Revenue Codes in Healthcare for 2022 | The Complete Guide (2024)

Are you struggling to understand your medical bill?

Bills from hospital visits and treatments can be very complex. Every test, procedure, and treatment need to be clearly marked on the bill in a way that can be easily understood. This is why the healthcare industry uses standardized codes. But to the uninitiated, these codes can be as hard to understand as medical jargon. Unless you know what the codes mean, you won’t be any closer to understanding what you are being billed for.

We are here to help. Read on for our guide on healthcare revenue codes to help you understand what you see on your medical bills.

What Are Revenue Codes?

Revenue codes are a set of standardized 4-digit numbers used in medical billing. Although codes are four digits, you may see codes with only three digits. In this case, a leading 0 is implied. For example, revenue code 761 is the same as revenue code 0761.

Revenue codes are set by the National Uniform Billing Committee (NUBC). This means every healthcare provider gives standardized information when billing.

The purpose of revenue codes is to provide extra information about a procedure or service, such as where a patient received care. 

Revenue codes are on every billing line and are always linked with other codes used by healthcare professionals:

1. ICD, diagnostic codes for each patient
2. CPT, procedure codes for each service given
3. HCPCS, codes for products, supplies and services administered

This information is essential for medical insurers and other third-party payers. The reason revenue codes are so important is because hospitals have many different areas and wards able to provide the same service. As there can be a difference in price for the same procedure in different areas, revenue codes help track this.

Your insurer needs to know whether they happened in the emergency room, observation room, or ward. When linked to a product or equipment, they show where it was to be used/taken.

Insurers will reject any claims without a revenue code.

ICD Codes

International Classification of Diseases (ICD) codes represent one of 70,000 plus symptoms and diseases. As such, you will likely find the same code on any bills you receive for ongoing issues.

ICD codes are an international standard run by the World Health Organization (WHO). You will find them in use in most countries around the world. The version currently in use is ICD-10, the tenth revision of the system.

ICD-10 codes are broken down into chapters and subchapters. These group conditions or characteristics are given a letter.

Here are some examples:

• E for represent an endocrine, nutritional, or metabolic issues
• I for problems with the circulatory system
• P for perinatal issues
• K for digestive issues

Although some code letters match up the first letter of the issue, this is not standard practice.

This is followed by two numbers, a period and another number, to denote the specific condition. This gives each diagnosis a code in the following format: X00.0.

As well as your medical bills, the ICD code will also be on your paperwork, charts, and hospital records. The hospital will also use them to track disease statistics.

CPT Codes

Current Procedural Terminology (CPT codes) represent the services given to a patient. This covers diagnostic, medical, and surgical services.

Standardized CPT codes are managed by the American Medical Association (AMA). The complex nature of medical treatment means that thousands of codes are in use. As new procedures come into use, codes are revised and new ones created.

All CPT codes are organized into three main categories:

• Category I: Procedures, services, devices, and drugs
• Category II: performance measurement
• Category III: emerging technology, services, and procedures

Each code consists of 5 characters, either five numbers or four numbers and one letter. Codes are highly specific and are designed to have as little overlap as possible.

Every procedure you have received is shown on the bill and assigned its relevant CPT code on your medical bill. The insurer then uses this to work out how much they pay the medical provider of the service.

When an insurer receives your claim, they will look at the ICD code and the CPT and check if the procedure is relevant for your issue.

For example, they will likely query any stitches for a stomach upset. If they don’t make sense, they will reject the claim.

HCPCS Codes

Healthcare Common Procedure Coding System (HCPCS codes), like CPT codes, represent services given to patients. They differ in that they are created specifically for Medicare and Medicaid.

The Centers manage the codes for Medicare and Medicaid (CMS) specifically to show what procedures Medicare and Medicaid recipients are eligible for.

HCPCS codes are split into three levels:

• Level 1: Procedures and services
• Level 2: Non-physician services (such as ambulance rides and provided wheelchairs)
• Level 3: Local codes set by the state Medicaid body

As Level 1 codes serve the same purpose as CPT codes, the CMS decided to use the same CPT codes themselves. Although technically, this greatly simplifies the system, the CPT codes will be HCPCS codes when used for billing Medicare.

