Code library
Every code we cover, with 2026 Medicare wRVU and national-GPCI non-facility payment. Click any code for documentation requirements, modifiers, ICD-10 pairings, and common denial reasons.
Showing 196 of 196 codes
| Code ↑ | Description | Group | wRVU | Total RVU | Medicare $ | |
|---|---|---|---|---|---|---|
| 10060 | Incision & drainage abscess simple | Dermatology | 1.22 | 3.24 | $108 | Details → |
| 10061 | I&D abscess complicated/multiple | Dermatology | 2.45 | 5.57 | $186 | Details → |
| 11042 | Debridement subq tissue 20 sq cm | Dermatology | 1.01 | 2.49 | $83 | Details → |
| 11043 | Debridement muscle 20 sq cm | Dermatology | 2.55 | 5.87 | $196 | Details → |
| 11102 | Tangential biopsy single lesion | Dermatology | 0.66 | 1.87 | $62 | Details → |
| 11104 | Punch biopsy single lesion | Dermatology | 0.83 | 2.26 | $75 | Details → |
| 11981 | Subdermal contraceptive insert | GYN | 1.48 | 2.91 | $97 | Details → |
| 12001 | Simple repair scalp/trunk <= 2.5 cm | Dermatology | 0.85 | 2.22 | $74 | Details → |
| 17000 | Destruction premalig lesion first | Dermatology | 0.61 | 1.75 | $58 | Details → |
| 17003 | Destruction premalig lesion 2-14 ea | Dermatology | 0.04 | 0.10 | $3 | Details → |
| 17110 | Destruction benign lesions up to 14 | Dermatology | 0.70 | 2.16 | $72 | Details → |
| 20550 | Inj tendon sheath/ligament | Ortho / Rheum | 0.75 | 1.62 | $54 | Details → |
| 20551 | Inj tendon origin/insertion | Ortho / Rheum | 0.75 | 1.55 | $52 | Details → |
| 20552 | Inj trigger point 1-2 muscles | Ortho / Rheum | 0.66 | 1.36 | $45 | Details → |
| 20553 | Inj trigger point 3+ muscles | Ortho / Rheum | 0.75 | 1.55 | $52 | Details → |
| 20600 | Arthrocentesis small joint w/o US | Ortho / Rheum | 0.66 | 1.54 | $51 | Details → |
| 20605 | Arthrocentesis intermediate joint | Ortho / Rheum | 0.68 | 1.60 | $53 | Details → |
| 20606 | Intermediate joint inj, US-guided | Rheumatology | 1.00 | 3.18 | $106 | Details → |
| 20610 | Arthrocentesis major joint w/o US | Ortho / Rheum | 0.94 | 2.06 | $69 | Details → |
| 20611 | Arthrocentesis major joint w/ US | Ortho / Rheum | 1.10 | 3.19 | $107 | Details → |
| 43235 | Diagnostic EGD | GI | 2.06 | 5.30 | $177 | Details → |
| 43239 | EGD w/ biopsy | GI | 2.39 | 5.94 | $198 | Details → |
| 43249 | EGD with balloon dilation | GI | 3.16 | 7.39 | $247 | Details → |
| 45378 | Diagnostic colonoscopy | GI | 3.36 | 8.62 | $288 | Details → |
| 45380 | Colonoscopy w/ biopsy | GI | 3.91 | 9.79 | $327 | Details → |
| 45381 | Colonoscopy with submucosal injection | GI | 4.42 | 9.80 | $327 | Details → |
| 45385 | Colonoscopy w/ snare polypectomy | GI | 4.43 | 10.90 | $364 | Details → |
| 57452 | Colposcopy of cervix | GYN | 1.50 | 3.19 | $107 | Details → |
| 57454 | Colposcopy w/ biopsy & ECC | GYN | 2.45 | 4.87 | $163 | Details → |
| 58100 | Endometrial biopsy w/o D&C | GYN | 1.53 | 3.15 | $105 | Details → |
