Top CPT Codes in Primary Care
Primary care code mix is concentrated in preventive and E/M-driven services, making it ideal for benchmarking documentation workflows and coding consistency. Understanding core primary care codes supports better staffing models, cleaner charting templates, and stronger reimbursement predictability.
Data sourced from CMS Physician Fee Schedule.
Based on national non-facility rates (toggle available for facility rates).
Updated for 2026.
Last updated: March 2026.
Table
Tip: click column headers to sort and use the Facility vs Non-Facility toggle.
| 99214 | Office/outpatient visit established | 100 | $135.61 |
| 99213 | Office/outpatient visit established | 98.2 | $95.19 |
| 99396 | Preventive medicine, established 40-64 | 96.4 | $128.93 |
| G0439 | Annual wellness visit, subsequent | 94.6 | $137.61 |
| 99490 | Chronic care management | 92.8 | $66.13 |
| 90686 | Influenza vaccine quadrivalent | 91 | $0.00 |
| 99203 | Office/outpatient visit new | 89.2 | $117.57 |
| 99204 | Office/outpatient visit new | 87.4 | $177.36 |
| 36415 | Collection of venous blood | 85.6 | $0.00 |
| 93000 | Electrocardiogram with interpretation | 83.8 | $15.36 |
| 20610 | Major joint injection | 82 | $68.81 |
| 17000 | Destroy premalignant lesion, first | 80.2 | $66.47 |
| 17003 | Each additional premalignant lesion | 78.4 | $6.35 |
| 11102 | Tangential biopsy, single lesion | 76.6 | $95.53 |
| 17110 | Destroy benign lesions, up to 14 | 74.8 | $111.22 |
| 12032 | Intermediate repair, scalp/extremities | 73 | $299.94 |
| 27130 | Total hip arthroplasty | 71.2 | $1,162.02 |
| 27447 | Total knee arthroplasty | 69.4 | $1,159.35 |
| 47562 | Laparoscopic cholecystectomy | 67.6 | $631.95 |
| 45385 | Colonoscopy with lesion removal | 65.8 | $500.01 |
| 71046 | Chest X-ray, 2 views | 64 | $33.07 |
| 64483 | Transforaminal epidural injection | 62.2 | $264.87 |
| 76856 | Pelvic ultrasound non-obstetric | 60.4 | $105.21 |
| 11721 | Debridement of nails, 6+ | 58.6 | $45.09 |
| 81001 | Urinalysis automated with microscopy | 56.8 | $0.00 |
Insights
- E/M and preventive services dominate primary care billing patterns.
- Visit coding consistency has significant effect on net collections.
- Recurring preventive workflows provide strong opportunities for automation.
Why This Matters for Reimbursement Strategy
Primary care benchmarking pages are frequently linked by medical group operations teams, ACO resources, and ambulatory care strategy content. They provide practical context for clinicians and administrators.
This page is also relevant for educational backlinking from documentation training portals and quality-improvement programs focused on outpatient performance.
