Cost analysis for CPT G0439 — Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit
Average Medicare Payment
$115.54
2023 data
Total Payments (2023)
$1.1B
Services (2023)
9.7M
Price Change (2014–2023)
+4.8%
| Year | Avg Payment | Total Payments | Services | YoY Change |
|---|---|---|---|---|
| 2014 | $110.29 | $372.5M | 3.4M | — |
| 2015 | $113.11 | $485.5M | 4.3M | +2.6% |
| 2016 | $111.72 | $597.0M | 5.3M | -1.2% |
| 2017 | $111.80 | $718.0M | 6.3M | +0.1% |
| 2018 | $112.77 | $825.6M | 7.2M | +0.9% |
| 2019 | $113.12 | $932.5M | 8.1M | +0.3% |
| 2020 | $113.79 | $917.6M | 8.0M | +0.6% |
| 2021 | $127.54 | $1.1B | 8.8M | +12.1% |
| 2022 | $118.49 | $1.1B | 9.2M | -7.1% |
| 2023 | $115.54 | $1.1B | 9.7M | -2.5% |
The most expensive state pays 2.2x more than the cheapest for this procedure. AK averages $152.04 vs ME at $68.25.
| State | Avg Payment | Total Payments | Services | Providers |
|---|---|---|---|---|
| AK | $152.04 | $1.5M | 9.5K | 141 |
| DC | $142.80 | $3.0M | 21.0K | 247 |
| NY | $134.52 | $70.2M | 522.2K | 6.3K |
| AE | $133.63 | $56.0K | 419 | 4 |
| GU | $133.51 | $121.0K | 906 | 15 |
| CT | $133.39 | $15.1M | 113.3K | 1.5K |
| MD | $132.96 | $37.2M | 279.5K | 2.3K |
| CA | $131.06 | $92.8M | 707.8K | 7.8K |
| WA | $130.30 | $23.1M | 177.2K | 2.4K |
| IL | $130.18 | $54.8M | 421.1K | 4.0K |
| PR | $127.81 | $80.9K | 633 | 19 |
| XX | $126.95 | $41.0K | 323 | 2 |
| NV | $123.52 | $6.9M | 55.7K | 719 |
| VI | $123.23 | $137.8K | 1.1K | 17 |
| MN | $123.06 | $15.9M | 128.9K | 2.3K |
| VA | $123.03 | $43.5M | 353.5K | 3.0K |
| TX | $122.40 | $75.5M | 616.8K | 7.1K |
| SD | $122.01 | $2.6M | 21.6K | 241 |
| MA | $121.83 | $39.9M | 327.1K | 3.3K |
| WY | $121.64 | $2.3M | 18.7K | 174 |
| VT | $121.57 | $2.0M | 16.4K | 239 |
| GA | $121.43 | $36.0M | 296.3K | 2.9K |
| AZ | $120.54 | $29.0M | 240.3K | 2.4K |
| UT | $119.89 | $10.7M | 88.9K | 991 |
| WI | $119.67 | $21.5M | 179.6K | 2.4K |
| NC | $118.90 | $43.6M | 366.6K | 4.2K |
| SC | $118.72 | $27.1M | 228.0K | 1.9K |
| FL | $118.59 | $96.3M | 812.2K | 7.2K |
| DE | $117.45 | $8.4M | 71.1K | 485 |
| IN | $117.18 | $24.5M | 209.2K | 2.4K |
| NJ | $117.15 | $38.7M | 330.6K | 3.4K |
| NM | $117.03 | $4.7M | 40.2K | 487 |
| WV | $116.71 | $5.2M | 44.7K | 559 |
| AP | $116.49 | $47.6K | 409 | 3 |
| AL | $116.39 | $16.8M | 144.2K | 1.5K |
| LA | $116.32 | $12.4M | 106.6K | 1.1K |
| IA | $115.99 | $13.8M | 119.1K | 1.1K |
| MS | $114.15 | $11.6M | 101.6K | 808 |
| ID | $113.69 | $4.7M | 41.5K | 530 |
| TN | $112.32 | $29.7M | 264.7K | 2.7K |
| NH | $112.05 | $5.5M | 49.3K | 621 |
| PA | $108.56 | $50.1M | 461.4K | 5.2K |
| HI | $107.35 | $2.1M | 19.7K | 261 |
| KY | $106.37 | $14.6M | 137.0K | 1.6K |
| MO | $105.26 | $18.1M | 172.3K | 1.8K |
| MI | $100.08 | $26.9M | 268.6K | 4.1K |
| RI | $98.79 | $3.5M | 35.2K | 450 |
| ND | $97.99 | $1.9M | 18.9K | 269 |
| OH | $94.87 | $34.9M | 367.4K | 4.7K |
| OR | $94.04 | $6.6M | 69.8K | 1.1K |
| OK | $93.41 | $11.7M | 125.7K | 1.2K |
| Provider | Specialty | State | Payments | Services | Avg/Service |
|---|---|---|---|---|---|
| Pete Coury | Family Practice | AZ | $209.8K | 1.7K | $124.51 |
| Alex Dickert | Family Practice | FL | $179.0K | 1.4K | $125.73 |
| Tollin Sullivan | Family Practice | CA | $178.9K | 1.3K | $134.89 |
| Jennifer Hurd | Internal Medicine | DE | $178.6K | 1.4K | $130.10 |
| Renato Alfonso | Internal Medicine | FL | $177.7K | 1.4K | $126.28 |
| Matthew Mesnik | General Practice | MN | $173.6K | 1.4K | $125.02 |
| Amardeep Majhail | Internal Medicine | AZ | $160.4K | 1.3K | $124.54 |
| Babita Patel | Internal Medicine | VA | $155.9K | 1.2K | $125.82 |
| Douglas Lakin | Internal Medicine | AZ | $152.8K | 1.2K | $124.73 |
| Rakesh Malik | Internal Medicine | MD | $148.6K | 1.0K | $143.73 |
| Than Aung | Internal Medicine | CA | $145.7K | 1.1K | $134.89 |
| Ajith Purush | General Practice | AZ | $144.1K | 1.1K | $125.67 |
| Frank Scafuri | Internal Medicine | NY | $142.9K | 943 | $151.51 |
| Richard Maples | Family Practice | CA | $141.9K | 1.1K | $134.86 |
| Vel Natesan | Internal Medicine | MD | $141.4K | 1.1K | $129.81 |
| Stephen Luther | Internal Medicine | SC | $140.7K | 1.1K | $123.42 |
| Gautham Reddy | Family Practice | NV | $140.5K | 1.1K | $128.00 |
| Armine Nazaryan | General Practice | CA | $139.8K | 973 | $143.64 |
| Diana Gorokhovsky | Family Practice | FL | $138.2K | 1.1K | $130.59 |
| Philip Devane | Internal Medicine | FL | $136.7K | 1.1K | $125.50 |
The data suggests significant pricing inconsistencies for CPT G0439. With a 2.2x price gap between the most and least expensive states, geography plays an outsized role in what Medicare pays for this procedure.
Costs have remained relatively stable over time, but the geographic variation suggests Medicare's geographic adjustment factors may not fully capture the true cost differences across states.
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.