Level 2 codes fill a gap in CPT by giving information about non-service items like the specific product provided. This extends to drugs given and is highly specific. The type of drug, dosage, and how the drug was administered are all covered.

HCPCS are treated in the same way as CPT codes by third-party payers. Like CPT, they will be compared against the revenue code and ICD when analyzing a claim.

Common Revenue Codes

Healthcare is a wide area with hundreds of revenue codes in use. Healthcare administrators need to put a lot of work into learning all the codes and uses. But most people will only ever see the most common ones.

Here are some of the most common codes you are likely to encounter.

Revenue Code 761

Revenue Code 076X covers specialty services.

The most seen code in this group is 0761, which covers a treatment room. In fact, it is probably the most common revenue code you will see. This covers most general visits to a doctor unless you need more specific diagnostic equipment.

Anther common revenue code in the group is 0762, which covers observation hours.

Revenue Code 0250

Revenue Code 025X covers Pharmacy services. These include drugs dispensed by a licensed pharmacist.

Code 0250 is used for “General” pharmaceutical services, as opposed to generic drugs (251) or home drugs (253). Some hospitals use this to report general drugs not covered by the more specific categories or for appointments with pharmacists.

You may also see pharmacy services under code 063X. This extends the original pharmacy codes and includes services like 0631 (Single source drug) and 0637 (Self-administrable drugs).

Revenue Code 0170

Revenue code 017X covers nursery services. This covers a baby’s stay in hospital.

Code 0170 is used for nursery charges in good health, likely due to the mother receiving postpartum care. Other codes in the group are used to specify the needs of babies, if they are premature, otherwise unwell, etc.

Revenue Code 301

Revenue code 030X covers laboratory services. Most samples taken for testing will end up with this revenue code.

The most common revenue code in this group is 0301, chemistry. Most laboratory tests will be covered by this code, although a notable exception is 0307, urology for urine samples.

Revenue Code 915

Codes 090X and 091X cover behavioral health treatments and services. You may also this category referred to as psychiatric and psychological services.

Hospitals offer several different therapies that fall under these categories, including play therapy (0903), chemical dependency (0906), and rehabilitation (0911). The most common therapy that you will see is revenue code 915, which covers group therapy.

Revenue Code 361

Revenue code 036X covers operating room services. You will see a line on your bill with this code group if you are operated on.

The most commonly seen code is 361, minor surgery. Most surgeries are covered by this code. Organ transplants also have their own codes, 0367 for kidney transplants and 0362 for all others.

Revenue Code 370

Revenue code 037X covers anesthesia.

The most common anesthesia code you are likely to see is revenue code 370, general anesthesia. This will be used for almost all situations where traditional anesthesia is used, including local and general anesthetics.

What are UB 04 Revenue Codes?

The UB 04 revenue code refers to a billing form known as the UB-04. It’s a uniform institutional provider bill that can be used for billing multiple third-party payers. It’s often used to bill Medicare, Medicaid, and other forms of health insurance.

It’s important to understand the UB-04 because it’s a commonly seen revenue code.

Now that we have a general idea of the different types of medical and revenue codes, let’s look at some examples:

Room and Board- Private (Medical or General)

• 110 General
• 111 Medical/Surgical/GYN
• 112 OB
• 113 Pediatric
• 114 Psychiatric
• 115 Hospice
• 116 Detoxification
• 117 Oncology
• 118 Rehabilitation
• 119 Other

Room and Board-Semi-Private Two Bed (Medical or General)

• 120 General
• 121 Medical/Surgical/GYN
• 122 OB
• 123 Pediatric
• 124 Psychiatric
• 125 Hospice
• 126 Detoxification
• 127 Oncology
• 128 Rehabilitation
• 129 Other

Semi-Private: Three and Four Beds

• 130 General
• 131 Medical/Surgical/GYN
• 132 OB
• 133 Pediatric
• 134 Psychiatric
• 135 Hospice
• 136 Detoxification
• 137 Oncology
• 138 Rehabilitation
• 139 Other

Private

• 140 General
• 141 Medical/Surgical/GYN
• 142 OB
• 143 Pediatric
• 144 Psychiatric
• 145 Hospice
• 146 Detoxification
• 147 Oncology
• 148 Rehabilitation
• 149 Other

