| Code | Description | Claims | Beneficiaries | Total Paid |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
191,727 |
185,062 |
$8.02M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
81,592 |
80,632 |
$6.62M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
39,421 |
39,112 |
$2.62M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
81,137 |
77,910 |
$2.50M |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
52,417 |
51,472 |
$2.14M |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
80,830 |
32,165 |
$1.92M |
| 99233 |
Prolong inpt eval add15 m |
48,693 |
19,056 |
$1.67M |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
39,687 |
38,705 |
$1.43M |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
19,463 |
18,931 |
$958K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
11,312 |
5,063 |
$931K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
34,198 |
33,693 |
$908K |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
251,970 |
219,061 |
$896K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
27,173 |
26,436 |
$768K |
| 99215 |
Prolong outpt/office vis |
12,489 |
11,873 |
$708K |
| 99223 |
Prolong inpt eval add15 m |
9,148 |
8,708 |
$662K |
| 70450 |
Computed tomography, head or brain; without contrast material |
36,826 |
35,234 |
$583K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
6,610 |
6,581 |
$509K |
| 01967 |
Neuraxial labor analgesia/anesthesia for planned vaginal delivery |
1,046 |
1,045 |
$480K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
18,319 |
17,804 |
$444K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
32,175 |
31,681 |
$442K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
13,242 |
12,467 |
$434K |
| 71046 |
Radiologic examination, chest; 2 views |
81,899 |
78,173 |
$410K |
| 71045 |
Radiologic examination, chest; single view |
108,658 |
79,517 |
$393K |
| 88307 |
|
5,878 |
5,809 |
$377K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
9,800 |
9,690 |
$368K |
| 99239 |
Hospital discharge day management, more than 30 minutes |
7,629 |
7,526 |
$356K |
| 99222 |
Initial hospital care, per day, moderate complexity |
5,066 |
4,823 |
$252K |
| 59025 |
Fetal non-stress test |
8,967 |
5,612 |
$250K |
| 71250 |
|
13,502 |
13,173 |
$248K |
| 78815 |
Positron emission tomography (PET) for limited area imaging |
4,527 |
4,399 |
$199K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
7,631 |
7,398 |
$185K |
| 76830 |
Ultrasound, transvaginal |
7,190 |
6,962 |
$181K |
| 90935 |
Hemodialysis procedure with single evaluation by a physician |
9,003 |
3,717 |
$173K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
5,626 |
4,989 |
$165K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
3,632 |
3,620 |
$163K |
| 99460 |
|
1,412 |
1,408 |
$142K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
4,193 |
4,161 |
$142K |
| 85390 |
|
6,886 |
4,928 |
$135K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
6,018 |
5,947 |
$113K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
1,023 |
1,017 |
