Medicare's 500 most-billed CPT codes of 2018

All 500 codes, ranked Copy link

Sorted by allowed per service. 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 7,826 CPT codes billed to Medicare in CY2018, 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 55.5% of the $82.8B these 500 codes account for.

1. 1 99214 Long Follow-Up Office Visit $10.4B
2. 2 99213 Routine Follow-Up Office Visit $6.4B
3. 3 99232 Daily Hospital Visit $3.3B
4. 4 99233 Extended Daily Hospital Visit $2.5B
5. 5 66984 Cataract Surgery $2.3B
6. 6 99223 Extended Hospital Admission Visit $2.1B
7. 7 99285 Emergency Visit, Highest Urgency $2.0B
8. 8 99204 Long New Patient Office Visit $1.6B
9. 9 92014 Full Eye Exam, Returning Patient $1.5B
10. 10 97110 Physical Therapy Exercises $1.5B

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, CY2018. 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.