| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
53,557 |
51,512 |
$9.18M |
| H0035 |
Mental health partial hospitalization, treatment, less than 24 hours |
24,777 |
2,200 |
$8.24M |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
43,315 |
41,960 |
$5.80M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
61,571 |
50,824 |
$4.60M |
| 92507 |
Treatment of speech, language, voice, communication, and/or auditory processing disorder |
40,700 |
12,555 |
$2.07M |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
43,362 |
13,485 |
$1.87M |
| 96361 |
Intravenous infusion, hydration; each additional hour |
8,506 |
7,993 |
$1.39M |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
11,951 |
9,627 |
$1.24M |
| 90834 |
Psychotherapy, 45 minutes with patient |
19,102 |
10,728 |
$1.19M |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
17,782 |
13,998 |
$1.14M |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
32,406 |
13,773 |
$921K |
| 99215 |
Prolong outpt/office vis |
9,500 |
8,320 |
$896K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
9,579 |
9,139 |
$817K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
6,903 |
6,758 |
$767K |
| 59025 |
Fetal non-stress test |
4,384 |
3,892 |
$760K |
| 99233 |
Prolong inpt eval add15 m |
8,579 |
2,446 |
$714K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
11,155 |
7,452 |
$703K |
| 36415 |
Collection of venous blood by venipuncture |
73,658 |
67,459 |
$678K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
15,032 |
12,112 |
$621K |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
9,130 |
2,655 |
$543K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
5,212 |
5,061 |
$507K |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
1,975 |
1,851 |
$474K |
| 76825 |
|
2,958 |
2,368 |
$425K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
1,924 |
1,102 |
$401K |
| 93296 |
|
12,303 |
12,024 |
$391K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
2,615 |
2,471 |
$356K |
| 97535 |
Self-care/home management training, each 15 minutes |
10,481 |
5,579 |
$350K |
| 90837 |
Psychotherapy, 53 minutes with patient |
3,423 |
2,115 |
$340K |
| 93325 |
|
3,743 |
3,147 |
$263K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
19,230 |
17,884 |
$262K |
| G0378 |
Hospital observation service, per hour |
1,158 |
1,008 |
$257K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
64,875 |
58,981 |
$256K |
| 99223 |
Prolong inpt eval add15 m |
1,704 |
1,557 |
$251K |
| 93303 |
Transthoracic echocardiography for congenital cardiac anomalies, follow-up or limited study |
491 |
482 |
$179K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
3,260 |
1,816 |
$171K |
| 99244 |
Office or other outpatient consultation, moderate to high complexity |
1,423 |
1,366 |
$170K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
350 |
343 |
$159K |
| 90847 |
Family psychotherapy with the patient present, 50 minutes |
1,683 |
1,170 |
$159K |
| 80053 |
Comprehensive metabolic panel |
25,869 |
21,812 |
$150K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
848 |
665 |
$147K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
4,419 |
2,044 |
$146K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
25,742 |
24,093 |
$140K |
| 71046 |
Radiologic examination, chest; 2 views |
5,244 |
5,015 |
$138K |
| 97161 |
|
2,268 |
2,164 |
$137K |
| 99239 |
Hospital discharge day management, more than 30 minutes |
1,422 |
1,307 |
$135K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
2,931 |
2,543 |
$128K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
291 |
273 |
$124K |
| 76820 |
|
3,717 |
1,505 |
$109K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
4,273 |
1,784 |
$109K |
| H0001 |
Alcohol and/or drug assessment |
589 |
564 |
$100K |
| 90791 |
Psychiatric diagnostic evaluation |
1,071 |
1,023 |
$100K |
| 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 |
2,814 |
2,764 |
$99K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
