Reference

CPT procedure codes

396 top CPT codes with descriptions and common denial patterns.

Codes indexed

396

Code	Description	Category
10060	Incision and drainage of abscess, simple	surgery
10061	Incision and drainage of abscess, complicated	surgery
11042	Debridement, subcutaneous tissue, first 20 sq cm	surgery
11043	Debridement, muscle and/or fascia, first 20 sq cm or less	surgery
11044	Debridement, bone, first 20 sq cm or less	surgery
11045	Debridement, subcutaneous, each additional 20 sq cm	surgery
11055	Paring or cutting of benign hyperkeratotic lesion (e.g. corn or callus), single	surgery
11102	Tangential biopsy of skin, single lesion	surgery
11103	Tangential biopsy, each additional lesion	surgery
11104	Punch biopsy of skin, single lesion	surgery
11105	Punch biopsy, each additional lesion	surgery
11106	Incisional biopsy of skin	surgery
11107	Incisional biopsy, each additional lesion	surgery
11200	Removal of skin tags, up to and including 15 lesions	surgery
11400	Excision benign lesion, including margins, 0.5 cm or less	surgery
11401	Excision benign lesion, 0.6-1.0 cm	surgery
11402	Excision benign lesion, 1.1-2.0 cm	surgery
11403	Excision benign lesion, 2.1-3.0 cm	surgery
11404	Excision benign lesion, 3.1-4.0 cm	surgery
11406	Excision benign lesion, >4.0 cm	surgery
11420	Excision benign lesion, scalp/neck/hands/feet/genitalia, ≤0.5 cm	surgery
11600	Excision malignant lesion, trunk arms legs, ≤0.5 cm	surgery
11602	Excision malignant lesion, trunk/arms/legs, 1.1-2.0 cm	surgery
11604	Excision malignant lesion, trunk/arms/legs, 3.1-4.0 cm	surgery
11606	Excision malignant lesion, trunk/arms/legs, >4.0 cm	surgery
12001	Simple repair of superficial wounds, ≤2.5 cm	surgery
12002	Simple wound repair, ≤2.5-7.5 cm	surgery
12011	Simple repair, face/ears/lips/mucous membranes, ≤2.5 cm	surgery
13100	Complex repair, trunk, 1.1-2.5 cm	surgery
13120	Complex repair, scalp/arms/legs, 1.1-2.5 cm	surgery
13131	Complex repair, forehead/cheeks/chin/mouth/neck/axillae/genitalia/hands/feet, 1.1-2.5 cm	surgery
13160	Secondary closure of surgical wound or dehiscence, extensive or complicated	surgery
15271	Skin substitute graft, trunk/arms/legs, total wound surface area up to 100 sq cm	surgery
15275	Skin substitute graft, face/scalp/eyes/mouth/neck/genitalia/hands/feet, up to 100 sq cm	surgery
17000	Destruction premalignant lesions, first	surgery
17003	Destruction of premalignant lesion, second through 14th	surgery
17004	Destruction of premalignant lesions, 15 or more	surgery
17110	Destruction benign lesion(s), up to 14	surgery
17111	Destruction of benign lesion, 15 or more	surgery
17260	Destruction of malignant lesion, trunk/arms/legs, ≤0.5 cm	surgery
20550	Injection of single tendon sheath or ligament	surgery
20551	Injection of tendon origin/insertion	surgery
20552	Injection of trigger point, 1-2 muscles	surgery
20553	Injection of trigger point, 3+ muscles	surgery
20600	Arthrocentesis, small joint (e.g., finger, toe)	surgery
20605	Arthrocentesis, intermediate joint (e.g., wrist, elbow, ankle)	surgery
20610	Arthrocentesis, aspiration, injection major joint	surgery
20611	Arthrocentesis with ultrasound guidance, major joint	surgery
27130	Total hip arthroplasty (THA)	surgery
27447	Total knee arthroplasty (TKA)	surgery
27486	Revision of total knee arthroplasty	surgery
27488	Removal of total knee arthroplasty	surgery
29826	Arthroscopic decompression of subacromial space	surgery
29827	Arthroscopic rotator cuff repair	surgery
29881	Arthroscopic meniscectomy, medial OR lateral	surgery
29888	Arthroscopic ACL reconstruction	surgery
31231	Diagnostic nasal endoscopy	surgery
31237	Nasal endoscopy with biopsy	surgery
