Gastroenterology

What they do most for Medicare patients

Service, sort	Code, sort	Times billed, sort	Patients, sort
Established patient office or other outpatient visit, 30-39 minutes	99214	1,298,401	971,734
Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope	43239	1,000,783	967,376
Established patient office or other outpatient visit, 20-29 minutes	99213	904,241	704,996
Removal of polyps or growths of large bowel using an endoscope with mechanical snare	45385	870,630	863,105
Biopsy of large bowel using a flexible endoscope	45380	748,241	743,355
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	99232	687,101	327,784
New patient office or other outpatient visit, 45-59 minutes	99204	477,318	477,292
Pathology examination of tissue using a microscope, intermediate complexity	88305	338,220	127,971
Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	99222	325,442	312,535
New patient office or other outpatient visit, 30-44 minutes	99203	267,207	267,194
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	99233	217,248	104,219
Chronic care management services for two or more chronic conditions, additional 20 minutes of clinical staff time directed by health care professional, per calendar month	99439	206,196	21,950
Moderate sedation services provided by the same physician or other qualified health care professional performing a gastrointestinal endoscopic service that sedation supports, requiring the presence of an independent trained observer to assist in the monito	G0500	202,749	195,139
Colorectal cancer screening; colonoscopy on individual at high risk	G0105	192,896	192,267
Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	99223	191,045	181,194
Diagnostic exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope	43235	158,542	154,849
Diagnostic exam of large bowel using a flexible endoscope	45378	149,483	147,856
Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month	99490	126,391	23,627
Established patient office or other outpatient visit, 40-54 minutes	99215	118,059	92,449
Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk	G0121	114,812	114,449
Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes	99231	114,033	65,652
Insertion of needle into vein for collection of blood sample	36415	108,909	75,713
Balloon dilation of esophagus, stomach, and/or upper small bowel using a flexible endoscope, less than 3.0 cm	43249	74,515	67,525
Insertion of guide wire with dilation of esophagus using a flexible endoscope	43248	63,201	58,840
Special stained specimen slides to examine tissue including interpretation and report	88313	61,167	24,818
Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count	85025	60,709	38,269
Blood test, comprehensive group of blood chemicals	80053	56,969	36,070
Established patient office or other outpatient visit, 10-19 minutes	99212	54,745	46,857
Special stained specimen slides to identify organisms including interpretation and report	88312	47,371	23,972
Initial hospital care with straightforward or low level of medical decision making, per day, if using time, at least 40 minutes	99221	41,868	40,788
Dilation of esophagus	43450	41,353	39,666
Removal of stone or debris from bile or pancreatic duct using a flexible endoscope	43264	37,493	31,109
Blood test, lipids (cholesterol and triglycerides)	80061	36,218	24,915
Review by radiologist of image from tube placement into bile duct using an endoscope	74328	31,475	25,156
New patient office or other outpatient visit, 60-74 minutes	99205	31,349	31,347
New patient office or other outpatient visit, 15-29 minutes	99202	27,276	27,275
Insertion of stent into pancreatic or bile duct using a flexible endoscope	43274	26,364	20,995
Ultrasound exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope	43259	24,696	24,025
Blood test, thyroid stimulating hormone (tsh)	84443	24,238	17,527
Measurement of liver stiffness	91200	21,396	20,814
Telephone medical discussion with physician, 11-20 minutes	99442	21,152	16,893
Hemoglobin a1c level	83036	19,522	12,405
Ultrasound guided needle aspiration or biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope	43242	19,505	18,813
Infusion into a vein for therapy, prevention, or diagnosis, 1 hour or less	96365	19,435	10,834
Injection beneath lining of large bowel using a flexible endoscope	45381	19,381	19,105
Measurement of antibody (ige) to allergic substance, crude allergen extract, each	86003	18,462	320
Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	99308	18,114	3,175
