| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 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 |
18,563 |
15,949 |
$1.58M |
| 80047 |
|
48,137 |
40,829 |
$1.55M |
| 70450 |
Computed tomography, head or brain; without contrast material |
9,459 |
8,305 |
$744K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
5,436 |
4,880 |
$688K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
6,407 |
5,630 |
$627K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
1,671 |
1,377 |
$503K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
4,432 |
4,033 |
$470K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
1,944 |
1,612 |
$388K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
51,868 |
42,516 |
$367K |
| 36415 |
Collection of venous blood by venipuncture |
60,220 |
50,174 |
$329K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
5,157 |
4,516 |
$321K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
1,726 |
1,546 |
$304K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
33,436 |
28,077 |
$287K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
5,578 |
3,639 |
$271K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
1,453 |
1,245 |
$254K |
| 84132 |
|
9,109 |
7,942 |
$244K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
2,398 |
2,157 |
$235K |
| 72141 |
|
1,232 |
1,007 |
$234K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
3,496 |
3,165 |
$216K |
| 93975 |
|
2,676 |
2,391 |
$200K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
8,618 |
6,455 |
$194K |
| 87633 |
Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets |
998 |
902 |
$166K |
| 80076 |
|
14,037 |
11,994 |
$158K |
| T1015 |
Clinic visit/encounter, all-inclusive |
14,064 |
11,706 |
$157K |
| 86901 |
|
6,673 |
5,678 |
$154K |
| 80061 |
Lipid panel |
4,268 |
3,676 |
$128K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
4,469 |
3,899 |
$124K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
11,941 |
10,453 |
$121K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
1,005 |
845 |
$120K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
10,310 |
8,005 |
$114K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
2,346 |
2,258 |
$111K |
| 71045 |
Radiologic examination, chest; single view |
15,449 |
13,188 |
$111K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
2,911 |
2,347 |
$107K |
| 82947 |
|
8,013 |
5,393 |
$105K |
| 84703 |
|
11,354 |
10,087 |
$105K |
| 71046 |
Radiologic examination, chest; 2 views |
6,701 |
5,835 |
$104K |
| 85014 |
|
10,436 |
8,799 |
$100K |
| 83880 |
|
4,893 |
4,143 |
$99K |
| 70496 |
|
858 |
773 |
$97K |
| 84484 |
|
13,745 |
10,506 |
$93K |
| 87631 |
|
1,287 |
1,178 |
$92K |
| 81025 |
|
10,969 |
9,748 |
$88K |
| 95886 |
|
3,073 |
2,564 |
$86K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
7,038 |
5,506 |
$86K |
| 95811 |
|
819 |
697 |
$80K |
| 86900 |
|
6,675 |
5,679 |
$79K |
| 76000 |
|
1,317 |
1,176 |
$75K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
5,527 |
4,946 |
$74K |
| 87070 |
|
1,164 |
848 |
$74K |
| 70498 |
|
702 |
630 |
$72K |
| J2785 |
Injection, regadenoson, 0.1 mg |
624 |
530 |
$69K |
| 82962 |
|
8,739 |
4,288 |
$68K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
420 |
365 |
$65K |
| 36430 |
|
850 |
645 |
$64K |
| 85027 |
|
8,136 |
6,465 |
$64K |
| 83690 |
|
9,803 |
8,492 |
$63K |
| C1769 |
Guide wire |
1,284 |
1,150 |
$62K |
| 95910 |
|
1,769 |
