CPT Code

CPT codes are used to describe tests, surgeries, evaluations, and any other medical procedure performed by a healthcare provider on a patient. Choosing and assigning the correct cpt diagnosis code ensure the efficient and accurate processing of your medical claims.

A good reason to understand CPT codes is so you can make sense of your hospital bill and catch any billing errors. Check your cpt code in here.Try to take the time to review your bill carefully and compare it with your EOB to check for any errors. Healthcare providers or facilities can make typographical errors, coding for the wrong type of visit or service.

CPT codes are used for reporting devices and drugs (including vaccines) required for the performance of a service or procedure, services or procedures performed by physicians and other health care providers, services or procedures performed intended for clinical use, services or procedures performed according to current medical practice, and services or procedures that meet CPT requirements. These codes are billable for reimbursement.

There are 10 main CPT sections:

00000-09999 Anesthesia Services
10000-19999 Integumentary System
20000-29999 Musculoskeletal System
30000-39999 Respiratory, Cardiovascular, Hemic, and Lymphatic System
40000-49999 Digestive System
50000-59999 Urinary, Male Genital, Female Genital, Maternity Care, and Delivery System
60000-69999 Endocrine, Nervous, Eye and Ocular Adnexa, Auditory System
70000-79999 Radiology Services
80000-89999 Pathology and Laboratory Services
90000-99999 Evaluation & Management Services

CPT Code List:

Select starting letter or number from the list :


CPT Categories

CPT codes 'Category' refers to the division of the code set.

Category I

  • Evaluation and Management: 99201 - 99499
  • Anesthesia: 00100 - 01999; 99100 - 99140
  • Surgery: 10021 - 69990
  • Radiology: 70010 - 79999
  • Pathology and Laboratory: 80047 - 89398
  • Medicine: 90281 - 99199; 99500 - 99607

Category I CPT codes are numeric, and are five digits long.

Category II

These codes are five character-long, alphanumeric codes that provide additional information to the Category I codes. These codes are formatted to have four digits, followed by the character F.

  • Composite codes
    • These codes combine a number of procedures that typically occur in conjunction with one main procedure.
      • Example: 0001F: heart failure assessed (includes all of the following):
        • Blood pressure measured
        • Level of activity assessed
        • Clinical symptoms of volume overload assessed
        • Weight recorded
        • Clinical signs of volume overload assessed
    • Patient Management
      • Includes patient care provided for specific clinical purposes like pre- and postnatal care.
        • Example: 0503F: Postpartum care visit
    • Patient History
      • Describes measures for select elements of patient history or symptom review
        • Example: 1030F: Pneumococcus immunization status assessed
    • Physical Examination
      • Example: 2014F: Mental status assessed
    • Diagnostic/Screening Processes or Results
      • Includes results of tests ordered, including clinical lab tests and radiological procedures
        • Example: 3006F: Chest X-ray documented and reviewed
    • Therapeutic, Preventive, or Other Interventions
      • Describes pharmacologic, procedural or behavioral therapies
        • Example: 4037F: influenza immunization ordered or administered
    • Follow-up or Other Outcomes
      • These codes describe the review and communication of test results to a patient, patient satisfaction, patient functional status, and patient morbidity or mortality
        • Example: 5005F: patient counseled on self-examination for new or changing moles
    • Patient Safety
      • Includes codes that describe patient safety precautions
        • Example: 6015F: Patient receiving or eligible to receive foods, fluids, or medication by mouth
    • Structural Measures
      • This short section includes codes that describe the setting of the delivered care, and also covers the capabilities of the healthcare provider
        • Example: 7025F: patient information entered into a reminder system with a target due date for the next mammogram

Category III

Category III codes allow for more specificity in coding. Cat-3 CPT codes is made up of temporary codes that represent emergent or experimental services, technology, and procedures.Category III codes are archived in the CPT manual for five years.

Patient Status Codes

Using CPT code in billing form requires patient status codes. They are :

