Top 50 Billed Physician Procedures by Volume

Healthcare Insights

Top 50 Billed Physician Procedures by Volume

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. In many cases, physicians also influence supply spending by requesting preferred medical devices and supplies. The following list contains the top 25 physician procedures billed to Medicare in 2017 by total volume nationwide — including total payments — based on Definitive Healthcare data.

Routine office visits (CPT codes 99213 & 99214) are the most common and heavily reimbursed of all physician procedures, numbering nearly 195 million with total Medicare payments of over $11.4 billion in 2017, according to Definitive Healthcare. Inpatient care visits (CPT codes 99232 & 99233) followed with a total of 68.8 million cases and nearly $4.4 billion in reimbursements.

Injections also constitute a large number of physician procedures. Of the top 50 billed procedures, injections represent over 30%. Many are drugs related to cancer treatment or chronic kidney disease. Most are relatively inexpensive procedures, with the physician billing only for the act of injecting the medication.

Top Billed Physician Procedures by Volume

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	CPT/HCPCS Code	Description	Total Procedures	Total Payments	Explore These Claims
1.	99214	OFFICE/OUTPATIENT VISIT EST	99,626,002	$6,974,311,013	Explore This Code
2.	99213	OFFICE/OUTPATIENT VISIT EST	94,919,508	$4,471,913,850	Explore This Code
3.	Q9967	LOCM 300-399mg/ml iodine,1ml	78,668,277	$7,440,311	Explore This Code
4.	97110	THERAPEUTIC EXERCISES	54,393,670	$1,140,934,353	Explore This Code
5.	J1071	Inj testosterone cypionate	49,800,446	$829,013	Explore This Code
6.	J1439	Inj ferric carboxymaltos 1mg	49,508,115	$40,598,480	Explore This Code
7.	99232	SUBSEQUENT HOSPITAL CARE	46,106,986	$2,591,914,432	Explore This Code
8.	J0897	Denosumab injection	37,465,625	$488,307,369	Explore This Code
9.	J0878	Daptomycin injection	35,598,810	$19,604,876	Explore This Code
10.	J0881	Darbepoetin alfa, non-esrd	31,313,977	$94,510,055	Explore This Code
11.	J0585	Injection,onabotulinumtoxinA	30,584,363	$139,737,460	Explore This Code
12.	97140	MANUAL THERAPY 1/> REGIONS	26,088,213	$475,667,947	Explore This Code
13.	Q0138	Ferumoxytol, non-esrd	25,846,625	$17,892,278	Explore This Code
14.	36415	ROUTINE VENIPUNCTURE	25,335,944	$74,048,233	Explore This Code
15.	J0717	Certolizumab Pegol Inj 1mg	22,635,572	$131,430,258	Explore This Code
16.	99233	SUBSEQUENT HOSPITAL CARE	22,326,900	$1,830,239,473	Explore This Code
17.	Q5101	Inj filgrastim gcsf biosimil	20,820,121	$12,050,132	Explore This Code
18.	93010	ELECTROCARDIOGRAM REPORT	18,964,299	$124,387,384	Explore This Code
19.	J1100	Dexamethasone sodium phos	18,761,250	$1,628,913	Explore This Code
20.	J3262	Tocilizumab injection	18,724,105	$61,936,152	Explore This Code
21.	17003	Destruct premalg les 2-14	18,065,304	$71,592,654	Explore This Code
22.	J1442	Inj filgrastim excl biosimil	17,806,541	$13,913,848	Explore This Code
23.	J1453	Fosaprepitant injection	16,141,612	$24,192,982	Explore This Code
24.	71010	Chest x-ray 1 view frontal	15,930,630	$112,355,963	Explore This Code
25.	88305	TISSUE EXAM BY PATHOLOGIST	14,184,470	$506,548,211	Explore This Code
26.	J9267	Paclitaxel injection	13,451,978	$70,876,138	Explore This Code
27.	J0885	Epoetin alfa, non-esrd	13,162,159	$374,283,353	Explore This Code
28.	98941	CHIROPRACT MANJ 3-4 REGIONS	12,623,458	$675,838,481	Explore This Code
29.	J3301	Triamcinolone acet inj NOS	12,600,397	$124,731,510	Explore This Code
30.	J1756	Iron sucrose injection	12,298,539	$19,443,903	Explore This Code
31.	92014	EYE EXAM&TX ESTAB PT 1/>VST	11,970,872	$2,165,013,133	Explore This Code
32.	97530	THERAPEUTIC ACTIVITIES	11,900,819	$705,828,229	Explore This Code
33.	97112	NEUROMUSCULAR REEDUCATION	11,871,569	$704,237,429	Explore This Code
34.	A9585	Gadobutrol injection	11,862,402	$33,402,389	Explore This Code
35.	99285	EMERGENCY DEPT VISIT	11,470,444	$12,197,902,558	Explore This Code
36.	99212	OFFICE/OUTPATIENT VISIT EST	11,466,146	$949,753,114	Explore This Code
37.	71020	Chest x-ray 2vw frontal&latl	11,385,276	$617,060,681	Explore This Code
38.	93000	ELECTROCARDIOGRAM COMPLETE	11,189,097	$715,809,261	Explore This Code
39.	85025	COMPLETE CBC W/AUTO DIFF WBC	11,133,462	$354,593,187	Explore This Code
40.	J9299	Injection, nivolumab	10,802,842	$653,575,924	Explore This Code
41.	99308	NURSING FAC CARE SUBSEQ	10,269,428	$1,292,414,484	Explore This Code
42.	99223	INITIAL HOSPITAL CARE	10,219,906	$4,630,105,013	Explore This Code
43.	99203	OFFICE/OUTPATIENT VISIT NEW	10,193,122	$2,156,663,225	Explore This Code
44.	95004	PERCUT ALLERGY SKIN TESTS	9,506,647	$115,560,910	Explore This Code
45.	99204	OFFICE/OUTPATIENT VISIT NEW	9,190,963	$2,972,508,881	Explore This Code
46.	99215	OFFICE/OUTPATIENT VISIT EST	9,040,347	$2,567,729,800	Explore This Code
47.	A9575	Inj gadoterate meglumi 0.1ml	8,732,252	$12,460,335	Explore This Code
48.	99309	NURSING FAC CARE SUBSEQ	8,672,301	$1,472,795,237	Explore This Code
49.	J0641	Inj., levoleucovorin, 0.5 mg	8,621,211	$36,456,919	Explore This Code
50.	96372	THER/PROPH/DIAG INJ SC/IM	8,333,190	$408,238,599	Explore This Code

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 2017; 2018 data is scheduled to be released in July 2020.