1,455 |
$62K |
| 73560 |
|
2,358 |
2,022 |
$61K |
| 82550 |
|
11,988 |
9,901 |
$57K |
| 87637 |
Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV |
601 |
538 |
$56K |
| 80053 |
Comprehensive metabolic panel |
2,572 |
2,072 |
$56K |
| 76801 |
|
1,685 |
1,496 |
$56K |
| 72100 |
|
2,208 |
1,983 |
$52K |
| 84443 |
Thyroid stimulating hormone (TSH) |
2,958 |
2,597 |
$52K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
962 |
878 |
$50K |
| 87040 |
|
4,927 |
3,071 |
$50K |
| 85610 |
|
13,344 |
11,060 |
$50K |
| 83605 |
|
5,438 |
3,781 |
$48K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
1,021 |
898 |
$48K |
| 93971 |
|
1,365 |
1,206 |
$48K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
8,768 |
6,953 |
$47K |
| 59025 |
Fetal non-stress test |
274 |
185 |
$45K |
| 82077 |
|
2,970 |
2,633 |
$45K |
| 81001 |
|
14,440 |
12,716 |
$44K |
| 95810 |
Polysomnography; sleep staging with 4 or more additional parameters |
445 |
393 |
$43K |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
1,462 |
1,316 |
$43K |
| 87088 |
|
5,244 |
4,615 |
$42K |
| 96376 |
|
4,819 |
2,809 |
$41K |
| 77066 |
Tomosynthesis, mammo |
823 |
759 |
$40K |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
5,657 |
4,829 |
$40K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
4,483 |
3,855 |
$39K |
| 80320 |
|
2,640 |
2,214 |
$37K |
| C1894 |
Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser |
1,008 |
891 |
$36K |
| 80143 |
|
2,067 |
1,865 |
$35K |
| 80179 |
|
2,066 |
1,863 |
$35K |
| C9803 |
Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
24,693 |
21,530 |
$35K |
| 87486 |
|
1,011 |
914 |
$34K |
| 87581 |
|
1,011 |
914 |
$34K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
3,248 |
1,271 |
$34K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
437 |
389 |
$33K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
854 |
739 |
$33K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
2,653 |
1,877 |
$33K |
| 73030 |
|
1,710 |
1,513 |
$33K |
| 84702 |
|
3,266 |
2,803 |
$32K |
| 81003 |
|
15,604 |
13,726 |
$31K |
| 66984 |
Extracapsular cataract removal with insertion of intraocular lens prosthesis |
231 |
200 |
$30K |
| 93296 |
|
2,856 |
2,670 |
$30K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
13,651 |
11,442 |
$28K |
| 86850 |
|
5,178 |
4,367 |
$28K |
| 80329 |
|
2,369 |
1,910 |
$28K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
24,908 |
18,981 |
$28K |
| 71250 |
|
350 |
321 |
$27K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
229 |
209 |
$26K |
| M0243 |
Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring |
163 |
154 |
$26K |
| A4556 |
Electrodes, (e.g., apnea monitor), per pair |
445 |
406 |
$25K |
| 85730 |
|
5,116 |
4,359 |
$24K |
| 93458 |
|
389 |
312 |
$23K |
| 97161 |
|
589 |
540 |
$22K |
| 73630 |
|
964 |
832 |
$21K |
| 73502 |
|
1,113 |
979 |
$20K |
| A9500 |
Technetium tc-99m sestamibi, diagnostic, per study dose |
968 |
820 |
$20K |
| 73610 |
|
1,283 |
1,094 |
$20K |
| 0202U |
Oncology (prostate), multianalyte, gene expression profiling |
1,654 |
1,540 |
$19K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
2,393 |
2,139 |
$19K |
| 87077 |
|
2,203 |
1,923 |
$19K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
2,566 |
2,289 |
$18K |
| 90715 |
|
1,118 |
1,018 |
$17K |
| 75574 |
|
91 |
90 |
$17K |
| G0378 |
Hospital observation service, per hour |
2,204 |
1,831 |
$17K |
