Healthcare Insights

Top 25 physician procedures

Physicians are the backbone of any healthcare system. As the primary caregivers, they identify patient ailments and determine courses of treatment that define each episode of care. They also deliver those treatments, sometimes with the assistance of other healthcare professionals.

From an operational perspective, physicians also influence supply spending by requesting preferred medical devices and supplies. A physician’s preferred equipment will largely depend on the types of procedures they’re performing most often.

The following list contains the top 25 physician procedures billed to Medicare in 2022 by percentage of total volume nationwide—including total payments—based on Definitive Healthcare data.

Top-billed physician procedures by percentage of total volume in 2022

Rank HCPCS/CPT Code HCPCS/CPT description % total procedures Total charges Explore dataset
99213 OFFICE O/P EST LOW 20-29 MIN 4.20% $22,744,552,432  Explore
99214 OFFICE O/P EST MOD 30-39 MIN 4.00% $31,426,774,050  Explore
97110 THERAPEUTIC EXERCISES 2.90% $12,999,629,015  Explore
90999 UNLISTED DIALYSIS PROCEDURE 1.90% $375,492,457,713  Explore
97530 THERAPEUTIC ACTIVITIES 1.80% $7,193,216,463  Explore
36415 ROUTINE VENIPUNCTURE 1.70% $1,212,939,521  Explore
97140 MANUAL THERAPY 1/> REGIONS 1.70% $5,009,161,955  Explore
85025 COMPLETE CBC W/AUTO DIFF WBC 1.40% $4,062,516,153  Explore
97112 NEUROMUSCULAR REEDUCATION 1.40% $4,452,759,081  Explore
10 80053 COMPREHEN METABOLIC PANEL 1.20% $6,807,063,033  Explore
11 A4657 Syringe w/wo needle 1.00% $4,005,557,698  Explore
12 99232 SBSQ HOSP IP/OBS MODERATE 35 1.00% $5,591,692,100  Explore
13 90837 PSYTX W PT 60 MINUTES 0.80% $4,991,903,127  Explore
14 99285 EMERGENCY DEPT VISIT HI MDM 0.80% $48,244,948,825  Explore
15 99284 EMERGENCY DEPT VISIT MOD MDM 0.80% $34,937,925,615  Explore
16 99233 SBSQ HOSP IP/OBS HIGH 50 0.80% $6,821,684,676  Explore
17 Q4081 Epoetin alfa, 100 units ESRD 0.80% $15,463,770,065  Explore
18 99203 OFFICE O/P NEW LOW 30-44 MIN 0.70% $5,727,860,338  Explore
19 99283 EMERGENCY DEPT VISIT LOW MDM 0.70% $20,692,875,249  Explore
20 99204 OFFICE O/P NEW MOD 45-59 MIN 0.70% $8,333,307,110  Explore
21 J1644 Inj heparin sodium per 1000u 0.70% $5,400,477,018  Explore
22 71045 X-RAY EXAM CHEST 1 VIEW 0.60% $3,707,587,316  Explore
23 93010 ELECTROCARDIOGRAM REPORT 0.60% $1,009,381,938  Explore
24 G0299 Hhs/hospice of rn ea 15 min 0.60% $4,381,385,059  Explore
25 99212 OFFICE O/P EST SF 10-19 MIN 0.60% $2,070,204,448  Explore

Fig 1. Medicare data is from the Centers for Medicare and Medicaid Services (CMS) Provider Utilization and Payment Data: Physician and Other Supplier Public Use File (PUF). Calendar Year data is projected to be released each July by the CMS. The most recent data is from calendar year 2022.

Which were the most common physician procedures in 2022?

Routine office visits (CPT codes 99213 & 99214) are the most common and heavily reimbursed of all physician procedures, with 4.2% of total Medicare payments of over $54.1 billion in 2022, according to Definitive Healthcare.

Therapeutic exercises (CPT code 97110) followed with 2.9% of total claims and nearly $13 billion in reimbursements. This procedure refers to common rehabilitation exercises designed to develop strength, endurance, range of motion, and flexibility.

Dialysis also constitutes a large number of physician procedures, with 1.9% of total procedure claims in 2022. 

What are procedure codes for billing?

Medical procedure codes, or Current Procedural Terminology (CPT) codes, are numerical identifiers and descriptions used to report medical, surgical, and diagnostic services for reimbursement from Medicare and other payors.

Procedure codes give healthcare professionals a standardized language for reporting services, processing claims, and developing new guidelines for medical care review.

Codes exist for nearly every point in a patient’s care journey, beginning with their initial contact with a physician’s office. Healthcare administrators must employ correct coding in order to receive the appropriate reimbursement for services rendered.

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