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HCPCS code G0438: Annual wellness visit, initial visit, first AWV2026 Medicare rate & RVUs in Oxnard, CA

First Medicare Annual Wellness Visit, reported once per lifetime to complete a health risk assessment and build a personalized prevention plan for a Part B beneficiary.

CMS RVU26DEffective Oct 1, 2026One payment locality676.9K Medicare services in 2024

In Oxnard, CA, Medicare pays $189.54 for G0438 in the office.

$189.54Office (non-facility)
Not available in this settingHospital or facility
+8.7%vs the national office rate ($174.35)

Check a contract rate as a % of Medicare · G0438 nationwide

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

We’ll open G0438 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Oxnard, CA
  2. What G0438 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What G0438 covers

The initial Medicare Annual Wellness Visit is preventive planning, not a head-to-toe physical. A physician, nurse practitioner, physician assistant, clinical nurse specialist, or medical professional under a physician’s direct supervision, such as a health educator or registered dietitian, usually furnishes it in primary care. Required elements include a health risk assessment, medical and family history, a list of providers and suppliers, routine measurements, cognitive and depression-risk assessments, functional and safety review, review of opioid prescriptions and substance use risk, and a written screening schedule and personalized prevention plan.

Report G0438 for the beneficiary’s first AWV with any practice, once per lifetime, after more than 12 months of Part B coverage and at least 12 months after any IPPE. Use G0439 for later AWVs. Document the assessment, required elements, and written plan furnished to the patient. Medicare waives the AWV deductible and coinsurance. A separately supported problem-oriented E/M visit can be reported with modifier 25 on the E/M; its usual cost sharing remains. If separately furnished with the AWV, advance care planning may be reported with 99497 and modifier 33 for its cost-sharing waiver.

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.

Billing guides for G0438: Annual wellness visit codes

How Oxnard, CA compares for G0438

Across 109 of 109 payment localities, the office rate for G0438 runs from $160.06 in Arkansas to $220.54 in Alaska. Oxnard, CA pays $189.54. The RVUs are the same everywhere; the geographic indexes change the dollars.

G0438 in Oxnard, CA vs other payment areas
  1. Oxnard, CA · this page$189.54
  2. Bakersfield, CA · California$181.64−$7.90
  3. Chico, CA · California$181.05−$8.49
  4. El Centro, CA · California$181.08−$8.46
  5. Fresno, CA · California$181.05−$8.49
  6. Hanford, CA · California$181.05−$8.49
  7. Los Angeles, CA · California$190.98+$1.44

Other areas in California first, then benchmark localities. Bars start at $0.

Every other payment area

G0438 in every other Medicare payment locality
Payment localityOfficeFacility
Madera, CACalifornia$181.05—
Merced, CACalifornia$181.05—
Modesto, CACalifornia$181.05—
Napa, CACalifornia$203.05—
Redding, CACalifornia$181.05—
Rest of CaliforniaCalifornia$181.05—
Riverside, CACalifornia$182.94—
Sacramento, CACalifornia$188.18—

G0438 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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.

$160.06

$220.54

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
G0438 office rate range by state
State / territoryOffice rate rangeLocalities
AK$220.541
AL$161.661
AR$160.061
AZ$171.001
CA$181.05–$217.4429
CO$179.391
CT$183.581
DC$194.251
DE$173.231
FL$173.61–$186.393
GA$166.61–$177.062
GU$183.171
HI$183.171
IA$163.971
ID$164.811
IL$170.43–$182.724
IN$165.461
KS$163.681
KY$164.791
LA$164.70–$170.302
MA$178.93–$193.162
MD$175.74–$194.253
ME$165.66–$171.522
MI$167.97–$175.382
MN$172.731
MO$162.91–$170.443
MS$161.501
MT$174.341
NC$166.821
ND$170.981
NE$164.521
NH$177.001
NJ$185.91–$193.302
NM$168.701
NV$173.491
NY$168.57–$200.245
OH$167.281
OK$164.331
OR$172.34–$183.372
PA$167.33–$180.372
PR$175.171
RI$178.091
SC$167.281
SD$170.581
TN$164.281
TX$166.58–$178.638
UT$168.861
VA$171.29–$194.252
VI$175.171
VT$170.731
WA$178.46–$196.232
WI$166.991
WV$166.081
WY$172.881

See G0438 in every payment locality

How the G0438 rate is calculated

Each of G0438’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 · G0438

RVUs × geographic indexes × conversion factor

Office or facility?

