HCPCS and CPT codes by Medicare payment, 2020
Every code billed to Original Medicare Part B, with how many providers bill it and what it paid.
By category
| observed | calculated | calculated | calculated | |
|---|---|---|---|---|
| Evaluation and management | 103 | $26,152,773,192 | 32% | 365,425,889 |
| Other services | 1,281 | $20,822,326,473 | 26% | 580,898,651 |
| Procedures | 2,641 | $11,698,355,640 | 15% | 131,724,082 |
| Drugs | 391 | $10,297,981,287 | 13% | 846,374,688 |
| Laboratory | 1,187 | $6,330,738,675 | 7.9% | 298,843,280 |
| Imaging | 513 | $5,237,212,990 | 6.5% | 104,620,676 |
Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). Category from the latest CMS drug flag and CPT ranges (see methodology). Data year 2020.
Top 200 codes
The 200 with the most payment of 3,768 codes.
Not listed: 2,348 codes billed by fewer than 11 providers (small cells; each has its own page with the count).
| observed | calculated | calculated | calculated | calculated | calculated | |||
|---|---|---|---|---|---|---|---|---|
| 99214 | Descriptor not shown (CPT code) | Evaluation and management | 427,811 | $6,217,850,436 | 7.7% | 87,626,387 | 102 | |
| 99213 | Descriptor not shown (CPT code) | Evaluation and management | 442,931 | $3,641,690,420 | 4.5% | 74,817,627 | 82 | |
| J0178 | Injection, aflibercept, 1 mg | Drugs | 2,954 | $2,270,531,860 | 2.8% | 3,076,947 | 714 | |
| 99232 | Descriptor not shown (CPT code) | Evaluation and management | 172,753 | $2,261,919,758 | 2.8% | 38,917,470 | 93 | |
| 99233 | Descriptor not shown (CPT code) | Evaluation and management | 129,015 | $2,028,050,351 | 2.5% | 23,969,727 | 93 | |
| 99223 | Descriptor not shown (CPT code) | Evaluation and management | 131,506 | $1,463,534,404 | 1.8% | 9,060,604 | 42 | |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | Other services | 6,952 | $1,458,570,191 | 1.8% | 4,146,263 | 179 | |
| 66984 | Descriptor not shown (CPT code) | Procedures | 15,059 | $1,307,633,532 | 1.6% | 5,896,885 | 92 | |
| 99285 | Descriptor not shown (CPT code) | Evaluation and management | 58,816 | $1,294,974,635 | 1.6% | 9,187,779 | 123 | |
| 99291 | Descriptor not shown (CPT code) | Evaluation and management | 68,223 | $1,097,626,171 | 1.4% | 5,952,087 | 47 | |
| 97110 | Descriptor not shown (CPT code) | Other services | 64,571 | $960,189,403 | 1.2% | 47,795,505 | 463 | |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | Other services | 91,502 | $917,643,170 | 1.1% | 7,968,825 | 55 | |
| 99204 | Descriptor not shown (CPT code) | Evaluation and management | 165,869 | $879,474,824 | 1.1% | 7,780,468 | 31 | |
| 92014 | Descriptor not shown (CPT code) | Other services | 36,885 | $868,185,817 | 1.1% | 10,309,822 | 133 | |
| J2778 | Injection, ranibizumab, 0.1 mg | Drugs | 1,474 | $845,963,540 | 1.1% | 3,179,518 | 956 | |
| 99215 | Descriptor not shown (CPT code) | Evaluation and management | 107,887 | $786,264,171 | 0.98% | 7,848,467 | 35 | |
| A0425 | Ground mileage, per statute mile | Other services | 9,105 | $784,399,287 | 0.97% | 121,513,493 | 3,347 | |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | Other services | 8,010 | $775,594,649 | 0.96% | 2,577,083 | 102 | |
| J9271 | Injection, pembrolizumab, 1 mg | Drugs | 1,467 | $753,229,592 | 0.94% | 19,161,479 | 10,830 | |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | Other services | 3,057 | $725,795,555 | 0.90% | 4,338,292 | 283 | |
| U0003 | Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high throughput technologies as described by cms-2020-01-r | Other services | 2,130 | $719,559,418 | 0.89% | 7,216,396 | 33 | |
| J0897 | Injection, denosumab, 1 mg | Drugs | 9,672 | $696,220,853 | 0.86% | 45,291,470 | 2,640 | |
