--- title: "CPT, Current Procedural Terminology Codes | MedTech Terms" description: "AMA-maintained codes used to report medical procedures and services for billing. Plain-English Reimbursement definition for MedTech teams, with examples and rel" lang: en json-ld: | { "@context": "https://schema.org", "@graph": [ { "@type": "DefinedTerm", "@id": "https://medtechterms.com/terms/cpt#term", "name": "Current Procedural Terminology Codes", "alternateName": "CPT", "description": "CPT codes are five-character codes maintained by the American Medical Association that describe medical, surgical, and diagnostic services. 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Manufacturers may design their devices to better align with existing codes or develop strategies for new code applications." } }, { "@type": "Question", "name": "What is the difference between Category I and Category III CPT codes?", "acceptedAnswer": { "@type": "Answer", "text": "Category I codes describe procedures widely performed and approved for general use, often with established reimbursement. Category III codes are temporary codes for emerging technologies and procedures, used for data collection and to substantiate claims for permanent status." } }, { "@type": "Question", "name": "What is the role of the AMA in CPT codes?", "acceptedAnswer": { "@type": "Answer", "text": "The AMA is responsible for maintaining, updating, and publishing the CPT code set. They convene expert panels to review applications for new and revised codes annually." } }, { "@type": "Question", "name": "Can a MedTech company apply for a new CPT code?", "acceptedAnswer": { "@type": "Answer", "text": "Yes, MedTech companies can work with professional medical societies to submit applications for new CPT codes, particularly for novel procedures enabled by their devices. This process requires substantial clinical data and justification, demonstrating the efficacy and necessity of the new procedure." } } ] } ] } --- [ MedTech Terms The authoritative reference ](/) Browse Learn [Latest](/latest) About 1. [Home](/) 2. / 3. [Terms](/terms) 4. / 5. [Reimbursement](/terms?cat=Reimbursement) 6. / 7. Current Procedural Terminology Codes [All terms](/terms) Reimbursement [Hospital Buyer & Reimbursement](/ecosystems/hospital-buyer)CPT # Current Procedural Terminology Codes AMA-maintained codes used to report medical procedures and services for billing. Reviewed by [Christian Espinosa, Founder, Blue Goat Cyber](/authors/christian-espinosa) Last reviewed May 5, 2026 ## Definition [CPT codes](/terms/cpt-codes) are five-character codes maintained by the American Medical Association that describe medical, surgical, and diagnostic services. Category I codes describe established services; Category III codes describe emerging technologies. What the regulation says The Centers for Medicare & Medicaid Services (CMS) requires the use of [CPT codes](/terms/cpt-codes) for billing Medicare and Medicaid services, as outlined in their billing and claims processing manuals. The American Medical Association (AMA) maintains the CPT code set and provides guidance on its appropriate use, as detailed in the annual CPT Manual. ## What this means in practice Reimbursement strategy for new devices often hinges on whether an existing Category I [CPT](/terms/cpt-codes) code adequately describes the procedure or whether a Category III, then Category I application is needed. ## Examples - A medical device company developing a new surgical instrument seeks an existing Category I CPT code that accurately reflects the procedure performed with their device to ensure immediate reimbursement upon market entry. - A startup introduces a novel diagnostic test and applies for a Category III CPT code to gather utilization data and clinical evidence, aiming for a future Category I designation. - A hospital billing department uses a specific CPT code to submit claims for a patient who underwent an endoscopic procedure using a newly approved medical device. Common pitfalls - • Misinterpreting Category I codes as sufficient for novel procedures, potentially leading to claim denials. - • Failing to apply for a Category III CPT code for new technology, delaying reimbursement. - • Not understanding the specific documentation requirements associated with particular CPT codes. - • Using an unlisted CPT code without proper justification and accompanying documentation. ## Frequently asked questions How do CPT codes impact MedTech product development? [CPT codes](/terms/cpt-codes) influence product development by signaling the existence of established reimbursement pathways, which can de-risk investment. Manufacturers