1,068 |
1,028 |
$93K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
14,420 |
13,568 |
$90K |
| 76827 |
|
2,944 |
2,359 |
$88K |
| 90832 |
Psychotherapy, 30 minutes with patient |
1,839 |
1,460 |
$84K |
| 96040 |
|
2,478 |
2,404 |
$81K |
| 76801 |
|
1,007 |
808 |
$78K |
| 99243 |
|
953 |
905 |
$78K |
| 90870 |
|
566 |
290 |
$76K |
| 99443 |
|
1,501 |
1,359 |
$64K |
| 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 |
717 |
685 |
$58K |
| 96131 |
|
167 |
158 |
$50K |
| 92523 |
|
350 |
306 |
$47K |
| 99205 |
Prolong outpt/office vis |
347 |
326 |
$46K |
| 97162 |
|
696 |
668 |
$44K |
| 99442 |
|
1,212 |
1,101 |
$44K |
| 76818 |
|
625 |
271 |
$42K |
| 93320 |
|
492 |
483 |
$40K |
| 95886 |
|
542 |
230 |
$39K |
| 99231 |
Subsequent hospital care, per day, straightforward or low complexity |
1,612 |
1,023 |
$38K |
| 93299 |
|
1,010 |
973 |
$34K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
1,363 |
1,301 |
$34K |
| 99245 |
|
222 |
213 |
$34K |
| 76813 |
|
833 |
653 |
$33K |
| 90839 |
|
411 |
374 |
$33K |
| 84484 |
|
8,433 |
7,524 |
$31K |
| 76821 |
|
836 |
304 |
$31K |
| 97164 |
|
736 |
670 |
$31K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
1,340 |
1,268 |
$28K |
| 45385 |
Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) |
107 |
88 |
$27K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
700 |
530 |
$25K |
| 70450 |
Computed tomography, head or brain; without contrast material |
152 |
139 |
$24K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
181 |
173 |
$23K |
| Q3014 |
Telehealth originating site facility fee |
5,088 |
4,730 |
$22K |
| M0243 |
Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring |
109 |
107 |
$22K |
| 80305 |
|
1,766 |
1,554 |
$21K |
| 71045 |
Radiologic examination, chest; single view |
626 |
613 |
$20K |
| 36591 |
|
1,277 |
795 |
$20K |
| 93298 |
|
521 |
513 |
$19K |
| J0585 |
Injection, onabotulinumtoxina, 1 unit |
31 |
27 |
$19K |
| 99417 |
Prolong home eval add 15m |
380 |
336 |
$19K |
| 80306 |
|
4,638 |
1,495 |
$18K |
| 96130 |
|
167 |
159 |
$17K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
650 |
625 |
$17K |
| 99358 |
Prolong nursin fac eval 15m |
81 |
81 |
$15K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
51 |
50 |
$15K |
| 86140 |
|
4,147 |
3,959 |
$15K |
| M0245 |
Intravenous infusion, bamlanivimab and etesevimab, includes infusion and post administration monitoring |
54 |
54 |
$15K |
| 99242 |
|
267 |
259 |
$14K |
| 97166 |
|
198 |
186 |
$12K |
| 99220 |
|
56 |
50 |
$12K |
| 83690 |
|
3,912 |
3,770 |
$12K |
| 99254 |
|
55 |
50 |
$11K |
| 81001 |
|
6,009 |
5,760 |
$11K |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
1,970 |
1,736 |
$11K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
200 |
157 |
$11K |
| 96137 |
|
50 |
45 |
$11K |
| 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) |
855 |
723 |
$10K |
| J7050 |
Infusion, normal saline solution, 250 cc |
5,087 |
2,304 |
$10K |
| 90785 |
|
967 |
670 |
$10K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
145 |
138 |
$9K |
| J1642 |
Injection, heparin sodium, (heparin lock flush), per 10 units |
2,100 |
1,071 |
$9K |
| 96101 |
|
47 |
44 |
$9K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
74 |
72 |
$9K |
| 80076 |
|
1,813 |
1,736 |
$9K |
| 82565 |
|
3,429 |
3,296 |
$8K |
| M0247 |
Intravenous infusion, sotrovimab, includes infusion and post administration monitoring |
31 |
31 |
$7K |
| J2704 |
Injection, propofol, 10 mg |
2,518 |
1,461 |
$7K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
922 |
869 |
$6K |
| 83735 |
|
2,448 |
1,943 |
$6K |
| 85652 |
|
2,789 |
2,656 |
$5K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
3,958 |
2,533 |
$5K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
2,695 |
2,591 |
$5K |
| 84450 |
|
2,279 |
2,196 |
$5K |
| 84460 |
|
2,149 |
2,072 |
$4K |
| 98968 |
|
156 |
85 |
$4K |
| 73630 |
|
65 |
58 |
$4K |
| 99219 |
|
28 |
27 |
$4K |
| 84703 |
|
1,706 |
1,639 |
$4K |
| 74178 |
|
14 |