| 72040 |
|
796 |
698 |
$17K |
| 76830 |
Ultrasound, transvaginal |
309 |
280 |
$17K |
| 73130 |
|
776 |
668 |
$16K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
1,250 |
1,186 |
$15K |
| 82977 |
|
1,501 |
1,353 |
$15K |
| 82565 |
|
2,479 |
2,037 |
$15K |
| 93970 |
|
617 |
550 |
$15K |
| 83735 |
|
3,323 |
2,255 |
$15K |
| 71020 |
|
1,258 |
1,119 |
$15K |
| 80306 |
|
930 |
768 |
$15K |
| 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 |
387 |
331 |
$14K |
| 77065 |
Tomosynthesis, mammo |
429 |
358 |
$13K |
| 82803 |
|
797 |
659 |
$13K |
| 80050 |
General health panel |
437 |
370 |
$13K |
| 85018 |
|
3,979 |
3,233 |
$13K |
| C1725 |
Catheter, transluminal angioplasty, non-laser (may include guidance, infusion/perfusion capability) |
70 |
60 |
$13K |
| 85055 |
|
781 |
643 |
$12K |
| 97165 |
|
283 |
255 |
$11K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
281 |
256 |
$11K |
| 93017 |
|
1,045 |
874 |
$11K |
| 76642 |
|
516 |
475 |
$11K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
3,263 |
2,714 |
$10K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
4,874 |
3,839 |
$10K |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
2,820 |
1,533 |
$10K |
| A9577 |
Injection, gadobenate dimeglumine (multihance), per ml |
268 |
234 |
$10K |
| 97162 |
|
215 |
198 |
$10K |
| 86923 |
|
719 |
581 |
$10K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
620 |
547 |
$9K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
12,075 |
9,979 |
$9K |
| 84450 |
|
1,174 |
1,062 |
$8K |
| 87186 |
|
1,637 |
1,428 |
$8K |
| 84460 |
|
1,137 |
1,028 |
$8K |
| 95908 |
|
316 |
267 |
$8K |
| 99152 |
|
2,966 |
2,544 |
$8K |
| 85379 |
|
985 |
854 |
$8K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
563 |
507 |
$8K |
| 72131 |
|
137 |
123 |
$7K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
682 |
602 |
$7K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
1,368 |
1,174 |
$7K |
| 97001 |
|
444 |
354 |
$7K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
811 |
656 |
$7K |
| 93880 |
|
317 |
271 |
$7K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,431 |
1,298 |
$7K |
| 70486 |
|
60 |
60 |
$6K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
288 |
241 |
$6K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
131 |
123 |
$6K |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
12,295 |
9,082 |
$6K |
| 10060 |
|
26 |
24 |
$5K |
| 85380 |
|
574 |
529 |
$5K |
| 77001 |
|
117 |
96 |
$5K |
| J0690 |
Injection, cefazolin sodium, 500 mg |
9,927 |
7,309 |
$5K |
| 80074 |
|
145 |
126 |
$5K |
| 97003 |
|
227 |
191 |
$4K |
| 86352 |
|
342 |
235 |
$4K |
| 88307 |
|
39 |
36 |
$4K |
| A4364 |
Adhesive, liquid or equal, any type, per oz |
182 |
166 |
$4K |
| 80051 |
|
384 |
297 |
$4K |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
201 |
134 |
$4K |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
12,518 |
10,754 |
$4K |
| 82607 |
|
430 |
390 |
$4K |
| 67113 |
|
12 |
12 |
$4K |
| M0245 |
Intravenous infusion, bamlanivimab and etesevimab, includes infusion and post administration monitoring |
12 |
12 |
$4K |
| 85007 |
|
1,319 |
1,119 |
$4K |
| 87205 |
|
1,297 |
1,005 |
$4K |
| 77062 |
|
81 |
74 |
$3K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
17,354 |
14,850 |
$3K |
| 97166 |
|
78 |
73 |
$3K |
| 95816 |
|
231 |
184 |
$3K |
| 82746 |
|
316 |
289 |
$3K |
| 73700 |
|
49 |
38 |
$3K |
| 90686 |
|
324 |
306 |