may design their devices to better align with existing codes or develop strategies for new code applications. What is the difference between Category I and Category III CPT codes? What is the role of the AMA in CPT codes? Can a MedTech company apply for a new CPT code? ## Cross-references ### Contains Sub-elements or required artefacts of this term. - [ Category III CPT Codes ](/terms/category-iii-codes) ### See also Closely related context worth reading. - [ HCPCS Codes(HCPCS) ](/terms/hcpcs) - [ ICD-10-CM / ICD-10-PCS ](/terms/icd-10) ## Related terms Grouped by theme ### Editor's picks · Hand-selected related concepts [ Reimbursement HCPCS Codes(HCPCS) CMS-maintained codes for products, supplies, and services not in CPT. ](/terms/hcpcs)[ Reimbursement ICD-10-CM / ICD-10-PCS Diagnosis (CM) and inpatient procedure (PCS) coding systems used in U.S. claims. ](/terms/icd-10)[ Reimbursement National and Local Coverage Determinations(NCD / LCD) Medicare coverage policies issued nationally (NCD) or by individual MAC contractors (LCD). ](/terms/ncd-lcd)[ Reimbursement Category III CPT Codes Temporary CPT codes for emerging technologies, services, and procedures. ](/terms/category-iii-codes) ### Reimbursement & Market Access · From this learning path [ Reimbursement CPT Codes(CPT) AMA-maintained codes that describe medical procedures and services. Adjacent lesson ](/terms/cpt-codes?from=reimbursement-and-market-access)[ Reimbursement Budget Impact Model(BIM) Financial model that estimates the total cost consequences of adopting a new technology to a payer's budget over a defined horizon. ](/terms/budget-impact-model?from=reimbursement-and-market-access)[ Reimbursement Health Technology Assessment(HTA) Systematic evaluation of clinical and economic value of a health technology. ](/terms/hta?from=reimbursement-and-market-access)[ Reimbursement LCD and NCD Local and National Coverage Determinations from Medicare. ](/terms/lcd-ncd?from=reimbursement-and-market-access) Cited by Where this term appears across MedTech Terms. Learning paths (1) - [Reimbursement & Market Access](/paths/reimbursement-and-market-access)Lesson 1 of 14 Ecosystems (1) - [Hospital Buyer & Reimbursement](/ecosystems/hospital-buyer) ## Primary references 2 sources Link health: 2 verified · last checked 2026-06-20 AMA· 1 AdvaMed· 1 1. [1 AMA CPT Verified AMA · ama-assn.org ](https://www.ama-assn.org/practice-management/cpt) 2. [2 AdvaMed - Payment & Coverage Verified AdvaMed · advamed.org ](https://www.advamed.org/our-work/) Inline markers like \[1\] jump to the matching reference above. Sponsor note ### Need cybersecurity expertise on a connected-device launch? Blue Goat Cyber helps MedTech teams ship connected products that hospital security teams will actually procure. [Book a 30-minute discovery session](https://go.bluegoatcyber.com/meetings/blue-goat-cyber/discovery-session) - No obligation - Expert-led from minute one - NDA available on request MedTech Terms is a community resource sponsored by [Blue Goat Cyber](https://bluegoatcyber.com). Definitions are independent of any vendor. On this term Category Reimbursement Acronym CPT Sources 2 Updated 5/5/2026 [Compare with another term](/compare?a=cpt) Learn in 60 seconds Card Lesson Quiz AMA-maintained codes used to report medical procedures and services for billing. - · Reimbursement strategy for new devices often hinges on whether an existing Category I CPT code adequately describes the procedure or whether a Category III, then Category I application is needed. - · Category I codes describe established services; Category III codes describe emerging technologies. Remember this Watch out: Misinterpreting Category I codes as sufficient for novel procedures, potentially leading to claim denials. Related terms - [Category III CPT Codes ](/terms/category-iii-codes) - [HCPCS Codes(HCPCS) ](/terms/hcpcs) - [ICD-10-CM / ICD-10-PCS ](/terms/icd-10) - [National and Local Coverage Determinations(NCD / LCD) ](/terms/ncd-lcd) You may also need Auto-suggested from Reimbursement and shared keywords. - [CPT Codes(CPT) ](/terms/cpt-codes) - [Category III CPT Code ](/terms/category-iii-cpt) - [CMS IDE Coverage (Category A & B) ](/terms/ide-coverage) - [Proprietary Laboratory Analyses Codes(PLA) ](/terms/pla-codes) - [Transitional Coverage for Emerging Technologies(TCET) ](/terms/tcet) - [Ambulatory Payment Classification(APC) ](/terms/apc) [All Reimbursement terms](/terms?cat=Reimbursement) MedTech Terms An authoritative, plain-language reference for the regulatory, quality, cybersecurity, and software terms that shape modern medical devices. 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