31285	Endoscopic ethmoidectomy, anterior, total	surgery
31288	Endoscopic sphenoidotomy	surgery
31622	Bronchoscopy, diagnostic	surgery
31624	Bronchoscopy with bronchoalveolar lavage	surgery
31625	Bronchoscopy with transbronchial biopsy	surgery
31628	Bronchoscopy with TBNA	surgery
33208	Insertion of permanent pacemaker, atrial and ventricular	surgery
33249	Insertion of single-chamber pacing-cardioverter-defibrillator	surgery
33270	Insertion or replacement of subcutaneous implantable defibrillator	surgery
33361	Transcatheter aortic valve replacement, percutaneous femoral artery	surgery
33405	Open aortic valve replacement, bioprosthetic	surgery
33533	Coronary artery bypass, single arterial graft	surgery
33534	Coronary artery bypass, two coronary arterial grafts	surgery
33535	Coronary artery bypass, three coronary arterial grafts	surgery
36415	Venipuncture, routine	surgery
36416	Capillary blood sample, finger/heel/ear stick	surgery
36556	Insertion of non-tunneled central venous catheter, age ≥5	surgery
36561	Insertion of tunneled centrally inserted central venous access device	surgery
36569	PICC line, age ≥5	surgery
36598	Mechanical or fluoroscopic guidance for central line	surgery
43235	EGD, diagnostic	surgery
43236	EGD, submucosal injection	surgery
43239	EGD with biopsy	surgery
43249	EGD with esophageal dilation, balloon	surgery
43250	EGD with ablation of tumor/polyp, hot biopsy/snare	surgery
43251	EGD with snare polypectomy	surgery
43644	Roux-en-Y gastric bypass	surgery
43645	Laparoscopic gastric bypass with small intestine reconstruction	surgery
43770	Laparoscopic gastric band, initial placement	surgery
43775	Sleeve gastrectomy	surgery
44950	Open appendectomy	surgery
44970	Laparoscopic appendectomy	surgery
45378	Colonoscopy, diagnostic	surgery
45380	Colonoscopy with biopsy	surgery
45381	Colonoscopy with submucosal injection	surgery
45384	Colonoscopy with hot biopsy/snare ablation	surgery
45385	Colonoscopy with snare polypectomy	surgery
47562	Laparoscopic cholecystectomy	surgery
47563	Laparoscopic cholecystectomy with cholangiography	surgery
47564	Laparoscopic cholecystectomy with exploration common duct	surgery
49505	Inguinal hernia repair, initial, age 5+	surgery
49560	Open ventral/incisional hernia repair, reducible	surgery
49587	Open inguinal hernia repair, reducible, ≥5 years	surgery
49650	Laparoscopic inguinal hernia repair, initial	surgery
52000	Cystoscopy	surgery
52234	Cystoscopy with fulguration of small bladder tumor	surgery
52332	Cystoscopy with double-J stent insertion	surgery
52601	TURP, complete	surgery
55700	Prostate biopsy, transperineal	surgery
57170	Diaphragm or cervical cap fitting	surgery
58100	Endometrial biopsy without cervical dilation	surgery
58150	Total abdominal hysterectomy	surgery
58300	IUD insertion	surgery
58301	IUD removal	surgery
58340	Hysterosalpingography with introduction of contrast	surgery
58353	Endometrial ablation, thermal	surgery
58563	Hysteroscopic endometrial ablation	surgery
58570	Laparoscopic hysterectomy, uterus ≤250 g	surgery
58571	Laparoscopic hysterectomy ≤250 g with removal of tubes/ovaries	surgery
58572	Laparoscopic hysterectomy >250 g	surgery
58661	Laparoscopy with removal of adnexal structures	surgery
59025	Fetal non-stress test	surgery
59425	Antepartum care, 4-6 visits	surgery
59426	Antepartum care, 7+ visits	surgery
62321	Injection of diagnostic or therapeutic substance into cervical/thoracic epidural	surgery
62322	Injection of diagnostic or therapeutic substance into lumbar epidural	surgery
62323	Lumbar ESI with imaging guidance	surgery
63685	Insertion or replacement of spinal neurostimulator pulse generator	surgery
