HCPCS G0439 at Forks Community Hospital

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit

Forks Community Hospital, Forks

Description from CMS's HCPCS Level II code file.

What Forks Community Hospital publishes for this code: as an outpatient

Forks Community Hospital’s prices for HCPCS G0439, as an outpatient
Who pays	Hospital’s fee (lowest – highest)	Doctor’s fee the hospital lists
Commercial insuranceInsurer rates	—	$141 – $190
Medicare AdvantageInsurer rates	—	$141 – $250
Medicaid managed careInsurer rates	—	$714 – $757
Other government programInsurer rates	—	$141 – $142
UnknownInsurer rates	—	$151 – $678
Cash pricePaying yourself, without insurance	—	$571
List priceBefore any discount; few people pay it	—	$714

Lowest and highest amounts Forks Community Hospital lists for this code as an outpatient, including lines it lists for both settings or without saying which. Its price file is dated 2026-10-27. 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 G0439 at Forks Community 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	$141	$166 – $253

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

Compare HCPCS G0439 at every Washington hospital, with Medicare’s reference amounts.