Room and Board Ward (Medical or General)

• 150 General
• 151 Medical/Surgical/GYN
• 152 OB
• 153 Pediatric
• 154 Psychiatric
• 155 Hospice
• 156 Detoxification
• 157 Oncology
• 158 Rehabilitation
• 159 Other

Other Room and Board

• 160 General
• 164 Sterile Environment
• 167 Self Care
• 168 Rehabilitation
• 169 Other

Nursery

• 170 Newborn (well-baby)
• 171 Newborn-level I
• 172 Newborn-level II
• 173 Newborn-level III
• 174 Newborn-level IV
• 179 Boarder baby

Leave of Absence

• 180 General
• 181 Reserved
• 182 Patient Convenience Charges Billable
• 183 Therapeutic Leave
• 184 ICF/MR-any reason
• 185 Nursing Home (for hospitalization)
• 189 Other Leave of Absence

Subacute Care

• 190 General Classification
• 191 Subacute Care-level I
• 192 Subacute Care-level II
• 193 Subacute Care-level III
• 194 Subacute Care-level IV
• 199 Other Subacute Care
• 20x Intensive Care
• 200 General
• 201 Surgical
• 202 Medical
• 203 Pediatric
• 204 Psychiatric
• 206 Intermediate ICU
• 207 Burn Care
• 208 Trauma
• 209 Other Intensive Care

Coronary Care

• 210 General
• 211 Myocardial Infarction
• 212 Pulmonary Care
• 213 Heart Transplant
• 214 Intermediate CCU
• 219 Other Coronary Care
• 22x Special Charges
• 220 General
• 221 Admission Charge
• 222 Technical Support Charge
• 223 UR Service Charge
• 224 Medically Necessary Late Discharge
• 229 Other Special Charges

Incremental Nursing Care Rate

• 230 General
• 231 Nursery
• 232 OB
• 233 ICU
• 234 CCU
• 235 Hospice
• 239 Other

All-Inclusive Ancillary

• 240 General
• 249 Other Inclusive Ancillary

Pharmacy

• 250 General
• 251 Generic Drugs
• 252 Non-generic Drugs
• 253 Take Home Drugs
• 254 Drugs incidental to other Diagnostic Services
• 255 Drugs incidental to Radiology
• 256 Experimental Drugs
• 257 Non-prescription
• 258 IV Solutions
• 259 Other Pharmacy

IV Therapy

• 260 General
• 261 Infusion Pump
• 262 IV Therapy/Pharmacy Services
• 263 IV Therapy/Drug/Supply Delivery
• 264 IV Therapy/Supplies
• 269 Other IV Therapy

Medical/Surgical Supplies and Devices

• 270 General
• 271 Non-Sterile Supply
• 272 Sterile Supply
• 273 Take Home Supplies
• 274 Prosthetic/Orthotic Devices
• 275 Pace Maker
• 276 Intraocular Lens
• 277 Oxygen-Take Home
• 278 Other Implants
• 279 Other Supplies/Devices

Oncology

• 280 General
• 289 Other Oncology

Durable Medical Equipment (Other than Renal)

• 290 General
• 291 Rental
• 292 Purchase of New DME
• 293 Purchase of Used DME
• 294 Supplies/Drug for DME Effectiveness
• 299 Other Equipment

Laboratory-Clinical

• 300 General
• 301 Chemistry
• 302 Immunology
• 303 Renal Patient (home)
• 304 Non-routine Dialysis
• 305 Hematology
• 306 Bacteriology & Microbiology
• 307 Urology
• 309 Other Laboratory

Laboratory Anatomical

• 310 General
• 311 Cytology
• 312 Histology
• 314 Biopsy
• 319 Other

Radiology-Diagnostic

• 320 General
• 321 Angiocardiography
• 322 Arthrography
• 323 Arteriography
• 324 Chest X-ray
• 329 Digital Subtraction Angiography

Radiology-Therapeutic

• 330 General
• 331 Chemotherapy-injected
• 332 Chemotherapy-oral
• 333 Radiation Therapy
• 335 Chemotherapy-IV
• 339 Other