| 58300 | IUD insertion | GYN | 1.01 | 3.94 | $132 | Details → |
| 58301 | IUD removal | GYN | 1.13 | 2.33 | $78 | Details → |
| 60100 | Biopsy thyroid percutaneous needle | Endocrinology | 1.53 | 2.70 | $90 | Details → |
| 76536 | US soft tissue head/neck (thyroid) | Endocrinology | 0.59 | 3.22 | $108 | Details → |
| 76942 | US needle placement guidance | Endocrinology | 0.67 | 2.08 | $69 | Details → |
| 77080 | DEXA axial skeleton | Ortho / Rheum | 0.20 | 1.88 | $63 | Details → |
| 90460 | Vaccine admin first component < 19y | Procedures | 0.17 | 0.83 | $28 | Details → |
| 90461 | Vaccine admin ea addl comp < 19y | Procedures | 0.15 | 0.58 | $19 | Details → |
| 90471 | Immunization admin | Procedures | 0.17 | 0.66 | $22 | Details → |
| 90472 | Immunization admin each add | Procedures | 0.15 | 0.48 | $16 | Details → |
| 90473 | Immunization oral/nasal first | Procedures | 0.17 | 0.65 | $22 | Details → |
| 90474 | Immunization oral/nasal ea addl | Procedures | 0.15 | 0.48 | $16 | Details → |
| 90791 | Psych diagnostic eval no med | Behavioral Health | 3.00 | 4.47 | $149 | Details → |
| 90792 | Psych diagnostic eval w/ med | Behavioral Health | 3.25 | 4.87 | $163 | Details → |
| 90832 | Psychotherapy 30 min | Behavioral Health | 1.50 | 2.22 | $74 | Details → |
| 90834 | Psychotherapy 45 min | Behavioral Health | 2.00 | 2.95 | $99 | Details → |
| 90837 | Psychotherapy 60 min | Behavioral Health | 3.00 | 4.43 | $148 | Details → |
| 90838 | Psychotherapy 60 min w/ E/M add-on | Behavioral Health | 2.62 | 3.87 | $129 | Details → |
| 90853 | Group psychotherapy | Behavioral Health | 0.59 | 0.93 | $31 | Details → |
| 90951 | ESRD service mo 0-1 yrs full month | Nephrology | 7.21 | 9.92 | $331 | Details → |
| 90954 | ESRD MCP, 2-11yr, 4+ visits/mo | Nephrology | 4.36 | 7.75 | $259 | Details → |
| 90957 | ESRD MCP, 12-19yr, 4+ visits/mo | Nephrology | 4.13 | 7.28 | $243 | Details → |
| 90960 | ESRD service mo adult 4 visits | Nephrology | 4.30 | 6.01 | $201 | Details → |
| 90961 | ESRD service mo adult 2-3 visits | Nephrology | 3.47 | 4.85 | $162 | Details → |
| 90962 | ESRD service mo adult 1 visit | Nephrology | 1.74 | 2.43 | $81 | Details → |
| 90963 | ESRD home dialysis, <2yr | Nephrology | 4.39 | 8.10 | $271 | Details → |
| 90970 | ESRD MCP per diem, 20+yr | Nephrology | 0.10 | 0.18 | $6 | Details → |
| 90989 | Home dialysis training, complete | Nephrology | 5.00 | 9.22 | $308 | Details → |
| 91065 | Breath test H pylori | GI | 0.00 | 1.33 | $44 | Details → |
| 91110 | Capsule endoscopy small bowel | GI | 2.85 | 7.56 | $253 | Details → |
| 93000 | EKG complete (tracing+I&R) | Cardiology | 0.17 | 0.45 | $15 | Details → |
| 93005 | EKG tracing only (technical) | Cardiology | 0.00 | 0.19 | $6 | Details → |
| 93010 | EKG interpretation & report only | Cardiology | 0.17 | 0.23 | $8 | Details → |
| 93015 | Cardiovascular stress test, complete | Cardiology | 0.75 | 2.53 | $85 | Details → |
