How much does Medicare pay for HCPCS G0422?

Medicare allowed an average of $126.65 per service and paid $100.56 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $296.92, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is HCPCS code G0422?

Intensive cardiac rehabilitation; with or without continuous ecg monitoring with exercise, per session. It was billed 90,946 times to 6,659 Medicare beneficiaries by 112 providers in 2024.

Which specialty bills G0422 most?

Cardiology, with 59,044 services from 72 clinicians. Next are Interventional Cardiology, Intensive Cardiac Rehabilitation, Family Practice.

HCPCS G0422

Intensive cardiac rehabilitation; with or without continuous ecg monitoring with exercise, per session

$126.65Medicare-allowed amount per service, averaged across 90,946 services

Providers submitted

$296.92

Asking price, not received

Medicare allowed

$126.65

The fee schedule figure

Medicare paid

$100.56

Balance is patient coinsurance

Providers submitted an average of $296.92 for this code and Medicare allowed $126.65 — 2.3× 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 $100.56 (79%); the rest is the patient’s coinsurance and deductible.

Services: 90,946
Beneficiaries: 6,659
Providers billing it: 112
Total allowed: $11,518,311

What Medicare pays for HCPCS G0422

Across 90,946 services billed by 112 providers to 6,659 beneficiaries, Medicare allowed an average of $126.65 per service. That is 13.7 services per beneficiary, so this is a code patients typically receive more than once. 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 G0422

Specialty	Services	Beneficiaries	Avg allowed	Providers
Cardiology	59,044	4,714	$126.32	72
Interventional Cardiology	8,354	655	$128.64	18
Intensive Cardiac Rehabilitation	8,336	373	$132.64	8
Family Practice	5,477	266	$123.04	1
Advanced Heart Failure and Transplant Cardiology	4,121	201	$124.46	2
Internal Medicine	3,043	165	$122.14	6
Clinical Cardiac Electrophysiology	2,054	260	$125.40	4
Pulmonary Disease	517	25	$122.52	1

G0422 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
Nevada	15,488	$125.12	$99.33	3
California	13,954	$135.16	$100.15	21
Arkansas	9,784	$121.27	$99.46	4
Louisiana	6,613	$122.87	$99.39	4
Pennsylvania	6,282	$123.11	$100.03	7
North Carolina	6,190	$119.87	$99.45	1
Florida	5,977	$128.48	$99.67	8
Texas	3,801	$120.96	$100.37	4
Colorado	3,713	$128.63	$99.12	17
Arizona	3,221	$124.50	$99.88	7
New York	3,201	$146.19	$99.23	14
Missouri	3,070	$122.94	$99.30	4
Georgia	2,854	$126.09	$99.13	3
Virginia	2,291	$124.27	$100.46	4
New Jersey	1,707	$136.93	$99.50	5
Idaho	984	$118.25	$99.86	1
Michigan	784	$128.79	$99.21	1
South Carolina	680	$126.76	$99.31	1
Delaware	177	$126.00	$100.48	1
Massachusetts	124	$140.01	$100.48	1
Illinois	51	$126.95	$97.98	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.