How much does Medicare pay for HCPCS G0405?

Medicare allowed an average of $7.90 per service and paid $3.60 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $36.47, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

Does G0405 pay differently in an office than a hospital?

Yes. The allowed amount averaged $7.91 in an office setting and $7.82 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills G0405 most?

Internal Medicine, with 1,451 services from 78 clinicians. Next are Family Practice, Cardiology, Interventional Cardiology.

HCPCS G0405

Electrocardiogram, routine ecg with 12 leads; interpretation and report only, performed as a screening for the initial preventive physical examination

$7.90Medicare-allowed amount per service, averaged across 4,462 services

Providers submitted

$36.47

Asking price, not received

Medicare allowed

$7.90

The fee schedule figure

Medicare paid

$3.60

Balance is patient coinsurance

Providers submitted an average of $36.47 for this code and Medicare allowed $7.90 — 4.6× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $3.60 (46%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $7.91
Hospital / facility: $7.82

The office rate is higher because the practice supplies the room, staff and equipment out of that payment. In a hospital the facility bills those separately, so the clinician's share is smaller — the total cost to Medicare is usually higher, not lower. 3,844 services were billed in an office setting and 618 in a facility.

Services: 4,462
Beneficiaries: 4,462
Providers billing it: 230
Total allowed: $35,250

What Medicare pays for HCPCS G0405

Across 4,462 services billed by 230 providers to 4,462 beneficiaries, Medicare allowed an average of $7.90 per service. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills G0405

Specialty	Services	Beneficiaries	Avg allowed	Providers
Internal Medicine	1,451	1,451	$8.03	78
Family Practice	1,181	1,181	$7.96	66
Cardiology	759	759	$7.81	37
Interventional Cardiology	601	601	$7.86	23
Clinical Cardiac Electrophysiology	228	228	$7.76	11
Physician Assistant	80	80	$6.75	6
Nurse Practitioner	66	66	$6.69	4
Advanced Heart Failure and Transplant Cardiology	38	38	$7.64	2
General Practice	25	25	$9.37	1
Emergency Medicine	21	21	$8.35	1
Geriatric Medicine	12	12	$7.74	1

G0405 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
Michigan	407	$7.99	$3.37	13
Iowa	390	$7.51	$3.28	20
Florida	364	$7.94	$3.55	20
California	298	$8.30	$3.82	17
Illinois	231	$8.15	$3.44	16
New Jersey	230	$8.51	$3.82	11
Pennsylvania	211	$7.72	$3.39	8
North Carolina	209	$7.65	$2.89	9
Texas	190	$7.80	$3.20	9
New York	168	$8.73	$4.22	8
Wisconsin	150	$7.59	$2.79	5
Virginia	146	$7.73	$3.91	11
Montana	144	$7.94	$3.48	8
North Dakota	117	$7.77	$3.26	5
Washington	109	$8.24	$3.20	7
Georgia	109	$7.74	$3.79	6
Colorado	101	$8.01	$4.58	7
Arizona	79	$7.50	$3.41	4
Kentucky	75	$7.59	$5.86	1
South Carolina	74	$7.14	$4.93	3
Missouri	70	$7.78	$3.97	5
Kansas	69	$7.57	$3.24	3
Maryland	58	$8.26	$4.96	3
South Dakota	57	$7.72	$3.69	3
Delaware	55	$7.90	$4.09	4
New Hampshire	54	$7.96	$3.58	4
Rhode Island	42	$8.03	$5.65	1
Tennessee	41	$7.55	$2.85	3
Massachusetts	38	$7.93	$2.85	3
Minnesota	36	$7.72	$2.70	2
Indiana	28	$7.57	$3.65	2
Nebraska	24	$7.50	$4.25	2
Alabama	23	$7.56	$2.68	2
Wyoming	19	$7.79	$4.63	1
Ohio	12	$7.74	$3.73	1
Oregon	12	$7.88	$4.21	1
Oklahoma	11	$6.51	$1.63	1
Mississippi	11	$7.80	$5.73	1

Related codes

G0439Annual wellness visit$117.95
G0444Annual depression screening$17.80
G0471Collection of venous blood by venipuncture or urine sample by catheter$10.56
G0442Annual alcohol misuse screening$17.96
G0480Drug test(s), definitive, utilizing (1) drug identification methods ab$110.33
G0483Drug test(s), definitive, utilizing (1) drug identification methods ab$240.71
G0482Drug test(s), definitive, utilizing (1) drug identification methods ab$193.45
G0481Drug test(s), definitive, utilizing (1) drug identification methods ab$152.51
G0438Annual wellness visit; includes a personalized prevention plan of serv$151.05
G0453Continuous intraoperative neurophysiology monitoring$32.00
G0446Annual, face-to-face intensive behavioral therapy for cardiovascular d$24.56
G0447Face-to-face behavioral counseling for obesity$24.83

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.