HCPCS code G0402: Welcome visit, first 12 months of Part B2026 Medicare rate & RVUs in North Carolina
G0402 reports Medicare’s one-time Welcome to Medicare visit, including a prevention-focused health review and examination during the initial Part B enrollment period.
In North Carolina, Medicare pays $167.13 for G0402 in the office and $110.73 when it’s performed in a hospital or facility.
Check a contract rate as a % of Medicare · G0402 nationwide
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 11 sections
What G0402 covers
G0402 covers the one-time Welcome to Medicare visit, a prevention-focused review rather than a routine comprehensive physical. A physician or qualified nonphysician practitioner typically performs it in an office or outpatient setting. The clinician reviews medical and social history, assesses health risks, depression risk, functional ability and safety, performs an appropriate examination, and provides prevention counseling and a written screening schedule. Advance care planning may be discussed when the patient chooses to address it.
Report G0402 when the patient is within the first 12 months of Part B enrollment and the visit’s documented elements support the service. Record relevant history, risk and functional assessments, examination findings, counseling, and recommended preventive services. If a screening ECG is furnished, report the applicable ECG service separately using G0403 or its tracing and interpretation components, G0404 and G0405.
This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.
How North Carolina compares for G0402
Across 109 of 109 payment localities, the office rate for G0402 runs from $160.35 in Arkansas to $220.90 in Alaska. North Carolina pays $167.13. The RVUs are the same everywhere; the geographic indexes change the dollars.
- North Carolina · this page$167.13
- Los Angeles, CA · California$191.38+$24.25
- Washington, DC area · District of Columbia$194.64+$27.51
- Miami, FL · Florida$186.74+$19.61
- Chicago, IL · Illinois$183.06+$15.93
- Manhattan, NY · New York$196.88+$29.75
- Alaska · Alaska$220.90+$53.77
Other areas in North Carolina first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $161.95 | $109.05 |
| ArkansasArkansas | $160.35 | $108.42 |
| ArizonaArizona | $171.32 | $112.74 |
| Bakersfield, CACalifornia | $182.00 | $115.75 |
| Chico, CACalifornia | $181.42 | $115.16 |
| El Centro, CACalifornia | $181.44 | $115.19 |
| Fresno, CACalifornia | $181.42 | $115.16 |
| Hanford, CACalifornia | $181.42 | $115.16 |
| Madera, CACalifornia | $181.42 | $115.16 |
| Merced, CACalifornia | $181.42 | $115.16 |
| Modesto, CACalifornia | $181.42 | $115.16 |
| Napa, CACalifornia | $203.49 | $123.81 |
| Oxnard, CACalifornia | $189.93 | $118.47 |
| Redding, CACalifornia | $181.42 | $115.16 |
| Rest of CaliforniaCalifornia | $181.42 | $115.16 |
| Riverside, CACalifornia | $183.30 | $117.04 |
| Sacramento, CACalifornia | $188.57 | $118.26 |
| Salinas, CACalifornia | $187.81 | $117.74 |
| San Diego, CACalifornia | $190.80 | $118.49 |
| Marin County, CACalifornia | $213.55 | $128.31 |
| San Francisco, CACalifornia | $213.36 | $128.12 |
| San Benito County, CACalifornia | $217.92 | $130.75 |
| Santa Clara County, CACalifornia | $217.13 | $129.96 |
| San Luis Obispo, CACalifornia | $184.95 | $116.09 |
| Santa Cruz, CACalifornia | $191.54 | $118.09 |
| Santa Maria, CACalifornia | $188.12 | $117.63 |
| Santa Rosa, CACalifornia | $193.39 | $119.15 |
| Stockton, CACalifornia | $181.42 | $115.16 |
| Vallejo, CACalifornia | $203.21 | $123.53 |
