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 2021 by total volume nationwide—including total payments—based on Definitive Healthcare data.

Top Billed Physician Procedures by Volume

Rank HCPCS/CPT Code HCPCS/CPT Description # Total Procedures Total Charges
1 99213 OFFICE O/P EST LOW 20-29 MIN 151,659,174 $23,315,036,796
2 99214 OFFICE O/P EST MOD 30-39 MIN 136,511,403 $30,539,626,351
3 97110 THERAPEUTIC EXERCISES 90,421,076 $12,428,505,229
4 36415 ROUTINE VENIPUNCTURE 61,263,779 $1,229,544,451
5 90999 DIALYSIS PROCEDURE 59,114,240 $333,694,070,166
6 97140 MANUAL THERAPY 1/> REGIONS 53,576,123 $4,866,382,327
7 97530 THERAPEUTIC ACTIVITIES 50,986,425 $6,002,227,339
8 85025 COMPLETE CBC W/AUTO DIFF WBC 48,229,239 $4,110,045,256
9 80053 COMPREHEN METABOLIC PANEL 39,926,984 $6,473,298,632
10 97112 NEUROMUSCULAR REEDUCATION 39,129,504 $3,694,262,042
11 99232 SUBSEQUENT HOSPITAL CARE 33,804,598 $5,812,067,291
12 A4657 Syringe w/wo needle 33,477,222 $3,609,777,409
13 99285 EMERGENCY DEPT VISIT 28,426,540 $47,168,859,305
14 99203 OFFICE O/P NEW LOW 30-44 MIN 28,095,323 $6,427,101,736
15 99284 EMERGENCY DEPT VISIT 26,990,553 $34,077,786,785
16 99233 SUBSEQUENT HOSPITAL CARE 25,341,714 $6,559,878,476
17 99204 OFFICE O/P NEW MOD 45-59 MIN 23,755,389 $8,171,132,028
18 99283 EMERGENCY DEPT VISIT 23,455,970 $19,839,109,676
19 Q4081 Epoetin alfa, 100 units ESRD 23,425,443 $13,911,110,369
20 90837 PSYTX W PT 60 MINUTES 23,415,197 $3,907,458,132
21 71045 X-RAY EXAM CHEST 1 VIEW 22,458,991 $3,713,398,726
22 99212 OFFICE O/P EST SF 10-19 MIN 22,296,832 $2,384,150,019
23 G0299 Hhs/hospice of rn ea 15 min 21,569,391 $4,561,599,891
24 J1644 Inj heparin sodium per 1000u 21,539,630 $5,067,882,009
25 93010 ELECTROCARDIOGRAM REPORT 20,784,450 $1,031,715,278

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 2021.

Which were the most common physician procedures in 2021?

Routine office visits (CPT codes 99213 & 99214) are the most common and heavily reimbursed of all physician procedures, numbering over 288 million with total Medicare payments of over $53.8 billion in 2021, according to Definitive Healthcare.

Therapeutic exercises (CPT code 97110) followed with a total of 90.4 million claims and over $12.4 billion in reimbursements. This procedure refers to common rehabilitation exercises designed to develop strength, endurance, range of motion, and flexibility.

Routine venipuncture also constitutes a large number of physician procedures, with 61.2 million performed in 2021.

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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