Pediatric CPT Data, 2015

I have so much data and information to share, I’ve been overwhelmed and, as a result, haven’t shared anything.  This is my effort to kick myself in gear.

One thing I want to talk about is RVUs.  But to do a proper RVU analysis, I need to start with CPT usage. What are the most common and popular pediatric CPT codes? Which ones generate the most revenue? Which have the highest volume?

I asked Igor to generate the data for 2015.  I hate just slapping data in here, but we have to start somewhere.  Let’s review the columns:

  • CPT – This is the 5-character CPT code. It means that all modifiers have been removed, it means that codes have been merged.
  • The average charge and average payment are locked values.  The implication is that the charges are accurate, but the payments are definitely understated because all of the payments aren’t in yet.
  • The “%age” of each measure reflects the total represented by THAT CPT code.  In other words, 90460 is the most popular pediatric CPT code by volume (12.6%) but represents only 7.8% and 6.7% of charges and payments, respectively.
  • The “Running…” totals summarize each of the columns as we go down the list.

Tell me what you think…Top 60 Codes.

CPT AVG CHG AVG DEP %age of
Units
%age of
Charges
%age of
Payments
Running
Units
Running
Charges
Running
Payments
90460 $41.70 $19.10 12.6% 7.8% 6.7% 12.6% 7.8% 6.7%
99213 $117.13 $61.92 10.4% 18.1% 18.0% 23.0% 25.9% 24.7%
90461 $25.02 $9.62 8.1% 3.0% 2.2% 31.2% 29.0% 26.9%
99214 $172.29 $88.02 4.4% 11.3% 10.9% 35.6% 40.3% 37.8%
99392 $169.31 $93.68 2.6% 6.5% 6.8% 38.2% 46.8% 44.6%
99391 $157.01 $84.85 2.5% 5.7% 5.8% 40.6% 52.6% 50.4%
96110 $38.44 $10.61 2.4% 1.4% 0.7% 43.0% 53.9% 51.1%
99173 $20.01 $3.42 2.3% 0.7% 0.2% 45.3% 54.6% 51.3%
87880 $32.21 $12.12 2.2% 1.1% 0.8% 47.6% 55.7% 52.1%
99393 $32.22 $95.49 2.2% 1.1% 6.0% 49.8% 56.8% 58.0%
90670 $139.63 $97.44 1.8% 3.8% 5.0% 51.6% 60.6% 63.0%
36416 $12.11 $1.27 1.7% 0.3% 0.1% 53.3% 60.9% 63.1%
90471 $37.62 $19.77 1.6% 0.9% 0.9% 54.9% 61.8% 64.0%
99394 $190.78 $105.88 1.5% 4.2% 4.4% 56.4% 66.0% 68.4%
92551 $26.97 $10.19 1.4% 0.6% 0.4% 57.8% 66.6% 68.8%
90633 $43.83 $21.44 1.2% 0.8% 0.7% 59.0% 67.4% 69.5%
J1050 $0.51 $0.27 1.1% 0.0% 0.0% 60.1% 67.4% 69.5%
99051 $44.91 $7.42 1.1% 0.7% 0.2% 61.1% 68.1% 69.7%
90680 $86.48 $53.01 1.1% 1.4% 1.6% 62.2% 69.5% 71.3%
