Medical Billing Codes (CPT & HCPCS) Explained in Plain English

Every line on an itemized medical bill is a code, not a sentence. CPT codes (five digits, like 99213) describe what a clinician did — an office visit, a scan, a surgical step. HCPCS codes (a letter plus four digits, like J1885) cover drugs, supplies, and services that CPT does not. A hospital bill can list dozens of them with nothing but a dollar amount beside each.

This lookup translates 308 of the codes patients actually encounter into plain English, and adds three things a bare code list will not tell you. First, what Medicare pays: for 251 of these codes we publish the 2025 national average payment, which is the closest thing to a public reference price. Second, how many units are normally expected in one day, taken from Medicare's Medically Unlikely Edits — the fastest way to spot a duplicated or mis-keyed line. Third, which codes are normally billed as one, from Medicare's National Correct Coding Initiative, which is how unbundled charges get noticed.

None of these numbers is a verdict on your bill. Medicare rates are not a cap on what a provider may charge, and a code above its usual unit count can be perfectly legitimate with the right documentation. What they give you is something better than a vague sense that a bill looks high: a specific, checkable question to put to the billing office.

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Looking for the codes that explain why insurance denied or reduced a claim instead? Those are on the denial and remark code lookup. Hospital bills also carry department-level revenue codes.

Lab test

80048A basic metabolic blood panel — checks kidney function, blood sugar, and electrolytes. 80053A comprehensive metabolic blood panel — kidney, liver, blood sugar, and electrolytes. 80061A cholesterol / lipid blood panel. 81001A urine test analyzed by machine, with a microscope check. 81002A basic urine dipstick test, without a microscope. 83036A hemoglobin A1c blood test — average blood sugar over ~3 months. 84443A thyroid function (TSH) blood test. 85025A complete blood count (CBC) with a differential — checks red cells, white cells, and platelets. 85027A complete blood count (CBC) without a differential. 87880A rapid strep throat test. 80047A basic metabolic blood panel (with ionized calcium). 80051A blood test of electrolytes (sodium, potassium, chloride, CO2). 80069A kidney-function blood panel. 80076A liver-function blood panel. 82040A blood albumin (protein) test. 82247A total bilirubin blood test (liver/jaundice marker). 82565A creatinine blood test (kidney function). 82550A CK (creatine kinase) blood test — a muscle enzyme. 82374A CO2 (bicarbonate) blood test. 83690A lipase blood test (pancreas enzyme). 82150An amylase blood test (pancreas enzyme). 84295A sodium blood test. 84132A potassium blood test. 82947A blood glucose (sugar) test. 83735A magnesium blood test. 82306A vitamin D blood test. 82728A ferritin blood test (iron stores). 83540A serum iron blood test. 84439A free T4 thyroid hormone blood test. 84481A free T3 thyroid hormone blood test. 85610A blood-clotting time test (PT/INR), often for warfarin monitoring. 85730A PTT blood-clotting time test. 85652A sed rate (ESR) blood test for inflammation. 86140A C-reactive protein (CRP) blood test for inflammation. 84703A pregnancy blood test (qualitative hCG). 81025A urine pregnancy test. 81003A urine dipstick test read by a machine (no microscope). 87086A urine culture to identify bacteria. 87088Identifying the specific bacteria found in a urine culture. 87070A culture of a sample to find bacteria. 87040A blood culture to find bacteria in the bloodstream. 87186Testing which antibiotics will kill a cultured bacteria. 87804A rapid flu (influenza) test. 87811A rapid COVID-19 antigen test. 87635A COVID-19 PCR test. 87426A COVID-19 antigen test by immunoassay. 86769A COVID-19 antibody blood test. 87491A chlamydia test by DNA/RNA method. 87591A gonorrhea test by DNA/RNA method. 83001An FSH hormone blood test. 84153A PSA (prostate) blood test. 82043A urine albumin test (kidney marker). 83880A BNP blood test (heart-failure marker). 84484A troponin blood test (heart-injury marker). 80305A drug screen (urine) read by direct observation. 85018A hemoglobin blood test. 85014A hematocrit blood test. 85049A platelet count. 86900Blood typing — ABO group. 86901Blood typing — Rh factor.

