Procedure · Updated Aug 1, 2026
Annual physical: CPT code and Medicare rate
A comprehensive preventive exam for a patient who has been seen before, billed by the patient's age band—99397 for age 65 and over, 99396 for ages 40 to 64.
Also called: yearly physical, annual exam, routine physical, preventive exam.
Usually billed as
99397 has no national Medicare amount in the Q4 2026 release. Its status is non-covered, and what Medicare pays depends on the circumstances of the individual claim.
Traditional Medicare does not cover a routine annual physical. It covers the Annual Wellness Visit (G0438/G0439) instead, which is a different service—a health-risk review and prevention plan rather than a head-to-toe exam.
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Annual physical: which code is it?
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Every code page carries the full locality breakdown, the RVU and GPCI inputs, and the release the numbers come from.
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This page maps everyday language to the code a claim normally carries. It's general information about how Medicare prices a service, not coding advice for a specific claim. The correct code always depends on what was actually documented and performed.
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