Medicare's 500 most-billed CPT codes of 2015

All 500 codes, ranked Copy link

Sorted by allowed dollars. Every code links to its full rate breakdown.

Beneficiary counts apply to one code at a time. A patient who received two of these codes is counted under both, so the column cannot be added up into a number of people. Rank is each code's position among all 7,751 CPT codes billed to Medicare in CY2015, so the column skips a number wherever a code we don't yet cover sits.

Which codes bring in the most Medicare money? Copy link

Spending is heavily concentrated. The top 25 codes carry 57.5% of the $77.5B these 500 codes account for.

1. 1 99214 Long Follow-Up Office Visit $9.7B
2. 2 99213 Routine Follow-Up Office Visit $6.8B
3. 3 99232 Daily Hospital Visit $3.5B
4. 4 99233 Extended Daily Hospital Visit $2.3B
5. 5 99223 Extended Hospital Admission Visit $2.2B
6. 6 66984 Cataract Surgery $2.1B
7. 7 99285 Emergency Visit, Highest Urgency $1.9B
8. 8 99204 Long New Patient Office Visit $1.5B
9. 9 92014 Full Eye Exam, Returning Patient $1.4B
10. 10 97110 Physical Therapy Exercises $1.3B

Why the most common codes aren't the most expensive Copy link

Rank the same 500 codes by patients and then by dollars, and the two lists disagree. A cheap service given to millions and a costly one given to thousands can land far apart depending on which question you ask.

What this data covers—and what it doesn't Copy link

Source: CMS Medicare Physician & Other Practitioners—by Geography and Service, national rows, CY2015. This is a calendar-year snapshot on its own publication cycle, separate from the quarterly fee schedule that produces the rates on each code page. Full methodology.