G0403

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

Medicare pricing data for 27,583 providers across 51 states

🤖AI Overview

Note: These costs reflect the Medicare physician/supplier component. Hospital facility fees are billed separately and can be 2-5x the physician fee.

💡 What You Should Know

Electrocardiogram, routine ecg with 12 leads; performed as a screening for the initial preventive physical examination with interpretation and report (HCPCS code G0403) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $14.20, but hospitals typically charge $52.00 — a 3.7x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$2.84

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $14.20, your out-of-pocket cost would be approximately $2.84. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$14.20
Average Hospital Charge
$52.00
Markup Ratio
3.7x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$52.00
Medicare Allowed$14.20
Medicare Payment$6.69

Hospitals charge 3.7x more than what Medicare allows for this procedure. Medicare actually pays $6.69 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$17$10051152+22.1%
New York$16$691,5735,928+15.6%
District of Columbia$16$4567265+15.3%
New Jersey$16$581,3166,003+11.1%
California$16$561,2705,045+10.8%
Maryland$15$478674,419+6.9%
Connecticut$15$556851,969+6.9%
Massachusetts$15$647802,628+6.8%
Illinois$15$699503,795+5.3%
Rhode Island$15$49116328+2.6%
Hawaii$15$331746+2.4%
Virginia$14$481,1214,972+1.1%
Washington$14$464561,215+1.1%
Colorado$14$405902,084+0.4%
Michigan$14$449433,064+0.1%
New Hampshire$14$68106338-0.5%
Florida$14$412,17710,045-0.6%
Pennsylvania$14$501,5376,409-0.6%
Delaware$14$34121612-0.9%
Maine$14$594072-1.4%
Montana$14$3993370-2.3%
Nevada$14$4279238-2.5%
Vermont$14$643298-3.1%
Texas$14$511,9487,438-3.2%
Georgia$14$521,2145,072-3.3%
South Dakota$14$6433140-3.5%
Oregon$14$47148407-3.8%
Utah$14$4179248-4.0%
Minnesota$14$65131242-4.2%
Missouri$14$543541,195-4.3%
Ohio$14$471,2704,786-4.6%
Wisconsin$13$1573681,111-5.2%
Arizona$13$378463,200-5.4%
North Carolina$13$521,6497,160-6.5%
Louisiana$13$51107436-6.9%
West Virginia$13$4461160-6.9%
New Mexico$13$4780205-7.0%
South Carolina$13$537633,790-7.0%
Oklahoma$13$40138396-7.4%
Wyoming$13$7238106-7.4%
Kansas$13$562961,318-7.7%
Iowa$13$513551,343-8.2%
Alabama$13$38248863-8.2%
Indiana$13$476582,192-9.0%
Nebraska$13$392871,211-9.6%
Kentucky$13$423631,045-9.8%
Arkansas$13$44133545-9.9%
Idaho$13$4254161-10.1%
North Dakota$13$80914-10.1%
Tennessee$13$488603,581-10.9%
Mississippi$13$4986301-11.1%

⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.

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