HCPCS G0402 at Skyline Hospital

Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment

Skyline Hospital, White Salmon

Description from CMS's HCPCS Level II code file.

What Skyline Hospital publishes for this code: as an outpatient

Skyline Hospital’s prices for HCPCS G0402, as an outpatient
Who pays	Hospital’s fee (lowest – highest)	Doctor’s fee the hospital lists
Commercial insuranceInsurer rates	$337 – $5552 plans	$51.00 – $57.00
Medicare AdvantageInsurer rates	$191 – $4013 plans	$115 – $152
Medicaid managed careInsurer rates	$198 – $5723 plans	$217 – $228
Other government programInsurer rates	$229 – $2861 plan	$115
UnknownInsurer rates	$210 – $5906 plans	$51.00 – $230
Cash pricePaying yourself, without insurance	$286 – $425	$156
List priceBefore any discount; few people pay it	$397 – $590	$217

Lowest and highest amounts Skyline Hospital lists for this code as an outpatient, including lines it lists for both settings or without saying which. Its price file is dated 2026-08-21. This is one line of a bill; most care brings several.

Bills to expect

The hospital’s fee is the price above. Doctors usually send their own bills. Their amounts here are what original Medicare allows in the rest of Washington for 2026, and a private-plan estimate of 118% to 179% of that (the range found across studies of what insurers pay doctors). Those are estimates, not quotes.

Bills to expect for HCPCS G0402 at Skyline Hospital
Bill	What it’s for	Original Medicare allows	Private plan estimate
Hospital's feeThe hospital	The clinic's facility fee, when the clinic belongs to the hospital	—	The price above
Doctor's visitThe doctor's practice	The visit itself	$115	$136 – $206

Original Medicare amounts are only for people on original Medicare. Your share depends on your plan’s deductible, copay and coinsurance.

Compare HCPCS G0402 at every Washington hospital, with Medicare’s reference amounts.