| Visalia, CACalifornia | $181.42 | $115.16 |
| Yuba City, CACalifornia | $181.42 | $115.16 |
| ColoradoColorado | $179.74 | $115.42 |
| ConnecticutConnecticut | $183.94 | $118.83 |
| DelawareDelaware | $173.56 | $113.83 |
| Fort Lauderdale, FLFlorida | $180.34 | $119.10 |
| Rest of FloridaFlorida | $173.93 | $116.13 |
| Atlanta, GAGeorgia | $177.40 | $115.98 |
| Rest of GeorgiaGeorgia | $166.90 | $112.98 |
| Hawaii, Guam, HIHawaii | $183.55 | $114.81 |
| IowaIowa | $164.28 | $108.96 |
| IdahoIdaho | $165.12 | $109.50 |
| East St. Louis, ILIllinois | $173.87 | $118.25 |
| Rest of IllinoisIllinois | $170.74 | $115.54 |
| Suburban Chicago, ILIllinois | $181.90 | $119.81 |
| IndianaIndiana | $165.77 | $109.73 |
| KansasKansas | $163.98 | $109.33 |
| KentuckyKentucky | $165.08 | $111.34 |
| New Orleans, LALouisiana | $170.61 | $113.72 |
| Rest of LouisianaLouisiana | $165.00 | $111.50 |
| Metropolitan Boston, MAMassachusetts | $193.56 | $121.38 |
| Rest of MassachusettsMassachusetts | $179.28 | $115.62 |
| Baltimore area, MDMaryland | $183.42 | $118.55 |
| Rest of MarylandMaryland | $176.08 | $114.89 |
| Rest of MaineMaine | $165.97 | $110.35 |
| Southern Maine, MEMaine | $171.85 | $111.94 |
| Detroit, MIMichigan | $175.71 | $117.37 |
| Rest of MichiganMichigan | $168.27 | $113.07 |
| MinnesotaMinnesota | $173.07 | $110.86 |
| Metropolitan Kansas City, MOMissouri | $169.54 | $112.78 |
| Metropolitan St. Louis, MOMissouri | $170.75 | $113.20 |
| Rest of MissouriMissouri | $163.20 | $111.09 |
| MississippiMississippi | $161.78 | $109.73 |
| MontanaMontana | $174.68 | $114.22 |
| North DakotaNorth Dakota | $171.31 | $110.86 |
| NebraskaNebraska | $164.83 | $109.03 |
| New HampshireNew Hampshire | $177.35 | $114.41 |
| Northern New JerseyNew Jersey | $193.69 | $123.56 |
| Rest of New JerseyNew Jersey | $186.27 | $120.25 |
| New MexicoNew Mexico | $169.01 | $113.57 |
| NevadaNevada | $173.82 | $113.30 |
| NYC suburbs and Long Island, NYNew York | $200.64 | $128.76 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $187.59 | $121.39 |
| Queens, NYNew York | $197.71 | $126.25 |
| Rest of New YorkNew York | $168.89 | $111.46 |
| OhioOhio | $167.58 | $112.39 |
| OklahomaOklahoma | $164.63 | $110.64 |
| Portland, OROregon | $183.74 | $116.58 |
| Rest of OregonOregon | $172.67 | $112.46 |
| Metropolitan Philadelphia, PAPennsylvania | $180.71 | $117.78 |
| Rest of PennsylvaniaPennsylvania | $167.64 | $112.14 |
| Puerto RicoPuerto Rico | $175.51 | $114.38 |
| Rhode IslandRhode Island | $178.43 | $115.98 |
| South CarolinaSouth Carolina | $167.59 | $111.73 |
| South DakotaSouth Dakota | $170.92 | $110.46 |
| TennesseeTennessee | $164.58 | $109.63 |
| Austin, TXTexas | $178.98 | $115.02 |
| Beaumont, TXTexas | $166.89 | $111.87 |
| Brazoria, TXTexas | $173.39 | $113.48 |
| Dallas, TXTexas | $174.33 | $114.12 |
| Fort Worth, TXTexas | $173.59 | $113.98 |
| Galveston, TXTexas | $173.83 | $113.80 |
| Houston, TXTexas | $176.94 | $116.91 |
| Rest of TexasTexas | $169.95 | $112.57 |
| UtahUtah | $169.18 | $112.35 |
| VirginiaVirginia | $171.62 | $112.19 |
| Virgin Islands, VIUnited States Virgin Islands | $175.51 | $114.38 |
| VermontVermont | $171.06 | $111.21 |
| Rest of WashingtonWashington | $178.81 | $115.15 |
| King County, WAWashington | $196.64 | $122.46 |
| WisconsinWisconsin | $167.31 | $109.39 |
| West VirginiaWest Virginia | $166.37 | $113.83 |
| WyomingWyoming | $173.21 | $112.75 |
G0402 rates by state
Office rate range in each state. Select a state to see its payment localities.
