Tennessee · G0404

Electrocardiogram, Routine Ecg With 12 Leads; Tracing Only, Without Interpretation And Report, Performed As A Screening For The Initial Preventive Physical Examination in Tennessee

Tennessee Medicare Avg
$2.45
17% below national avg
National Medicare Avg
$2.95
All states combined
Billed Charge (TN)
$45.52
What providers submit
Est. Commercial (TN)
$11.83
National avg: $14.06
Est. Cash / Self-Pay (TN)
$16.64
Typical self-pay discount

Estimated using RAND 2024 commercial-to-Medicare ratios. Actual prices vary by insurer, plan, and facility.

49
Services in TN
19
Providers
N/A
Min Payment
N/A
Max Payment

Top Providers in Tennessee

Provider Medicare Services
Clough, John M.D. $2.94 12

Tennessee Pricing in Context

In Tennessee, CPT code G0404 (Electrocardiogram, Routine Ecg With 12 Leads; Tracing Only, Without Interpretation And Report, Performed As A Screening For The Initial Preventive Physical Examination) carries an average Medicare payment of $2.45 — 17% below the national benchmark of $2.95. 19 providers across the state submitted claims for this procedure in 2023, performing 49 total services. Individual payments in TN ranged from N/A at the low end to N/A at the high end, reflecting differences in provider setting (office vs. facility), modifiers, and the specific geographic locality code applied within the state.

The average billed charge in Tennessee is $45.52, which is the figure uninsured patients would most likely encounter before any negotiation or charity discount. Medicare, by statute, only reimburses the allowed amount — the balance between billed and paid is written off under provider participation agreements. Insured patients generally pay a negotiated rate that falls between these two figures; the exact amount depends on plan design, deductible status, and in-network participation. Because Tennessee sits below the national Medicare average, commercial rates in the state may also run lower than the US median.

Using RAND 2024 commercial-to-Medicare ratios for Preventive Screening procedures, the estimated commercial insurance price in Tennessee lands near $11.83, with self-pay cash prices typically around $16.64. Before scheduling, patients can request a Good Faith Estimate under the No Surprises Act, compare cash rates from hospital Machine-Readable Files, and confirm whether the provider is in-network with their specific plan. This page presents CMS reference data for informational use; it does not constitute medical or financial advice.

Frequently Asked Questions

How much does Electrocardiogram, Routine Ecg With 12 Leads; Tracing Only, Without Interpretation And Report, Performed As A Screening For The Initial Preventive Physical Examination cost in Tennessee?

The average Medicare payment for Electrocardiogram, Routine Ecg With 12 Leads; Tracing Only, Without Interpretation And Report, Performed As A Screening For The Initial Preventive Physical Examination in Tennessee is $2.45, which is 17% below the national average of $2.95. Providers in TN typically bill $45.52 for this procedure.

What does Electrocardiogram, Routine Ecg With 12 Leads; Tracing Only, Without Interpretation And Report, Performed As A Screening For The Initial Preventive Physical Examination cost with insurance in Tennessee?

With commercial insurance in Tennessee, Electrocardiogram, Routine Ecg With 12 Leads; Tracing Only, Without Interpretation And Report, Performed As A Screening For The Initial Preventive Physical Examination costs an estimated $11.83. Without insurance, the estimated cash price is $16.64. These estimates are based on RAND 2024 commercial-to-Medicare ratios and vary by insurer, plan, and facility.

How many providers perform Electrocardiogram, Routine Ecg With 12 Leads; Tracing Only, Without Interpretation And Report, Performed As A Screening For The Initial Preventive Physical Examination in Tennessee?

19 providers in Tennessee billed Medicare for Electrocardiogram, Routine Ecg With 12 Leads; Tracing Only, Without Interpretation And Report, Performed As A Screening For The Initial Preventive Physical Examination in 2023, performing 49 total services. Medicare payments ranged from N/A to N/A depending on the provider.

Is Electrocardiogram, Routine Ecg With 12 Leads; Tracing Only, Without Interpretation And Report, Performed As A Screening For The Initial Preventive Physical Examination cheaper in Tennessee than the national average?

Yes — Electrocardiogram, Routine Ecg With 12 Leads; Tracing Only, Without Interpretation And Report, Performed As A Screening For The Initial Preventive Physical Examination costs 17% below the national average in Tennessee. The state average Medicare payment is $2.45 compared to $2.95 nationally. Factors like local cost of living, provider competition, and regional Medicare fee schedules all influence state-level pricing.

Related

Data sourced from the CMS Medicare Physician and Other Practitioners dataset. See our methodology for details. Retrieved and formatted by PlainProcedure Editorial