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Data Sources: Centers for Medicare & Medicaid Services (CMS), Medicare Provider Utilization and Payment Data
Disclaimer: This site is an independent journalism project. Data analysis and editorial content are not affiliated with or endorsed by CMS or any government agency. All spending figures are based on publicly available Medicare payment records.
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Methodology•Download Data
  1. Home
  2. Procedures
  3. G0402
  4. Cost Analysis

How Much Does Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment Cost on Medicare?

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

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Average Medicare Payment

$158.82

2023 data

Total Payments (2023)

$31.8M

Services (2023)

199.3K

Price Change (2014–2023)

+0.8%

📈 Year-over-Year Cost Trend

YearAvg PaymentTotal PaymentsServicesYoY Change
2014$157.57$23.3M147.8K—
2015$160.15$27.2M169.8K+1.6%
2016$158.55$32.3M203.7K-1.0%
2017$159.55$35.7M223.7K+0.6%
2018$160.71$40.2M249.9K+0.7%
2019$162.17$42.8M263.6K+0.9%
2020$164.24$34.2M207.9K+1.3%
2021$165.94$35.8M215.5K+1.0%
2022$162.24$32.6M200.6K-2.2%
2023$158.82$31.8M199.3K-2.1%

🗺️ State-by-State Cost Variation

The most expensive state pays 1.6x more than the cheapest for this procedure. AK averages $207.23 vs ND at $132.18.

StateAvg PaymentTotal PaymentsServicesProviders
AK$207.23$42.5K20512
DC$183.69$48.7K26517
NY$183.69$1.8M9.5K600
CT$175.19$142.8K81558
CA$173.84$2.0M11.4K660
NJ$171.73$1.7M9.7K572
MD$170.03$1.4M8.0K468
MA$169.58$1.0M6.1K394
WA$165.50$188.2K1.1K84
IL$165.48$2.2M13.3K803
NV$163.15$98.7K60534
FL$159.90$2.6M16.0K948
VA$158.53$1.6M10.0K602
DE$158.10$344.7K2.2K111
WY$157.69$70.2K44530
GA$157.30$1.2M7.4K449
CO$157.26$452.6K2.9K192
TX$157.13$2.4M15.3K923
OR$157.09$106.2K67646
PA$156.98$1.9M11.8K751
AZ$156.12$622.1K4.0K251
RI$156.07$37.6K24119
UT$155.31$119.0K76652
NM$154.60$93.2K60337
NC$153.25$909.9K5.9K383
SC$153.25$908.8K5.9K351
MI$153.14$624.7K4.1K278
HI$153.00$18.8K1238
IN$152.85$695.2K4.5K287
MN$152.68$106.1K69552
LA$152.52$410.6K2.7K170
AL$152.08$200.6K1.3K92
WI$150.70$424.7K2.8K198
MT$149.94$142.6K95162
MO$149.89$450.0K3.0K195
KY$149.51$395.6K2.6K171
VT$149.18$30.4K20415
NH$148.82$141.4K95067
OH$148.24$972.2K6.6K450
MS$146.83$208.3K1.4K80
IA$146.74$532.2K3.6K241
WV$146.38$103.1K70447
SD$146.27$72.1K49332
OK$146.19$370.6K2.5K161
TN$145.44$917.6K6.3K374
ID$144.70$67.1K46434
KS$142.94$470.9K3.3K197
ME$142.02$20.3K14311
AR$141.20$273.1K1.9K125
NE$141.14$313.9K2.2K140
ND$132.18$41.1K31121

💰 Who Bills the Most for This Procedure?

ProviderSpecialtyStatePaymentsServicesAvg/Service
Rafael GonzalezInternal MedicineFL$28.1K161$174.52
Rakesh MalikInternal MedicineMD$16.2K88$183.88
Brendan MulhollandFamily PracticeNJ$14.1K80$175.91
Najmuddin KarimjeeInternal MedicineTX$12.8K79$162.06
Robert OkerblomFamily PracticeCA$12.0K67$179.72
Paramjit TakharFamily PracticeCA$11.7K68$172.44
Stephen LutherInternal MedicineSC$11.6K73$158.71
Frank ScafuriInternal MedicineNY$11.5K59$194.36
Armine NazaryanGeneral PracticeCA$11.3K62$182.96
John VanderzylFamily PracticeTX$11.1K70$158.40
David TamresInternal MedicineNJ$11.1K61$181.42
Curtiss CombsFamily PracticeCA$10.9K64$170.36
William FarrFamily PracticeCA$10.8K64$169.51
Rodney SwensonFamily PracticeCA$10.8K64$168.31
William WareInternal MedicinePA$10.5K61$171.33
Trevor MarcotteFamily PracticeIN$10.2K69$147.75
Lizett MarzaInternal MedicineNJ$10.2K58$175.66
Robert DudleyFamily PracticeFL$10.1K60$168.19
Garbis ApelianFamily PracticeCA$9.9K54$182.96
Jennifer HurdInternal MedicineDE$9.5K57$166.42

🤔 Is Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment Overpriced?

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.

Data Sources

  • • Centers for Medicare & Medicaid Services (CMS)
  • • Medicare Provider Utilization and Payment Data (2014-2023)
  • • Medicare Physician Fee Schedule

Note: All data is from publicly available Medicare records. OpenMedicare is an independent journalism project not affiliated with CMS.