Table 5.
Weighted Average Distribution of Charges by CPT Code Office Visits
| CPT Code | Adult Hematology/ Medical Oncology |
Adult Bone Marrow/ Stem-Cell Transplantation |
||
|---|---|---|---|---|
| Mean (%) | Institutional Range (%)* | Mean (%) | Institutional Range (%)* | |
| New office/outpatient visits | ||||
| 99201 | 0.4 | 0.0–.3 | 0.5 | 0.0–1.6 |
| 99202 | 1.8 | 0.0–34.1 | 1.7 | 0.0–13.2 |
| 99203 | 6.5 | 0.3–50.6 | 8.9 | 0.0–22.6 |
| 99204 | 23 | 19.1–52.3 | 17.5 | 7.4–41.0 |
| 99205 | 68.1 | 10.4–89.9 | 71.4 | 41.0–92.6 |
| Mean count across all institutions | 651 | 83 | ||
| Established office/outpatient visits | ||||
| 99211 | 2.1 | 0.0–8.9 | 0.9 | 0.0–4.6 |
| 99212 | 2.0 | 0.5–8.5 | 2.0 | 0.1–13.9 |
| 99213 | 20.7 | 3.6–61.5 | 15.7 | 0.6–75.6 |
| 99214 | 52.8 | 23.9–65.5 | 52.6 | 4.7–90.2 |
| 99215 | 22.5 | 0.5–44.2 | 28.8 | 61.0–99.1 |
| Mean count across all institutions | 13,162 | 2,904 | ||
| Total office/outpatient visits | ||||
| New | 4.7 | 1.9–9.4 | 2.4 | 0.2–5.8 |
| Established Consults | 95.3 | 90.6–98.1 | 97.6 | 94.2–99.8 |
| Outpatient consults | ||||
| 99241 | 0.3 | 0.0–0.7 | 0.4 | 0.0–1.5 |
| 99242 | 0.8 | 0.0–2.2 | 0.6 | 0.0–2.4 |
| 99243 | 4.7 | 0.4–10.7 | 2.3 | 0.0–7.3 |
| 99244 | 17.9 | 2.6–90.6 | 10.9 | 0.7–33.7 |
| 99245 | 76.4 | 3.1–96.8 | 85.8 | 61.0–99.1 |
| Mean count across all institutions | 1,471 | 238 | ||
| Initial inpatient consults | ||||
| 99242 | 0.8 | 0.0–2.2 | 0.6 | 0.0–2.4 |
| 99251 | 3.2 | 0.0–9.4 | 2.6 | 0.0–10.5 |
| 99252 | 7.8 | 0.0–38.8 | 9.0 | 0.0–26.7 |
| 99253 | 19.0 | 5.8–55.8 | 23.9 | 0.0–60. |
| 99254 | 34.1 | 2.0–75.9 | 11.6 | 0.0–36.8 |
| 99255 | 35.8 | 2.0–76.7 | 52.9 | 3.3–100 |
| Mean count | 217 | 10 | ||
| Follow-up consults | ||||
| 99261 | 18.6 | 9.7–21.2 | 6.7 | |
| 99262 | 63.3 | 51.6–71.6 | 86.7 | |
| 99263 | 18.1 | 8.0–38.7 | 6.7 | |
| Mean count across all institutions | 14 | 2 | ||
| Confirmatory consults | ||||
| 99271 | 0.5 | 0.0–2.9 | 1.9 | 0.0–6.1 |
| 99272 | 0.7 | 0.0–3.1 | 0.0 | 0.0–0.0 |
| 99273 | 3.7 | 0.0–7.6 | 2.9 | 0.0–4.8 |
| 99274 | 15.8 | 3.6–57.1 | 2.9 | 0.0–6.1 |
| 99275 | 79.2 | 34.3–95.9 | 92.2 | 84.8–100 |
| Mean count across all institutions | 238 | 11 | ||
| Consults, all categories | ||||
| Outpatient | 75.8 | 54.8–100 | 90.8 | 64.1–100 |
| Initial inpatient | 11.2 | 0.0–30.7 | 5.2 | 0.0–15.5 |
| Follow-up | 0.7 | 0.0–4.8 | 0.5 | 0.0–15.3 |
| Confirmatory | 12.3 | 0.0–27.2 | 3.5 | 0.0–32.8 |
| Inpatient care | ||||
| Initial hospital care | ||||
| 99221 | 11.5 | 0.0–73.4 | 12.2 | 0.0–40.1 |
| 99222 | 16.4 | 0.9–52.4 | 12.0 | 0.0–83.3 |
| 99223 | 72.1 | 21.4–97.6 | 75.8 | 16.7–99.8 |
| Mean count | 824 | 216 | ||
| Subsequent hospital care | ||||
| 99231 | 5.2 | 0.0–15.1 | 1.2 | 0.0–32.6 |
| 99232 | 43.5 | 6.5–84.9 | 28.8 | 0.5–99.7 |
| 99233 | 51.3 | 9.7–93.3 | 70.0 | 0.3–99.3 |
| Mean count across all institutions | 5,729 | 3,090 | ||
| Prolonged physician service | ||||
| 99354 | 45.6 | 35.2 | ||
| 99355 | 22.1 | 17.2 | ||
| 99356 | 32.4 | 44.5 | ||
| 99357 | 0.0 | 3.1 | ||
| Mean count across all institutions | 5 | 38 | ||
Abbreviations: CPT, American Medical Association Current Procedural Terminology.
* Institutional range for institutions with at least 10 visits (not given if number of institutions less than three).
Current Procedural Terminology (CPT) is copyright 2005 American Medical Association. All Rights Reserved. No fee schedules, basic units, relative values, or related listings are included in CPT. The AMA assumes no liability for the data contained herein. Applicable FARS/DFARS restrictions apply to government use.