Procedure

20610An injection or fluid draw from a large joint (like a knee or shoulder). 12001Simple stitches to close a small wound. 17110Removing benign skin growths like warts (up to 14). 45378A diagnostic colonoscopy — examining the colon with a camera. 43239An upper endoscopy with a biopsy — examining the esophagus/stomach with a camera and taking a sample. 45380Colonoscopy with a biopsy (tissue sample taken). 45385Colonoscopy with removal of polyps using a snare. 45384Colonoscopy with removal of polyps by cautery (burning). 45391Colonoscopy that includes an ultrasound of the colon wall. 43235Upper endoscopy — examining the esophagus and stomach with a camera. 43236Upper endoscopy with an injection (for example to stop bleeding). 43249Upper endoscopy with balloon stretching of a narrowed esophagus. 11042Cleaning/removal of dead skin and tissue down to fat, first 20 sq cm. 11043Cleaning/removal of dead tissue down to muscle, first 20 sq cm. 11102Skin biopsy using a tangential (shave-style) technique, one spot. 11104Skin biopsy using a punch tool, one spot. 11106Skin biopsy of deeper tissue (incisional), one spot. 11406Removal of a large non-cancerous growth from the trunk, arms, or legs. 10060Draining a simple or single skin abscess. 10061Draining a complex or multiple skin abscess. 12002Simple stitches to close a wound 2.6–7.5 cm on the face, scalp, or trunk. 12004Simple stitches to close a wound 7.6–12.5 cm. 13132Complex, layered repair of a wound on the face 1.1–2.5 cm. 62323Spinal (epidural) steroid injection in the lower back, with imaging guidance. 64483Injection near a spinal nerve root in the lower back, with imaging guidance. 20550Injection into a single tendon or ligament. 20605Injection or fluid draw from a medium joint (like a wrist or elbow). 20600Injection or fluid draw from a small joint (like a finger or toe). 11730Removal of a fingernail or toenail. 57452Colposcopy — a close-up exam of the cervix. 57454Colposcopy with a biopsy and sampling of the cervical canal. 52000Cystoscopy — examining the bladder with a camera. 19081Breast biopsy using a needle, guided by mammogram imaging. 32551Placement of a chest tube to drain the space around the lung. 31500Emergency insertion of a breathing tube (intubation). 36556Placement of a central IV line through the skin (age 5 or older). 36569Placement of a PICC line (a long-term IV) through the arm. 49440Placement of a feeding tube into the stomach through the skin. 51702Insertion of a temporary bladder catheter. 64635Destroying a spinal nerve in the lower back to relieve pain (with imaging). 49320Diagnostic laparoscopy — looking inside the abdomen with a camera. 58558Hysteroscopy with biopsy and/or removal of tissue from the uterus. 94640A breathing (nebulizer) treatment with inhaled medicine. 94002Ventilator (breathing machine) management, first hospital day. 62270Lumbar puncture (spinal tap) to collect spinal fluid. 31575Flexible scope exam of the voice box (larynx). 93458Heart catheterization with imaging of the left heart arteries. 36430A transfusion of blood into a vein.

Imaging

71045A single-view chest X-ray. 71046A chest X-ray with two views. 73030A shoulder X-ray. 73110A wrist X-ray with multiple views. 73610An ankle X-ray with multiple views. 70450A CT scan of the head without contrast dye. 74177A CT scan of the abdomen and pelvis with contrast dye. 72148An MRI of the lower back (lumbar spine) without contrast. 76700A complete abdominal ultrasound. 77065Diagnostic mammogram of one breast. 77066Diagnostic mammogram of both breasts. 77067Screening mammogram of both breasts. 77080Bone density (DEXA) scan to check for osteoporosis. 76805Detailed pregnancy ultrasound after the first trimester. 76816Follow-up pregnancy ultrasound to re-check the baby. 76817Pregnancy ultrasound done through the vagina (transvaginal). 93306Complete heart ultrasound (echocardiogram) with Doppler blood-flow. 76770A complete ultrasound of the kidneys and surrounding area. 93880Ultrasound of the neck arteries (carotid) on both sides. 93970Ultrasound to check leg veins for blood clots (both legs). 74176CT scan of the abdomen and pelvis without contrast dye. 74178CT scan of the abdomen and pelvis, with and without contrast. 70486CT scan of the face/sinuses without contrast. 70553MRI of the brain, with and without contrast. 73721MRI of a leg joint (like a knee) without contrast. 72110Lower-back (lumbar) X-ray with multiple views. 71250CT scan of the chest without contrast. 71275CT angiogram of the chest (blood-vessel imaging with contrast). 74018A single X-ray of the abdomen. 73562Knee X-ray with three views. 73130Hand X-ray with multiple views. 70260Skull X-ray with multiple views.