Work2.60

2.60 RVUs× 1.000 GPCI

Practice expense2.45

2.45 RVUs× 1.000 GPCI

Malpractice0.17

0.17 RVUs× 1.000 GPCI

Adjusted RVUs

5.2200

Conversion factor

$33.4009

Medicare rate

$174.35

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Oxnard, CA inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

15,260

Code
G0438
Physician work
2.60
Practice expense
2.45
Malpractice
0.17

GPCI2026.csv

18

Locality
Oxnard, CA
Physician work
1.028
Practice expense
1.182
Malpractice
0.623
Office calculation for G0438 in Oxnard, CA
ComponentRVULocality factorAdjusted
Physician work2.60× 1.0282.6728
Practice expense2.45× 1.1822.8959
Malpractice0.17× 0.6230.1059
Total RVUs5.6746
Conversion factor× 33.4009

Office rate, Oxnard, CA$189.54

Office: (2.6 × 1.028 + 2.45 × 1.182 + 0.17 × 0.623) × $33.4009 = $189.54

Open G0438 in the RVU calculator

Payment rules and modifiers for G0438

G0438 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 · G0438

Which rate does Medicare pay?

The POS code on the claim line (CMS-1500 box 24B).

POS 11 · non-facility rate · national

$174.35

Higher because the practice carries its own overhead.

Codes related to G0438

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

Codes related to G0438
CodeHow it relatesOffice range, Oxnard, CA
Same family
G0439Annual wellness visit, subsequent visitSubsequent AWV reported for every annual wellness visit after the initial one.$150.35
Used instead
G0402Welcome visit, first 12 months of Part BWelcome to Medicare preventive visit available within the first 12 months of Part B.$189.93
Often billed with
99497Advance care planning, first 30 minutesAdvance care planning furnished with the AWV; modifier 33 identifies it for a cost-sharing waiver.$93.25
G0136SDOH assessment, 5–15 minutesOptional, separately reported social determinants of health risk assessment furnished during the AWV.$22.58
99214Office visit, established patient, moderate complexitySeparate same-day problem E/M supported by moderate MDM or qualifying E/M time; append modifier 25.$147.80
99213Office visit, established patient, low complexitySeparate same-day problem E/M supported by low MDM or qualifying E/M time; append modifier 25.$104.15

How G0438 has changed in Oxnard, CA

G0438 · Office / nonfacility

$189.54

Effective 2026-10-01

The base rate is $15.70 higher than on 2025-10-01, moving from $173.84 to $189.54 (9.0%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

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

  1. January 1, 2026

    RVU26A

    $173.84changed to$189.54

    • Conversion factor 32.3465 changed to 33.4009
    • Practice expense RVU 2.20 changed to 2.45
    • Malpractice RVU 0.16 changed to 0.17
    • Work GPCI 1.026 changed to 1.028
    • Practice expense GPCI 1.183 changed to 1.182
    • Malpractice GPCI 0.651 changed to 0.623

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $179.12changed to$173.84

    • Conversion factor 33.2875 changed to 32.3465
    • Malpractice RVU 0.17 changed to 0.16

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $176.19changed to$179.12

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $179.93changed to$176.19

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 2.13 changed to 2.20
    • Malpractice RVU 0.18 changed to 0.17
    • Work GPCI 1.027 changed to 1.026
    • Practice expense GPCI 1.181 changed to 1.183
    • Malpractice GPCI 0.689 changed to 0.651

