HCPCS G0403: Preventive ECGMedicare rate & RVUs in Texas
Reports a 12-lead screening ECG performed as part of the initial preventive physical examination when the complete test service is furnished.
Medicare pays $14.51–$15.82 for G0403 in the office in Texas, from Beaumont to Austin. Which amount applies depends on the service address.
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 9 sections
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 in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 payment localities
$14.51 to $15.82
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin | $15.82 | Unavailable |
| Beaumont | $14.51 | Unavailable |
| Brazoria | $15.18 | Unavailable |
| Dallas | $15.28 | Unavailable |
| Fort Worth | $15.20 | Unavailable |
| Galveston | $15.23 | Unavailable |
| Houston | $15.60 | Unavailable |
| Rest Of Texas | $14.84 | Unavailable |
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.
How the rate is built · G0403
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 0.17Practice expense 0.27Malpractice 0.02
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for G0403
The CMS indicators that decide how G0403 is paid alongside other services.
CMS payment indicators · G0403
Preventive ECG
| Rule | CMS value | What it means |
|---|---|---|
| Global period | XXX | The global surgery concept doesn’t apply. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 4 | Global test only. |
G0403 compared with similar codes
Compare codes
G0403 vs G0402 vs G0404 vs G0405: national Medicare rates
Swap in your local Medicare rate.
How to choose
- G0402Welcome visit
- G0402 represents the initial preventive physical examination; G0403 represents the ECG performed as part of that examination.
- G0404IPPE ECG
- G0404 is for the ECG tracing portion alone. G0403 is used when the complete test service is furnished and billed together.
- G0405ECG interpretation
- G0405 is for the ECG interpretation and report portion alone. G0403 represents the complete ECG test service.
G0403 billing questions
When should the practice report G0403 rather than G0404 or G0405?
Report G0403 when the complete ECG service is furnished and billed together. G0404 is for the tracing portion, and G0405 is for the interpretation and report portion.
Is G0403 the code for the initial preventive examination?
No. G0403 reports the ECG performed as part of that examination; G0402 represents the initial preventive physical examination.
What documentation supports G0403?
The record should show that the ECG was performed in connection with the initial preventive examination and include the tracing and its interpretation and report.
Can G0403 be reported when the practice provides only the tracing?
Use G0404 for the tracing portion when the complete test is not furnished and billed. G0403 represents the complete test service.
Can G0403 be reported when only the interpretation is provided?
Use G0405 for the interpretation and report portion when that is the service furnished. G0403 represents the complete test service.
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
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