Nuclear Medicine

• 340 General
• 341 Diagnostic
• 342 Therapeutic
• 343 Diagnostic Radio-pharmaceuticals
• 344 Therapeutic Radio-pharmaceuticals
• 349 Other

CT Scan

• 350 General
• 351 Head Scan
• 352 Body Scan
• 359 Other CT Scans

Operating Room Services

• 360 General
• 361 Minor Surgery
• 362 Organ Transplant-Other Than Kidney
• 367 Kidney Transplant
• 369 Other Operating Room Services

Anesthesia

• 370 General
• 371 Anesthesia incident to Radiology
• 372 Anesthesia incident to Other Diagnostic Services
• 374 Acupuncture
• 379 Other Anesthesia

Blood

• 380 General
• 380 General
• 381 Packed Red Cells
• 382 Whole Blood
• 383 Blood-Plasma
• 384 Blood-Platelets
• 385 Blood-Leucocytes
• 386 Blood-Other Components
• 387 Blood-Other Derivatives
• 389 Other Blood

Blood Storage and Processing

• 390 General
• 391 Blood Administration
• 399 Other Blood Storage & Processing

Other Imaging Services

• 400 General
• 401 Diagnostic Mammography
• 402 Ultrasound
• 403 Screening Mammography
• 404 Positron Emission Tomography
• 409 Other Imaging Services

Respiratory Services

• 410 General
• 412 Inhalation Services
• 413 Hyperbaric Oxygen Therapy
• 419 Other Respiratory Services

Physical Therapy

• 420 General
• 421 Visit Charge
• 422 Hourly Charge
• 423 Group Rate
• 424 Evaluation or Re-evaluation
• 429 Other Physical Therapy

Occupational Therapy

• 430 General
• 431 Visit Charge
• 432 Hourly Charge
• 433 Group Rate
• 434 Evaluation or Re-evaluation
• 439 Other Occupational Therapy

Speech-Language Pathology

• 440 General
• 441 Visit Charge
• 442 Hourly Charge
• 443 Group Rate
• 444 Evaluation or Re-evaluation
• 449 Other Speech-Language Pathology

Emergency Room

• 450 General
• 451 EMTALA Emergency Medical Screening Services
• 452 ER Beyond EMTALA Screening
• 456 Urgent Care
• 459 Other Emergency Room

Pulmonary Function

• 460 General
• 469 Other Pulmonary Function

Audiology

• 470 General
• 471 Diagnostic
• 472 Treatment
• 479 Other Audiology

Cardiology

• 480 General
• 481 Cardiac Cath Lab
• 482 Stress Test
• 483 Echocardiology
• 489 Other Cardiology
• 49x Ambulatory Surgical Care
• 490 Ambulatory Surgical Care
• 499 Other Ambulatory Surgical Care

Outpatient Services

• 500 General
• 509 Other Outpatient

Clinic

• 510 General
• 511 Chronic Pain Center
• 512 Dental Clinic
• 513 Psychiatric
• 514 OB-GYN
• 515 Pediatric
• 516 Urgent Care Clinic
• 517 Family Practice Clinic
• 519 Other Clinic

Freestanding Clinic

• 520 General
• 521 Rural Health-Clinic
• 522 Rural Health-Home
• 523 Family Practice
• 526 Urgent Care Clinic
• 529 Other Freestanding Clinic

Osteopathic Services

• 530 General
• 531 Osteopathic Therapy
• 539 Other Osteopathic Services

Ambulance

• 540 General
• 541 Supplies
• 542 Medical Transport
• 543 Heart Mobile
• 544 Oxygen
• 545 Air Ambulance
• 546 NeoNatal
• 547 Pharmacy
• 548 Telephone Transmission EKG
• 549 Other Ambulance

Skilled Nursing (Home Health & CORFs only)

• 550 General
• 551 Visit Charge
• 552 Hourly Charge
• 559 Other Skilled Nursing

Medical Social Services

• 560 General
• 561 Visit Charge
• 562 Hourly Charge
• 569 Other Medical Social Services

Home Health Aide (Home Health)