64483	Transforaminal epidural injection, lumbar/sacral, single level	surgery
64484	Transforaminal epidural injection, lumbar/sacral, each additional level	surgery
64615	Chemodenervation of muscles innervated by facial, trigeminal, cervical spinal, and accessory nerves bilateral for chronic migraine	surgery
64635	Radiofrequency neurolysis of facet joint nerves, lumbar/sacral, single level	surgery
64636	Radiofrequency neurolysis, lumbar/sacral, each additional level	surgery
70450	CT scan of head/brain without contrast	radiology
70460	CT head/brain, with contrast	radiology
70470	CT head/brain, without and with contrast	radiology
70486	CT sinuses, without contrast	radiology
70551	MRI brain without contrast	radiology
70553	MRI brain without and with contrast	radiology
71045	Chest X-ray, single view (PA or lateral)	radiology
71046	X-ray chest, 2 views	radiology
71250	CT chest without contrast	radiology
71260	CT chest, with contrast	radiology
71270	CT chest, without and with contrast	radiology
71275	CT angiography of chest	radiology
72040	Cervical spine X-ray, 2-3 views	radiology
72100	Lumbar spine X-ray, 2-3 views	radiology
72110	Lumbar spine X-ray, complete, ≥4 views	radiology
72141	MRI cervical spine, without contrast	radiology
72146	MRI thoracic spine, without contrast	radiology
72148	MRI lumbar spine without contrast	radiology
72157	MRI cervical spine with and without contrast	radiology
72158	MRI lumbar spine, with and without contrast	radiology
73030	Shoulder X-ray, complete, 2+ views	radiology
73060	Humerus X-ray, 2+ views	radiology
73221	MRI shoulder without contrast	radiology
73560	Knee X-ray, 1-2 views	radiology
73564	Knee X-ray, complete, 4+ views	radiology
73721	MRI lower extremity joint without contrast (e.g. knee)	radiology
74176	CT abdomen and pelvis without contrast	radiology
74177	CT abdomen/pelvis with contrast	radiology
74178	CT abdomen and pelvis without and with contrast	radiology
74183	MRI abdomen	radiology
76536	Ultrasound, soft tissues of head and neck (e.g., thyroid)	radiology
76700	Abdominal ultrasound, complete	radiology
76705	Abdominal ultrasound, limited	radiology
76770	Retroperitoneal ultrasound	radiology
76801	OB ultrasound, first trimester, single fetus	radiology
76830	Transvaginal ultrasound	radiology
76942	Ultrasound guidance for needle placement	radiology
77065	Diagnostic mammogram unilateral	radiology
77066	Diagnostic mammogram bilateral	radiology
77067	Screening mammography, bilateral	radiology
78306	Bone imaging, whole body	radiology
78815	PET-CT, whole body	radiology
80048	Basic metabolic panel (BMP)	pathology
80050	General health panel	pathology
80053	Comprehensive metabolic panel (CMP)	pathology
80061	Lipid panel	pathology
80069	Renal function panel	pathology
80074	Hepatic function panel	pathology
80076	Lipid panel + apo A and apo B	pathology
80100	Drug screen, qualitative, single class	pathology
80162	Digoxin level	pathology
80164	Dipropylacetic acid (valproic acid), total	pathology
80185	Phenytoin level	pathology
80305	Drug test, presumptive, capable of being read by direct optical observation	pathology
80307	Drug test, presumptive, instrument-assisted	pathology
81001	Urinalysis, automated, with microscopy	pathology
81002	Urinalysis, automated, without microscopy	pathology
81003	Urinalysis, automated, without microscopy	pathology
81025	Urine pregnancy test (POC)	pathology
82043	Albumin, urine, microalbumin, quantitative	pathology
82150	Amylase	pathology
82270	Fecal occult blood test, peroxidase activity	pathology
82274	Blood, occult, by fecal hemoglobin determination, immunoassay (FIT)	pathology
82306	Vitamin D, 25-hydroxy	pathology
82533	Cortisol, total	pathology
