The Big Four: The Most-Billed CPT Codes in Outpatient Therapy

Not That Big Four

Although "The Big Four" is most commonly known as the four largest global accounting and professional services firms — Deloitte, PwC, EY, and KPMG — today I'm referring to the four most used CPT/HCPCS codes in outpatient therapy.

Where This Data Comes From

Each year CMS publishes the "Top 200 Level I Current Procedural Terminology/HCPCS Codes Ranked by Services." It ranks the CPT/HCPCS codes most frequently billed to Medicare Part B. Most are surprised to learn that the four most utilized codes in outpatient therapy — 97110 (Therapeutic Exercises), 97530 (Therapeutic Activities), 97112 (Neuromuscular Re-education), and 97140 (Manual Therapy) — all land within the Top 10.

CY2024 Top 10 CPT/HCPCS Codes by Volume

Source: CMS Part B Physician/Supplier National Data. Codes copyrighted by the American Medical Association.

Rank	HCPCS Code	Description	Allowed Services	Allowed Charges
1	99214	E/M, Established Patient	103,756,876	$12,493,376,407
2	99213	E/M, Established Patient	69,301,624	$5,914,372,895
3	97110	Therapeutic Exercises	64,241,407	$1,525,240,465
4	97530	Therapeutic Activities	44,663,864	$1,468,535,301
5	36415	Venipuncture	40,286,512	$349,864,473
6	97112	Neuromuscular Re-education	34,780,930	$980,362,258
7	99232	Subsequent Hospital Care	34,687,153	$2,676,454,801
8	97140	Manual Therapy	29,289,784	$626,364,882
9	80053	Comprehensive Metabolic Panel	27,226,532	$287,381,549
10	85025	Complete Blood Count	26,204,438	$203,564,402

Why Therapy Volume Tells a Different Story Than Other Specialties

This data set tells a compelling story about outpatient therapy services. The frequency of interaction between rehab therapists and their patients is unlike other healthcare providers. We routinely see our patients for 30-60 minutes, 2-3 times per week, for many consecutive weeks. Compare that to a primary care or orthopedic physician, who may only see their patients for 10-15 minutes once or twice a year.

"The Big Four" therapy codes combine annually for nearly 173 million services and more than four billion in allowed charges. So, although outpatient therapists do not generate high-ticket claims like an orthopedic surgeon, we still have tremendous revenue earning potential due to the sheer volume of services we provide.

Why Revenue Integrity Should Be a Hospital-Wide Priority

As such, the revenue integrity of outpatient therapy services should be a priority for every hospital in the country. Gaps we routinely find in charge capture, documentation, coding, and denial management are often costing hospitals hundreds of thousands or even millions of dollars in annual revenue.

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Partner With Ripple HLTH

At Ripple HLTH we are enthusiastic about making sure our clients are fully, accurately, and compliantly reimbursed for every therapy service they provide. If you are in charge of a hospital's outpatient therapy department and have questions about its current performance, we'd love to connect and talk about conducting a FREE, no-strings-attached assessment.

About Ripple HLTH

Ripple HLTH partners with hospital-based outpatient therapy departments to close the gap between clinical excellence and financial performance. Through our proprietary software platform, Streamline, we transform complex EMR data—from Epic, Cerner, Meditech, CPSI, Athena, Allscripts, and more—into actionable insights that drive revenue, compliance, and operational efficiency. Our contingency-based engagements mean we only succeed when you do.

Ready to see what's possible for your therapy department?

Ripple HLTH offers a free, no-obligation assessment for hospital-based outpatient therapy leaders. We'll analyze your department's historical data to identify and quantify revenue opportunities specific to your organization—no guesswork, no generic benchmarks.