Explore a state
Local rates. Clear comparisons.
Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.
$160.35
$220.90
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $220.90 | 1 |
| AL | $161.95 | 1 |
| AR | $160.35 | 1 |
| AZ | $171.32 | 1 |
| CA | $181.42–$217.92 | 29 |
| CO | $179.74 | 1 |
| CT | $183.94 | 1 |
| DC | $194.64 | 1 |
| DE | $173.56 | 1 |
| FL | $173.93–$186.74 | 3 |
| GA | $166.90–$177.40 | 2 |
| GU | $183.55 | 1 |
| HI | $183.55 | 1 |
| IA | $164.28 | 1 |
| ID | $165.12 | 1 |
| IL | $170.74–$183.06 | 4 |
| IN | $165.77 | 1 |
| KS | $163.98 | 1 |
| KY | $165.08 | 1 |
| LA | $165.00–$170.61 | 2 |
| MA | $179.28–$193.56 | 2 |
| MD | $176.08–$194.64 | 3 |
| ME | $165.97–$171.85 | 2 |
| MI | $168.27–$175.71 | 2 |
| MN | $173.07 | 1 |
| MO | $163.20–$170.75 | 3 |
| MS | $161.78 | 1 |
| MT | $174.68 | 1 |
| NC | $167.13 | 1 |
| ND | $171.31 | 1 |
| NE | $164.83 | 1 |
| NH | $177.35 | 1 |
| NJ | $186.27–$193.69 | 2 |
| NM | $169.01 | 1 |
| NV | $173.82 | 1 |
| NY | $168.89–$200.64 | 5 |
| OH | $167.58 | 1 |
| OK | $164.63 | 1 |
| OR | $172.67–$183.74 | 2 |
| PA | $167.64–$180.71 | 2 |
| PR | $175.51 | 1 |
| RI | $178.43 | 1 |
| SC | $167.59 | 1 |
| SD | $170.92 | 1 |
| TN | $164.58 | 1 |
| TX | $166.89–$178.98 | 8 |
| UT | $169.18 | 1 |
| VA | $171.62–$194.64 | 2 |
| VI | $175.51 | 1 |
| VT | $171.06 | 1 |
| WA | $178.81–$196.64 | 2 |
| WI | $167.31 | 1 |
| WV | $166.37 | 1 |
| WY | $173.21 | 1 |
How the G0402 rate is calculated
Each of G0402’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · G0402
RVUs × geographic indexes × conversion factor
Work2.60
2.60 RVUs× 1.000 GPCI
Practice expense2.46
2.46 RVUs× 1.000 GPCI
Malpractice0.17
0.17 RVUs× 1.000 GPCI
Adjusted RVUs
5.2300
Conversion factor
$33.4009
Medicare rate
$174.69
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact North Carolina inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
15,231
- Code
- G0402
- Physician work
- 2.60
- Practice expense
- 2.46
- Malpractice
- 0.17
GPCI2026.csv
83
- Locality
- North Carolina
- Physician work
- 1.000
- Practice expense
- 0.933
- Malpractice
- 0.639
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 2.60 | × 1.000 | 2.6000 |
| Practice expense | 2.46 | × 0.933 | 2.2952 |
| Malpractice | 0.17 | × 0.639 | 0.1086 |
| Total RVUs | 5.0038 | ||
| Conversion factor | × 33.4009 | ||
Office rate, North Carolina$167.13
Office: (2.6 × 1 + 2.46 × 0.933 + 0.17 × 0.639) × $33.4009 = $167.13
Facility: (2.6 × 1 + 0.65 × 0.933 + 0.17 × 0.639) × $33.4009 = $110.73
Payment rules and modifiers for G0402
G0402 has no global surgery period, no multiple-procedure, bilateral or assistant-at-surgery adjustment, and no professional/technical split. What changes the payment is where the service happens: the place of service on the claim decides whether Medicare pays the office or the facility rate.
Place of service · G0402
Which rate does Medicare pay?
The POS code on the claim line (CMS-1500 box 24B).
POS 11 · non-facility rate · national
$174.69
- Non-facility (office)
- $174.69
- Facility
- $114.23
Higher because the practice carries its own overhead.
How G0402 has changed in North Carolina
G0402 · Office / nonfacility
$167.13
Effective 2026-10-01
The base rate is $13.39 higher than on 2025-10-01, moving from $153.74 to $167.13 (8.7%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.
