Billing Code Lookup — CPT, HCPCS, DRG Codes & More
Browse codes25
- CPT99214Medicare avg $140Commercial avg $15599214 – The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the provider spends 30 minutes or more of total time on the encounter on a single date.Established Patient
- CPT99213Medicare avg $98Commercial avg $11099213 – The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the provider spends 20 or more minutes of total time on the encounter on a single date.Established Patient
- CPT99215Medicare avg $198Commercial avg $21699215 – The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the provider spends 40 or more minutes of total time on the encounter on a single date.Established Patient
- CPT90837Medicare avg $172Commercial avg $26090837 – In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or more.Psychotherapy Services and Procedures
- CPT97110Medicare avg $30Commercial avg $6097110 – Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with injury–related disabilities, it can also be utilized on normally active and healthy persons to improve their overall health. Therapeutic exercises can be helpful to people recovering from surgery, to improve overall health during pregnancy and to provide relief to people with osteoporosis. The exercise program is designed specifically to suit each person and involves physical as well breathing exercises.Physical Medicine and Rehabilitation Therapeutic Procedures
- CPT96372Medicare avg $16Commercial avg $4896372 – A therapeutic, prophylactic, or diagnostic substance (a fluid, a drug, etc.) is injected via intramuscular or subcutaneous route into the patient's body. The procedure is performed by the physician himself or by his assistant or nurse under direct supervision of the physician. Injection of a vaccine or toxoid is not included in this code.Therapeutic, Prophylactic, and Diagnostic Injections and Infusions (Excludes Chemotherapy and Other Highly Complex Drug or Highly Complex Biologic Agent Administration)
- CPT72148Medicare avg $133Commercial avg $53772148 – In this diagnostic procedure, the provider performs magnetic resonance imaging (MRI) of the lumbar spinal canal and contents without using contrast.Diagnostic Radiology (Diagnostic Imaging) Procedures of the Spine and Pelvis
- CPT43239Medicare avg $436Commercial avg $73243239 – The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis.Esophagogastroduodenoscopy Procedures
- CPT29827Medicare avg $993Commercial avg $322729827 – The provider examines the tissue inside the shoulder joint with an arthroscope. She inserts additional instruments to repair a torn rotator cuff, the grouping of muscles and tendons that surround and support the shoulder joint. Rotator cuff tears frequently result from sports injuries and repetitive overhead motion of the arm, causing pain and limitation of movement.Endoscopy/Arthroscopy Procedures on the Musculoskeletal System
- CPT27447Medicare avg $1176Commercial avg $639727447 – In this procedure, the provider replaces the damaged weight bearing surfaces of both the medial and lateral compartments in the knee joint using implants of metal or other strong materials. The provider may or may not replace the patella with an implant. The aim of this procedure is to relieve the pain and disability in a severely damaged knee.Repair, Revision, and/or Reconstruction Procedures on the Femur (Thigh Region) and Knee Joint
- CPT73721Medicare avg $142Commercial avg $54573721 – In this diagnostic procedure, the provider performs magnetic resonance imaging of a lower extremity joint without using contrast material.Diagnostic Radiology (Diagnostic Imaging) Procedures of the Lower Extremities
- CPT99233Medicare avg $109Commercial avg $12799233 – The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the provider spends at least 50 minutes of total time on the encounter on a single date.Subsequent Hospital Inpatient or Observation Care
- CPT99221Medicare avg $76Commercial avg $25299221 – The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a straightforward or low level of medical decision making or the provider spends at least 40 minutes of total time on the encounter on a single date.New or Established Patient
- CPT66984Medicare avg $476Commercial avg $181666984 – The provider inserts an artificial lens after removing an extracapsular cataract by aspiration or use of ultrasonic waves. This procedure is done without the use of an endoscopic laser probe to shrink the ciliary processes, a procedure to treat glaucoma.Intraocular Lens Procedures
