HCPCS and CPT codes by Medicare payment, 2021
Every code billed to Original Medicare Part B, with how many providers bill it and what it paid.
By category
| observed | calculated | calculated | calculated | calculated | |
|---|---|---|---|---|---|
| Evaluation and management | 105 | $30,105,186,116 | 33% | +15.1% | 374,953,158 |
| Other services | 1,346 | $24,604,615,204 | 27% | +18.2% | 677,206,585 |
| Procedures | 2,656 | $13,043,979,031 | 14% | +11.5% | 141,779,053 |
| Drugs | 401 | $10,656,554,082 | 12% | +3.5% | 878,943,218 |
| Laboratory | 1,230 | $7,454,990,901 | 8.1% | +17.8% | 315,559,224 |
| Imaging | 515 | $5,669,737,065 | 6.2% | +8.3% | 111,459,867 |
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 2021.
Top 200 codes
The 200 with the most payment of 3,860 codes.
Not listed: 2,393 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 | 449,158 | $8,409,089,386 | 9.2% | 96,343,071 | 109 | |
| 99213 | Descriptor not shown (CPT code) | Evaluation and management | 455,329 | $4,578,684,345 | 5.0% | 74,572,954 | 80 | |
| J0178 | Injection, aflibercept, 1 mg | Drugs | 3,037 | $2,598,280,485 | 2.8% | 3,546,845 | 808 | |
| 99232 | Descriptor not shown (CPT code) | Evaluation and management | 171,284 | $2,086,298,005 | 2.3% | 36,440,764 | 90 | |
| 99233 | Descriptor not shown (CPT code) | Evaluation and management | 133,387 | $2,057,591,731 | 2.2% | 24,794,817 | 94 | |
| 66984 | Descriptor not shown (CPT code) | Procedures | 16,131 | $1,573,931,045 | 1.7% | 7,363,296 | 104 | |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | Other services | 6,963 | $1,433,341,736 | 1.6% | 4,032,692 | 177 | |
| 99223 | Descriptor not shown (CPT code) | Evaluation and management | 131,670 | $1,391,283,334 | 1.5% | 8,794,981 | 41 | |
| 99285 | Descriptor not shown (CPT code) | Evaluation and management | 58,527 | $1,367,877,121 | 1.5% | 9,121,353 | 122 | |
| 99204 | Descriptor not shown (CPT code) | Evaluation and management | 214,681 | $1,290,527,754 | 1.4% | 10,853,501 | 33 | |
| 99215 | Descriptor not shown (CPT code) | Evaluation and management | 133,298 | $1,261,370,854 | 1.4% | 9,935,165 | 37 | |
| 97110 | Descriptor not shown (CPT code) | Other services | 71,360 | $1,142,844,669 | 1.2% | 57,756,591 | 505 | |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | Other services | 97,284 | $1,137,586,032 | 1.2% | 8,795,150 | 58 | |
| 99291 | Descriptor not shown (CPT code) | Evaluation and management | 69,264 | $1,062,688,965 | 1.2% | 5,807,747 | 47 | |
| J9271 | Injection, pembrolizumab, 1 mg | Drugs | 1,548 | $874,037,553 | 0.95% | 21,421,855 | 11,600 | |
| 92014 | Descriptor not shown (CPT code) | Other services | 36,828 | $822,752,852 | 0.90% | 9,662,893 | 126 | |
| J2778 | Injection, ranibizumab, 0.1 mg | Drugs | 1,445 | $797,320,622 | 0.87% | 3,168,850 | 1,015 | |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | Other services | 8,016 | $776,702,411 | 0.85% | 2,554,604 | 102 | |
| J0897 | Injection, denosumab, 1 mg | Drugs | 9,981 | $763,317,410 | 0.83% | 46,983,078 | 2,640 | |
| A0425 | Ground mileage, per statute mile | Other services | 9,088 | $744,306,469 | 0.81% | 113,973,104 | 3,364 | |
| 88305 | Descriptor not shown (CPT code) | Laboratory | 14,708 | $722,157,640 | 0.79% | 18,432,755 | 516 | |