| 93016 | Stress test, supervision only | Cardiology | 0.45 | 0.62 | $21 | Details → |
| 93018 | Stress test, interpretation only | Cardiology | 0.30 | 0.40 | $13 | Details → |
| 93040 | Rhythm ecg with report | Procedures | 0.15 | 0.45 | $15 | Details → |
| 93224 | Holter monitor 48 hrs to 7 days | Cardiology | 0.52 | 1.70 | $57 | Details → |
| 93228 | Mobile cardiac telemetry physician | Cardiology | 0.52 | 0.77 | $26 | Details → |
| 93293 | Pacemaker interrogation in-person | Cardiology | 0.45 | 0.88 | $29 | Details → |
| 93294 | ICD dual lead interrogation in-person | Cardiology | 0.74 | 1.30 | $43 | Details → |
| 93295 | ICD-CRT interrogation in-person | Cardiology | 0.85 | 1.48 | $49 | Details → |
| 93306 | Echo TTE complete w/ Doppler | Cardiology | 1.50 | 7.59 | $254 | Details → |
| 93307 | Echo TTE complete no Doppler | Cardiology | 1.20 | 6.04 | $202 | Details → |
| 93350 | Stress echo complete | Cardiology | 1.75 | 5.34 | $178 | Details → |
| 93351 | Echo stress, in-office global | Cardiology | 1.75 | 10.74 | $359 | Details → |
| 93798 | Cardiac rehab w/ continuous ECG | Cardiology | 0.28 | 0.62 | $21 | Details → |
| 93970 | Venous duplex extr complete bilat | Cardiology | 0.45 | 2.52 | $84 | Details → |
| 94010 | Spirometry incl flow-volume loop | Pulmonology | 0.17 | 0.69 | $23 | Details → |
| 94060 | Spirometry pre/post bronchodilator | Pulmonology | 0.22 | 1.65 | $55 | Details → |
| 94375 | Flow-volume loop | Pulmonology | 0.21 | 0.58 | $19 | Details → |
| 94640 | Nebulizer treatment | Pulmonology | 0.00 | 0.28 | $9 | Details → |
| 94660 | CPAP titration/management | Pulmonology | 0.90 | 1.39 | $46 | Details → |
| 94726 | Plethysmography, lung volumes | Pulmonology | 0.65 | 2.01 | $67 | Details → |
| 94760 | Pulse oximetry single | Pulmonology | 0.00 | 0.07 | $2 | Details → |
| 95004 | Percutaneous allergy test (per test) | Allergy | 0.01 | 0.14 | $5 | Details → |
| 95024 | Intradermal allergy test (per test) | Allergy | 0.01 | 0.17 | $6 | Details → |
| 95044 | Patch test allergy (per test) | Allergy | 0.01 | 0.19 | $6 | Details → |
| 95115 | Allergen injection, single | Allergy | 0.07 | 0.28 | $9 | Details → |
| 95117 | Allergen injection, 2 or more | Allergy | 0.12 | 0.40 | $13 | Details → |
| 95165 | Antigen preparation, per dose | Allergy | 0.07 | 0.39 | $13 | Details → |
| 95180 | Rapid desensitization, per hour | Allergy | 1.00 | 1.62 | $54 | Details → |
| 95249 | CGM personal, patient-provided setup | Endocrinology | 0.00 | 1.80 | $60 | Details → |
| 95250 | Cont gluc mntr phys/qhp eqp | Procedures | 0.00 | 4.57 | $153 | Details → |
| 95251 | Cont gluc mntr analysis i&r | Procedures | 0.68 | 1.05 | $35 | Details → |
| 95806 | Sleep study, home, unattended | Pulmonology | 1.05 | 5.74 | $192 | Details → |
| 95810 | Polysomnography 4+ params | Pulmonology | 3.10 | 13.34 | $446 | Details → |
