Guides HCPCS levels
HCPCS Level I vs Level II
HCPCS is one system with two levels under it. Level I is CPT, published and copyrighted by the American Medical Association. Level II is the alphanumeric set CMS maintains. The difference is about ownership and scope, not about seniority.
One system, two levels
HCPCS stands for Healthcare Common Procedure Coding System. The name covers two distinct code sets, published by two different organizations:
- Level I — CPT (Current Procedural Terminology). Published and copyrighted by the American Medical Association. It describes medical, surgical and diagnostic procedures and services.
- Level II. Maintained by CMS. It covers products, supplies, drugs, equipment, transport and services that CPT does not describe.
“Level” here is a division of labour, not a ranking. Neither level outranks the other, and neither is a subset of the other. They exist because a single publisher's procedure vocabulary could not cover everything a claim needs to identify.
Side by side
| Level I — CPT | Level II | |
|---|---|---|
| Published by | American Medical Association | CMS |
| Covers | Medical, surgical and diagnostic procedures and services | Supplies, drugs, equipment, prosthetics, transport, and other services |
| Code format | Five characters, most commonly five digits | One letter followed by four digits |
| Copyright | Copyrighted by the AMA; use requires a license | Published by CMS as part of the public code file |
| Update cycle | On the AMA's own publishing schedule | Quarterly — January, April, July, October |
| On MedCodeSearch | Not included | 8,769 codes in the October 2026 release |
Level I: CPT
CPT is the AMA's procedure and service terminology. Its codes are five characters long — most are five digits, and some categories end in a letter. It is the vocabulary used to report physician and outpatient procedures and services.
The key structural fact about CPT is that it is proprietary. The AMA owns the copyright, and reproducing the code set requires a license from the AMA. That is the single biggest practical difference between the two levels, and it is why free reference sites can list HCPCS Level II in full but cannot do the same for CPT.
Level II: the CMS alphanumeric set
Level II is a flat list of codes in a fixed format: one letter, then four digits, with the leading letter grouping related kinds of items and services. It exists to identify things a procedure terminology has no natural way to name — a specific mask, a specific wheelchair configuration, a specific quantity of an injected drug.
- A7030Full face mask used with a positive airway pressure device
- E1130Standard wheelchair
- J0129Injection, abatacept, 10 mg
Descriptions above are shortened for the link; each code page shows the CMS wording in full. The format, the letter groups, and the additional administrative fields CMS publishes with each code are covered in What Are HCPCS Level II Codes?
The Level II system also defines two-character modifiers that attach to codes. MedCodeSearch imports the HCPCS Level II code records; the modifier list is not part of what is loaded here. See Data Sources for exactly what is.
Why CPT is not on this site
MedCodeSearch publishes only code sets it can reproduce in full from official public files. CPT is copyrighted by the AMA and requires a license we do not hold, so no CPT code, description or excerpt appears here. The same reasoning excludes the CDT dental codes — the D-series — which are maintained by the American Dental Association.
A five-digit query will not resolve to a code page here, because five-digit codes are CPT and CPT is not in the database. A query shaped like a letter followed by four digits, such as J0129, is HCPCS Level II and will resolve.
How they meet in practice
A single claim can carry codes from both levels: a CPT code for the procedure performed and a Level II code for a supply or drug furnished with it. They are complementary rather than alternatives, and choosing between them is a coding question governed by the payer's rules and the official guidance for each set — not something a reference lookup can decide.
For the third code set in the picture, inpatient hospital procedures, see What Is ICD-10-PCS? and ICD-10-CM vs ICD-10-PCS.
Official sources
Where the facts on this page come from. MedCodeSearch is an independent reference service; these organizations publish the code sets themselves.
- CMS — HCPCS quarterly update
Each quarterly HCPCS Level II release file, published by CMS.
- CMS — Centers for Medicare & Medicaid Services
The federal agency responsible for ICD-10-PCS and HCPCS Level II.
- American Medical Association
CPT (HCPCS Level I) is an AMA publication. MedCodeSearch does not include CPT.
Look up a code
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This guide explains how the code sets are built and published. It is not coding, billing, legal or medical advice, and it never recommends a code for a specific patient or claim. See the Disclaimer and Methodology pages.