Surgery

44950Removal of the appendix (open appendectomy). 44970Removal of the appendix using minimally-invasive (laparoscopic) surgery. 47562Removal of the gallbladder using laparoscopic (keyhole) surgery. 47563Laparoscopic gallbladder removal that also includes an X-ray of the bile ducts. 49505Repair of a groin (inguinal) hernia in a patient age 5 or older. 49650Laparoscopic repair of a groin (inguinal) hernia. 29881Knee arthroscopy with removal of torn meniscus cartilage (one side). 29880Knee arthroscopy with removal of torn meniscus cartilage (both sides). 29827Shoulder arthroscopy with rotator cuff repair. 27447Total knee replacement surgery. 27130Total hip replacement surgery. 64721Carpal tunnel release surgery (freeing a pinched wrist nerve). 66984Cataract removal with insertion of an artificial lens. 59510Cesarean (C-section) delivery, including routine before- and after-care. 59400Vaginal delivery, including routine before- and after-care. 59409Vaginal delivery only (delivery service by itself). 58150Removal of the uterus (abdominal hysterectomy). 58571Laparoscopic removal of the uterus (up to normal size), with tubes/ovaries. 58661Laparoscopic removal of ovaries and/or fallopian tubes. 11606Removal of a large skin cancer from the trunk, arms, or legs. 42820Removal of tonsils and adenoids in a patient under age 12. 42826Removal of tonsils only, in a patient age 12 or older. 69436Placement of ear tubes in a child (under general anesthesia). 19120Removal of a breast lump or lesion. 29826Shoulder arthroscopy to make more space under the shoulder blade. 22551Neck (cervical) spinal fusion surgery through the front. 63030Removing part of a lower-back disc to relieve a pinched nerve. 47600Open removal of the gallbladder. 44140Removal of part of the colon with reconnection (open surgery). 44204Laparoscopic removal of part of the colon with reconnection. 92928Placement of a heart stent in one artery (with imaging). 92920Balloon opening of a blocked heart artery (angioplasty).

Anesthesia

00100Anesthesia for procedures on the salivary glands. 00160Anesthesia for procedures on the nose and sinuses. 00300Anesthesia for procedures on the head, neck, or trunk (soft tissue). 00400Anesthesia for skin procedures on the trunk or limbs. 00520Anesthesia for procedures inside the chest. 00790Anesthesia for upper-abdomen surgery. 00840Anesthesia for lower-abdomen surgery. 00842Anesthesia for a tubal ligation (sterilization). 00851Anesthesia for a laparoscopic tubal procedure. 00860Anesthesia for lower-abdomen and pelvic organ surgery. 00902Anesthesia for anal or rectal procedures. 00920Anesthesia for male genital procedures. 00940Anesthesia for vaginal procedures. 01202Anesthesia for a knee arthroscopy. 01214Anesthesia for a hip replacement. 01230Anesthesia for upper-leg bone surgery. 01400Anesthesia for knee-joint surgery. 01402Anesthesia for a total knee replacement. 01480Anesthesia for lower-leg bone surgery. 01630Anesthesia for shoulder surgery. 01810Anesthesia for surgery on forearm, wrist, or hand nerves and tendons. 01961Anesthesia for a cesarean (C-section) delivery. 01967Epidural anesthesia for labor and vaginal delivery. 01991Anesthesia (nerve block) for pain management, provided by an anesthesiologist.

Medication

Therapy

97161Physical therapy evaluation, low complexity. 97162Physical therapy evaluation, moderate complexity. 97163Physical therapy evaluation, high complexity. 97110Therapeutic exercise to build strength and range of motion (per 15 min). 97112Therapy to retrain movement, balance, and coordination (per 15 min). 97140Hands-on (manual) therapy such as joint or soft-tissue work (per 15 min). 97530Therapy using dynamic activities to improve function (per 15 min). 97116Gait (walking) training therapy (per 15 min). 97035Ultrasound therapy applied to tissue (per 15 min). 97165Occupational therapy evaluation, low complexity. 97166Occupational therapy evaluation, moderate complexity. 97167Occupational therapy evaluation, high complexity. 92507Speech, language, or swallowing therapy (individual session). 92523Evaluation of speech sound production and language.

Vaccine

G0008Administering a flu vaccine (the injection service). G0009Administering a pneumonia vaccine (the injection service). 90686The flu vaccine (injectable, preservative-free). 90688The flu vaccine (injectable, standard vial). 90715The Tdap vaccine (tetanus, diphtheria, whooping cough). 90707The MMR vaccine (measles, mumps, rubella). 90750The shingles (Shingrix) vaccine. 90734The meningococcal (meningitis) vaccine. 90651The HPV vaccine (Gardasil 9). 90471Giving a vaccine — the injection/administration service (first vaccine). 90472Giving each additional vaccine at the same visit. 90460Giving a vaccine to a child, with counseling (first component).

Pathology

88304Lab exam of removed tissue under a microscope (simple specimen). 88305Lab exam of removed tissue under a microscope (common biopsy specimen). 88307Lab exam of removed tissue under a microscope (complex specimen). 88309Lab exam of removed tissue under a microscope (most complex specimen). 88312Special stain on a tissue sample to look for microbes. 88342Special antibody stain on a tissue sample (first stain). 88341Each additional antibody stain on a tissue sample. 88112Cell exam (cytology) of a fluid or brushing sample, enhanced method. 88175Pap smear screening read by an automated system with doctor review. 88173Doctor's interpretation of a fine-needle aspiration sample. 88321Second-opinion review of slides prepared elsewhere.