| 95812 | EEG, 41-60 min | Neurology | 1.08 | 5.21 | $174 | Details → |
| 95816 | EEG awake & drowsy | Neurology | 1.08 | 4.64 | $155 | Details → |
| 95819 | EEG awake & asleep | Neurology | 1.08 | 4.89 | $163 | Details → |
| 95885 | EMG limited, 1 extremity | Neurology | 0.37 | 0.82 | $27 | Details → |
| 95886 | EMG complete, 1 extremity | Neurology | 0.96 | 1.77 | $59 | Details → |
| 95910 | Nerve conduction 7-8 studies | Neurology | 1.60 | 3.12 | $104 | Details → |
| 95911 | Nerve conduction 9-10 studies | Neurology | 2.05 | 3.94 | $132 | Details → |
| 95913 | NCS, 13+ studies | Neurology | 3.56 | 7.26 | $242 | Details → |
| 96127 | Brief emotional/behav assmt | Screening / Counsel | 0.00 | 0.15 | $5 | Details → |
| 96132 | Neuropsych testing eval first hour | Neurology | 1.86 | 2.78 | $93 | Details → |
| 96138 | Psych/neuropsych test admin first hr | Neurology | 0.51 | 0.82 | $27 | Details → |
| 96160 | Pt-focused hlth risk assmt | Screening / Counsel | 0.00 | 0.09 | $3 | Details → |
| 96161 | Caregiver health risk assmt | Screening / Counsel | 0.00 | 0.10 | $3 | Details → |
| 96360 | Hydration IV first 31 min - 1 hr | Infusions | 0.17 | 1.38 | $46 | Details → |
| 96361 | Hydration IV, each addl hr | Heme/Onc | 0.09 | 0.37 | $12 | Details → |
| 96365 | Therapeutic IV infusion first hour | Infusions | 0.21 | 2.04 | $68 | Details → |
| 96366 | Therapeutic IV infusion ea addl hour | Infusions | 0.18 | 0.68 | $23 | Details → |
| 96367 | Sequential IV infusion new drug | Infusions | 0.19 | 0.95 | $32 | Details → |
| 96372 | Ther/proph/diag inj sc/im | Procedures | 0.17 | 0.46 | $15 | Details → |
| 96374 | IV push single substance | Infusions | 0.18 | 1.04 | $35 | Details → |
| 96375 | IV push ea addl new substance | Infusions | 0.10 | 0.42 | $14 | Details → |
| 96409 | Chemo IV push, single drug | Heme/Onc | 0.28 | 3.28 | $110 | Details → |
| 96413 | Chemo IV infusion first hour | Infusions | 0.29 | 4.73 | $158 | Details → |
| 96415 | Chemo IV infusion, each addl hr | Heme/Onc | 0.19 | 1.26 | $42 | Details → |
| 96417 | Chemo IV infusion, additional drug | Heme/Onc | 0.28 | 2.37 | $79 | Details → |
| 97802 | MNT initial 15 min individual | Endocrinology | 0.00 | 0.85 | $28 | Details → |
| 97803 | MNT subseq 15 min individual | Endocrinology | 0.00 | 0.74 | $25 | Details → |
| 99202 | Office o/p new sf 15 min | E/M New | 0.93 | 2.25 | $75 | Details → |
| 99203 | Office o/p new low 30 min | E/M New | 1.60 | 3.52 | $118 | Details → |
| 99204 | Office o/p new mod 45 min | E/M New | 2.60 | 5.31 | $177 | Details → |
| 99205 | Office o/p new hi 60 min | E/M New | 3.50 | 7.09 | $237 | Details → |
| 99211 | Off/op est may x req phy/qhp | E/M Est | 0.18 | 0.73 | $24 | Details → |
| 99212 | Office o/p est sf 10 min | E/M Est | 0.70 | 1.78 | $59 | Details → |
| 99213 | Office o/p est low 20 min | E/M Est | 1.30 | 2.85 | $95 | Details → |
