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See a sample rate comparisonHCPCS G0403 Fee Schedule
Last Verified: September 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
Electrocardiogram, routine ECG with 12 leads; performed as a screening for the initial preventive physical examination with interpretation and report
| Key Fact | Detail |
|---|---|
| Service Type | Procedures / Professional Services Initial Services for Medicare Enrollment |
| Complexity Level | Low |
| Medicaid Fee Schedule | View Medicaid rates for G0403 |
National average reimbursement for HCPCS G0403 by major payers:
$21.23
$23.19
$20.36
$15.72
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HCPCS G0403
5 of 25 sample ratesHigher to lower in this preview
Leonardo Holguin
$57.36Published rateDaniel Goldman
Advocare, LLC
$29.36Published rateMadhuri Adabala
Capital Health Multispecialty Group
$18.85Published rateMaria Comsti
Comsti Medical LLC
$14.38Published rateAra Manougian
Ara Manougian Md LLC
$10.92Published rate
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See a sample payer proposalHCPCS G0403 vs. Other Initial Services for Medicare Enrollment Codes
The HCPCS G0403 code is part of the Procedures / Professional Services services used for Initial Services for Medicare Enrollment. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The HCPCS G0403 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| G0402-HCPCS | Low | Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of Medicare enrollment |
| G0403-HCPCS | Low | Electrocardiogram, routine ECG with 12 leads; performed as a screening for the initial preventive physical examination with interpretation and report |
| G0404-HCPCS | Low | Electrocardiogram, routine ECG with 12 leads; tracing only, without interpretation and report, performed as a screening for the initial preventive physical examination |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS G0403. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the G0403 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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