For MedTech companies, building innovative devices is only half the battle. The harder part is getting them into the right hands — those of physicians who not only perform the relevant procedures but are also open to adopting new technologies.
This is where CPT (Current Procedural Terminology) and HCPCS (Healthcare Common Procedure Coding System) claims data becomes invaluable. Together, these billing datasets reveal what’s being done, where, and by whom. But while raw claims data provides massive potential, most MedTech teams struggle to translate it into actionable commercial intelligence.
At Alpha Sophia, we specialize in turning billing codes into context — and context into adoption. Let’s explore how CPT and HCPCS claims data can power smarter physician targeting, stronger sales strategies, and faster market expansion.
CPT codes cover medical, surgical, and diagnostic procedures. They tell you what physicians are actually doing in practice.
HCPCS codes cover products, supplies, and services (including devices). They reveal how those procedures are billed and reimbursed.
Together, they provide a 360° view of clinical activity: who is performing a relevant procedure, how often, and under what reimbursement dynamics.
👉 Example: An interventional cardiologist billing CPT 92928 (percutaneous coronary intervention with stent) and linked HCPCS codes for stent devices signals a high-value target for MedTech companies in cardiovascular devices.
Authoritative reference: American Medical Association (AMA) CPT Overview
Claims datasets are enormous. Without enrichment, they’re little more than numbers. But with the right tools, they unlock precision targeting.
Ways MedTech can leverage claims:
Identify physicians by specialty + procedure volume (e.g., orthopedic surgeons performing >200 knee replacements annually).
Map device-relevant CPT/HCPCS codes to real-world adoption opportunities.
Spot emerging categories when new CPT codes are introduced — a leading indicator of innovation.
Tie procedures to geographies to inform sales rep territories and market entry.
👉 Related: How Alpha Sophia Helps Clinical Research Organizations with Site Selection
You’re launching a new device for minimally invasive spine surgery. By analyzing CPT codes for relevant procedures, you can identify ZIP codes, hospitals, and surgical centers where volume is highest — focusing resources on the areas with the best ROI.
Instead of generating a broad list of neurosurgeons, claims data helps you prioritize those with actual procedure volume tied to your device category. This ensures reps spend time on physicians most likely to convert.
By tracking HCPCS billing codes linked to competitor devices, you can map where market share is currently concentrated — and identify opportunities to displace incumbent technologies.
Recruiting sites for a trial? CPT data shows you which physicians already perform procedures aligned with your study, helping reduce recruitment timelines.
👉 Related: Recruiting Physicians for Specialty and Concierge Practices with Alpha Sophia
Raw CPT/HCPCS data is powerful but messy. Here’s why MedTech companies often get stuck:
Group billing under NPIs makes it difficult to tie claims to individual physicians.
Coding variability leads to under- or over-reporting of certain procedures.
Lack of context: raw codes don’t reveal peer networks, physician influence, or likelihood of adoption.
Alpha Sophia’s solution:
Clean and normalize claims data to physician-level granularity.
Enrich with KOL AI to identify physicians publishing in relevant fields and linking them back to procedure data.
Overlay attention signals (publications, conference participation, digital engagement) to prioritize physicians most open to new technologies.
When you combine CPT and HCPCS claims with Alpha Sophia’s enrichment layers, you get:
Precision filtering: physicians segmented by volume, specialty, training, and geography.
Network intelligence: identifying influencers and collaborators who accelerate adoption.
Attention scoring: knowing which physicians are actively engaging with new ideas.
The result is a commercial strategy that:
Reduces wasted sales and marketing spend.
Accelerates adoption timelines.
Improves retention and repeat usage.
CPT and HCPCS claims data are the fuel for MedTech growth — but only if you can transform them into actionable insights. By contextualizing billing codes with physician networks, attention signals, and predictive modeling, Alpha Sophia enables MedTech companies to build smarter targeting strategies, stronger sales funnels, and faster adoption cycles.