| 99214 | Office o/p est mod 30 min | E/M Est | 1.92 | 4.06 | $136 | Details → |
| 99215 | Office o/p est hi 40 min | E/M Est | 2.80 | 5.76 | $192 | Details → |
| 99221 | Initial hospital inpt/obs sf 40 min | Hospital | 1.63 | 2.42 | $81 | Details → |
| 99222 | Initial hospital inpt/obs mod 55 | Hospital | 2.60 | 3.85 | $129 | Details → |
| 99223 | Initial hospital inpt/obs high 75 | Hospital | 3.50 | 5.19 | $173 | Details → |
| 99231 | Subseq hosp inpt/obs sf 25 min | Hospital | 0.76 | 1.12 | $37 | Details → |
| 99232 | Subseq hosp inpt/obs mod 35 min | Hospital | 1.39 | 2.04 | $68 | Details → |
| 99233 | Subseq hosp inpt/obs high 50 min | Hospital | 2.00 | 2.95 | $99 | Details → |
| 99234 | Hosp same-day adm/disch sf 45 min | Hospital | 2.11 | 3.13 | $105 | Details → |
| 99235 | Hosp same-day adm/disch mod 70 min | Hospital | 3.24 | 4.79 | $160 | Details → |
| 99236 | Hosp same-day adm/disch high 85 min | Hospital | 4.20 | 6.21 | $207 | Details → |
| 99238 | Hospital discharge day <= 30 min | Hospital | 1.50 | 2.21 | $74 | Details → |
| 99239 | Hospital discharge day > 30 min | Hospital | 2.15 | 3.17 | $106 | Details → |
| 99385 | Prev visit new age 18-39 | Preventive | 1.92 | 4.03 | $135 | Details → |
| 99386 | Prev visit new age 40-64 | Preventive | 2.33 | 4.66 | $156 | Details → |
| 99387 | Init pm e/m new pat 65+ yrs | Preventive | 2.50 | 5.05 | $169 | Details → |
| 99395 | Prev visit est age 18-39 | Preventive | 1.75 | 3.64 | $122 | Details → |
| 99396 | Prev visit est age 40-64 | Preventive | 1.90 | 3.86 | $129 | Details → |
| 99397 | Per pm reeval est pat 65+ yr | Preventive | 2.00 | 4.16 | $139 | Details → |
| 99406 | Behav chng smoking 3-10 min | Screening / Counsel | 0.24 | 0.46 | $15 | Details → |
| 99407 | Behav chng smoking > 10 min | Screening / Counsel | 0.50 | 0.87 | $29 | Details → |
| 99417 | Prolng op e/m each 15 min | E/M Est | 0.61 | 0.96 | $32 | Details → |
| 99421 | Online digital E/M est 5-10 min | Telehealth | 0.25 | 0.43 | $14 | Details → |
| 99422 | Online digital E/M est 11-20 min | Telehealth | 0.50 | 0.85 | $28 | Details → |
| 99423 | Online digital E/M est 21+ min | Telehealth | 0.80 | 1.35 | $45 | Details → |
| 99437 | Chronic care mgmt physician 30 min | Care Mgmt | 1.00 | 1.47 | $49 | Details → |
| 99439 | Chrnc care mgmt staf ea addl | Care Mgmt / Counsel | 0.70 | 1.51 | $50 | Details → |
| 99453 | RPM device setup & patient education | Care Mgmt | 0.00 | 0.55 | $18 | Details → |
| 99454 | RPM device supply ea 30 day | Care Mgmt | 0.00 | 1.42 | $47 | Details → |
| 99457 | RPM treatment mgmt 20 min/mo | Care Mgmt | 0.61 | 1.27 | $42 | Details → |
| 99458 | RPM treatment mgmt ea addl 20 min | Care Mgmt | 0.61 | 1.11 | $37 | Details → |
| 99483 | Cognitive assessment & care plan | Neurology | 3.44 | 6.08 | $203 | Details → |
| 99484 | Behav health care mgmt 20 min/mo | Care Mgmt | 0.61 | 1.31 | $44 | Details → |
