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 |
|---|---|---|---|---|---|
| 1 | 99213 | OFFICE O/P EST LOW 20-29 MIN | 4.20% | $22,744,552,432 | Explore |
| 2 | 99214 | OFFICE O/P EST MOD 30-39 MIN | 4.00% | $31,426,774,050 | Explore |
| 3 | 97110 | THERAPEUTIC EXERCISES | 2.90% | $12,999,629,015 | Explore |
| 4 | 90999 | UNLISTED DIALYSIS PROCEDURE | 1.90% | $375,492,457,713 | Explore |
| 5 | 97530 | THERAPEUTIC ACTIVITIES | 1.80% | $7,193,216,463 | Explore |
| 6 | 36415 | ROUTINE VENIPUNCTURE | 1.70% | $1,212,939,521 | Explore |
| 7 | 97140 | MANUAL THERAPY 1/> REGIONS | 1.70% | $5,009,161,955 | Explore |
| 8 | 85025 | COMPLETE CBC W/AUTO DIFF WBC | 1.40% | $4,062,516,153 | Explore |
| 9 | 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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