What changed, release by release
January 1, 2026
RVU26A
$153.74changed to$167.13
- Conversion factor 32.3465 changed to 33.4009
- Practice expense RVU 2.21 changed to 2.46
- Malpractice RVU 0.16 changed to 0.17
- Practice expense GPCI 0.926 changed to 0.933
- Malpractice GPCI 0.665 changed to 0.639
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$158.43changed to$153.74
- Conversion factor 33.2875 changed to 32.3465
- Malpractice RVU 0.17 changed to 0.16
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$155.85changed to$158.43
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$159.86changed to$155.85
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 2.14 changed to 2.21
- Malpractice RVU 0.18 changed to 0.17
- Practice expense GPCI 0.927 changed to 0.926
- Malpractice GPCI 0.742 changed to 0.665
January 1, 2023
RVU23A
$163.20changed to$159.86
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 2.13 changed to 2.14
- Malpractice RVU 0.17 changed to 0.18
- Practice expense GPCI 0.928 changed to 0.927
- Malpractice GPCI 0.819 changed to 0.742
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$163.33changed to$163.20
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 2.11 changed to 2.13
- Malpractice RVU 0.15 changed to 0.17
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$162.07changed to$163.33
- Conversion factor 36.0896 changed to 34.8931
- Work RVU 2.43 changed to 2.60
- Malpractice RVU 0.13 changed to 0.15
- Practice expense GPCI 0.930 changed to 0.928
- Malpractice GPCI 0.757 changed to 0.819
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$162.13changed to$162.07
- Conversion factor 36.0391 changed to 36.0896
- Malpractice RVU 0.15 changed to 0.13
- Practice expense GPCI 0.931 changed to 0.930
- Malpractice GPCI 0.695 changed to 0.757
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$162.96changed to$162.13
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 2.14 changed to 2.11
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$161.98changed to$162.96
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 2.12 changed to 2.14
- Malpractice GPCI 0.732 changed to 0.695
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$161.05changed to$161.98
- Conversion factor 35.8043 changed to 35.8887
- Practice expense RVU 2.10 changed to 2.12
- Practice expense GPCI 0.930 changed to 0.931
- Malpractice GPCI 0.768 changed to 0.732
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$162.25changed to$161.05
- Conversion factor 35.9335 changed to 35.8043
- Practice expense RVU 2.11 changed to 2.10
- Malpractice RVU 0.16 changed to 0.15
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$161.44changed to$162.25
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$158.49changed to$161.44
- Conversion factor 35.8228 changed to 35.7547
- Practice expense RVU 2.06 changed to 2.11
- Malpractice RVU 0.11 changed to 0.16
- Practice expense GPCI 0.929 changed to 0.930
- Malpractice GPCI 0.732 changed to 0.768
Held through RVU15B.
January 1, 2014
RVU14A
$156.79changed to$158.49
- Conversion factor 34.0230 changed to 35.8228
- Practice expense RVU 2.26 changed to 2.06
- Malpractice RVU 0.12 changed to 0.11
- Practice expense GPCI 0.927 changed to 0.929
- Malpractice GPCI 0.695 changed to 0.732
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $156.79
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $167.13 | $110.73 | RVU26D |
| 2026-07-01 | $167.13 | $110.73 | RVU26C |
| 2026-04-01 | $167.13 | $110.73 | RVU26B |
| 2026-01-01 | $167.13 | $110.73 | RVU26A |
| 2025-10-01 | $153.74 | $121.39 | RVU25D |
| 2025-07-01 | $153.74 | $121.39 | RVU25C |
| 2025-04-01 | $153.74 | $121.39 | RVU25B |
| 2025-01-01 | $153.74 | $121.39 | RVU25A |