82550	Creatine kinase (CK), total	pathology
82565	Creatinine, blood	pathology
82570	Creatinine, urine	pathology
82607	Vitamin B12	pathology
82728	Ferritin	pathology
82746	Folate, serum	pathology
82947	Glucose, quantitative, blood	pathology
82948	Glucose, blood by reagent strip device	pathology
82951	Glucose tolerance test, three specimens	pathology
82962	Glucose, blood by glucose monitoring device	pathology
82977	Gamma-glutamyl transferase (GGT)	pathology
83036	Hemoglobin; glycosylated (A1C)	pathology
83037	HbA1c by device cleared by FDA for home use	pathology
83540	Iron	pathology
83550	Iron binding capacity, total (TIBC)	pathology
83655	Lead, blood	pathology
83721	LDL cholesterol, direct	pathology
83880	Natriuretic peptide	pathology
84132	Potassium, serum	pathology
84134	Prealbumin	pathology
84153	PSA, total	pathology
84154	PSA, free	pathology
84155	Protein, total, serum	pathology
84439	T4, free	pathology
84443	TSH (thyroid stimulating hormone)	pathology
84478	Triglycerides	pathology
84479	Thyroid hormone (T3 or T4), uptake or thyroid hormone binding ratio	pathology
84480	T3, total	pathology
85007	Manual differential white cell count	pathology
85025	Blood count; complete (CBC) with WBC differential	pathology
85027	Complete CBC without differential	pathology
85610	Prothrombin time (PT)	pathology
85730	Partial thromboplastin time (PTT)	pathology
85975	Bleeding time	pathology
86038	Antinuclear antibody (ANA)	pathology
86140	C-reactive protein (CRP)	pathology
86141	High sensitivity CRP	pathology
86592	Syphilis test, non-treponemal antibody, qualitative	pathology
86703	HIV-1 and HIV-2, antibodies	pathology
86706	Hepatitis B surface antibody	pathology
86708	Hepatitis A antibody, total	pathology
86803	Hepatitis C antibody	pathology
87086	Urine culture	pathology
87186	Susceptibility testing, antimicrobial, minimum inhibitory concentration	pathology
87635	Infectious agent detection by nucleic acid, SARS-CoV-2	pathology
87880	Strep group A direct antigen	pathology
88305	Level IV surgical pathology, gross and microscopic exam	pathology
88307	Pathology, level V surgical	pathology
89230	Sweat collection by iontophoresis	pathology
90385	Rho(D) immune globulin, full dose, intramuscular	medicine
90460	Immunization administration, first/single vaccine, with counseling	medicine
90461	Immunization administration, each additional vaccine	medicine
90471	Immunization administration; first vaccine	medicine
90472	Immunization administration, each additional vaccine	medicine
90474	Immunization administration, intranasal/oral, each additional	medicine
90686	Influenza vaccine, quadrivalent, IM (Fluarix Quadrivalent)	medicine
90707	MMR vaccine	medicine
90715	Tdap vaccine	medicine
90716	Varicella vaccine	medicine
90734	Meningococcal conjugate vaccine, quadrivalent (MenACWY)	medicine
90750	Zoster (shingles) vaccine, recombinant, subcutaneous (Shingrix)	medicine
90791	Psychiatric diagnostic evaluation	medicine
90792	Psychiatric diagnostic evaluation with medical services	medicine
90832	Psychotherapy, 30 min	medicine
90833	Psychotherapy, 30 min, with E&M	medicine
90834	Psychotherapy, 45 min	medicine
90836	Psychotherapy, 45 min, with E&M	medicine
90837	Psychotherapy, 60 min	medicine
90838	Psychotherapy, 60 min, with E&M	medicine
90839	Psychotherapy crisis, first 60 min	medicine
90840	Psychotherapy crisis, each additional 30 min	medicine
90846	Family psychotherapy without patient	medicine
90847	Family psychotherapy with patient	medicine
90853	Group psychotherapy	medicine
90867	TMS therapy, initial planning	medicine
90868	TMS therapy, subsequent delivery	medicine
92012	Ophthalmological services; intermediate, established patient	medicine