| 99203 | Descriptor not shown (CPT code) | Evaluation and management | 167,692 | $696,009,828 | 0.76% | 9,003,185 | 32 | |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | Other services | 3,055 | $667,108,161 | 0.73% | 3,893,734 | 260 | |
| 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 | 3,685 | $651,494,320 | 0.71% | 8,699,096 | 35 | |
| 97530 | Descriptor not shown (CPT code) | Other services | 47,233 | $648,879,561 | 0.71% | 23,095,011 | 292 | |
| 99309 | Descriptor not shown (CPT code) | Evaluation and management | 25,682 | $640,927,746 | 0.70% | 9,717,535 | 176 | |
| 93306 | Descriptor not shown (CPT code) | Other services | 24,936 | $617,442,573 | 0.67% | 6,789,570 | 218 | |
| 99308 | Descriptor not shown (CPT code) | Evaluation and management | 25,898 | $514,203,246 | 0.56% | 10,032,624 | 146 | |
| 97112 | Descriptor not shown (CPT code) | Other services | 50,279 | $504,155,757 | 0.55% | 20,887,222 | 253 | |
| 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 | 1,147 | $494,732,891 | 0.54% | 12,181,772 | 8,475 | |
| 99222 | Descriptor not shown (CPT code) | Evaluation and management | 95,113 | $489,225,504 | 0.53% | 4,567,046 | 28 | |
| 90960 | Descriptor not shown (CPT code) | Other services | 7,057 | $478,375,612 | 0.52% | 1,657,334 | 195 | |
| 97140 | Descriptor not shown (CPT code) | Other services | 59,794 | $475,479,281 | 0.52% | 27,045,503 | 287 | |
| 90662 | Descriptor not shown (CPT code) | Drugs | 81,422 | $442,090,023 | 0.48% | 6,981,890 | 50 | |
| 77067 | Descriptor not shown (CPT code) | Imaging | 15,713 | $421,333,434 | 0.46% | 6,028,027 | 212 | |
| 27447 | Descriptor not shown (CPT code) | Procedures | 11,135 | $410,771,990 | 0.45% | 429,083 | 27 | |
| 81479 | Descriptor not shown (CPT code) | Laboratory | 71 | $408,675,867 | 0.45% | 185,562 | 192 | |
| 99205 | Descriptor not shown (CPT code) | Evaluation and management | 63,399 | $379,340,110 | 0.41% | 2,326,610 | 25 | |
| 17311 | Descriptor not shown (CPT code) | Procedures | 2,822 | $372,098,193 | 0.41% | 823,401 | 221 | |
| 99284 | Descriptor not shown (CPT code) | Evaluation and management | 59,298 | $368,046,210 | 0.40% | 3,899,328 | 52 | |
| 99239 | Descriptor not shown (CPT code) | Evaluation and management | 57,251 | $367,610,766 | 0.40% | 4,359,408 | 56 | |
| 90837 | Descriptor not shown (CPT code) | Other services | 15,011 | $365,855,912 | 0.40% | 3,651,645 | 183 | |
| 45385 | Descriptor not shown (CPT code) | Procedures | 15,699 | $365,003,434 | 0.40% | 1,341,942 | 50 | |
| 98941 | Descriptor not shown (CPT code) | Other services | 27,089 | $353,906,838 | 0.39% | 12,387,832 | 320 | |
| 0012A | Descriptor not shown (CPT code) | Other services | 40,028 | $353,496,088 | 0.39% | 10,138,551 | 75 | |
| 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 | 1,427 | $339,420,624 | 0.37% | 1,107,941 | 536 | |
| 0064A | Descriptor not shown (CPT code) | Other services | 32,249 | $331,802,445 | 0.36% | 8,263,616 | 145 | |
| 67028 | Descriptor not shown (CPT code) | Procedures | 4,148 | $323,376,372 | 0.35% | 3,436,774 | 537 | |
| 99212 | Descriptor not shown (CPT code) | Evaluation and management | 122,768 | $320,057,140 | 0.35% | 8,331,445 | 32 | |
| 78815 | Descriptor not shown (CPT code) | Imaging | 6,635 | $319,117,689 | 0.35% | 650,350 | 50 |
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 2021.
Original Medicare Part B fee-for-service only; CMS suppresses provider lines with fewer than 11 beneficiaries. How these figures are computed