| 2024-10-01 | $158.43 | $125.14 | RVU24D |
| 2024-07-01 | $158.43 | $125.14 | RVU24C |
| 2024-04-01 | $158.43 | $125.14 | RVU24B |
| 2024-03-09 | $158.43 | $125.14 | RVU24AR |
| 2024-01-01 | $155.85 | $123.10 | RVU24A |
| 2023-10-01 | $159.86 | $127.19 | RVU23D |
| 2023-07-01 | $159.86 | $127.19 | RVU23C |
| 2023-04-01 | $159.86 | $127.19 | RVU23B |
| 2023-01-01 | $159.86 | $127.19 | RVU23A |
| 2022-10-01 | $163.20 | $131.08 | RVU22D |
| 2022-07-01 | $163.20 | $131.08 | RVU22C |
| 2022-04-01 | $163.20 | $131.08 | RVU22B |
| 2022-01-01 | $163.20 | $131.08 | RVU22A |
| 2021-10-01 | $163.33 | $131.92 | RVU21D |
| 2021-07-01 | $163.33 | $131.92 | RVU21C |
| 2021-04-01 | $163.33 | $131.92 | RVU21B |
| 2021-01-01 | $163.33 | $131.92 | RVU21A |
| 2020-10-01 | $162.07 | $125.48 | RVU20D |
| 2020-07-01 | $162.07 | $125.48 | RVU20C |
| 2020-04-01 | $162.07 | $125.48 | RVU20B |
| 2020-01-01 | $162.07 | $125.48 | RVU20A |
| 2019-10-01 | $162.13 | $124.88 | RVU19D |
| 2019-07-01 | $162.13 | $124.88 | RVU19C |
| 2019-04-01 | $162.13 | $124.88 | RVU19B |
| 2019-01-01 | $162.13 | $124.88 | RVU19A |
| 2018-10-01 | $162.96 | $125.42 | RVU18D |
| 2018-07-01 | $162.96 | $125.42 | RVU18C |
| 2018-04-01 | $162.96 | $125.42 | RVU18B |
| 2018-01-01 | $162.96 | $125.42 | RVU18AR1 |
| 2017-10-01 | $161.98 | $125.23 | RVU17D |
| 2017-07-01 | $161.98 | $125.23 | RVU17C |
| 2017-04-01 | $161.98 | $125.23 | RVU17B |
| 2017-01-01 | $161.98 | $125.23 | RVU17A |
| 2016-10-01 | $161.05 | $124.43 | RVU16D |
| 2016-07-01 | $161.05 | $124.43 | RVU16C |
| 2016-04-01 | $161.05 | $124.43 | RVU16B |
| 2016-01-01 | $161.05 | $124.43 | RVU16A |
| 2015-10-01 | $162.25 | $125.49 | RVU15D |
| 2015-07-01 | $162.25 | $125.49 | RVU15C |
| 2015-04-01 | $161.44 | $124.86 | RVU15B |
| 2015-01-01 | $161.44 | $124.86 | RVU15A |
| 2014-10-01 | $158.49 | $122.88 | RVU14D |
| 2014-07-01 | $158.49 | $122.88 | RVU14C |
| 2014-04-01 | $158.49 | $122.88 | RVU14B |
| 2014-01-01 | $158.49 | $122.88 | RVU14A |
| 2013-10-01 | $156.79 | $118.95 | RVU13D |
| 2013-07-01 | $156.79 | $118.95 | RVU13C |
| 2013-04-01 | $156.79 | $118.95 | RVU13B |
| 2013-01-01 | $156.79 | $118.95 | RVU13AR |
Where the North Carolina rate applies
North Carolina is a Medicare payment area, not a city. Our Census mapping connects it to 785 cities and communities in North Carolina. Some span more than one payment area; confirm with the service ZIP.
- Aberdeen
- Advance
- Ahoskie
- Alamance
- Albemarle
- Alexis
- Alliance
- Altamahaw
G0402 billing questions
How is G0402 different from the initial Annual Wellness Visit?
G0402 is the one-time Welcome to Medicare visit available during the first 12 months of Part B enrollment. G0438 reports the initial Annual Wellness Visit, a separate preventive benefit.
Can G0402 be reported again as an annual visit?
No. G0402 is a one-time benefit, not a recurring annual visit code. Use the applicable Annual Wellness Visit code for a qualifying later wellness visit.
How should an ECG furnished at the visit be reported?
Report the ECG using G0403 when the service includes the tracing, interpretation, and report. G0404 and G0405 identify the tracing and interpretation/report portions, respectively.
What documentation supports G0402?
Document the patient’s Part B enrollment timing and the visit elements performed, including history, health-risk and functional assessments, examination, counseling, and preventive-service recommendations.
Is G0402 selected by visit time?
No time threshold is used to distinguish G0402. Selection is based on the patient’s eligibility for the one-time benefit and the documented preventive-visit elements.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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