| 99490 | Chrnc care mgmt staff 1st 20 | Care Mgmt / Counsel | 1.00 | 1.98 | $66 | Details → |
| 99491 | CCM physician 30 min/mo | Care Mgmt | 1.45 | 2.21 | $74 | Details → |
| 99492 | Behav health CoCM initial 70 min | Care Mgmt | 2.00 | 3.11 | $104 | Details → |
| 99493 | Behav health CoCM subseq 60 min | Care Mgmt | 2.00 | 3.11 | $104 | Details → |
| 99494 | Behav health CoCM ea addl 30 min | Care Mgmt | 1.00 | 1.53 | $51 | Details → |
| 99495 | Transj care mgmt mod f2f 14d | Care Mgmt / Counsel | 2.78 | 6.59 | $220 | Details → |
| 99496 | Transj care mgmt high f2f 7d | Care Mgmt / Counsel | 3.79 | 8.94 | $299 | Details → |
| 99497 | Advncd care plan 30 min | Care Mgmt / Counsel | 1.50 | 2.60 | $87 | Details → |
| 99498 | Advncd care plan addl 30 min | Care Mgmt / Counsel | 1.40 | 2.34 | $78 | Details → |
| G0101 | Pelvic & breast exam (Medicare) | GYN | 0.45 | 1.03 | $34 | Details → |
| G0105 | Screening colonoscopy high risk | GI | 3.36 | 8.62 | $288 | Details → |
| G0108 | Diabetes self-mgmt training 30 min | Endocrinology | 0.00 | 1.18 | $39 | Details → |
| G0109 | DSMT group session 30 min | Endocrinology | 0.00 | 0.30 | $10 | Details → |
| G0121 | Screening colonoscopy avg risk | GI | 3.36 | 8.62 | $288 | Details → |
| G0136 | SDOH risk assessment, 5-15 min | Care Mgmt / Counsel | 0.18 | 0.37 | $12 | Details → |
| G0270 | MNT subsequent, 15 min, dx changed | Endocrinology | 0.45 | 0.77 | $26 | Details → |
| G0296 | LDCT lung cancer screening visit | Pulmonology | 0.52 | 0.83 | $28 | Details → |
| G0316 | Prolonged hospital E/M ea 15 min | Hospital | 0.61 | 0.83 | $28 | Details → |
| G0317 | Prolonged nursing facility E/M ea 15 min | Hospital | 0.61 | 0.83 | $28 | Details → |
| G0318 | Prolonged home/residence E/M ea 15 min | Hospital | 0.61 | 0.83 | $28 | Details → |
| G0402 | Initial preventive exam | Medicare Wellness | 2.60 | 5.23 | $175 | Details → |
| G0438 | Ppps, initial visit | Medicare Wellness | 2.60 | 5.22 | $174 | Details → |
| G0439 | Ppps, subseq visit | Medicare Wellness | 1.92 | 4.12 | $138 | Details → |
| G0444 | Depression screen annual | Screening / Counsel | 0.18 | 0.56 | $19 | Details → |
| G0447 | Behavior counsel obesity 15m | Screening / Counsel | 0.60 | 1.02 | $34 | Details → |
| G0537 | Risk ascvd tst once pr 12 mo | Screening / Counsel | 0.18 | 0.60 | $20 | Details → |
| G0538 | Ascvd rsk mng clin stf pr mo | Screening / Counsel | 0.18 | 0.51 | $17 | Details → |
| G2010 | Remote eval recorded video/img | Telehealth | 0.18 | 0.32 | $11 | Details → |
| G2012 | Brief check-in by physician 5-10 min | Telehealth | 0.25 | 0.40 | $13 | Details → |
| G2211 | Complex e/m visit add on | E/M Est | 0.33 | 0.52 | $17 | Details → |
| G2212 | Prolonged office o/p E/M ea 15 min (Medicare) | E/M Est | 0.61 | 0.96 | $32 | Details → |
| Q0091 | Screening Pap smear obtaining | GYN | 0.37 | 0.95 | $32 | Details → |