$112K |
| J0585 |
Injection, onabotulinumtoxina, 1 unit |
704 |
371 |
$112K |
| 31579 |
|
1,319 |
1,307 |
$110K |
| 84165 |
|
17,841 |
16,604 |
$109K |
| 31231 |
|
1,161 |
1,148 |
$101K |
| 86334 |
|
15,954 |
14,763 |
$100K |
| 88342 |
|
3,919 |
3,768 |
$93K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
2,480 |
2,455 |
$87K |
| 97803 |
|
2,064 |
2,022 |
$86K |
| 99469 |
Subsequent inpatient neonatal critical care, per day, 28 days or younger |
269 |
61 |
$77K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
2,193 |
2,166 |
$76K |
| 99231 |
Subsequent hospital care, per day, straightforward or low complexity |
4,529 |
1,962 |
$73K |
| 76801 |
|
1,801 |
1,748 |
$68K |
| 76642 |
|
3,067 |
2,715 |
$60K |
| 99462 |
|
1,384 |
1,092 |
$60K |
| 74174 |
|
1,427 |
1,360 |
$56K |
| 95951 |
|
453 |
234 |
$56K |
| 74183 |
|
1,068 |
1,043 |
$51K |
| 64615 |
|
1,228 |
1,217 |
$50K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
1,305 |
1,292 |
$50K |
| 95720 |
|
577 |
309 |
$50K |
| 90960 |
End-stage renal disease related services monthly, for patients 20 years and older, with 4 or more face-to-face visits |
639 |
639 |
$47K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
1,141 |
1,057 |
$47K |
| 93016 |
|
5,434 |
5,381 |
$45K |
| 93970 |
|
3,028 |
2,850 |
$45K |
| 90961 |
|
737 |
734 |
$44K |
| 88189 |
|
1,108 |
1,003 |
$43K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
2,084 |
1,994 |
$42K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
2,025 |
1,968 |
$42K |
| 70496 |
|
1,114 |
1,105 |
$42K |
| 76536 |
|
2,453 |
2,367 |
$39K |
| 36902 |
|
870 |
840 |
$38K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
1,138 |
1,125 |
$38K |
| G0452 |
Molecular pathology procedure; physician interpretation and report |
2,811 |
2,528 |
$38K |
| 70498 |
|
1,064 |
1,058 |
$38K |
| 99205 |
Prolong outpt/office vis |
313 |
304 |
$35K |
| 88141 |
|
1,523 |
1,516 |
$33K |
| 90834 |
Psychotherapy, 45 minutes with patient |
468 |
286 |
$30K |
| 99255 |
|
124 |
122 |
$30K |
| 93018 |
|
5,426 |
5,374 |
$30K |
| 92557 |
|
1,125 |
1,121 |
$28K |
| 94010 |
|
6,852 |
6,483 |
$28K |
| 73630 |
|
6,227 |
5,292 |
$28K |
| 76820 |
|
1,350 |
1,205 |
$27K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
847 |
827 |
$26K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,559 |
1,543 |
$25K |
| 31575 |
|
439 |
427 |
$25K |
| 74018 |
|
6,999 |
6,000 |
$24K |
| 90686 |
|
1,948 |
1,943 |
$23K |
| 77080 |
|
5,766 |
5,744 |
$21K |
| 54150 |
|
264 |
264 |
$20K |
| 83020 |
|
1,491 |
1,438 |
$20K |
| 73564 |
|
3,707 |
3,022 |
$20K |
| 88291 |
|
1,536 |
1,392 |
$19K |
| 93295 |
|
948 |
934 |
$18K |
| 88321 |
|
508 |
428 |
$18K |
| 72100 |
|
3,073 |
2,984 |
$16K |
| 95165 |
Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy, multiple dose vials |
1,039 |
642 |
$16K |
| 73030 |
|
3,536 |
3,229 |
$15K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
871 |
854 |
$14K |
| 99443 |
|
2,733 |
2,560 |
$14K |
| 99217 |
|
455 |
453 |
$14K |
| 99308 |
Subsequent nursing facility care, per day, straightforward |