$3K |
| 87075 |
|
330 |
233 |
$3K |
| 83615 |
|
417 |
337 |
$3K |
| 84550 |
|
508 |
417 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
250 |
223 |
$2K |
| 76937 |
|
570 |
476 |
$2K |
| 0001A |
|
111 |
109 |
$2K |
| 71010 |
|
484 |
432 |
$2K |
| G2066 |
Interrogation device evaluation(s), (remote) up to 30 days; implantable cardiovascular physiologic monitor system, implantable loop recorder system, or subcutaneous cardiac rhythm monitor system, remote data acquisition(s), receipt of transmissions and technician review, technical support and distribution of results |
369 |
361 |
$2K |
| 82010 |
|
339 |
290 |
$2K |
| 84520 |
|
525 |
428 |
$2K |
| A9575 |
Injection, gadoterate meglumine, 0.1 ml |
26 |
26 |
$2K |
| J2704 |
Injection, propofol, 10 mg |
12,706 |
11,205 |
$2K |
| M0247 |
Intravenous infusion, sotrovimab, includes infusion and post administration monitoring |
14 |
13 |
$2K |
| 82728 |
|
173 |
157 |
$2K |
| M0239 |
Intravenous infusion, bamlanivimab-xxxx, includes infusion and post administration monitoring |
30 |
30 |
$2K |
| J1815 |
Injection, insulin, per 5 units |
4,588 |
2,251 |
$2K |
| 74174 |
|
12 |
12 |
$2K |
| G0330 |
Facility services for dental rehabilitation procedure(s) performed on a patient who requires monitored anesthesia (e.g., general, intravenous sedation (monitored anesthesia care) and use of an operating room |
159 |
149 |
$2K |
| 88313 |
|
13 |
13 |
$2K |
| J1644 |
Injection, heparin sodium, per 1000 units |
6,370 |
3,610 |
$2K |
| 87102 |
|
183 |
121 |
$2K |
| 93976 |
|
32 |
25 |
$2K |
| 76775 |
|
138 |
130 |
$2K |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
8,990 |
6,981 |
$2K |
| 84436 |
|
378 |
336 |
$2K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
36 |
32 |
$1K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
36 |
32 |
$1K |
| 76536 |
|
27 |
25 |
$1K |
| 86021 |
|
44 |
37 |
$1K |
| 83540 |
|
296 |
269 |
$1K |
| J2060 |
Injection, lorazepam, 2 mg |
2,319 |
1,907 |
$1K |
| P9016 |
Red blood cells, leukocytes reduced, each unit |
621 |
483 |
$1K |
| J1170 |
Injection, hydromorphone, up to 4 mg |
8,388 |
6,157 |
$1K |
| 82805 |
|
46 |
44 |
$1K |
| 73110 |
|
68 |
56 |
$1K |
| 73564 |
|
45 |
38 |
$1K |
| J3370 |
Injection, vancomycin hcl, 500 mg |
1,820 |
1,232 |
$1K |
| C1887 |
Catheter, guiding (may include infusion/perfusion capability) |
47 |
42 |
$1K |
| 82248 |
|
222 |
195 |
$1K |
| J2370 |
Injection, phenylephrine hcl, up to 1 ml |
2,186 |
1,914 |
$1K |
| 74022 |
|
45 |
38 |
$1K |
| 83550 |
|
143 |
126 |
$1K |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
125 |
92 |
$1K |
| 87400 |
|
104 |
98 |
$998.53 |
| 82375 |
|
89 |
79 |
$996.68 |
| 85384 |
|
105 |
80 |
$984.88 |
| 82800 |
|
110 |
107 |
$955.90 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
70 |
57 |
$916.70 |
| 73590 |
|
53 |
41 |
$888.48 |
| 93298 |
|
76 |
71 |
$840.02 |
| J0171 |
Injection, adrenalin, epinephrine, 0.1 mg |
2,901 |
2,550 |
$826.16 |
| 93297 |
|
166 |
152 |
$806.86 |
| 93308 |
|
39 |
24 |
$739.69 |
| 73552 |
|
46 |
36 |
$729.73 |
| 73070 |
|
62 |
51 |
$688.86 |
| 74018 |
|
51 |
39 |
$659.72 |
| 84145 |
|
40 |
37 |
$584.79 |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
30 |
26 |
$530.06 |
| 87210 |
|
251 |
181 |
$522.84 |
| J7030 |
Infusion, normal saline solution , 1000 cc |
9,135 |
7,405 |
$520.53 |
| 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 |
