HCPCS code G0403: Preventive ECG, initial preventive examination2026 Medicare rate & RVUs

Medicare pays $15.36 for G0403 nationally in the office. Local office rates run $13.77–$19.67.

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What G0403 covers

G0403 represents a screening 12-lead ECG connected to the initial preventive physical examination, often called the Welcome to Medicare visit. The service includes the ECG tracing and its interpretation and report when furnished as a complete test. In an office or outpatient setting, clinical staff commonly obtain the tracing, while a physician or other qualified practitioner interprets it and documents the findings. The ECG is distinct from the preventive examination itself.

Report G0403 when the practice furnishes and bills the complete ECG service as part of the initial preventive examination. Documentation should identify the preventive visit, the ECG performed, and the interpretation and report. CMS identifies G0403 as a global-test-only code: use the separate component codes when billing only the tracing or only the interpretation and report. G0404 describes the tracing portion, and G0405 describes the interpretation and report portion.

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.

Where G0403 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

G0403 rates by state

Office rate range in each state. Select a state to see its payment localities.

How the G0403 rate is calculated

Each of G0403’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.

Payment rules and modifiers for G0403

The CMS indicators that decide how G0403 is paid alongside other services.

G0403 compared with similar codes

How to choose

G0402Welcome visitFirst 12 months of Part B

G0402 represents the initial preventive physical examination; G0403 represents the ECG performed as part of that examination.

G0404IPPE ECGTracing only

G0404 is for the ECG tracing portion alone. G0403 is used when the complete test service is furnished and billed together.

G0405ECG interpretationIPPE screening only

G0405 is for the ECG interpretation and report portion alone. G0403 represents the complete ECG test service.

Codes related to G0403

Related codes aren’t interchangeable: bill the code that matches the service performed.

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

Open CMS sourceHow we calculate rates