schedule prices off this locality's allowed amount — $368.41 in the office (non-facility) setting — not the $378.43 national baseline.

Opens the calculator already set to Phoenix, AZ and the office (non-facility) setting. It also compares what a payer actually paid against the expected amount. See how to find your contract's actual percentage.

ZIP codes this Phoenix, AZ rate covers Copy link

The CMS ZIP-to-locality crosswalk maps 571 ZIP codes to this payment locality. G0121 prices identically in every one of them. 1 of them span more than one locality and need ZIP+4 for an exact match.

85001 85002 85003 85004 85005 85006 85007 85008 85009 85010 85011 85012 85013 85014 85015 85016 85017 85018 85019 85020 85021 85022 85023 85024 85025 85026 85027 85028 85029 85030 85031 85032 85033 85034 85035 85036 85037 85038 85039 85040 85041 85042 85043 85044 85045 85046 85048 85050 85051 85053 85054 85055 85060 85061 85062 85063 85064 85065 85066 85067 85068 85069 85070 85071 85072 85073 85074 85075 85076 85077 85078 85079 85080 85082 85083 85085 85086 85087 85096 85097 85098 85099 85117 85118 85119 85120 85121 85122 85123 85127 85128 85130 85131 85132 85135 85137 85138 85139 85140 85141

471 more ZIP codes map to this locality. The Phoenix, AZ locality page lists the full set.

Resolves the ZIP to its payment locality, so you can confirm whether this amount applies.

G0121 in nearby payment localities Copy link

Payment localities in the same region as Phoenix, AZ, nearest first. Each amount is that locality's own GPCI-adjusted office (non-facility) figure for G0121. Proximity doesn't imply similar pricing — neighbouring localities often differ.

G0121 allowed amount in payment localities near Phoenix, AZ
Metro Allowed amount vs. Phoenix, AZ
Albuquerque, NM $359.82 -2.3%
Las Vegas, NV $376.35 +2.2%
San Diego, CA $425.80 +15.6%
Riverside, CA $403.07 +9.4%
Los Angeles, CA $425.32 +15.4%
Salt Lake City, UT $361.51 -1.9%

Every payment locality nationwide is on the HCPCS G0121 rate map.

Other codes priced in Phoenix, AZ Copy link

Office (non-facility) allowed amounts in this same payment locality, Q3 2026.

Other curated codes and their allowed amounts in Phoenix, AZ
Code Service Phoenix, AZ vs. national
43239 Upper Gastrointestinal Endoscopy With Tissue Sampling $407.26 -2.8%
45385 Colonoscopy With Polyp Removal $487.20 -2.6%
45380 Colonoscopy With Tissue Sampling $467.10 -2.7%
45378 Diagnostic Colonoscopy $368.12 -2.6%
43235 Screening and endoscopy $313.86 -2.7%
45384 Screening and endoscopy $524.51 -2.8%
45381 Screening and endoscopy $477.13 -2.7%
G0105 Screening and endoscopy $368.12 -2.6%
99213 Routine Follow-Up Office Visit $93.25 -2.0%
99214 Long Follow-Up Office Visit $132.86 -2.0%
66984 Cataract Surgery $453.65 -1.9%
92014 Full Eye Exam, Returning Patient $124.63 -2.1%

Common questions Copy link

Which ZIP codes does the Phoenix, AZ rate for G0121 cover?
The CMS ZIP-to-locality crosswalk maps 571 ZIP codes to this payment locality, and every one of them prices G0121 identically. Examples include 85001, 85002, 85003, 85004, 85005, 85006. 1 of them span more than one payment locality, so those need ZIP+4 for an exact match.
Why is the G0121 rate in Phoenix, AZ different from the national amount?
The national figure is a GPCI 1.000 baseline, not an amount any provider is paid. This locality's geographic practice cost indices — work 1.000, practice expense 0.969, malpractice 0.856 — scale each RVU component before the conversion factor is applied, which is why Phoenix, AZ allows less than the $378.43 baseline.
Does this G0121 rate apply everywhere in Arizona?
Yes. CMS prices Arizona as a single Medicare payment locality, so the same GPCIs — and the same allowed amount — apply statewide, not only in Phoenix, AZ. That includes Tucson, Mesa, Scottsdale and Chandler. The city name here is a search-facing label for a statewide payment locality, not a city-specific rate.
What is the facility rate for G0121 in Phoenix, AZ?
$161.59 in a facility, versus $368.41 in the office (non-facility) setting — a $206.82 difference. Only the practice-expense RVU changes with the setting: in an office the practice carries the overhead, so the professional payment is higher; in a hospital or ASC the facility bills its own fee.
What is the non-participating amount and limiting charge for G0121 in Phoenix, AZ?
A non-participating provider is paid $349.99 — 95% of the $368.41 participating fee schedule amount. On an unassigned claim the limiting charge caps what the patient can be billed at $402.49, which is 115% of the non-participating amount.
How much of the Phoenix, AZ G0121 rate does Medicare actually pay?
Medicare pays 80% of the allowed amount ($294.73) once the annual Part B deductible is met, and the beneficiary owes 20% ($73.68). Sequestration reduces Medicare's share by about 2% ($5.89), leaving $288.84. Sequestration never changes the allowed amount itself, which is why it is shown separately here.

Source & method Copy link

Computed from the CMS Medicare Physician Fee Schedule Q3 2026 release : this code's RVUs from the relative value file, multiplied by payment locality 03102-00's GPCIs, then by the 2026 conversion factor of $33.4009. ZIP coverage from the CMS ZIP-to-locality crosswalk, Q3 2026 release . Releases are immutable: an amount retrieved for a past quarter always reflects that PFS release. Coverage and coding correctness are outside this calculation.

Physician relative value file (Q3 2026) · rvu26c-updated-06-30-2026.zip (PPRRVU2026_Jul_nonQPP.csv row 15,024)
Geographic practice cost indices (Q3 2026) · rvu26c-updated-06-30-2026.zip (GPCI2026.csv row 6)
ZIP code to carrier locality crosswalk (Q3 2026) · zip-code-carrier-locality-file-updated-05-13-2026.zip (ZIP5_JUL2026.txt)

Working a claim with an earlier date of service? The calculator prices G0121 in Phoenix, AZ against the release that governed that date. The last 12 months price without an account; older dates of service need a free account.

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