Table 4. Forty most frequently provided hospital outpatient department procedures, ranked by HCPCS code: 1987.
HCPCS code and description | Number of claims | Percent of all claims1 | Average charge2 | Percent of all charges3 |
---|---|---|---|---|
Surgery | ||||
45330 Sigmoidoscopy, flexible fiberoptic diagnostic | 4,547 | 0.97 | 266.79 | 1.60 |
45378 Colonoscopy, fiberoptic | 2,382 | 0.51 | 292.95 | 0.92 |
66984 Extracapsular cataract removal with insertion of intraocular lens prosthesis (one-stage procedure) | 4,601 | 0.98 | 1,691.46 | 10.24 |
Radiology | ||||
70450 Computerized axial tomography, head or brain | 2,424 | 0.52 | 319.06 | 1.02 |
70470 Computerized axial tomography, head or brain without contrast material, followed | 5,807 | 1.24 | 420.26 | 3.21 |
71020 Radiologic examination, chest, two views, frontal and lateral | 19,382 | 4.12 | 56.10 | 1.43 |
74160 Computerized axial tomography, abdomen with contrast material(s) | 3,526 | 0.75 | 436.74 | 2.03 |
74240 Radiologic examination, gastrointestinal tract | 4,651 | 0.99 | 111.16 | 0.68 |
74270 Radiologic examination, colon barium enema | 7,873 | 1.68 | 115.42 | 1.20 |
74280 Radiologic examination, colon air contrast with specific high-density barium | 4,217 | 0.90 | 144.71 | 0.80 |
74400 Urography (pyelography), intravenous | 2,759 | 0.59 | 133.64 | 0.49 |
76091 Mammography bilateral | 23,157 | 4.93 | 74.86 | 2.28 |
76700 Echography, abdominal, b-scan and/or real-time with image documentation | 3,463 | 0.74 | 144.65 | 0.66 |
77405 Daily megavoltage treatment management intermediate | 2,664 | 0.57 | 556.86 | 1.95 |
77410 Daily megavoltage treatment management complex | 2,494 | 0.53 | 568.99 | 1.87 |
78306 Bone imaging whole body | 6,247 | 1.33 | 268.51 | 2.21 |
Laboratory-pathology | ||||
80002 Automated multichannel test 1 or 2 clinical chemistry test(s) | 3,574 | 0.76 | 53.45 | 0.25 |
80019 Automated multichannel test 19 or more clinical chemistry tests | 3,643 | 0.78 | 60.59 | 0.29 |
81000 Urinalysis routine (Ph, specific gravity, protein) | 8,000 | 1.70 | 71.71 | 0.75 |
82947 Glucose except urine (e.g., blood, spinal fluid, joint fluid) | 8,325 | 1.77 | 26.53 | 0.29 |
84132 Potassium blood | 2,410 | 0.51 | 31.00 | 0.10 |
85022 Blood count hemogram, automated, and manual differential | 4,590 | 0.98 | 118.97 | 0.72 |
85028 Blood count | 3,079 | 0.66 | 139.69 | 0.57 |
85610 Prothrombin time | 9,174 | 1.95 | 17.76 | 0.21 |
88150 Cytopathology, smears, cervical or vaginal (e.g., Papanicolaou), up to three smears | 2,839 | 0.60 | 20.73 | 0.08 |
88304 Surgical pathology, gross and microscopic examination of presumptively abnormal tissue(s) | 4,254 | 0.91 | 85.47 | 0.48 |
Medicine | ||||
90040 Office medical service, established patient brief service | 6,308 | 1.34 | 51.18 | 0.42 |
90050 Office medical service, established patient limited service | 15,664 | 3.33 | 71.47 | 1.47 |
90060 Office medical service, established patient intermediate service | 13,141 | 2.80 | 80.00 | 1.38 |
90070 Office medical service, established patient extended service | 2,594 | 0.55 | 93.94 | 0.32 |
90500 Emergency department service, new patient minimal service | 2,746 | 0.58 | 42.78 | 0.15 |
90505 Emergency department service, new patient brief service | 8,535 | 1.82 | 47.52 | 0.53 |
90510 Emergency department service, new patient limited service | 13,200 | 2.81 | 57.09 | 0.99 |
90515 Emergency department service, new patient intermediate service | 7,755 | 1.65 | 74.54 | 0.76 |
90540 Emergency department service, established patient brief service | 3,265 | 0.69 | 36.89 | 0.16 |
90550 Emergency department service, established patient limited service | 5,012 | 1.07 | 43.16 | 0.28 |
90560 Emergency department service, established patient intermediate service | 4,417 | 0.94 | 45.75 | 0.27 |
93010 Electrocardiogram, routine with at least 12 leads interpretation and report only | 4,512 | 0.96 | 88.95 | 0.53 |
93018 Cardiovascular stress test using maximal or submaximal treadmill or bicycle exercise | 3,134 | 0.67 | 180.33 | 0.74 |
93870 Non-invasive studies of carotid arteries, imaging (e.g., flow imaging by ultrasonic arteriography, high resolution) | 3,371 | 0.72 | 227.34 | 1.01 |
These 40 procedures account for 52 percent of all claims.
All averages are claims-weighted.
These 40 procedures account for 45 percent of all charges.
NOTE: HCPCS is Health Care Financing Administration Common Procedure Coding System.
SOURCES: Health Care Financing Administration: Hospital Outpatient Bill file and Part B Medicare Annual Data file, both 1987; data development by the Urban Institute.