• 570 General
• 571 Visit Charge
• 572 Hourly Charge
• 579 Other Home Health Aide

Other Visits (Home Health)

• 580 General
• 581 Visit Charge
• 582 Hourly Charge
• 583 Dietician
• 589 Other Home Health Visits
• 59x Units of Service (Home Health)
• 590 General
• 599 Other Home Health Units

Oxygen (Home Health)

• 600 General
• 601 Oxygen-State/Equip/Supply/Cont.
• 602 Oxygen-State/Equip/Supply/Under 1 LPM
• 603 Oxygen-State/Equip/Over 4 LPM
• 604 Oxygen-Portable Add-on
• 61x Magnetic Resonance Imaging (MRI)
• 610 General
• 611 Brain (including brain stem)
• 612 Spinal Cord (including spine)
• 619 Other MRI

Medical/Surgical Supplies (Extension of Revenue 27x)

• 621 Supplies Incidental to Radiology
• 622 Supplies Incidental to Other Diagnostic Services
• 623 Surgical Dressing
• 624 FDA Investigational Devices

Drugs Requiring Specific Identification

• 630 General Classification
• 631 Single Source Drug
• 632 Multiple Source Drug
• 633 Restrictive Prescription
• 634 Erythropoietin (EPO) less than 10,000 units
• 635 Erythropoietin (EPO) more than 10,000 units
• 636 Drugs Requiring Detailed Coding

Home IV Therapy Services

• 640 General Classification
• 641 Nonroutine Nursing, Central Line
• 642 IV Site Care, Central Line
• 643 IV Start/Change, Peripheral Line
• 644 Nonroutine Nursing, Peripheral Line
• 645 Training, Patient/Caregiver, Central Line
• 646 Training, Disabled Patient, Central Line
• 647 Training, Patient/Caregiver, Peripheral Line
• 648 Training, Disabled Patient, Peripheral Line
• 649 Other IV Therapy Services

Hospice Services

• 650 General
• 651 Routine Home Care
• 652 Continuous Home Care
• 655 Inpatient Respite Care
• 656 General Inpatient Care
• 657 Physician Service
• 659 Other Hospice

Respite Care (HHA Only)

• 660 General Classification
• 661 Hourly Charge/Skilled Nursing
• 662 Hourly Charge/Home Health Aide/Homemaker
• 67x Outpatient Special Residence Charges
• 670 General
• 671 Hospital Based
• 672 Contracted
• 679 Other Special Residence Charges

Cast Room

• 700 General
• 709 Other Cast Room

Recovery Room

• 710 General
• 719 Other Recovery Room

Labor Room/Delivery

• 720 General
• 721 Labor
• 722 Delivery
• 723 Circumcision
• 724 Birthing Center
• 729 False Labor

EKG/ECG (Electrocardiogram)

• 730 General
• 731 Holter Monitor
• 732 Telemetry
• 739 Computerized EKG/ECG

EEG (Electroencephalogram)

• 740 General
• 741 Electronystagmography
• 742 Diagnostic Sleep Disorder
• 749 Other EEG

Gastro-Intestinal Services

• 750 General
• 759 Other Gastro-Intestinal

Treatment/Observation Room

• 760 General
• 761 Treatment Room
• 762 Observation Room
• 769 Other Treatment Room

Preventive Care Services

• 770 General Classification
• 771 Vaccine Administration
• 779 Other
• 79x Lithotripsy
• 790 General
• 799 Other Lithotripsy
• 80x Renal Dialysis- Inpatient
• 800 General
• 801 Inpatient Hemodialysis
• 802 Inpatient Peritoneal (Non-CAPD)
• 803 Inpatient Continuous Ambulatory Peritoneal Dialysis (CAPD)
• 804 Inpatient Continuous Cycling Peritoneal Dialysis
• 809 Other Inpatient Dialysis

Organ Acquisition

• 810 General
• 811 Living Donor
• 812 Cadaver Donor
• 813 Unknown Donor
• 814 Unsuccessful Organ Search-Donor Bank Charges
• 819 Other