94760 $16.24 $0.78 1.1% 0.3% 0.0% 63.3% 69.7% 71.3%
90672 $40.04 $19.59 1.0% 0.6% 0.6% 64.3% 70.3% 71.9%
87804 $32.38 $13.56 1.0% 0.5% 0.4% 65.4% 70.8% 72.3%
90686 $31.07 $13.32 0.9% 0.4% 0.3% 66.3% 71.3% 72.7%
90698 $92.86 $55.79 0.9% 1.3% 1.4% 67.2% 72.5% 74.1%
99000 $13.76 $0.87 0.9% 0.2% 0.0% 68.1% 72.7% 74.1%
85018 $14.85 $2.91 0.8% 0.2% 0.1% 68.9% 72.9% 74.2%
81002 $14.05 $2.45 0.8% 0.2% 0.1% 69.7% 73.1% 74.2%
90700 $38.50 $18.56 0.8% 0.5% 0.4% 70.6% 73.5% 74.7%
90685 $30.46 $15.79 0.8% 0.3% 0.3% 71.3% 73.9% 75.0%
90744 $39.34 $16.42 0.8% 0.4% 0.3% 72.1% 74.3% 75.3%
99420 $24.68 $5.52 0.7% 0.3% 0.1% 72.8% 74.6% 75.4%
99212 $76.37 $37.06 0.7% 0.9% 0.8% 73.6% 75.4% 76.2%
90734 $129.33 $88.19 0.7% 1.4% 1.8% 74.3% 76.9% 78.0%
92552 $40.34 $20.54 0.7% 0.4% 0.4% 75.0% 77.3% 78.4%
90716 $100.62 $69.35 0.7% 1.0% 1.3% 75.7% 78.3% 79.8%
90707 $64.72 $41.62 0.7% 0.7% 0.8% 76.4% 79.0% 80.6%
90472 $24.77 $13.22 0.7% 0.3% 0.3% 77.1% 79.2% 80.8%
96127 $30.42 $6.06 0.7% 0.3% 0.1% 77.7% 79.5% 80.9%
90649 $162.93 $113.44 0.6% 1.5% 2.0% 78.3% 81.0% 82.9%
85025 $28.05 $7.89 0.6% 0.3% 0.1% 79.0% 81.3% 83.0%
90688 $33.05 $14.21 0.6% 0.3% 0.2% 79.6% 81.6% 83.3%
92587 $87.53 $35.43 0.6% 0.8% 0.6% 80.2% 82.4% 83.9%
90648 $36.26 $18.36 0.6% 0.3% 0.3% 80.8% 82.7% 84.2%
81003 $15.50 $2.20 0.5% 0.1% 0.0% 81.3% 82.8% 84.2%
J0696 $12.11 $1.18 0.5% 0.1% 0.0% 81.7% 82.9% 84.2%
90715 $53.28 $29.60 0.5% 0.4% 0.4% 82.2% 83.3% 84.6%
90713 $42.57 $24.23 0.5% 0.3% 0.3% 82.7% 83.6% 84.9%
99174 $44.55 $15.45 0.4% 0.3% 0.2% 83.1% 83.9% 85.1%
J8540 $0.87 $0.20 0.4% 0.0% 0.0% 83.6% 83.9% 85.1%
90473 $36.55 $17.24 0.4% 0.2% 0.2% 84.0% 84.1% 85.3%
3008F $4.96 $0.40 0.4% 0.0% 0.0% 84.4% 84.1% 85.3%
99050 $44.18 $17.10 0.4% 0.3% 0.2% 84.8% 84.4% 85.5%
90651 $196.14 $117.76 0.4% 1.2% 1.3% 85.2% 85.6% 86.8%
90723 $60.31 $36.50 0.4% 0.3% 0.4% 85.6% 85.9% 87.2%
87081 $22.61 $6.54 0.4% 0.1% 0.1% 86.0% 86.0% 87.3%
94640 $39.99 $14.84 0.3% 0.2% 0.1% 86.3% 86.2% 87.5%
36415 $21.60 $2.97 0.3% 0.1% 0.0% 86.7% 86.3% 87.5%
81000 $17.28 $3.72 0.3% 0.1% 0.0% 87.0% 86.4% 87.5%
83655 $28.76 $11.25 0.3% 0.1% 0.1% 87.3% 86.6% 87.6%
99080 $14.86 $9.42 0.3% 0.1% 0.1% 87.6% 86.6% 87.7%
85013 $15.99 $3.96 0.3% 0.1% 0.0% 87.9% 86.7% 87.7%

 

0 replies

Leave a Reply

Want to join the discussion?
Feel free to contribute!

Leave a Reply