14,119 |
12,424 |
$504.00 |
| G0279 |
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) |
12 |
12 |
$503.26 |
| 87206 |
|
188 |
122 |
$493.08 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
465 |
393 |
$460.64 |
| 94760 |
|
36 |
35 |
$448.00 |
| J0360 |
Injection, hydralazine hcl, up to 20 mg |
2,634 |
2,131 |
$435.19 |
| J0702 |
Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg |
378 |
311 |
$423.80 |
| J2550 |
Injection, promethazine hcl, up to 50 mg |
1,610 |
1,336 |
$422.08 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
1,238 |
958 |
$405.67 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
3,486 |
2,900 |
$404.17 |
| J3360 |
Injection, diazepam, up to 5 mg |
868 |
748 |
$401.60 |
| 82570 |
|
80 |
58 |
$399.17 |
| 84100 |
|
135 |
95 |
$377.10 |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
14 |
12 |
$367.74 |
| 99153 |
Mod sedat endo service >5yrs |
475 |
426 |
$367.26 |
| 85347 |
|
53 |
43 |
$364.87 |
| 93321 |
|
75 |
53 |
$363.46 |
| 85049 |
|
35 |
29 |
$328.62 |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
14 |
12 |
$320.73 |
| 82310 |
|
16 |
12 |
$320.61 |
| 73562 |
|
17 |
15 |
$310.90 |
| 94729 |
|
12 |
12 |
$289.20 |
| 83986 |
|
68 |
63 |
$276.48 |
| 84156 |
|
74 |
56 |
$276.33 |
| 89051 |
|
17 |
12 |
$256.65 |
| 84295 |
|
25 |
25 |
$254.35 |
| 80164 |
|
16 |
14 |
$241.64 |
| 81015 |
|
221 |
201 |
$228.76 |
| 80069 |
|
84 |
44 |
$219.11 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
642 |
500 |
$210.63 |
| 93888 |
|
106 |
90 |
$210.00 |
| 87641 |
|
14 |
13 |
$202.68 |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
1,143 |
969 |
$197.37 |
| 80197 |
|
23 |
13 |
$194.98 |
| 96367 |
|
118 |
53 |
$190.39 |
| 76376 |
|
29 |
25 |
$180.22 |
| 86140 |
|
38 |
36 |
$180.20 |
| 73090 |
|
15 |
13 |
$180.00 |
| 93242 |
|
14 |
12 |
$175.59 |
| 94010 |
|
13 |
12 |
$170.38 |
| 74000 |
|
17 |
14 |
$170.00 |
| 97150 |
Therapeutic procedure(s), group (2 or more individuals) |
16 |
12 |
$169.73 |
| 93325 |
|
55 |
50 |
$160.00 |
| 92523 |
|
14 |
13 |
$148.32 |
| J3473 |
Injection, hyaluronidase, recombinant, 1 usp unit |
98 |
93 |
$136.20 |
| J7050 |
Infusion, normal saline solution, 250 cc |
17,237 |
10,852 |
$128.78 |
| J1630 |
Injection, haloperidol, up to 5 mg |
56 |
50 |
$125.21 |
| 72070 |
|
13 |
13 |
$120.00 |
| J3471 |
Injection, hyaluronidase, ovine, preservative free, per 1 usp unit (up to 999 usp units) |
2,435 |
2,134 |
$110.99 |
| 86704 |
|
14 |
13 |
$109.92 |
| G0257 |
Unscheduled or emergency dialysis treatment for an esrd patient in a hospital outpatient department that is not certified as an esrd facility |
108 |
78 |
$107.38 |
| 84479 |
|
30 |
24 |
$99.74 |
| A9270 |
Non-covered item or service |
21,916 |
3,740 |
$94.21 |
| J2272 |
Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg |
793 |
583 |
$93.76 |
| J1920 |
Injection, labetalol hydrochloride, 5 mg |
410 |
353 |
$87.64 |
| J1940 |
Injection, furosemide, up to 20 mg |
806 |
565 |
$86.56 |
| 85652 |
|
35 |
29 |
$80.55 |
| J3490 |
Unclassified drugs |
1,020 |
885 |
$58.34 |
| G0382 |
Level 3 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room or emergency department; (2) it is held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment; or (3) during the calendar year immediately preceding the calendar year in which a determination under 42 cfr 489.24 is being made, based on a representative sample of patient visits that occurred during that calendar year, it provides at least one-third of all of its outpatient visits for the treatment of emergency medical conditions on an urgent basis without requiring a previously scheduled appointment) |