92014	Ophthalmological services; comprehensive, established patient	medicine
92928	Percutaneous transcatheter placement of intracoronary stent(s) with coronary angioplasty	medicine
92929	PCI, each additional vessel	medicine
93000	Electrocardiogram, complete with interpretation and report	medicine
93005	Electrocardiogram, tracing only	medicine
93010	Electrocardiogram, interpretation and report only	medicine
93303	TTE for congenital heart disease, complete	medicine
93306	Echocardiography, transthoracic	medicine
93307	TTE, complete, without spectral or color Doppler	medicine
93308	TTE, follow-up or limited study	medicine
93312	Transesophageal echocardiogram, complete	medicine
93350	Stress echocardiogram	medicine
93458	Diagnostic cardiac catheterization, left heart, coronary angiography	medicine
93653	Comprehensive electrophysiology with arrhythmia induction and treatment of AV node ablation	medicine
93656	Comprehensive electrophysiology with arrhythmia induction and treatment of AF with ablation	medicine
94010	Spirometry, simple measurements	medicine
94060	Spirometry with bronchodilator	medicine
94375	Respiratory flow volume loop	medicine
94640	Pressurized or nonpressurized inhalation treatment	medicine
94664	Demonstration/training of MDI/spacer use	medicine
94760	Pulse oximetry, single determination	medicine
95800	Sleep study, home, unattended	medicine
95810	Polysomnography, sleep study	medicine
95811	Polysomnography with CPAP titration	medicine
95822	EEG, sleep + waking, awakened	medicine
96127	Brief emotional/behavioral assessment, e.g., PHQ-9	medicine
96130	Psychological testing evaluation services, first hour	medicine
96131	Psychological testing evaluation services, each additional hour	medicine
96132	Neuropsych testing eval, first hour	medicine
96136	Psychological/neuropsych testing administration first 30 min	medicine
96365	IV infusion, hydration or therapeutic, first hour	medicine
96374	Intravenous push of single substance/drug	medicine
96402	Chemotherapy administration, subcutaneous or intramuscular	medicine
97110	Therapeutic exercise, each 15 minutes	medicine
97112	Neuromuscular reeducation	medicine
97113	Aquatic therapy with exercises	medicine
97116	Gait training therapy	medicine
97124	Massage therapy	medicine
97140	Manual therapy techniques, 15 min	medicine
97150	Group therapy procedures	medicine
97162	Physical therapy evaluation, moderate complexity	medicine
97163	Physical therapy evaluation, high complexity	medicine
97165	Occupational therapy evaluation, low complexity	medicine
97166	Occupational therapy evaluation, moderate complexity	medicine
97530	Therapeutic activities, direct one-on-one	medicine
97535	Self-care/home management training	medicine
97542	Wheelchair management	medicine
97597	Debridement, selective, open wound, ≤20 sq cm	medicine
97607	Negative pressure wound therapy, including topical application	medicine
97750	Physical performance test or measurement	medicine
99202	Office visit, new patient, 15-29 min	EM
99203	Office visit, new patient, 30-44 min	EM
99204	Office visit, new patient, 45-59 min	EM
99205	Office visit, new patient, 60-74 min	EM
99211	Office visit, established patient, may not require physician	EM
99212	Office visit, established patient, 10-19 min	EM
99213	Office visit, established patient, 20-29 min	EM
99214	Office visit, established patient, 30-39 min	EM
99215	Office visit, established patient, 40-54 min	EM
99221	Initial hospital inpatient or observation, 30-44 min	EM
99222	Initial hospital inpatient or observation, 45-59 min	EM
99223	Initial hospital inpatient or observation, 60+ min	EM
99231	Subsequent hospital inpatient/observation, 15-24 min	EM