Administration of chemotherapy into vein, 1 hour or less	96413	18,101	9,569
Telephone medical discussion with physician, 21-30 minutes	99443	17,362	14,013
Management using the results of remote vital sign monitoring per calendar month, first 20 minutes	99457	16,371	3,480
Control of bleeding of esophagus, stomach, and/or upper small bowel using a flexible endoscope	43255	16,281	15,064
Removal of polyps or growths of esophagus, stomach, and/or upper small bowel using an endoscope with mechanical snare	43251	16,272	15,743
Removal of polyps or growths of large bowel using a flexible endoscope with electrical cautery	45384	16,003	15,875
Remote monitoring of physiologic parameters, initial supply of devices with daily recordings or programmed alerts transmission, each 30 days	99454	15,677	3,333
Imaging of digestive tract done from the inside of the digestive tract	91110	15,202	14,584
Ultrasound exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope through mouth	43237	15,189	14,851
Removal of external hemorrhoids by rubber banding	46221	14,603	6,511
Complete ultrasound scan of abdomen	76700	14,375	12,694
Removal of large bowel tissue using a flexible endoscope	45390	14,254	13,818
Study of esophagus to assess movement	91010	14,018	13,868
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report	93000	13,619	12,179
Measurement of hydrogen in breath to test for stomach and bowel symptoms	91065	12,372	9,931
Insertion of stomach tube using a flexible endoscope	43246	12,226	11,522
Ultrasound guided needle aspiration or biopsy of esophagus using a flexible endoscope	43238	12,051	11,636
Blood test, basic group of blood chemicals (calcium, total)	80048	11,675	7,022
Special stained specimen slides to examine tissue, initial procedure	88342	11,055	6,371
Incision of pancreatic outlet using a flexible endoscope	43262	10,235	10,062
Ultrasound scan of organ tissue for measuring elasticity	76981	9,911	9,416
Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional	99211	9,767	8,516
Vitamin d-3 level	82306	9,719	7,623
Injection of drug or substance under skin or into muscle	96372	9,597	3,609
Test for allergy using allergenic extract	95004	9,128	137
Liver function blood test panel	80076	8,979	5,564
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	G0439	8,919	8,919
Ferritin (blood protein) level	82728	8,497	6,551
Iron level	83540	8,155	6,207
Magnesium level	83735	7,626	4,471
Telephone medical discussion with physician, 5-10 minutes	99441	7,571	6,420
Use of a drug to induce depression of consciousness by physician performing a procedure, each additional 15 minutes	99153	7,548	6,145
Replacement of stent in pancreatic or bile duct using a flexible endoscope	43276	7,149	3,986
Use of a drug to induce depression of consciousness by physician performing a procedure (5 years or older), initial 15 minutes	99152	7,098	6,642
Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	99309	6,657	1,596
Iron binding capacity	83550	6,595	5,066
Cyanocobalamin (vitamin b-12) level	82607	6,431	5,453
Monitoring and recording of esophageal function through nasal tube with electrode	91037	6,310	6,268
Study of rectum sensitivity and function	91122	6,253	6,218
Destruction of polyp or growth of large bowel using a flexible endoscope	45388	6,225	6,154
Administration of chemotherapy into vein, each additional hour	96415	6,166	3,135
Advance care planning, first 30 minutes	99497	6,127	5,167
Stool analysis for blood, by peroxidase activity	82272	5,938	5,278
Limited ultrasound scan of abdomen	76705	5,783	5,178
Critical care, first 30-74 minutes	99291	5,232	2,011
Uric acid level, blood	84550	5,161	3,791
Removal of stent from pancreatic or bile duct using a flexible endoscope	43275	5,150	5,051
Administration of influenza virus vaccine	G0008	5,083	5,046
Creatine kinase (cardiac enzyme) level, total	82550	5,070	3,403
Measurement c-reactive protein for detection of infection or inflammation	86140	5,036	3,589
Prolonged hospital inpatient or observation care evaluation and management service(s) beyond the total time for the primary service (when the primary service has been selected using time on the date of the primary service); each additional 15 minutes by th	G0316	4,804	662
Thyroxine (thyroid chemical), free	84439	4,516	3,110
Folic acid level, serum	82746	4,458	3,820

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Sources: Medicare Care Compare (hospitals and schools; Medicare-enrolled clinicians), CMS Medicare Physician & Other Practitioners 2023 (services), Medicare Part D Prescribers 2024 (drugs).