CPT (Current Procedural Terminology)
Current Procedural Terminology
The AMA-maintained code set that describes medical, surgical, and diagnostic services for billing.
1 min read · Last reviewed May 23, 2026
At a glance
- Category
- Billing
- Acronym for
- Current Procedural Terminology
- Primary sources
- 2
- Workspace handoff
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Where this comes up
This shows up in revenue-cycle work — claim scrubbing, charge entry, posting, A/R follow-up, and month-end close. Billers and practice managers hit this term when reconciling a payment, working a denial queue, or auditing why a claim aged past 60 days.
Full definition
What it is in practice
CPT is the standard procedure code set required by HIPAA for outpatient billing transactions. It is divided into three categories: I (procedures, 99202-99499 for E/M plus 00100-99607 broadly), II (performance measurement), and III (emerging tech).
How it shows up in your practice
Every CMS-1500 or 837P claim carries CPT codes. Buy or license the AMA's annual CPT book and updates; coding from outdated codebooks is one of the most common audit findings.
Sources
- AMA — Current Procedural Terminology (CPT)https://www.ama-assn.org/practice-management/cpt
- AMA — 2021 / 2023 E/M Documentation Guidelineshttps://www.ama-assn.org/practice-management/cpt/cpt-evaluation-and-management
Look up a CPT code in Ask D3
Open ask d3 →Related terms
- BillingHCPCS Level IIThe CMS-maintained code set covering products, supplies, and services not included in CPT — primarily durable medical equipment, drugs, and Medicare-specific services.
- CodingICD-10-CMThe Clinical Modification of the WHO ICD-10 code set used in the United States to report diagnoses.
- BillingModifier 25CPT modifier indicating that a significant, separately identifiable E/M service was performed by the same provider on the same day as another procedure or service.
- CodingE/M CodingEvaluation and Management codes (99202-99499) used to bill office, hospital, and other professional visits.
- CodingCPT Category III CodesTemporary CPT codes (xxxxT) for emerging technology, services, and procedures.
D3rx is a healthcare-billing and compliance research aid maintained by D3rx Inc. Articles are drafted by an LLM (Anthropic Claude) against primary HHS, OCR, CMS, eCFR, NIST, and state-regulator publications, and reviewed for restraint and source fidelity by the D3rx team.
Reviewer status: a named credentialed reviewer (CHC, CHPC, or healthcare attorney) is being engaged. Until that engagement is finalized, this page does not claim credentialed review.
Related across the archive
- GlossaryHCPCS Level IIThe CMS-maintained code set covering products, supplies, and services not included in CPT — primarily durable medical equipment, drugs, and Medicare-specific services.
- GlossaryModifier 25CPT modifier indicating that a significant, separately identifiable E/M service was performed by the same provider on the same day as another procedure or service.
- GlossaryCPT Category III CodesTemporary CPT codes (xxxxT) for emerging technology, services, and procedures.
- GlossaryE/M CodingEvaluation and Management codes (99202-99499) used to bill office, hospital, and other professional visits.
- BillingModifier 25: When to Use It and Common MistakesWhen to use modifier -25, when to skip it, and the common mistakes that trigger audits and denials.
- GlossaryICD-10-CMThe Clinical Modification of the WHO ICD-10 code set used in the United States to report diagnoses.
- GlossaryModifier General ReferenceCatch-all reference for the wide CPT and HCPCS modifier set used in physician and outpatient billing.
- Glossary99214 vs 99215The two most common established-patient office E/M levels; 99214 represents moderate complexity and 99215 high complexity.
This glossary entry is a research aid for billing and compliance staff. It does not provide legal, medical, or financial advice and does not replace counsel. References cited link to primary sources at HHS, OCR, CMS, eCFR, NIST, and the relevant payer or industry body.