How much does Medicare pay for HCPCS G0439?

Medicare allowed an average of $117.95 per service and paid $117.95 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $278.42, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is HCPCS code G0439?

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit. It was billed 10,108,463 times to 10,108,423 Medicare beneficiaries by 110,126 providers in 2024.

Does G0439 pay differently in an office than a hospital?

Yes. The allowed amount averaged $118.14 in an office setting and $111.20 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 G0439 most?

Family Practice, with 4,168,511 services from 42,754 clinicians. Next are Internal Medicine, Nurse Practitioner, Physician Assistant.

HCPCS G0439

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit

$117.95Medicare-allowed amount per service, averaged across 10,108,463 services

Providers submitted

$278.42

Asking price, not received

Medicare allowed

$117.95

The fee schedule figure

Medicare paid

$117.95

Balance is patient coinsurance

Providers submitted an average of $278.42 for this code and Medicare allowed $117.95 — 2.4× 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 $117.95 (100%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $118.14
Hospital / facility: $111.20

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. 9,839,800 services were billed in an office setting and 268,663 in a facility.

Services: 10,108,463
Beneficiaries: 10,108,423
Providers billing it: 110,126
Total allowed: $1,192,293,211

What Medicare pays for HCPCS G0439

Across 10,108,463 services billed by 110,126 providers to 10,108,423 beneficiaries, Medicare allowed an average of $117.95 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 G0439

Specialty	Services	Beneficiaries	Avg allowed	Providers
Family Practice	4,168,511	4,168,494	$119.07	42,754
Internal Medicine	4,005,229	4,005,211	$122.66	31,387
Nurse Practitioner	1,224,579	1,224,575	$102.42	23,759
Physician Assistant	420,797	420,796	$102.08	8,458
General Practice	75,262	75,262	$126.91	913
Geriatric Medicine	54,531	54,531	$120.95	557
Hospitalist	24,296	24,296	$119.72	326
Pediatric Medicine	20,832	20,832	$119.03	274
Cardiology	19,208	19,208	$140.72	218
Emergency Medicine	17,841	17,841	$123.68	255
Nephrology	11,510	11,510	$134.73	133
Obstetrics & Gynecology	10,804	10,804	$132.54	292
Pulmonary Disease	9,913	9,913	$132.93	132
Osteopathic Manipulative Medicine	6,379	6,379	$122.09	89
Infectious Disease	5,502	5,502	$125.14	90

G0439 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
Florida	840,251	$121.11	$124.24	7,514
California	745,526	$130.18	$125.57	8,098
Texas	637,231	$122.29	$123.98	7,486
New York	546,336	$133.54	$124.85	6,483
Pennsylvania	474,491	$111.81	$124.38	5,364
Illinois	429,248	$130.02	$125.52	4,091
Ohio	399,846	$92.15	$123.80	4,968
Virginia	368,723	$123.13	$123.83	3,090
North Carolina	362,595	$118.12	$123.06	4,326
New Jersey	350,998	$118.38	$125.43	3,471
Massachusetts	338,339	$120.73	$123.84	3,401
Georgia	309,856	$121.17	$124.32	3,030
Maryland	294,145	$131.11	$123.58	2,441
Tennessee	271,287	$112.66	$122.68	2,791
Michigan	267,613	$107.46	$124.87	4,213
Arizona	249,416	$120.64	$122.64	2,437
South Carolina	245,052	$119.83	$123.91	2,029
Indiana	216,128	$116.91	$123.16	2,498
Wisconsin	184,606	$118.63	$123.72	2,460
Washington	176,387	$130.30	$123.92	2,483
Missouri	175,098	$104.06	$123.73	1,863
Colorado	158,123	$90.69	$123.18	2,062
Alabama	147,147	$114.69	$123.68	1,610
Kentucky	141,023	$107.68	$122.38	1,611
Minnesota	137,130	$122.17	$123.35	2,445
Oklahoma	130,055	$96.22	$123.58	1,266
Iowa	123,240	$115.27	$122.93	1,172
Arkansas	118,814	$94.38	$123.63	1,078
Connecticut	114,313	$134.50	$123.88	1,561
Kansas	111,285	$94.34	$123.85	980
Louisiana	107,994	$116.41	$123.63	1,144
Mississippi	102,788	$114.31	$122.75	823
Utah	89,629	$120.09	$124.42	1,034
Nebraska	85,312	$91.80	$123.76	861
Delaware	75,731	$116.81	$123.84	504
Oregon	74,867	$102.65	$122.57	1,175
Nevada	59,186	$121.53	$122.82	755
New Hampshire	53,852	$117.58	$121.88	671
Montana	45,627	$90.63	$122.35	399
West Virginia	45,130	$118.49	$122.65	559
Idaho	42,591	$114.73	$121.30	561
Maine	41,097	$74.52	$122.41	658
New Mexico	40,278	$114.08	$121.13	484
Rhode Island	37,674	$97.72	$123.65	492
South Dakota	25,849	$120.39	$123.15	275
North Dakota	22,070	$102.91	$120.87	280
Hawaii	22,062	$111.49	$125.22	283
District of Columbia	20,628	$142.61	$126.20	234
Wyoming	18,514	$119.50	$121.22	171
Vermont	17,590	$120.35	$122.77	233
Alaska	11,283	$151.78	$121.96	141
U.S. Virgin Islands	1,480	$120.10	$124.37	21
Guam	1,039	$129.83	$122.93	16
Puerto Rico	596	$126.32	$127.18	17
AP	483	$115.39	$127.20	3
XX	389	$131.96	$127.27	3

Related codes

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
G0402Initial preventive physical examination; face-to-face visit$158.02

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.