Cardiac test

93000A complete electrocardiogram (EKG/ECG) — including the tracing and the doctor's reading. 93005The tracing portion only of an EKG (no doctor interpretation). 93010The doctor's interpretation portion only of an EKG. 93015Treadmill/exercise stress test — full service with supervision and reading. 93016Exercise stress test — physician supervision portion only. 93017Exercise stress test — tracing portion only. 93018Exercise stress test — physician interpretation portion only. 9322424–48 hour heart-rhythm (Holter) monitor — full service. 93798Cardiac rehabilitation session with monitoring. 93288Check of an implanted pacemaker.

Office visit

99202A short office visit for a new patient — a straightforward evaluation. 99203A standard office visit for a new patient with a moderate evaluation. 99204A detailed office visit for a new patient — a more involved evaluation. 99205A comprehensive, high-complexity office visit for a new patient. 99211A very brief visit for an existing patient, often with a nurse. 99212A short follow-up visit for an existing patient. 99213A standard follow-up visit for an existing patient — the most common office visit. 99214A detailed follow-up visit for an existing patient with a moderate-to-complex issue. 99215A comprehensive, high-complexity visit for an existing patient.

Diagnostic test

95810Overnight sleep study (polysomnography) in a lab. 95811Overnight sleep study with a CPAP breathing-pressure titration. 95816Brain-wave test (EEG) while awake and drowsy. 95819Brain-wave test (EEG) while awake and asleep. 95910Nerve conduction study (testing several nerves). 95886Needle test of muscle electrical activity (EMG), full limb. 94010Breathing test (spirometry) to measure lung function. 94060Breathing test before and after an inhaled medicine.

Infusion

96413The first hour of a chemotherapy infusion through an IV. 96360IV hydration therapy, first hour. 96361IV hydration therapy, each additional hour. 96365IV infusion of a medication (not chemo), first hour. 96366IV infusion of a medication (not chemo), each additional hour. 96367Additional IV infusion of a different medication, up to one hour. 96415Chemotherapy IV infusion, each additional hour after the first. 96417Additional chemotherapy infusion of a different drug.

Hospital care

99221A hospital admission evaluation, lower complexity. 99222A hospital admission evaluation, moderate complexity. 99223A hospital admission evaluation, high complexity. 99232A daily hospital check-in visit, moderate complexity. 99233A daily hospital check-in visit, high complexity. 99238Hospital discharge management, 30 minutes or less. 99239Hospital discharge management, more than 30 minutes.

Emergency care

99281The lowest-intensity emergency room visit. 99282A low-intensity emergency room visit. 99283A moderate-intensity emergency room visit. 99284A high-intensity emergency room visit needing urgent evaluation. 99285The highest-intensity emergency room visit — a severe or life-threatening problem.

Ambulance

A0429A basic-life-support ambulance ride (emergency). A0427An advanced-life-support ambulance ride (emergency). A0425Ambulance mileage, per mile.

Injection

96372An injection of medication into a muscle or under the skin. 96374Push of a medication into an IV (not chemo), single dose. 96375Additional IV push of a different medication.

IV fluids

J7030A bag of IV saline fluid (normal saline, 1000 ml). J7120A bag of IV lactated Ringer's fluid. J7050A half-liter bag of IV normal saline fluid.

Facility fee

G0463A hospital outpatient clinic visit (facility charge for the visit). Q3014A telehealth 'originating site' facility fee.

Lab draw

36415Drawing blood from a vein for lab work (a routine blood draw).

Supplies

A4649A miscellaneous surgical supply item.

Frequently asked questions about medical billing codes

What is a CPT code?

A CPT code is a five-digit number that identifies a specific medical service — an office visit, an X-ray, a surgical step. It is what turns a line on your bill into a defined procedure, and it is the code an insurer prices the claim against.

What is the difference between a CPT code and an HCPCS code?

CPT codes are five digits and cover clinician services and procedures. HCPCS Level II codes are a letter followed by four digits and cover the things CPT does not — injectable drugs, supplies, equipment, and ambulance transport. Both appear on the same itemized bill.

How do I look up a code on my medical bill?

Find the five-digit number or letter-plus-four-digit code next to the charge, then look it up on this page. Each code has its own page with a plain-English explanation, Medicare's national average payment where one is published, and how many units are normally expected in a single day.

Does a code on my bill mean I was actually given that service?

It means that is what was billed, which is not always the same thing. Comparing the codes on an itemized bill against what you remember receiving is one of the most effective checks a patient can do, and it is the reason it is worth requesting an itemized bill rather than paying from a summary.

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Last reviewed 2026-08-09 · MDBillCheck Editorial Team. Plain-English explanations are original wording, not official code descriptors.