- CPT87880Commercial avg $2787880 – The analyst performs an immunoassay with direct optical, meaning visual, observation to detect Streptococcus, group A, in a patient sample, typically a throat swab.Infectious Agent Antigen Detection
- CPT95810Medicare avg $469Commercial avg $137395810 – Polysomnography refers to the continuous and simultaneous monitoring and recording of various physiological and pathophysiological parameters of sleep for six or more hours with physician review, interpretation, and report.Sleep Medicine Testing and Long-term EEG Procedures
- CPT45380Medicare avg $498Commercial avg $76945380 – The provider examines the rectum and colon using a flexible colonoscope, a tubular instrument with a light source and camera, to look for the cause of a patient's symptoms, which may include diarrhea, constipation, rectal bleeding, or abdominal pain. He excises one or more suspicious areas of tissue using biopsy forceps and submits the specimens for laboratory analysis.Endoscopy Procedures on the Rectum
- HCPCSJ8499J8499 – Prescription drug, oral, non chemotherapeutic, nosDrugs Administered Other than Oral Method
- HCPCSJ2327J2327 – Injection, risankizumab-rzaa, intravenous, 1 mgDrugs Administered Other than Oral Method
- HCPCSJ9035J9035 – Injection, bevacizumab, 10 mgChemotherapy Drugs
- HCPCSJ0585J0585 – Injection, onabotulinumtoxina, 1 unitDrugs Administered Other than Oral Method
- HCPCSJ3490J3490 – Unclassified drugsDrugs Administered Other than Oral Method
- HCPCSJ1885J1885 – Injection, ketorolac tromethamine, per 15 mgDrugs Administered Other than Oral Method
- DRG470Major Hip and Knee Joint Replacement or Reattachment of Lower Extremity without MCCDiseases and Disorders of the Musculoskeletal System and Connective Tissue
- DRG871Septicemia or Severe Sepsis without MV >96 Hours with MCCInfectious and Parasitic Diseases, Systemic or Unspecified Sites
1–25 of 21135
1 / 846
Tool Description
Search any CPT, HCPCS, J-code, DRG, or dental code by number or procedure name.
Enter a code directly (29827, CPT 36415, or 90837 CPT code) or describe the procedure (“anesthesia services” or “total knee replacement”).
Covers office visit E/M codes, such as 99213 and 99214; therapy and injections like 97110 and 96372; radiology and surgery codes; injectable drugs like J9035; and inpatient DRG codes like DRG 470.
Every code page includes the full description, billing and coding guidelines, common modifiers, Medicare reimbursement, and coverage and prior authorization requirements from UnitedHealthcare, Aetna, Cigna, Humana, and hundreds of other payers.
OpenPayer also links each code to live payer policy updates — coverage criteria, prior auth phone numbers, timely filing limits, and reimbursement rates.
FAQ
Type a code number (99213, J9035, 72148) or a procedure name (“total knee replacement,” “colonoscopy”) into the search bar. Filter results by code type (CPT, HCPCS, DRG, or ICD) or browse by category. Open any result for the complete procedure code description, coding and billing guidance, common modifiers, reimbursement information, and related payer coverage policies.
Go deeper
Explore OpenPayer Data
Each result here links into the full OpenPayer dataset. You can browse all CPT, HCPCS, J-code and DRG billing codes with payer coverage detail, or catch the latest payer policy updates in the live policy feed.
Toolbox
More OpenPayer Tools
- Healthcare Provider & Facility LookupFind hospitals and healthcare facilities by name, taxonomy, facility type, ownership, or state.
- Health Insurance Payer LookupSearch national health insurance payers and health plans by name and state presence.
- Provider Taxonomy Code LookupSearch NUCC taxonomy codes by code, specialty, grouping, or classification.
- CPT Modifier LookupSearch CPT modifiers by code or name — descriptions, when to use them, and payer policy context.
- Prior Authorization LookupSearch payer prior authorization policies by drug, procedure, or policy name.
- Timely Filing LookupFind payer timely filing policies: claim deadlines, corrected claim windows, and appeal timeframes.
- Coverage Criteria LookupSearch payer coverage criteria and medical necessity requirements by drug, procedure, or payer.
- Payer Contact DirectoryClaims, prior authorization, provider services, and appeals contacts for health insurance payers.
Sources
References
- 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
- 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
- 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
Published by
Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.