2,268 |
2,099 |
$14K |
| 62323 |
|
419 |
417 |
$13K |
| 00731 |
|
207 |
202 |
$13K |
| 88350 |
|
199 |
169 |
$13K |
| 99221 |
|
311 |
296 |
$12K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
168 |
168 |
$12K |
| 52000 |
|
153 |
153 |
$12K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
308 |
308 |
$12K |
| 93971 |
|
1,239 |
1,215 |
$12K |
| 76770 |
|
761 |
751 |
$11K |
| 71271 |
|
546 |
545 |
$11K |
| 51798 |
|
1,562 |
1,511 |
$11K |
| 62370 |
|
1,130 |
1,076 |
$11K |
| 88112 |
|
992 |
931 |
$11K |
| 43235 |
|
147 |
145 |
$11K |
| 73610 |
|
2,153 |
1,986 |
$11K |
| 11056 |
|
1,451 |
1,451 |
$11K |
| 77066 |
Tomosynthesis, mammo |
378 |
372 |
$10K |
| 20553 |
|
876 |
852 |
$10K |
| 78451 |
|
420 |
416 |
$10K |
| 77065 |
Tomosynthesis, mammo |
452 |
447 |
$10K |
| 73221 |
|
250 |
239 |
$9K |
| 73502 |
|
2,078 |
1,962 |
$9K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
130 |
129 |
$9K |
| 99442 |
|
2,820 |
2,632 |
$9K |
| 88313 |
|
1,136 |
1,086 |
$9K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
364 |
359 |
$9K |
| 92567 |
|
758 |
758 |
$8K |
| G0279 |
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) |
493 |
491 |
$8K |
| 99254 |
|
42 |
39 |
$7K |
| 99464 |
|
126 |
126 |
$7K |
| 90791 |
Psychiatric diagnostic evaluation |
56 |
56 |
$7K |
| 95816 |
|
338 |
333 |
$7K |
| 91320 |
|
97 |
97 |
$7K |
| 73130 |
|
1,483 |
1,157 |
$7K |
| 76813 |
|
150 |
150 |
$7K |
| 90837 |
Psychotherapy, 53 minutes with patient |
86 |
37 |
$7K |
| 95806 |
|
191 |
191 |
$7K |
| 99152 |
|
2,717 |
2,554 |
$6K |
| 86255 |
|
724 |
710 |
$6K |
| 90833 |
Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) |
376 |
360 |
$6K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
219 |
209 |
$6K |
| 0124A |
|
238 |
237 |
$6K |
| 70544 |
|
252 |
244 |
$6K |
| 95924 |
|
142 |
138 |
$6K |
| 84166 |
|
893 |
867 |
$6K |
| 85097 |
|
315 |
281 |
$6K |
| 94729 |
|
1,553 |
1,538 |
$6K |
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
515 |
286 |
$5K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
88 |
88 |
$5K |
| 93308 |
|
522 |
494 |
$5K |
| 88312 |
|
268 |
268 |
$5K |
| 90962 |
|
82 |
81 |
$5K |
| 73562 |
|
1,030 |
871 |
$5K |
| 97802 |
|
85 |
85 |
$5K |
| 91065 |
|
882 |
862 |
$5K |
| 72141 |
|
134 |
131 |
$4K |
| 88348 |
|
141 |
137 |
$4K |
| 95819 |
|
181 |
180 |
$4K |
| 51701 |
|
278 |
276 |
$4K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
68 |
68 |
$4K |
| 99153 |
Mod sedat endo service >5yrs |
2,318 |
2,177 |
$4K |
| 20610 |
|
141 |
138 |
$4K |
| 99226 |
|
57 |
41 |
$3K |
| 88173 |
|
112 |
85 |
$3K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
76 |
67 |
$3K |
| 93294 |
|
498 |
491 |
$3K |
| G0127 |
Trimming of dystrophic nails, any number |
2,178 |
2,178 |
$3K |
| 94726 |
|
604 |
596 |
$3K |
| 77062 |
|
36 |
36 |
$3K |
| 95923 |
|
143 |
139 |
$3K |
| G0297 |
Low dose ct scan (ldct) for lung cancer screening |
177 |
176 |
$3K |
| 93000 |
|
450 |
443 |
$3K |
| 36215 |
|
120 |
108 |
$3K |
| 94003 |
|
132 |
49 |
$3K |