15 |
15 |
$56.64 |
| 76506 |
|
116 |
97 |
$56.40 |
| 82150 |
|
14 |
14 |
$55.56 |
| 87340 |
|
29 |
27 |
$49.91 |
| 86803 |
|
13 |
12 |
$48.60 |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
569 |
524 |
$46.39 |
| J2175 |
Injection, meperidine hydrochloride, per 100 mg |
415 |
321 |
$45.26 |
| 86705 |
|
13 |
12 |
$40.07 |
| 86709 |
|
13 |
12 |
$38.29 |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
3,361 |
2,846 |
$36.56 |
| J0280 |
Injection, aminophyllin, up to 250 mg |
14 |
12 |
$34.89 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
95 |
79 |
$32.46 |
| 87081 |
|
14 |
12 |
$28.41 |
| J1953 |
Injection, levetiracetam, 10 mg |
23 |
14 |
$24.05 |
| J1805 |
Injection, esmolol hydrochloride, 10 mg |
65 |
58 |
$8.20 |
| J1956 |
Injection, levofloxacin, 250 mg |
100 |
75 |
$8.20 |
| Q9969 |
Tc-99m from non-highly enriched uranium source, full cost recovery add-on, per study dose |
12 |
12 |
$8.18 |
| 36600 |
|
721 |
624 |
$6.44 |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
3,201 |
2,479 |
$6.00 |
| G1004 |
Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program |
1,919 |
1,439 |
$4.68 |
| 97535 |
Self-care/home management training, each 15 minutes |
746 |
627 |
$0.77 |
| Q0162 |
Ondansetron 1 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen |
490 |
416 |
$0.47 |
| J2371 |
Injection, phenylephrine hydrochloride, 20 micrograms |
538 |
487 |
$0.26 |
| J1171 |
Injection, hydromorphone, 0.1 mg |
105 |
85 |
$0.24 |
| J2305 |
Injection, nitroglycerin, 5 mg |
35 |
30 |
$0.04 |
| G8987 |
Self care functional limitation, current status, at therapy episode outset and at reporting intervals |
105 |
87 |
$0.02 |
| J1596 |
Injection, glycopyrrolate, 0.1 mg |
612 |
525 |
$0.02 |
| G8988 |
Self care functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting |
87 |
74 |
$0.01 |
| G8978 |
Mobility: walking & moving around functional limitation, current status, at therapy episode outset and at reporting intervals |
123 |
99 |
$0.01 |
| G8979 |
Mobility: walking & moving around functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting |
120 |
98 |
$0.01 |
| 88342 |
|
30 |
27 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
66 |
63 |
$0.00 |
| J3470 |
Injection, hyaluronidase, up to 150 units |
85 |
78 |
$0.00 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
212 |
123 |
$0.00 |
| J1790 |
Injection, droperidol, up to 5 mg |
13 |
12 |
$0.00 |
| J2470 |
Injection, pantoprazole sodium, 40 mg |
53 |
31 |
$0.00 |
| J2997 |
Injection, alteplase recombinant, 1 mg |
21 |
13 |
$0.00 |
| 97802 |
|
12 |
12 |
$0.00 |
| J3480 |
Injection, potassium chloride, per 2 meq |
25 |
13 |
$0.00 |
| J0736 |
Injection, clindamycin phosphate, 300 mg |
42 |
37 |
$0.00 |
| C9113 |
Injection, pantoprazole sodium, per vial |
552 |
256 |
$0.00 |
| 93356 |
|
486 |
452 |
$0.00 |
| 97116 |
|
84 |
59 |
$0.00 |
| 92610 |
|
45 |
39 |
$0.00 |
| J2919 |
Injection, methylprednisolone sodium succinate, 5 mg |
47 |
43 |
$0.00 |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
131 |
38 |
$0.00 |
| J3300 |
Injection, triamcinolone acetonide, preservative free, 1 mg |
12 |
12 |
$0.00 |