99232	Subsequent hospital inpatient/observation, 25-34 min	EM
99233	Subsequent hospital inpatient/observation, 35+ min	EM
99238	Hospital discharge day, 30 min or less	EM
99239	Hospital discharge day, more than 30 min	EM
99241	Office consultation, low MDM, 30 min (commercial)	EM
99242	Office consultation, low MDM, 30 min (commercial)	EM
99243	Office consultation, moderate MDM, 40 min (commercial)	EM
99244	Office consultation, moderate MDM, 60 min (commercial)	EM
99245	Office consultation, high MDM, 80 min (commercial)	EM
99281	ED visit, may not require physician	EM
99282	ED visit, low complexity	EM
99283	ED visit, moderate complexity	EM
99284	ED visit, high complexity	EM
99285	ED visit, high complexity, urgency	EM
99291	Critical care, first 30-74 min	EM
99292	Critical care, each additional 30 min	EM
99304	Initial nursing facility care, low MDM, 25 min	EM
99305	Initial nursing facility care, moderate MDM, 35 min	EM
99306	Initial nursing facility care, high MDM, 50 min	EM
99307	Subsequent nursing facility care, straightforward, 10 min	EM
99308	Subsequent nursing facility care, low MDM, 15 min	EM
99309	Subsequent nursing facility care, moderate MDM, 25 min	EM
99310	Subsequent nursing facility care, high MDM, 35 min	EM
99341	Home/residence visit, new patient, straightforward MDM, 25 min	EM
99342	Home/residence visit, new patient, low MDM, 35 min	EM
99344	Home/residence visit, new patient, moderate MDM, 55 min	EM
99345	Home/residence visit, new patient, high MDM, 70 min	EM
99347	Home/residence visit, established patient, straightforward MDM, 20 min	EM
99348	Home/residence visit, established patient, low MDM, 30 min	EM
99349	Home/residence visit, established patient, moderate MDM, 40 min	EM
99350	Home/residence visit, established patient, high MDM, 60 min	EM
99381	Preventive E&M, new patient, infant (under 1 year)	EM
99382	Preventive E&M, new patient, age 1-4	EM
99383	Preventive E&M, new patient, age 5-11	EM
99384	Preventive E&M, new patient, age 12-17	EM
99385	Preventive E&M, new patient, age 18-39	EM
99386	Preventive E&M, new patient, age 40-64	EM
99387	Preventive E&M, new patient, 65+	EM
99391	Preventive E&M, established patient, under 1 year	EM
99392	Preventive E&M, established patient, age 1-4	EM
99393	Preventive E&M, established patient, age 5-11	EM
99394	Preventive E&M, established patient, age 12-17	EM
99395	Periodic preventive medicine, established patient, 18-39 years	EM
99396	Periodic preventive medicine, established patient, 40-64 years	EM
99397	Preventive E&M, established patient, 65+	EM
99406	Smoking and tobacco use cessation counseling, intermediate, 3-10 min	EM
99407	Smoking and tobacco use cessation counseling, intensive, >10 min	EM
99408	Alcohol/substance abuse, structured screening + brief intervention, 15-30 min	EM
99409	Alcohol/substance abuse, structured screening + brief intervention, >30 min	EM
99417	Prolonged outpatient E&M, each 15 min	EM
99453	Remote monitoring of physiologic parameter, initial setup + patient education	EM
99454	Remote monitoring of physiologic parameter, device + supply, per 30 days	EM
99457	Remote physiologic monitoring treatment management services, first 20 min	EM
99458	RPM treatment management, additional 20 min	EM
99490	Chronic care management services, first 20 min/month	EM
99491	Chronic care management, by physician, first 30 min/month	EM
99495	Transitional care management, moderate complexity, F2F ≤14d post-discharge	EM
99496	Transitional care management, high complexity, F2F ≤7d post-discharge	EM
99497	Advance care planning, first 30 min	EM
99498	Advance care planning, additional 30 min	EM

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