{
    "code": "G0402",
    "coding_system": "HCPCS",
    "canonical_url": "https://localishealth.com/hcpcs/G0402/2016/A",
    "release_specific_url": "https://localishealth.com/hcpcs/G0402/2016/D",
    "description": "The one-time Initial Preventive Physical Examination available within the first 12 months of Medicare Part B enrollment. It covers a review of medical and social history, vital signs, vision screening, a written screening schedule, and counseling — not the treatment of a specific complaint or a hands-on physical exam.",
    "answer": {
        "question": "How much did Medicare pay for HCPCS G0402 in Q4 2016?",
        "text": "Medicare paid $167.56 for HCPCS G0402 in the office (non-facility) setting and $128.18 in a facility under the Q4 2016 Physician Fee Schedule, effective October 2016. These are the national allowed amounts before the ~2% sequestration cut and before locality (GPCI) adjustment. This price has been unchanged since Q1 2016, when it decreased 0.8%."
    },
    "release": {
        "schedule": "pfs",
        "year": 2016,
        "quarter": "D",
        "label": "Q4 2016",
        "effective": "October 1 – December 31, 2016",
        "revision": 1
    },
    "status": {
        "code": "A",
        "non_facility_payable": true,
        "facility_payable": true
    },
    "national_rates_usd": {
        "office_non_facility": 167.56,
        "facility": 128.18,
        "sequestration_applied": false,
        "gpci": 1
    },
    "rvus": {
        "work": 2.43,
        "practice_expense_non_facility": 2.1,
        "practice_expense_facility": 1,
        "malpractice": 0.15
    },
    "formula": "(work_rvu × work_gpci + pe_rvu × pe_gpci + mp_rvu × mp_gpci) × conversion_factor",
    "conversion_factor": 35.8043,
    "source": {
        "label": "Physician relative value file (Q4 2016)",
        "cms_url": "https://www.cms.gov/medicare/medicare-fee-for-service-payment/physicianfeesched/downloads/rvu16d.zip",
        "local_source_url": "https://localishealth.com/sources/physician-fee-schedule/2016/D",
        "file": "PPRRVU16_V0804.csv",
        "row": 1491,
        "sha256": "376b12d2df1b1c1abaed1e123e9501352bf559c75a0a4f87f52878742af491c9"
    },
    "modified_at": "2026-08-04T03:07:13+00:00"
}