G0405

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

Medicare pricing data for 3,210 providers across 48 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; interpretation and report only, performed as a screening for the initial preventive physical examination (HCPCS code G0405) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $7.95, but hospitals typically charge $36.85 — a 4.6x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$1.59

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $7.95, your out-of-pocket cost would be approximately $1.59. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$7.95
Average Hospital Charge
$36.85
Markup Ratio
4.6x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$36.85
Medicare Allowed$7.95
Medicare Payment$3.81

Hospitals charge 4.6x more than what Medicare allows for this procedure. Medicare actually pays $3.81 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
District of Columbia$9$98250+11.4%
New York$9$52232748+8.6%
New Jersey$9$3462300+7.7%
California$8$58156832+6.5%
Maryland$8$4550179+6.0%
Illinois$8$37174747+4.7%
Connecticut$8$1152848+3.6%
Washington$8$24135290+2.6%
Colorado$8$2586266+2.0%
Florida$8$23192731+0.9%
New Hampshire$8$62104367+0.4%
Montana$8$2233126+0.3%
Michigan$8$28162653-0.3%
South Dakota$8$201845-0.8%
Nevada$8$641119-1.0%
Pennsylvania$8$4382285-1.0%
North Dakota$8$462458-1.4%
Minnesota$8$3541112-1.5%
Texas$8$30145455-1.8%
Georgia$8$4769251-2.1%
Wisconsin$8$4766257-2.1%
Maine$8$323357-2.3%
Wyoming$8$281236-2.3%
Delaware$8$2433120-2.5%
Utah$8$232561-2.5%
Kansas$8$3149273-2.8%
Oregon$8$362038-3.0%
Rhode Island$8$31468-3.0%
Massachusetts$8$4266179-3.1%
Missouri$8$2770198-3.4%
Nebraska$8$4830167-3.9%
Ohio$8$44109202-3.9%
Virginia$8$22145494-3.9%
Arizona$8$4362156-3.9%
Indiana$8$334687-4.0%
Iowa$8$2899501-4.4%
Kentucky$8$24851-4.5%
Oklahoma$8$192352-5.5%
Arkansas$8$121473-5.5%
South Carolina$7$4431108-5.8%
Vermont$7$284373-6.0%
New Mexico$7$191448-6.2%
North Carolina$7$33209621-6.4%
Tennessee$7$3265191-6.5%
Idaho$7$1572150-6.7%
Alabama$7$541633-7.5%
Mississippi$7$411751-8.1%
West Virginia$7$22717-8.8%

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

Related from TheDataProject.ai

💊 Need post-procedure medications? Check costs on OpenPrescriber