01Discharge to home or self-care (routine discharge)
02Discharge/transfer to short-term general hospital
03Discharge/transfer to SNF
04Discharge/transfer to ICF
05Discharge/transfer to a designated cancer center or children's hospital
06Discharge/transfer to home care of another HHA OR discharge and readmit to the same HHA within a 60-day episode
07Left against medical advice or discontinued care
20Expired - Occurrence code 55 also required.
21Discharge/transfer to court/law enforcement
30Still a patient. Services continue to be provided. (Required on RAPs.)
43Discharge/transfer to federal hospital
50Discharge/transfer for hospice services in the home
51Discharge/transfer to hospice services in a medical facility
62Discharge/transfer to IRF (inpatient rehabilitation facility)
63Discharge/transfer to long-term care hospital
65Discharge/transfer to psychiatric hospital or psychiatric part unit of a hospital
66Discharge/transfer to Critical Access Hospital (CAH)
70Discharge/transfer to another type of health care institution not defined elsewhere in code list
81Discharged to home or self-care with a planned acute care hospital inpatient readmission (effective 10/1/13)
82Discharged/transferred to a short-term general hospital for inpatient care with a planned acute care hospital inpatient readmission (effective 10/1/13)
83Discharged/transferred to a skilled nursing facility (SNF) with Medicare certification with a planned acute care hospital inpatient readmission (effective 10/1/13)
84Discharged/transferred to a facility that provides custodial or supportive care with a planned acute care hospital inpatient readmission (effective 10/1/13)
85Discharged/transferred to a designated cancer center or children's hospital with a planned acute care hospital inpatient readmission (effective 10/1/13)
86Discharged/transferred to home under care of organized home health service organization in anticipation of covered skilled care with a planned acute care hospital inpatient readmission (effective 10/1/13)
87Discharged/transferred to court/law enforcement with a planned acute care hospital inpatient readmission (effective 10/1/13)
88Discharged/transferred to a federal health care facility with a planned acute care hospital inpatient readmission (effective 10/1/13)
89Discharged/transferred to a hospital-based Medicare approved swing bed with a planned acute care hospital inpatient readmission (effective 10/1/13)
90Discharged/transferred to an inpatient rehabilitation facility (IRF) including rehabilitation distinct part units of a hospital with a planned acute care hospital inpatient readmission (effective 10/1/13)
91Discharged/transferred to a Medicare certified long term care hospital (LTCH) with a planned acute care hospital inpatient readmission (effective 10/1/13)
92Discharged/transferred to a nursing facility certified under Medicaid but not certified under Medicare with a planned acute care hospital inpatient readmission (effective 10/1/13)
93Discharged/transferred to a psychiatric hospital or psychiatric distinct part unit of a hospital with a planned acute care hospital inpatient readmission (effective 10/1/13)
94Discharged/transferred to a critical access hospital (CAH) with a planned acute care hospital inpatient readmission (effective 10/1/13)
95Discharged/transferred to another type of health care institution not defined elsewhere in this code list with a planned acute care hospital inpatient readmission (effective 10/1/13)
96-99Reserved for national assignment

CPT Condition Codes

07Treatment of nonterminal condition for hospice patient
20 eneficiary requested billing (demand denial)
21Billing for denial notice (no-pay bill)
47Transfer from another HHA
54No skilled HH visits in billing period.
C3Expedited review - partial approval of Medicare-covered services
C4Expedited review - services denied
C7Expedited review extended authorization of Medicare-covered services

Most Expensive CPT Codes:

We have listed the most expensive CPT codes according to medical bill from several hospitals and insurance companies yearly book.

Code :Description: Number Of Procedures:
S2067Breast stacked "diep/gap"109
C1882AICD, other than sing/dual134
J7330Cultured chondrocytes implnt555
J1300Eculizumab injection273
C1722AICD, single chamber69
Q2043Sipuleucel-T auto CD54+95
J0221Lumizyme injection24
C9733Non-ophthalmic FVA48
55970Sex Transformation M to F35
S2068Breast DIEP or SIEA flap641
J2350Injection, ocrelizumab, 1 mg494
33264Removal & replacement of defibrillator generator; multiple lead system986
J0202Injection, alemtuzumab16
C1721AICD, dual chamber138
33263Removal & replacement of defibrillator generator; dual lead670
33249Insertion/replacement of permanent pacing cardioverter-defibrillator system with transvenous lead(s)2,968
L8614Cochlear device594
C9600Percutaneous transcatheter placement of drug-eluting intracoronary stent; single major coronary artery or branch371
69930Implant cochlear device1,515
J3385Velaglucerase alfa147
L8687Implant neurostimulator pulse generator, dual array, rechargeable2,318
33262Removal & replacement of defibrillator generator; single lead201
0375TTotal disc arthroplasty anterior approach15
L8688Implant neurostimulator pulse generator, dual array, non-rechargeable727
L5856Elec knee-shin swing/stance16
Important Notice :The coding, coverage, and payment information contained herein is gathered from various resources, general in nature, and subject to change without notice. Third-party payment for medical products and services is affected by numerous factors. It is always the provider's responsibility to determine the appropriate healthcare setting and to submit true and correct claims conforming to the requirements of the relevant payer for those products and services rendered.

CPT codes are an integral part of the billing process. CPT codes tell the insurance payer what procedures the healthcare provider would like to be reimbursed for.

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