NEVVI Medicare utilization intelligence

For the same yearly wellness visit, Medicare approves $125.76 in Arkansas and $173.21 in San Benito County, CA

Published Jul 2026 · CMS Medicare Physician Fee Schedule (RVU + GPCI files) 📋 Cite See the data →
Medicare's approved amount for the annual wellness visit · 2026
San Jose (San Benito)San Jose (San Benito): $173.21$173.21San Jose (Santa Clara)San Jose (Santa Clara): $172.61$172.61AlaskaAlaska: $172.22$172.22San Francisco (Marin)San Francisco (Marin): $169.70$169.70San Francisco (San Fran…San Francisco (San Francisco +): $169.55$169.55KansasKansas: $128.82$128.82Rest of MissouriRest of Missouri: $127.96$127.96AlabamaAlabama: $127.08$127.08MississippiMississippi: $126.87$126.87ArkansasArkansas: $125.76$125.76
The non-facility approved amount at the five highest and five lowest of 109 physician fee schedule localities, 2026. Bars start at zero, so the printed amounts carry the spread. An approved amount is what the fee schedule states before any claim is filed, not a record of money that changed hands. Part B pays 80% of an approved amount after the deductible for most services; the annual wellness visit is one of the preventive exceptions, paid in full.

One procedure with one national description comes out at 109 different approved amounts, 38% more at the top than at the bottom. About half of the work multipliers behind that spread are set in statute rather than measured. The visit itself is the no-cost yearly check-in Medicare added in 2011, not a head-to-toe physical.

Every procedure in the fee schedule carries three national values wherever it is billed: one for the clinician's work, one for the cost of running the practice, one for malpractice insurance. Those do not change by state. What changes is a set of three local multipliers, and Medicare publishes 109 sets of them.

For this visit the work and the practice are worth about the same before any local adjustment, 47% and 50% of its value. The practice multiplier runs from 0.859 to 1.442 across the country while the work multiplier barely moves, so 85% of the $47.45 gap between the two ends is the practice, not the clinician's time.

Malpractice insurance varies more than eightfold, 0.296 in Minnesota against 2.529 in Miami. It is also the smallest of the three, about 3% of this visit's value, so it moves the total least.

The work multiplier has a floor of 1.000 set in statute, and 51 of the 109 localities sit exactly on it. Measured costs do not pile up on a round number. Alaska sits at 1.500 for the same statutory reason, which puts its amount third highest in the country while its practice multiplier, 1.065, is closer to the middle than the top.

Why the practice multiplier is higher in one place than another is a question about local costs this page does not answer.

Across the 3,675 procedures the fee schedule computes this way, the typical one is approved at about 1.5 times as much in the locality that approves the most as in the one that approves the least.

A record of what Medicare's fee schedule approves before any claim is filed — always the amount approved, never the amount anyone was paid, and not a judgment about whether any amount is right.

What this is

What the 2026 Medicare physician fee schedule approves for the subsequent annual wellness visit, in the office setting, at each of the 109 fee-schedule localities.

What it is not

Not money anyone received — these are fee-schedule amounts, not a payment record. Part B pays 80% of an approved amount after the deductible for most services; this visit is a preventive exception Medicare pays in full. Not a claims record: no procedure was performed here and no beneficiary counted. Not the hospital-outpatient amount, which differs. Not all-payer, and not a statement about whether any amount is right.

How this is counted
Medicare's non-facility approved amount for the subsequent annual wellness visit at each of the 109 physician fee schedule localities, 2026 vintage. The amount is (work RVU x work multiplier + practice-expense RVU x practice multiplier + malpractice RVU x malpractice multiplier) x the national conversion factor. The relative value units are national — the same everywhere — and the three multipliers, which CMS calls geographic practice cost indices, are the only part that varies by place. The work multiplier carries a statutory floor of 1.000, so a locality CMS measures below it is raised to it. Figures are the NON-FACILITY amount, which applies when the visit happens in an office rather than a hospital outpatient department; the facility amount differs. An approved amount is not a payment. For most services Part B pays 80% of it after the deductible, and what a practice collects also depends on the beneficiary's other coverage — but the annual wellness visit is an Affordable Care Act preventive service, so its coinsurance and deductible are waived and Medicare pays the approved amount in full. Nothing on this page is scaled, estimated or suppressed — the fee schedule counts no beneficiaries. Source: CMS Medicare Physician Fee Schedule relative value and geographic practice cost index files, 2026.

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