| 88346 |
|
186 |
181 |
$3K |
| 75574 |
|
51 |
51 |
$3K |
| 90480 |
|
101 |
101 |
$3K |
| 91200 |
|
358 |
356 |
$3K |
| 95044 |
|
31 |
26 |
$2K |
| 96137 |
|
16 |
16 |
$2K |
| 88108 |
|
236 |
228 |
$2K |
| 95251 |
|
210 |
207 |
$2K |
| 72156 |
|
53 |
51 |
$2K |
| 72132 |
|
99 |
97 |
$2K |
| 93975 |
|
51 |
51 |
$2K |
| 11750 |
|
30 |
28 |
$2K |
| 72129 |
|
95 |
93 |
$2K |
| 99220 |
|
26 |
26 |
$2K |
| 99496 |
|
13 |
13 |
$2K |
| 93248 |
|
203 |
203 |
$2K |
| 11104 |
|
81 |
80 |
$2K |
| 93298 |
|
187 |
187 |
$2K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
62 |
62 |
$2K |
| 78431 |
|
64 |
63 |
$2K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
95 |
94 |
$2K |
| 94060 |
|
266 |
264 |
$2K |
| 74246 |
|
67 |
67 |
$2K |
| 75710 |
|
174 |
154 |
$2K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
69 |
69 |
$2K |
| 88304 |
|
261 |
252 |
$2K |
| 72157 |
|
42 |
39 |
$2K |
| 88331 |
|
50 |
49 |
$2K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
169 |
165 |
$1K |
| 85060 |
|
217 |
161 |
$1K |
| 0004A |
|
57 |
57 |
$1K |
| 77427 |
|
29 |
13 |
$1K |
| 74175 |
|
42 |
41 |
$1K |
| 36906 |
|
15 |
12 |
$1K |
| 99480 |
Subsequent intensive care, per day, low birth weight infant |
14 |
12 |
$1K |
| 72040 |
|
204 |
196 |
$1K |
| 73110 |
|
299 |
274 |
$1K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
47 |
41 |
$1K |
| 95913 |
|
13 |
12 |
$1K |
| G0141 |
Screening cytopathology smears, cervical or vaginal, performed by automated system, with manual rescreening, requiring interpretation by physician |
51 |
51 |
$1K |
| 93892 |
|
37 |
37 |
$1K |
| 49083 |
|
30 |
25 |
$968.59 |
| 93272 |
|
62 |
59 |
$941.10 |
| 93280 |
|
101 |
101 |
$921.90 |
| 78816 |
|
14 |
14 |
$920.00 |
| 93321 |
|
305 |
288 |
$894.86 |
| 76937 |
|
230 |
208 |
$888.60 |
| 95822 |
|
37 |
37 |
$885.57 |
| 95938 |
|
39 |
39 |
$867.40 |
| 93325 |
|
615 |
582 |
$866.90 |
| 36005 |
|
41 |
24 |
$857.93 |
| 17110 |
|
15 |
13 |
$836.10 |
| 81003 |
|
591 |
557 |
$821.41 |
| 11105 |
|
53 |
53 |
$800.18 |
| 73560 |
|
213 |
196 |
$792.68 |
| 95937 |
|
14 |
14 |
$783.42 |
| 96136 |
|
16 |
16 |
$782.79 |
| 11721 |
|
214 |
214 |
$780.29 |
| 46600 |
|
13 |
13 |
$751.14 |
| G2211 |
Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established) |
272 |
263 |
$747.39 |
| 70491 |
|
30 |
24 |
$739.10 |
| 92083 |
|
65 |
62 |
$714.58 |
| 88311 |
|
170 |
145 |
$712.09 |
| 92133 |
|
55 |
50 |
$683.04 |
| 99309 |
Subsequent nursing facility care, per day, low to moderate complexity |
20 |
15 |
$574.87 |
| 99441 |
|
78 |
74 |
$539.57 |
| 64483 |
|
12 |
12 |
$532.94 |
| 77001 |
|
71 |
67 |
$531.14 |
| 95886 |
|
24 |
24 |
$522.35 |
| 93922 |
|
26 |
25 |
$505.74 |
| 95800 |
|
16 |
16 |
$474.40 |
| 99306 |
Prolong nursin fac eval 15m |
13 |
13 |
$469.11 |
| 93244 |
|
44 |
44 |
$467.66 |
| 72197 |
|
12 |
12 |
$462.92 |
| J1030 |
Injection, methylprednisolone acetate, 40 mg |
70 |
70 |
$456.55 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
45 |
41 |
$451.88 |
| 88188 |
|
12 |
12 |
$445.56 |
| 31645 |
|
13 |