13 |
$4K |
| G0427 |
Telehealth consultation, emergency department or initial inpatient, typically 70 minutes or more communicating with the patient via telehealth |
21 |
17 |
$3K |
| 82248 |
|
1,983 |
1,915 |
$3K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
1,160 |
1,118 |
$3K |
| 82040 |
|
1,388 |
1,340 |
$3K |
| 96367 |
|
20 |
12 |
$3K |
| 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 |
327 |
317 |
$3K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
173 |
162 |
$3K |
| 96136 |
|
62 |
57 |
$2K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
14 |
14 |
$2K |
| 77336 |
|
21 |
12 |
$2K |
| 95874 |
|
147 |
76 |
$2K |
| 99001 |
|
509 |
481 |
$2K |
| 99441 |
|
96 |
82 |
$2K |
| 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) |
446 |
400 |
$2K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
29 |
25 |
$2K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
13 |
13 |
$2K |
| 99217 |
|
16 |
15 |
$2K |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
511 |
471 |
$1K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
680 |
590 |
$1K |
| 92611 |
|
27 |
27 |
$1K |
| 97035 |
|
139 |
66 |
$1K |
| 93280 |
|
27 |
26 |
$1K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
786 |
741 |
$1K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
836 |
816 |
$950.91 |
| 85027 |
|
246 |
215 |
$948.08 |
| 97167 |
|
12 |
12 |
$927.54 |
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
68 |
25 |
$881.98 |
| 87420 |
|
49 |
48 |
$808.32 |
| J0330 |
Injection, succinylcholine chloride, up to 20 mg |
306 |
183 |
$775.99 |
| 99238 |
Hospital discharge day management, 30 minutes or less |
16 |
12 |
$723.33 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
218 |
122 |
$553.63 |
| 97116 |
|
20 |
12 |
$498.61 |
| 90686 |
|
31 |
31 |
$455.47 |
| 76499 |
|
110 |
108 |
$389.15 |
| 87510 |
|
38 |
37 |
$354.41 |
| 83880 |
|
13 |
13 |
$349.66 |
| 82077 |
|
64 |
60 |
$347.16 |
| 81003 |
|
373 |
360 |
$305.85 |
| 84145 |
|
64 |
64 |
$289.37 |
| 96138 |
|
15 |
12 |
$284.76 |
| A9270 |
Non-covered item or service |
2,150 |
1,006 |
$282.08 |
| 87660 |
|
38 |
37 |
$266.20 |
| 99153 |
Mod sedat endo service >5yrs |
37 |
37 |
$239.08 |
| 86200 |
|
39 |
39 |
$221.36 |
| G2012 |
Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related e/m service provided within the previous 7 days nor leading to an e/m service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion |
71 |
68 |
$203.24 |
| 81025 |
|
92 |
90 |
$192.99 |
| 86160 |
|
15 |
14 |
$191.63 |
| J8597 |
Antiemetic drug, oral, not otherwise specified |
38 |
36 |
$188.37 |
| 87480 |
|
38 |
37 |
$185.10 |
| J1790 |
Injection, droperidol, up to 5 mg |
28 |
28 |
$161.20 |
| 87070 |
|
176 |
174 |
$159.30 |
| 99201 |
|
39 |
39 |
$158.82 |
| 86141 |
|
86 |
83 |
$149.73 |
| 86803 |
|
29 |
29 |
$145.25 |
| 86481 |
|
12 |
12 |
$129.87 |
| 85610 |
|
45 |
36 |
$128.70 |
| 82728 |
|
14 |
14 |
$120.56 |
| 83605 |
|
88 |
80 |
$114.63 |
| 80349 |
|
13 |
12 |
$89.76 |
| 82570 |
|
14 |
13 |
$63.47 |
| 82607 |
|
13 |
13 |
$60.58 |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
13 |
12 |
$59.56 |
| 82746 |
|
13 |
13 |
$56.50 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
40 |
37 |
$53.43 |
| 84156 |
|
14 |
13 |
$51.95 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
25 |
24 |
$51.24 |
| 87340 |
|
30 |
30 |
$45.85 |
| 85007 |
|
22 |
12 |
$41.58 |
| 83550 |
|
13 |
13 |
$38.02 |
| 83540 |
|
13 |
13 |
$36.96 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
12 |
12 |
$12.39 |
| 84520 |
|
12 |
12 |
$11.30 |
| G1004 |
Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program |
477 |
400 |
$0.41 |
| 87430 |
|
252 |
245 |
$0.00 |
| 99241 |
|
15 |
15 |
$0.00 |
| 99406 |
|
55 |
49 |
$0.00 |
| 84075 |
|
14 |
12 |
$0.00 |
| 82948 |
|
15 |
14 |
$0.00 |
| 80143 |
|
16 |
12 |
$0.00 |
| 80179 |
|
16 |
12 |
$0.00 |
| 82247 |
|
14 |
12 |
$0.00 |
| A9552 |
Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries |
12 |
12 |
$0.00 |