| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
29,141 |
26,582 |
$4.09M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
23,101 |
20,414 |
$3.50M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
9,867 |
8,311 |
$1.59M |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
1,279 |
1,101 |
$419K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
40,892 |
33,495 |
$315K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
2,342 |
2,173 |
$231K |
| G0378 |
Hospital observation service, per hour |
1,869 |
1,450 |
$226K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
13,934 |
11,883 |
$225K |
| 80053 |
Comprehensive metabolic panel |
29,408 |
25,408 |
$180K |
| 84484 |
|
13,369 |
10,328 |
$159K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
6,106 |
5,758 |
$153K |
| 42820 |
Tonsillectomy and adenoidectomy; younger than age 12 |
83 |
72 |
$147K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
7,497 |
6,996 |
$134K |
| 71045 |
Radiologic examination, chest; single view |
16,172 |
13,961 |
$115K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
9,236 |
7,248 |
$114K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
15,452 |
12,471 |
$109K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
1,115 |
1,016 |
$101K |
| G0379 |
Direct admission of patient for hospital observation care |
459 |
373 |
$97K |
| 81001 |
|
18,058 |
16,239 |
$94K |
| 69436 |
Tympanostomy (requiring insertion of ventilating tube), general anesthesia |
99 |
81 |
$88K |
| 83735 |
|
12,299 |
10,055 |
$78K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
1,696 |
643 |
$69K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
4,286 |
3,513 |
$63K |
| 81025 |
|
4,171 |
3,810 |
$59K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
6,527 |
5,021 |
$57K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
2,322 |
1,998 |
$56K |
| 83690 |
|
8,042 |
7,153 |
$53K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,314 |
1,214 |
$45K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
2,224 |
1,874 |
$43K |
| 70450 |
Computed tomography, head or brain; without contrast material |
1,489 |
1,242 |
$42K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
608 |
533 |
$42K |
| 83874 |
|
3,900 |
3,013 |
$39K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
6,396 |
5,301 |
$35K |
| 83880 |
|
3,298 |
2,716 |
$29K |
| 81003 |
|
1,704 |
1,406 |
$28K |
| X4011 |
State-specific procedure code |
139 |
111 |
$25K |
| 87430 |
|
1,852 |
1,765 |
$25K |
| 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 |
1,546 |
878 |
$25K |
| 85730 |
|
4,273 |
3,401 |
$24K |
| 87807 |
|
919 |
889 |
$24K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
1,333 |
1,001 |
$22K |
| 85610 |
|
4,839 |
3,890 |
$22K |
| 36415 |
Collection of venous blood by venipuncture |
18,153 |
14,501 |
$20K |
| 71046 |
Radiologic examination, chest; 2 views |
686 |
597 |
$18K |
| 41899 |
Unlisted procedure, dentoalveolar structures |
25 |
25 |
$14K |
| 59025 |
Fetal non-stress test |
274 |
220 |
$14K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
980 |
886 |
$13K |
| 52204 |
|
26 |
24 |
$12K |
| 82150 |
|
1,502 |
1,333 |
$11K |
| 87040 |
|
1,008 |
608 |
$10K |
| 84443 |
Thyroid stimulating hormone (TSH) |
585 |
463 |
$9K |
| 45378 |
Colonoscopy, flexible; diagnostic, including collection of specimen(s) |
56 |
51 |
$8K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
181 |
157 |
$7K |
| 87186 |
|
188 |
148 |
$5K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
230 |
220 |
$5K |
| 83605 |
|
1,243 |
1,056 |
$5K |
| 87077 |
|
1,070 |
930 |
$5K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
42 |
31 |
$4K |
| 82962 |
|
891 |
556 |
$4K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
30 |
24 |
$4K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
237 |
203 |
$4K |
| 10005 |
|
14 |
12 |
$4K |
| 91200 |
|
63 |
56 |
$3K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
446 |
374 |
$3K |
| G0105 |
Colorectal cancer screening; colonoscopy on individual at high risk |
18 |
15 |
$2K |
| 93458 |
|
26 |
15 |
$2K |
| 74018 |
|
131 |
110 |
$2K |
| 87081 |
|
331 |
323 |
$2K |
| 80305 |
|
212 |
197 |
$2K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
59 |
39 |
$2K |
| 86140 |
|
580 |
521 |
$1K |
| 96376 |
|
402 |
250 |
$1K |
| 80306 |
|
210 |
193 |
$1K |
| 82550 |
|
264 |
237 |
$866.70 |
| A9502 |
Technetium tc-99m tetrofosmin, diagnostic, per study dose |
38 |
28 |
$840.91 |
| 84702 |
|
29 |
26 |
$674.31 |
| L8699 |
Prosthetic implant, not otherwise specified |
82 |
69 |
$614.86 |
| 76536 |
|
14 |
13 |
$602.62 |
| 93017 |
|
39 |
29 |
$488.46 |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
14 |
12 |
$412.98 |
| 80061 |
Lipid panel |
65 |
40 |
$408.26 |
| 85379 |
|
85 |
70 |
$346.83 |
| 84703 |
|
53 |
50 |
$341.86 |
| 72100 |
|
83 |
66 |
$289.45 |
| 80076 |
|
178 |
155 |
$235.26 |
| 87070 |
|
43 |
39 |
$164.11 |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
22 |
15 |
$119.75 |
| 73630 |
|
31 |
25 |
$104.35 |
| J0561 |
Injection, penicillin g benzathine, 100,000 units |
105 |
90 |
$102.08 |
| 87205 |
|
42 |
39 |
$87.86 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
31 |
17 |
$75.93 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
1,792 |
1,260 |
$62.40 |
| 84145 |
|
13 |
12 |
$61.44 |
| 82565 |
|
35 |
25 |
$54.56 |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
309 |
268 |
$44.09 |
| 88300 |
|
75 |
68 |
$22.72 |
| 84439 |
|
16 |
13 |
$20.16 |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
328 |
266 |
$6.00 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
621 |
407 |
$1.31 |
| 99152 |
|
348 |
274 |
$0.00 |
| J1580 |
Injection, garamycin, gentamicin, up to 80 mg |
107 |
89 |
$0.00 |
| 88173 |
|
16 |
12 |
$0.00 |
| 76000 |
|
90 |
64 |
$0.00 |
| C1760 |
Closure device, vascular (implantable/insertable) |
43 |
29 |
$0.00 |
| C1894 |
Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser |
43 |
29 |
$0.00 |
| 88313 |
|
16 |
12 |
$0.00 |
| J7030 |
Infusion, normal saline solution , 1000 cc |
41 |
40 |
$0.00 |
| C1758 |
Catheter, ureteral |
12 |
12 |
$0.00 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
29 |
16 |
$0.00 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
803 |
600 |
$0.00 |
| J2704 |
Injection, propofol, 10 mg |
636 |
490 |
$0.00 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
133 |
107 |
$0.00 |
| 99153 |
Mod sedat endo service >5yrs |
117 |
100 |
$0.00 |
| C1769 |
Guide wire |
86 |
57 |
$0.00 |
| A9270 |
Non-covered item or service |
283 |
265 |
$0.00 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
13 |
13 |
$0.00 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
62 |
42 |
$0.00 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
158 |
98 |
$0.00 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
218 |
157 |
$0.00 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
91 |
73 |
$0.00 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
32 |
27 |
$0.00 |
| 88342 |
|
14 |
13 |
$0.00 |
| C1725 |
Catheter, transluminal angioplasty, non-laser (may include guidance, infusion/perfusion capability) |
43 |
29 |
$0.00 |