| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| X4011 |
State-specific procedure code |
13,283 |
12,417 |
$4.46M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
21,906 |
21,176 |
$3.84M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
14,861 |
14,027 |
$3.48M |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
46,548 |
43,278 |
$2.25M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
10,984 |
10,465 |
$2.19M |
| 80053 |
Comprehensive metabolic panel |
36,184 |
34,115 |
$1.35M |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
10,391 |
9,661 |
$1.09M |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
6,631 |
6,237 |
$891K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
9,027 |
8,790 |
$881K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
15,385 |
14,310 |
$860K |
| 36415 |
Collection of venous blood by venipuncture |
14,648 |
12,978 |
$618K |
| 81003 |
|
10,166 |
9,643 |
$608K |
| 81001 |
|
11,363 |
10,807 |
$598K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,943 |
1,907 |
$557K |
| 87070 |
|
10,306 |
10,129 |
$554K |
| 71046 |
Radiologic examination, chest; 2 views |
5,658 |
5,377 |
$488K |
| Y7506 |
|
2,573 |
1,821 |
$474K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
4,639 |
4,410 |
$464K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
3,001 |
2,891 |
$423K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
2,826 |
2,723 |
$403K |
| 86900 |
|
1,094 |
1,023 |
$370K |
| 86850 |
|
1,134 |
1,064 |
$369K |
| 86901 |
|
1,081 |
1,012 |
$366K |
| 84484 |
|
11,074 |
9,858 |
$342K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
5,074 |
4,753 |
$336K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
1,532 |
1,468 |
$329K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
1,172 |
1,149 |
$307K |
| 83690 |
|
4,891 |
4,655 |
$298K |
| Y7507 |
|
1,527 |
1,410 |
$263K |
| 83721 |
|
4,977 |
4,708 |
$228K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
3,620 |
3,280 |
$196K |
| X4006 |
|
348 |
245 |
$187K |
| 81025 |
|
2,934 |
2,812 |
$181K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
856 |
825 |
$179K |
| 84443 |
Thyroid stimulating hormone (TSH) |
5,426 |
5,285 |
$178K |
| 82950 |
|
1,294 |
1,242 |
$149K |
| 0202U |
Oncology (prostate), multianalyte, gene expression profiling |
369 |
365 |
$141K |
| 70450 |
Computed tomography, head or brain; without contrast material |
2,175 |
2,035 |
$134K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
2,886 |
2,024 |
$130K |
| U0003 |
Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high throughput technologies as described by cms-2020-01-r |
4,315 |
4,112 |
$120K |
| 83020 |
|
588 |
558 |
$115K |
| 71045 |
Radiologic examination, chest; single view |
3,181 |
2,943 |
$108K |
| 80081 |
|
899 |
879 |
$103K |
| J3490 |
Unclassified drugs |
5,399 |
4,035 |
$103K |
| 86803 |
|
1,012 |
990 |
$102K |
| 85027 |
|
738 |
712 |
$89K |
| 82248 |
|
1,154 |
1,101 |
$78K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
725 |
623 |
$76K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
686 |
643 |
$72K |
| 76801 |
|
523 |
485 |
$70K |
| X4003 |
|
1,215 |
676 |
$67K |
| 87807 |
|
143 |
143 |
$62K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
185 |
180 |
$62K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
489 |
435 |
$62K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
273 |
266 |
$60K |
| 87633 |
Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets |
74 |
73 |
$55K |
| 84439 |
|
325 |
313 |
$53K |
| 87801 |
Infectious agent detection by nucleic acid; amplified probe, multiple organisms |
557 |
552 |
$52K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
157 |
154 |
$48K |
| 82550 |
|
1,030 |
964 |
$48K |
| 84702 |
|
1,108 |
771 |
$44K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
514 |
504 |
$43K |
| 85610 |
|
856 |
787 |
$38K |
| 87631 |
|
95 |
95 |
$35K |
| 73630 |
|
643 |
568 |
$34K |
| 80061 |
Lipid panel |
2,569 |
2,518 |
$32K |
| 87040 |
|
492 |
454 |
$30K |
| U0005 |
Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, cdc or non-cdc, making use of high throughput technologies, completed within 2 calendar days from date of specimen collection (list separately in addition to either hcpcs code u0003 or u0004) as described by cms-2020-01-r2 |
2,851 |
2,670 |
$30K |
| 86592 |
|
719 |
712 |
$28K |
| 92507 |
Treatment of speech, language, voice, communication, and/or auditory processing disorder |
481 |
106 |
$27K |
| 87081 |
|
627 |
597 |
$26K |
| G0480 |
Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 1-7 drug class(es), including metabolite(s) if performed |
149 |
135 |
$25K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
407 |
397 |
$23K |
| 85730 |
|
535 |
494 |
$23K |
| 88304 |
|
55 |
55 |
$20K |
| 87077 |
|
643 |
622 |
$19K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
102 |
101 |
$18K |
| 86787 |
|
39 |
38 |
$17K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
173 |
173 |
$17K |
| G0378 |
Hospital observation service, per hour |
139 |
117 |
$17K |
| 87210 |
|
444 |
434 |
$17K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
450 |
398 |
$17K |
| 66984 |
Extracapsular cataract removal with insertion of intraocular lens prosthesis |
23 |
15 |
$16K |
| 82077 |
|
1,449 |
1,331 |
$15K |
| 83880 |
|
459 |
441 |
$14K |
| 83605 |
|
976 |
879 |
$13K |
| G0472 |
Hepatitis c antibody screening, for individual at high risk and other covered indication(s) |
382 |
371 |
$13K |
| 88142 |
|
134 |
132 |
$9K |
| 83615 |
|
36 |
30 |
$8K |
| 83655 |
|
163 |
153 |
$8K |
| 84550 |
|
33 |
27 |
$7K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
57 |
54 |
$7K |
| 84436 |
|
96 |
94 |
$7K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
12 |
12 |
$7K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
168 |
168 |
$7K |
| 87430 |
|
447 |
441 |
$6K |
| 93017 |
|
27 |
25 |
$6K |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
351 |
343 |
$5K |
| 83735 |
|
133 |
114 |
$5K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
175 |
170 |
$4K |
| 80143 |
|
476 |
446 |
$4K |
| 80179 |
|
419 |
394 |
$4K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
27 |
25 |
$4K |
| 82150 |
|
45 |
37 |
$3K |
| G0475 |
Hiv antigen/antibody, combination assay, screening |
157 |
153 |
$3K |
| 81511 |
|
12 |
12 |
$3K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
59 |
57 |
$2K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
80 |
68 |
$2K |
| 29580 |
|
36 |
25 |
$1K |
| J2704 |
Injection, propofol, 10 mg |
412 |
266 |
$1K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
13 |
13 |
$1K |
| 82607 |
|
100 |
96 |
$969.55 |
| 82803 |
|
52 |
48 |
$959.10 |
| 87184 |
|
118 |
112 |
$956.08 |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
12 |
12 |
$915.74 |
| 87205 |
|
65 |
60 |
$897.27 |
| 80074 |
|
25 |
25 |
$878.00 |
| 87075 |
|
52 |
48 |
$816.09 |
| 72125 |
Computed tomography, cervical spine; without contrast material |
13 |
13 |
$762.18 |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
24 |
24 |
$702.34 |
| 80050 |
General health panel |
95 |
94 |
$696.32 |
| 84100 |
|
18 |
18 |
$679.31 |
| 82805 |
|
12 |
12 |
$578.14 |
| 82570 |
|
117 |
111 |
$460.10 |
| 82043 |
|
99 |
95 |
$410.47 |
| 84156 |
|
76 |
68 |
$400.16 |
| 85379 |
|
57 |
54 |
$357.53 |
| 83970 |
|
13 |
13 |
$321.71 |
| 83550 |
|
37 |
37 |
$288.98 |
| 83540 |
|
38 |
38 |
$219.51 |
| 80069 |
|
30 |
27 |
$154.56 |
| 82375 |
|
13 |
13 |
$123.71 |
| 82105 |
|
86 |
84 |
$107.28 |
| Q9969 |
Tc-99m from non-highly enriched uranium source, full cost recovery add-on, per study dose |
12 |
12 |
$101.60 |
| 83050 |
|
13 |
13 |
$67.57 |
| 86140 |
|
14 |
14 |
$56.21 |
| 85651 |
|
19 |
19 |
$52.50 |
| 82731 |
|
12 |
12 |
$51.52 |
| 85014 |
|
24 |
24 |
$16.06 |
| 85018 |
|
24 |
24 |
$16.06 |
| 82962 |
|
13 |
13 |
$8.85 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
14 |
14 |
$0.00 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
73 |
67 |
$0.00 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
48 |
40 |
$0.00 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
27 |
24 |
$0.00 |
| V2632 |
Posterior chamber intraocular lens |
22 |
14 |
$0.00 |