Common procedures & services
Office visits & checkups
- New Patient Office Visit, Low Complexity HCPCS 99203
- Office Visit, New Patient (Moderate Complexity) HCPCS 99204
- Office Visit, New Patient (High Complexity) HCPCS 99205
- Specialist Office Consultation HCPCS 99243
- Detailed Specialist Consultation HCPCS 99244
- Annual Checkup, New Patient (Ages 18-39) HCPCS 99385
- Annual Checkup, New Patient (Ages 40-64) HCPCS 99386
Emergency room
- Emergency Department Visit, Level 1 (Lowest) HCPCS 99281
- Emergency Department Visit, Level 2 (Straightforward) HCPCS 99282
- Emergency Department Visit, Level 3 (Low Complexity) HCPCS 99283
- Emergency Department Visit, Level 4 (Moderate Complexity) HCPCS 99284
- Emergency Department Visit, Level 5 (Highest) HCPCS 99285
Lab tests
- Basic Metabolic Blood Panel HCPCS 80048
- Comprehensive Metabolic Panel HCPCS 80053
- Cholesterol (Lipid) Panel HCPCS 80061
- Renal (Kidney) Function Panel HCPCS 80069
- Liver Function Panel HCPCS 80076
- Urinalysis with Microscopic Exam, Manual HCPCS 81000
- Basic Dipstick Urinalysis HCPCS 81002
- PSA Blood Test (Total) HCPCS 84153
- TSH Blood Test HCPCS 84443
- Complete Blood Count With Differential HCPCS 85025
- Complete Blood Count Without Differential HCPCS 85027
- Prothrombin Time (PT) Blood Test HCPCS 85610
- Blood Clotting Time Test (PTT) HCPCS 85730
Imaging & scans
- CT Scan of the Head, Without Contrast HCPCS 70450
- MRI of the Brain, With and Without Contrast HCPCS 70553
- Lower Spine X-ray, Multiple Views HCPCS 72110
- MRI of the Lower Back, Without Contrast HCPCS 72148
- CT Scan of the Pelvis With Contrast HCPCS 72193
- MRI of a Leg Joint, Without Contrast HCPCS 73721
- CT Scan of Abdomen and Pelvis, With Contrast HCPCS 74177
- Abdominal Ultrasound (Complete) HCPCS 76700
- Transvaginal Ultrasound (Non-Obstetric) HCPCS 76830
- Diagnostic Mammogram, One Breast HCPCS 77065
- Diagnostic Mammogram, Both Breasts HCPCS 77066
- Screening Mammogram, Both Breasts HCPCS 77067
Colonoscopy & endoscopy
Mental health
Maternity & pregnancy
- Complete Maternity Care With Vaginal Delivery HCPCS 59400
- Cesarean Delivery With Prenatal and After Care HCPCS 59510
- Vaginal Delivery After A Prior Cesarean, Full Maternity Care HCPCS 59610
- Second/Third Trimester Pregnancy Ultrasound (Complete) HCPCS 76805
- Obstetric Blood Panel (Early Pregnancy) HCPCS 80055
Common surgeries
- Laparoscopic Gallbladder Removal HCPCS 47562
- Open Inguinal Hernia Repair, First-Time HCPCS 49505
- Knee Arthroscopy, One Meniscus Trimmed HCPCS 29881
- Shoulder Arthroscopy, Subacromial Decompression HCPCS 29826
- Cataract Removal With Lens Implant HCPCS 66984
- Laser Treatment For Clouded Vision After Cataract Surgery HCPCS 66821
- Surgical Removal of a Breast Lump HCPCS 19120
- Tonsil and Adenoid Removal, Under Age 12 HCPCS 42820
- Prostate Biopsy HCPCS 55700
- Keyhole or Robotic Removal of the Prostate HCPCS 55866
Spine, joints & therapy
Heart & sleep
Hospital stays (inpatient)
- Major Joint Replacement or Reattachment (without MCC) MS-DRG 470
- Spinal Fusion Except Cervical without Major Complications MS-DRG 460
- Cervical Spinal Fusion without Complications MS-DRG 473
- Cardiothoracic Procedures with Cath (with MCC) MS-DRG 216
- Uterine/Adnexa Surgery for Non-Malignancy (without CC/MCC) MS-DRG 743
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