Cost analysis for CPT G0402 — Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment
Average Medicare Payment
$158.82
2023 data
Total Payments (2023)
$31.8M
Services (2023)
199.3K
Price Change (2014–2023)
+0.8%
| Year | Avg Payment | Total Payments | Services | YoY Change |
|---|---|---|---|---|
| 2014 | $157.57 | $23.3M | 147.8K | — |
| 2015 | $160.15 | $27.2M | 169.8K | +1.6% |
| 2016 | $158.55 | $32.3M | 203.7K | -1.0% |
| 2017 | $159.55 | $35.7M | 223.7K | +0.6% |
| 2018 | $160.71 | $40.2M | 249.9K | +0.7% |
| 2019 | $162.17 | $42.8M | 263.6K | +0.9% |
| 2020 | $164.24 | $34.2M | 207.9K | +1.3% |
| 2021 | $165.94 | $35.8M | 215.5K | +1.0% |
| 2022 | $162.24 | $32.6M | 200.6K | -2.2% |
| 2023 | $158.82 | $31.8M | 199.3K | -2.1% |
The most expensive state pays 1.6x more than the cheapest for this procedure. AK averages $207.23 vs ND at $132.18.
| State | Avg Payment | Total Payments | Services | Providers |
|---|---|---|---|---|
| AK | $207.23 | $42.5K | 205 | 12 |
| DC | $183.69 | $48.7K | 265 | 17 |
| NY | $183.69 | $1.8M | 9.5K | 600 |
| CT | $175.19 | $142.8K | 815 | 58 |
| CA | $173.84 | $2.0M | 11.4K | 660 |
| NJ | $171.73 | $1.7M | 9.7K | 572 |
| MD | $170.03 | $1.4M | 8.0K | 468 |
| MA | $169.58 | $1.0M | 6.1K | 394 |
| WA | $165.50 | $188.2K | 1.1K | 84 |
| IL | $165.48 | $2.2M | 13.3K | 803 |
| NV | $163.15 | $98.7K | 605 | 34 |
| FL | $159.90 | $2.6M | 16.0K | 948 |
| VA | $158.53 | $1.6M | 10.0K | 602 |
| DE | $158.10 | $344.7K | 2.2K | 111 |
| WY | $157.69 | $70.2K | 445 | 30 |
| GA | $157.30 | $1.2M | 7.4K | 449 |
| CO | $157.26 | $452.6K | 2.9K | 192 |
| TX | $157.13 | $2.4M | 15.3K | 923 |
| OR | $157.09 | $106.2K | 676 | 46 |
| PA | $156.98 | $1.9M | 11.8K | 751 |
| AZ | $156.12 | $622.1K | 4.0K | 251 |
| RI | $156.07 | $37.6K | 241 | 19 |
| UT | $155.31 | $119.0K | 766 | 52 |
| NM | $154.60 | $93.2K | 603 | 37 |
| NC | $153.25 | $909.9K | 5.9K | 383 |
| SC | $153.25 | $908.8K | 5.9K | 351 |
| MI | $153.14 | $624.7K | 4.1K | 278 |
| HI | $153.00 | $18.8K | 123 | 8 |
| IN | $152.85 | $695.2K | 4.5K | 287 |
| MN | $152.68 | $106.1K | 695 | 52 |
| LA | $152.52 | $410.6K | 2.7K | 170 |
| AL | $152.08 | $200.6K | 1.3K | 92 |
| WI | $150.70 | $424.7K | 2.8K | 198 |
| MT | $149.94 | $142.6K | 951 | 62 |
| MO | $149.89 | $450.0K | 3.0K | 195 |
| KY | $149.51 | $395.6K | 2.6K | 171 |
| VT | $149.18 | $30.4K | 204 | 15 |
| NH | $148.82 | $141.4K | 950 | 67 |
| OH | $148.24 | $972.2K | 6.6K | 450 |
| MS | $146.83 | $208.3K | 1.4K | 80 |
| IA | $146.74 | $532.2K | 3.6K | 241 |
| WV | $146.38 | $103.1K | 704 | 47 |
| SD | $146.27 | $72.1K | 493 | 32 |
| OK | $146.19 | $370.6K | 2.5K | 161 |
| TN | $145.44 | $917.6K | 6.3K | 374 |
| ID | $144.70 | $67.1K | 464 | 34 |
| KS | $142.94 | $470.9K | 3.3K | 197 |
| ME | $142.02 | $20.3K | 143 | 11 |
| AR | $141.20 | $273.1K | 1.9K | 125 |
| NE | $141.14 | $313.9K | 2.2K | 140 |
| ND | $132.18 | $41.1K | 311 | 21 |
| Provider | Specialty | State | Payments | Services | Avg/Service |
|---|---|---|---|---|---|
| Rafael Gonzalez | Internal Medicine | FL | $28.1K | 161 | $174.52 |
| Rakesh Malik | Internal Medicine | MD | $16.2K | 88 | $183.88 |
| Brendan Mulholland | Family Practice | NJ | $14.1K | 80 | $175.91 |
| Najmuddin Karimjee | Internal Medicine | TX | $12.8K | 79 | $162.06 |
| Robert Okerblom | Family Practice | CA | $12.0K | 67 | $179.72 |
| Paramjit Takhar | Family Practice | CA | $11.7K | 68 | $172.44 |
| Stephen Luther | Internal Medicine | SC | $11.6K | 73 | $158.71 |
| Frank Scafuri | Internal Medicine | NY | $11.5K | 59 | $194.36 |
| Armine Nazaryan | General Practice | CA | $11.3K | 62 | $182.96 |
| John Vanderzyl | Family Practice | TX | $11.1K | 70 | $158.40 |
| David Tamres | Internal Medicine | NJ | $11.1K | 61 | $181.42 |
| Curtiss Combs | Family Practice | CA | $10.9K | 64 | $170.36 |
| William Farr | Family Practice | CA | $10.8K | 64 | $169.51 |
| Rodney Swenson | Family Practice | CA | $10.8K | 64 | $168.31 |
| William Ware | Internal Medicine | PA | $10.5K | 61 | $171.33 |
| Trevor Marcotte | Family Practice | IN | $10.2K | 69 | $147.75 |
| Lizett Marza | Internal Medicine | NJ | $10.2K | 58 | $175.66 |
| Robert Dudley | Family Practice | FL | $10.1K | 60 | $168.19 |
| Garbis Apelian | Family Practice | CA | $9.9K | 54 | $182.96 |
| Jennifer Hurd | Internal Medicine | DE | $9.5K | 57 | $166.42 |
Based on the data, CPT G0402 shows a 1.6x variation in pricing across states — moderate variation by Medicare standards.
Costs have increased 0.8% since 2014. Medicare's fee schedule attempts to standardize pricing, though some variation is expected due to geographic cost-of-living adjustments and practice expense differences.
This analysis is based on publicly available CMS data and does not account for patient complexity, comorbidities, or facility-specific factors that may justify pricing differences.
Note: All data is from publicly available Medicare records. OpenMedicare is an independent journalism project not affiliated with CMS.