Hemodialysis- Outpatient or Home

• 820 General
• 821 Hemodialysis/Composite or Other Rate
• 822 Home Supplies (Not used in Michigan)
• 823 Home Equipment (Not used in Michigan)
• 824 Maintenance/100% (Not used in Michigan)
• 825 Support Services
• 829 Other Outpatient Hemodialysis

Peritoneal Dialysis- Outpatient or Home

• 830 General
• 831 Peritoneal/Composite or Other Rate
• 832 Home Supplies (Not used in Michigan)
• 833 Home Equipment (Not used in Michigan)
• 834 Maintenance/100% (Not used in Michigan)
• 835 Support Services
• 839 Other Peritoneal Dialysis

Continuous Ambulatory Peritoneal Dialysis (CAPD)- Outpatient/Home

• 840 General
• 841 CAPD/Composite or Other Rate
• 842 Home Supplies (Not used in Michigan)
• 843 Home Equipment (Not used in Michigan)
• 844 Maintenance/100% (Not used in Michigan)
• 845 Support Services
• 849 Other Outpatient CAPD
• 85x Continuous Cycling Peritoneal Dialysis (CCPD)- Outpatient or Home
• 850 General
• 851 CCPD/Composite or Other Rate
• 852 Home Supplies (Not used in Michigan)
• 853 Home Equipment (Not used in Michigan)
• 854 Maintenance/100% (Not used in Michigan)
• 855 Support Services
• 859 Other CCPD

Psychiatric/Psychological Treatments

• 900 General
• 901 Electroshock Treatment
• 902 Milieu Therapy
• 903 Play Therapy
• 904 Activity Therapy
• 909 Other

Psychiatric/Psychological Services

• 910 General
• 911 Rehabilitation
• 912 Partial Hospitalization
• 914 Individual Therapy
• 915 Group Therapy
• 916 Family Therapy
• 917 Bio Feedback
• 918 Testing
• 919 Other

Other Diagnostic Services

• 920 General
• 921 Peripheral Vascular Lab
• 922 Electromyelogram
• 923 Pap Smear
• 924 Allergy Test
• 925 Pregnancy Test
• 929 Other Diagnostic Services

Other Therapeutic Services

• 940 General
• 941 Recreational Therapy
• 942 Education/Training/Diabetes Education
• 943 Cardiac Rehabilitation
• 944 Clinic-O/P Drug Rehabilitation
• 945 Clinic-O/P Alcohol Rehabilitation
• 946 Complex Medical Equipment-Routing
• 947 Complex Medical Equipment-Ancillary
• 949 Psoriasis Treatment Center

Other Therapeutic Services (Extension of 94x)

• 950 Reserved
• 951 Athletic Training
• 952 Kinesiotherapy

Professional Fees (Also See 97x and 98x)

• 960 General
• 961 Psychiatric
• 962 Ophthalmology
• 963 Anesthesiologist (MD)
• 964 Anesthetist (CRNA)
• 969 Midwife

Professional Fees (Extension of 96x)

• 971 Laboratory
• 972 Radiology-Diagnostic
• 973 Radiology-Therapeutic
• 974 Radiology-Nuclear Medicine
• 975 Operating Room
• 976 Respiratory Therapy
• 977 Physical Therapy
• 978 Occupational Therapy
• 979 Speech Pathology

Professional Fees (Extension of 96x and 97x)

• 981 Emergency Room
• 982 Outpatient Services
• 983 Clinic
• 984 Medical Social Services
• 985 EKG
• 986 EEG
• 987 Hospital Visit
• 988 Consultation
• 989 Private Duty Nurse
• 99x Patient Convenience Items
• 990 General
• 991 Cafeteria/Guest Tray
• 992 Private Linen Service
• 993 Telephone/Telegraph
• 994 TV/Radio
• 995 Non-Patient Room Rentals
• 996 Late Discharge Charge
• 997 Admission Kits
• 998 Beauty Shop/Barber
• 999 Other Patient Convenience Items

Understanding Revenue Codes

As you can see, healthcare billing has a lot of complexity. Not only does each line on your medical bill have a revenue code to say where a service was administered, but it also has a CPT or HCPCS code to define the service and an ICD code to cover what it was used to treat.

Although there are many revenue codes, most of us will mostly only see the most common ones, so learning these will go a long way to helping you understand your bill.