Reference·SV1 Segment·SV101-2
X12 837P Reference

SV101-2 in X12 837P: A Field Guide to Procedure Code

Jul 27, 2026 · 4 min read
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SV101-2 is the single field a payer's fee schedule actually keys off of — get the code right but truncate a digit or drop a leading zero, and the line either prices at zero or matches a completely different, unrelated procedure.

Quick answer

SV101-2 is the second component of the SV101 composite in an X12 837P service line — it holds the actual procedure code (typically a 5-character CPT or HCPCS Level II code) being billed for that line.

What this element contains

Format
5-character alphanumeric — CPT codes are numeric, HCPCS Level II codes start with a letter
99213
Example office visit code — established patient, low-to-moderate complexity office visit
J-codes
HCPCS Level II drug codes — begin with J, common for infusion and injection claims
Pairing
Depends on SV101-1 — the code is only meaningful alongside the qualifier that names its code set

Example

Synthetic example Generated by Synthibase
SV1*HC:99213:25*125.00*UN*1***1*

99213 is the CPT procedure code being billed on this line, qualified as HCPCS by SV101-1. Synthetic claim data.

Where this trips people up

A test data generator that stores procedure codes as numbers instead of fixed-width strings will happily strip a leading zero from a code like 09213 or truncate a trailing character during a type conversion, and the resulting file still validates syntactically — the code just silently becomes a different, real procedure that the payer prices and pays as if it were actually billed.

How to Test X12 837P SV1: A Field-by-Field Breakdown
What is X12 837P? Complete Format and Field Guide
EDI Rejection Codes: Complete List and How to Fix Them
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