12 |
$441.01 |
| 93790 |
|
68 |
68 |
$437.39 |
| 88381 |
|
43 |
41 |
$434.69 |
| A9585 |
Injection, gadobutrol, 0.1 ml |
44 |
43 |
$411.94 |
| 78434 |
|
27 |
27 |
$401.90 |
| 86256 |
|
47 |
47 |
$398.63 |
| 88360 |
|
14 |
14 |
$380.53 |
| 20550 |
|
16 |
16 |
$379.10 |
| 51705 |
|
13 |
13 |
$370.32 |
| J1010 |
Injection, methylprednisolone acetate, 1 mg |
51 |
51 |
$365.10 |
| 95885 |
|
44 |
42 |
$342.11 |
| 72170 |
|
109 |
105 |
$339.74 |
| 94621 |
|
15 |
15 |
$334.71 |
| G0500 |
Moderate sedation services provided by the same physician or other qualified health care professional performing a gastrointestinal endoscopic service that sedation supports, requiring the presence of an independent trained observer to assist in the monitoring of the patient's level of consciousness and physiological status; initial 15 minutes of intra-service time; patient age 5 years or older (additional time may be reported with 99153, as appropriate) |
465 |
461 |
$334.08 |
| 74230 |
|
53 |
49 |
$314.05 |
| G0108 |
Diabetes outpatient self-management training services, individual, per 30 minutes |
12 |
12 |
$305.91 |
| 92524 |
|
14 |
14 |
$297.81 |
| G0008 |
Administration of influenza virus vaccine |
643 |
642 |
$294.44 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
97 |
97 |
$279.45 |
| 70486 |
|
12 |
12 |
$263.41 |
| 78306 |
|
12 |
12 |
$248.86 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
85 |
77 |
$237.31 |
| 72158 |
|
12 |
12 |
$214.34 |
| 92504 |
|
26 |
26 |
$207.60 |
| 96127 |
|
567 |
565 |
$202.95 |
| 76604 |
|
13 |
13 |
$199.62 |
| 69210 |
|
12 |
12 |
$199.42 |
| 0054A |
|
12 |
12 |
$183.48 |
| 90662 |
|
128 |
127 |
$179.29 |
| 95991 |
|
13 |
12 |
$157.70 |
| 91010 |
|
14 |
14 |
$153.77 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
13 |
13 |
$143.56 |
| 73590 |
|
24 |
24 |
$111.99 |
| 77002 |
|
18 |
17 |
$103.22 |
| 73080 |
|
29 |
26 |
$100.84 |
| 36415 |
Collection of venous blood by venipuncture |
3,192 |
3,160 |
$99.28 |
| 94618 |
|
12 |
12 |
$89.00 |
| 77081 |
|
15 |
15 |
$68.89 |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
123 |
122 |
$67.18 |
| 73552 |
|
13 |
12 |
$58.27 |
| 93356 |
|
40 |
40 |
$57.68 |
| 82962 |
|
258 |
253 |
$54.78 |
| 73060 |
|
13 |
12 |
$44.67 |
| 80053 |
Comprehensive metabolic panel |
30 |
30 |
$42.24 |
| 81001 |
|
24 |
24 |
$36.22 |
| 11719 |
|
12 |
12 |
$35.06 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
14 |
13 |
$29.23 |
| 80061 |
Lipid panel |
14 |
14 |
$26.78 |
| 85027 |
|
13 |
13 |
$12.94 |
| J2795 |
Injection, ropivacaine hydrochloride, 1 mg |
12 |
12 |
$4.64 |
| 91312 |
|
234 |
233 |
$0.02 |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
14 |
14 |
$0.00 |
| 80048 |
Basic metabolic panel (calcium, ionized) |
12 |
12 |
$0.00 |
| G1004 |
Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program |
10,285 |
7,294 |
$0.00 |
| 99497 |
|
13 |
13 |
$0.00 |
| 90937 |
|
41 |
14 |
$0.00 |
| 90750 |
|
12 |
12 |
$0.00 |
| G0438 |
Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit |
26 |
26 |
$0.00 |