Quick answer version: 99406 and 99407, smoking cessation counseling, and the sports physical code question.
- Each code's value and its key requirement is most of the game.
- Use the list to audit your own habits against what the work is worth.
A short list does most of the work
CMS publishes an annual report of the top 200 CPT codes by Medicare volume, and office E/M dominates every year, with 99214 the most-coded code in healthcare by total charges. In family and internal medicine, revenue runs through a short list, and each code has one documentation requirement that decides whether it holds up. Providers who know the list cold capture more of their earned work than providers who know twice as much theory.
The Daily Drivers: Office E/M
The office visit codes you will use most, with the one requirement that supports each. How each requirement is scored, column by column, is in Choosing Your Level.
| Code | Service | wRVUs | The one thing your note needs |
|---|---|---|---|
| 99214 | Established, moderate | 1.92 | Two chronic conditions addressed, or one worsening, or Rx management documented |
| 99213 | Established, low | 1.30 | One stable chronic or acute uncomplicated problem, actively addressed |
| 99215 | Established, high | 2.80 | Severe exacerbation, or drug therapy with intensive monitoring, or 40+ documented minutes |
| 99204 | New patient, moderate | 2.60 | Same moderate MDM as 99214, plus the patient is new (3-year rule) |
| 99203 | New patient, low | 1.60 | Low MDM; do not default here when 99204 criteria are met |
| 99205 | New patient, high | 3.50 | High MDM or 60+ documented minutes |
| 99212 | Established, straightforward | 0.70 | Minimal problem; rarely the right code for a physician visit |
Nationally, 99214 now outnumbers 99213, a reversal from a decade ago under the 2021 rules. If your distribution still leans toward 99213, start there (see the undercoding chapter).
The Add-Ons Most Practices Miss
| Code | Service | wRVUs | The one thing your note needs |
|---|---|---|---|
| G2211 | Longitudinal care add-on | 0.33 | You are the patient's continuing focal point of care; eligibility and the same-day procedure rule are in the G2211 guide |
| 99406 | Tobacco cessation, 3-10 min | 0.24 | Counseling time documented, 3-minute minimum |
| 99407 | Tobacco cessation, >10 min | 0.50 | Counseling time documented, over 10 minutes |
| G0447 | Obesity counseling | 0.45 | 15 minutes face-to-face, BMI documented |
| 99497 | Advance care planning | 1.50 | Voluntary discussion of directives, first 30 minutes, time documented |
| G2212 | Prolonged services (Medicare) | 0.61 | Time-based 99215/99205 plus a full 15 minutes beyond the max (see the guide on prolonged services ) |
Wellness and Prevention
| Code | Service | wRVUs | The one thing your note needs |
|---|---|---|---|
| G0438 | Initial Medicare AWV | 2.43 | All required AWV components; once per beneficiary lifetime |
| G0439 | Subsequent Medicare AWV | 1.50 | Updated prevention plan; every year after the first |
| 99395-97 | Established preventive exam (adult) | 1.75-2.00 | Age-appropriate comprehensive preventive evaluation |
| G0444 | Depression screening | 0.18 | Validated instrument, annual, in primary care setting |
| G0442 | Alcohol misuse screening | 0.18 | Annual validated screening documented |
AWV plus a problem-oriented E/M with Modifier 25 plus G2211 is the best-reimbursed routine visit pattern in Medicare primary care; the step-by-step is in the guide on same-day AWV and E/M.
Between-Visit Care: The Codes for Work You're Already Doing
| Code | Service | wRVUs | The one thing your note needs |
|---|---|---|---|
| 99495 | Transitional care, moderate | 2.78 | Contact within 2 business days of discharge, visit within 14 days |
| 99496 | Transitional care, high | 3.79 | Contact within 2 business days, visit within 7 days, high-complexity MDM |
| 99490 | Chronic care mgmt, clinical staff | 1.00 | 2+ chronic conditions, 20 min/month of documented non-face-to-face care, patient consent |
| 99491 | CCM by physician/QHP | 1.45 | 30 min/month of personally performed care management |
A 99496 is worth nearly two 99214s, and most practices already do the post-discharge work informally. Document the discharge date and three dated things: an interactive contact (phone or in person) with the patient or caregiver within two business days of discharge; a face-to-face visit within 7 days (99496, high complexity) or 14 days (99495, moderate); and medication reconciliation by the date of that visit. TCM stays undercoded because the work happens but the dates do not get written down.
Common In-Office Procedures
| Code | Service | wRVUs | The one thing your note needs |
|---|---|---|---|
| 69210 | Cerumen removal, impacted | 0.61 | Instrumentation required (not just lavage by staff); unilateral |
| 17110 | Destruction of benign lesions | 0.70 | Method and number of lesions (up to 14) |
| 11102 | Skin biopsy, tangential | 0.66 | Lesion site and technique; pathology sent |
| 12001 | Simple laceration repair, ≤2.5 cm | 0.84 | Length, location, and closure method documented |
| 10060 | I&D of abscess, simple | 1.22 | Incision and drainage technique documented |
How to Use This List
Pull last quarter's coding report and check each code: did the work happen, and did it get coded? For most primary care practices the gaps cluster in five places: G2211, TCM, advance care planning, tobacco cessation, and the Modifier 25 procedure-plus-E/M combination. Close those five and you have most of what a full overhaul would find. The free wRVU tracker (a tab of the calculator) includes every code on this page.
The Level-4 Hook in Practice
Recognizing the legitimate level 4 is the highest-value habit in primary care coding. A stable patient with hypertension and hypothyroidism whose levothyroxine you adjust after a recent TSH is a 99214, not the reflex 99213: two stable chronic conditions plus prescription management is moderate MDM by definition, and coding it a level 3 is the most common way primary care leaves money behind. The column-by-column walkthrough and the five-note self-check are in Choosing Your Level.