  5. January 1, 2023

    RVU23A

    $183.58changed to$179.93

    • Conversion factor 34.6062 changed to 33.8872
    • Malpractice RVU 0.17 changed to 0.18
    • Practice expense GPCI 1.179 changed to 1.181
    • Malpractice GPCI 0.726 changed to 0.689

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $183.36changed to$183.58

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 2.10 changed to 2.13
    • Malpractice RVU 0.15 changed to 0.17

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $188.07changed to$183.36

    • Conversion factor 36.0896 changed to 34.8931
    • Work RVU 2.43 changed to 2.60
    • Practice expense RVU 2.23 changed to 2.10
    • Malpractice RVU 0.13 changed to 0.15
    • Work GPCI 1.026 changed to 1.027
    • Practice expense GPCI 1.178 changed to 1.179
    • Malpractice GPCI 0.700 changed to 0.726

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $188.92changed to$188.07

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 2.25 changed to 2.23
    • Malpractice RVU 0.16 changed to 0.13
    • Work GPCI 1.024 changed to 1.026
    • Practice expense GPCI 1.176 changed to 1.178
    • Malpractice GPCI 0.673 changed to 0.700

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $189.98changed to$188.92

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 2.28 changed to 2.25

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $189.17changed to$189.98

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 2.26 changed to 2.28
    • Malpractice RVU 0.15 changed to 0.16
    • Work GPCI 1.027 changed to 1.024
    • Practice expense GPCI 1.178 changed to 1.176
    • Malpractice GPCI 0.754 changed to 0.673

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $188.73changed to$189.17

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 2.24 changed to 2.26
    • Work GPCI 1.030 changed to 1.027
    • Practice expense GPCI 1.180 changed to 1.178
    • Malpractice GPCI 0.834 changed to 0.754

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $190.56changed to$188.73

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 2.26 changed to 2.24
    • Malpractice RVU 0.16 changed to 0.15

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $189.61changed to$190.56

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $186.65changed to$189.61

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 2.21 changed to 2.26
    • Malpractice RVU 0.11 changed to 0.16
    • Work GPCI 1.032 changed to 1.030
    • Practice expense GPCI 1.187 changed to 1.180
    • Malpractice GPCI 0.720 changed to 0.834

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $186.59changed to$186.65

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 2.43 changed to 2.21
    • Malpractice RVU 0.12 changed to 0.11
    • Work GPCI 1.034 changed to 1.032
    • Practice expense GPCI 1.193 changed to 1.187
    • Malpractice GPCI 0.605 changed to 0.720

    Held through RVU14B, RVU14C, RVU14D.