| 88305 | Descriptor not shown (CPT code) | Laboratory | 14,801 | $654,091,212 | 0.81% | 16,814,860 | 472 | |
| 99309 | Descriptor not shown (CPT code) | Evaluation and management | 26,044 | $646,293,211 | 0.80% | 9,727,635 | 172 | |
| 99203 | Descriptor not shown (CPT code) | Evaluation and management | 160,873 | $599,868,920 | 0.74% | 8,427,867 | 31 | |
| 93306 | Descriptor not shown (CPT code) | Other services | 24,804 | $586,689,450 | 0.73% | 6,362,987 | 205 | |
| 99308 | Descriptor not shown (CPT code) | Evaluation and management | 27,702 | $538,231,168 | 0.67% | 10,516,143 | 145 | |
| 99222 | Descriptor not shown (CPT code) | Evaluation and management | 98,326 | $528,723,342 | 0.66% | 4,835,349 | 28 | |
| 90960 | Descriptor not shown (CPT code) | Other services | 7,360 | $495,091,415 | 0.61% | 2,151,849 | 239 | |
| J0129 | Injection, abatacept, 10 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered) | Drugs | 1,037 | $490,770,177 | 0.61% | 11,127,563 | 8,425 | |
| 97530 | Descriptor not shown (CPT code) | Other services | 38,619 | $461,229,754 | 0.57% | 16,295,948 | 245 | |
| 90662 | Descriptor not shown (CPT code) | Drugs | 86,650 | $434,202,465 | 0.54% | 7,416,987 | 52 | |
| 97140 | Descriptor not shown (CPT code) | Other services | 54,252 | $396,619,998 | 0.49% | 22,262,856 | 264 | |
| 77067 | Descriptor not shown (CPT code) | Imaging | 15,787 | $386,037,687 | 0.48% | 5,387,962 | 196 | |
| 97112 | Descriptor not shown (CPT code) | Other services | 42,373 | $376,172,998 | 0.47% | 15,425,332 | 221 | |
| 99239 | Descriptor not shown (CPT code) | Evaluation and management | 56,028 | $376,041,147 | 0.47% | 4,395,652 | 56 | |
| 90837 | Descriptor not shown (CPT code) | Other services | 16,183 | $358,101,857 | 0.44% | 3,880,208 | 180 | |
| 99284 | Descriptor not shown (CPT code) | Evaluation and management | 59,468 | $348,455,248 | 0.43% | 3,888,994 | 51 | |
| G6015 | Intensity modulated treatment delivery, single or multiple fields/arcs,via narrow spatially and temporally modulated beams, binary, dynamic mlc, per treatment session | Other services | 1,451 | $334,995,677 | 0.42% | 1,146,266 | 540 | |
| 17311 | Descriptor not shown (CPT code) | Procedures | 2,713 | $333,735,814 | 0.41% | 758,162 | 203 | |
| 27447 | Descriptor not shown (CPT code) | Procedures | 10,465 | $332,059,865 | 0.41% | 378,316 | 26 | |
| 98941 | Descriptor not shown (CPT code) | Other services | 26,198 | $321,660,377 | 0.40% | 11,193,445 | 297 | |
| 92012 | Descriptor not shown (CPT code) | Other services | 22,800 | $309,495,999 | 0.38% | 4,967,341 | 106 | |
| 78815 | Descriptor not shown (CPT code) | Imaging | 6,681 | $306,941,068 | 0.38% | 636,031 | 50 | |
| 45385 | Descriptor not shown (CPT code) | Procedures | 14,759 | $291,403,814 | 0.36% | 1,088,627 | 44 | |
| 81479 | Descriptor not shown (CPT code) | Laboratory | 64 | $287,964,850 | 0.36% | 138,638 | 228 | |
| 99205 | Descriptor not shown (CPT code) | Evaluation and management | 53,673 | $285,584,548 | 0.35% | 1,912,999 | 25 | |
| 78452 | Descriptor not shown (CPT code) | Imaging | 15,340 | $284,968,739 | 0.35% | 1,376,513 | 62 | |
| 74177 | Descriptor not shown (CPT code) | Imaging | 23,389 | $279,469,717 | 0.35% | 3,105,865 | 103 | |
| 67028 | Descriptor not shown (CPT code) | Procedures | 4,147 | $274,660,157 | 0.34% | 3,275,993 | 503 |
Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). Descriptions of HCPCS Level II codes are the official CMS descriptors, shown verbatim; CPT codes show a ClaimLight category in place of the descriptor. Data year 2020.
Original Medicare Part B fee-for-service only; CMS suppresses provider lines with fewer than 11 beneficiaries. How these figures are computed