  16. October 1, 2013

    RVU13D

    No ratechanged to$186.59

  17. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$189.54Not available in this settingRVU26D
2026-07-01$189.54Not available in this settingRVU26C
2026-04-01$189.54Not available in this settingRVU26B
2026-01-01$189.54Not available in this settingRVU26A
2025-10-01$173.84Not available in this settingRVU25D
2025-07-01$173.84Not available in this settingRVU25C
2025-04-01$173.84Not available in this settingRVU25B
2025-01-01$173.84Not available in this settingRVU25A
2024-10-01$179.12Not available in this settingRVU24D
2024-07-01$179.12Not available in this settingRVU24C
2024-04-01$179.12Not available in this settingRVU24B
2024-03-09$179.12Not available in this settingRVU24AR
2024-01-01$176.19Not available in this settingRVU24A
2023-10-01$179.93Not available in this settingRVU23D
2023-07-01$179.93Not available in this settingRVU23C
2023-04-01$179.93Not available in this settingRVU23B
2023-01-01$179.93Not available in this settingRVU23A
2022-10-01$183.58Not available in this settingRVU22D
2022-07-01$183.58Not available in this settingRVU22C
2022-04-01$183.58Not available in this settingRVU22B
2022-01-01$183.58Not available in this settingRVU22A
2021-10-01$183.36Not available in this settingRVU21D
2021-07-01$183.36Not available in this settingRVU21C
2021-04-01$183.36Not available in this settingRVU21B
2021-01-01$183.36Not available in this settingRVU21A
2020-10-01$188.07Not available in this settingRVU20D
2020-07-01$188.07Not available in this settingRVU20C
2020-04-01$188.07Not available in this settingRVU20B
2020-01-01$188.07Not available in this settingRVU20A
2019-10-01$188.92Not available in this settingRVU19D
2019-07-01$188.92Not available in this settingRVU19C
2019-04-01$188.92Not available in this settingRVU19B
2019-01-01$188.92Not available in this settingRVU19A
2018-10-01$189.98Not available in this settingRVU18D
2018-07-01$189.98Not available in this settingRVU18C
2018-04-01$189.98Not available in this settingRVU18B
2018-01-01$189.98Not available in this settingRVU18AR1
2017-10-01$189.17Not available in this settingRVU17D
2017-07-01$189.17Not available in this settingRVU17C
2017-04-01$189.17Not available in this settingRVU17B
2017-01-01$189.17Not available in this settingRVU17A
2016-10-01$188.73Not available in this settingRVU16D
2016-07-01$188.73Not available in this settingRVU16C
2016-04-01$188.73Not available in this settingRVU16B
2016-01-01$188.73Not available in this settingRVU16A
2015-10-01$190.56Not available in this settingRVU15D
2015-07-01$190.56Not available in this settingRVU15C
2015-04-01$189.61Not available in this settingRVU15B
2015-01-01$189.61Not available in this settingRVU15A
2014-10-01$186.65Not available in this settingRVU14D
2014-07-01$186.65Not available in this settingRVU14C
2014-04-01$186.65Not available in this settingRVU14B
2014-01-01$186.65Not available in this settingRVU14A
2013-10-01$186.59Not available in this settingRVU13D
2013-07-01Rate data unavailableNot available in this settingRVU13C
2013-04-01Rate data unavailableNot available in this settingRVU13B
2013-01-01Rate data unavailableNot available in this settingRVU13AR

Price G0438 for an earlier date of service

Where the Oxnard, CA rate applies

Oxnard, CA is a Medicare payment area, not a city. Our Census mapping connects it to 26 cities and communities in California. Some span more than one payment area; confirm with the service ZIP.

  • Oxnard
  • Thousand Oaks
  • Bell Canyon
  • Camarillo
  • Casa Conejo
  • Channel Islands Beach
  • El Rio
  • Fillmore

Browse all communities in California

G0438 billing questions

When should G0438 be reported instead of G0439?

Use G0438 only for the patient’s first AWV with any provider. Every AWV after that is reported with G0439, even if the patient has changed practices.

Can G0438 be billed in the patient’s first year of Part B?

No. The patient must have had Part B coverage for more than 12 months and must not have had an IPPE (G0402) within the past 12 months. The IPPE may be furnished during the first 12 months of Part B coverage.

Is a physical exam part of this visit?

The AWV includes routine measurements such as height, weight, BMI, and blood pressure, but not a comprehensive physical exam. A routine preventive physical, such as 99387 or 99397, is not a substitute for the AWV.

Can a problem-oriented E/M be billed on the same day?

Yes, when a significant, separately identifiable problem is addressed, report the supported E/M code with modifier 25. Document the problem work separately from the AWV elements; the E/M is subject to deductible and coinsurance.

How is advance care planning handled with the initial AWV?

Advance care planning is an optional AWV element. When 99497 is separately furnished with the AWV, append modifier 33 to 99497 for the advance care planning cost-sharing waiver.

Who can perform the visit?

A physician, NP, PA, or CNS may furnish it, or a medical professional such as a health educator or registered dietitian working under a physician’s direct supervision.

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
RVUs for G0438PPRRVU2026_Oct_nonQPP.csv, line 15,260 (RVU26D)
Geographic factors for Oxnard, CAGPCI2026.csv, line 18 (RVU26D)

Open CMS sourceHow we calculate rates

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