| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
43,107 |
37,101 |
$13.62M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
22,076 |
19,754 |
$7.53M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
12,975 |
11,608 |
$5.11M |
| 90832 |
Psychotherapy, 30 minutes with patient |
44,258 |
19,468 |
$4.85M |
| G0378 |
Hospital observation service, per hour |
6,925 |
4,716 |
$4.78M |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
21,303 |
18,247 |
$4.57M |
| OP250 |
|
64,515 |
46,968 |
$2.02M |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
13,601 |
12,935 |
$1.70M |
| 90791 |
Psychiatric diagnostic evaluation |
4,423 |
4,181 |
$709K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
4,262 |
3,700 |
$701K |
| H0035 |
Mental health partial hospitalization, treatment, less than 24 hours |
6,908 |
777 |
$650K |
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
16,056 |
3,578 |
$564K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
732 |
655 |
$524K |
| 93017 |
|
882 |
800 |
$495K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
18,192 |
15,221 |
$403K |
| 70450 |
Computed tomography, head or brain; without contrast material |
7,176 |
6,330 |
$400K |
| OP272 |
|
27,299 |
23,074 |
$326K |
| 71046 |
Radiologic examination, chest; 2 views |
9,964 |
9,416 |
$320K |
| 80053 |
Comprehensive metabolic panel |
40,275 |
32,265 |
$288K |
| 0202U |
Oncology (prostate), multianalyte, gene expression profiling |
4,984 |
4,615 |
$276K |
| 71045 |
Radiologic examination, chest; single view |
9,422 |
8,087 |
$263K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
4,527 |
4,133 |
$261K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
44,103 |
35,774 |
$251K |
| 45378 |
Colonoscopy, flexible; diagnostic, including collection of specimen(s) |
328 |
298 |
$248K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
14,732 |
11,155 |
$246K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
1,701 |
1,523 |
$234K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
1,611 |
1,366 |
$207K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
1,454 |
1,404 |
$191K |
| 90834 |
Psychotherapy, 45 minutes with patient |
6,170 |
2,455 |
$187K |
| 76830 |
Ultrasound, transvaginal |
1,767 |
1,685 |
$182K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
24,321 |
18,646 |
$180K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
2,285 |
2,243 |
$179K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
6,293 |
5,533 |
$159K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
16,747 |
14,704 |
$153K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
1,304 |
1,212 |
$152K |
| 81025 |
|
17,017 |
15,624 |
$146K |
| 82948 |
|
19,857 |
11,895 |
$136K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
1,924 |
1,804 |
$127K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
3,684 |
2,927 |
$122K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
4,015 |
1,006 |
$120K |
| OP710 |
|
4,050 |
3,477 |
$116K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
11,319 |
7,517 |
$115K |
| OP251 |
|
8,755 |
7,038 |
$109K |
| 90847 |
Family psychotherapy with the patient present, 50 minutes |
1,227 |
1,019 |
$103K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
986 |
868 |
$101K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
7,162 |
6,170 |
$100K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
2,021 |
1,805 |
$99K |
| OP370 |
|
4,045 |
3,474 |
$98K |
| 73630 |
|
2,139 |
1,959 |
$90K |
| 90670 |
|
410 |
409 |
$86K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
6,772 |
5,897 |
$86K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
1,879 |
1,645 |
$82K |
| 93971 |
|
320 |
299 |
$78K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
3,146 |
2,901 |
$77K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
10,029 |
8,024 |
$74K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
419 |
400 |
$64K |
| 73610 |
|
1,867 |
1,718 |
$64K |
| 80320 |
|
3,951 |
3,177 |
$63K |
| 73562 |
|
1,874 |
1,754 |
$57K |
| 93970 |
|
288 |
263 |
$56K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
8,038 |
7,007 |
$54K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
634 |
591 |
$52K |
| 81003 |
|
22,241 |
19,818 |
$51K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
632 |
603 |
$51K |
| OP270 |
|
7,211 |
6,029 |
$49K |
| 73130 |
|
1,034 |
975 |
$48K |
| 80324 |
|
3,662 |
3,326 |
$47K |
| 76818 |
|
329 |
232 |
$46K |
| 84443 |
Thyroid stimulating hormone (TSH) |
5,227 |
4,495 |
$45K |
| 36415 |
Collection of venous blood by venipuncture |
16,157 |
11,866 |
$44K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
1,014 |
912 |
$43K |
| 73030 |
|
1,411 |
1,268 |
$42K |
| 86850 |
|
3,675 |
3,307 |
$39K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,875 |
1,756 |
$39K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
5,779 |
3,828 |
$38K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
7,533 |
7,150 |
$37K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
2,958 |
1,930 |
$35K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
1,406 |
1,281 |
$34K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
2,264 |
2,058 |
$32K |
| 80361 |
|
3,651 |
3,312 |
$32K |
| 84484 |
|
11,550 |
8,663 |
$31K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
8,439 |
7,672 |
$31K |
| 80061 |
Lipid panel |
4,835 |
4,161 |
$30K |
| 80345 |
|
3,646 |
3,310 |
$30K |
| 80349 |
|
3,645 |
3,309 |
$30K |
| 80353 |
|
3,648 |
3,311 |
$30K |
| 80346 |
|
3,644 |
3,308 |
$30K |
| 83992 |
|
3,658 |
3,325 |
$29K |
| 70486 |
|
494 |
471 |
$29K |
| 80358 |
|
3,645 |
3,308 |
$29K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
2,254 |
2,053 |
$28K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
3,337 |
3,019 |
$28K |
| 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 |
5,546 |
4,556 |
$27K |
| OP258 |
|
5,427 |
2,953 |
$27K |
| 87430 |
|
6,974 |
6,680 |
$27K |
| 90846 |
Family psychotherapy without the patient present, 50 minutes |
375 |
287 |
$27K |
| 87070 |
|
7,585 |
7,217 |
$24K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
507 |
462 |
$22K |
| 87040 |
|
6,570 |
4,903 |
$22K |
| 85610 |
|
9,457 |
8,020 |
$21K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
6,091 |
4,213 |
$21K |
| 85027 |
|
4,803 |
3,876 |
$21K |
| 83880 |
|
3,022 |
2,552 |
$20K |
| 85730 |
|
8,847 |
7,599 |
$19K |
| 96376 |
|
3,814 |
2,247 |
$19K |
| 73110 |
|
602 |
562 |
$17K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
939 |
253 |
$17K |
| 97161 |
|
475 |
462 |
$16K |
| 90715 |
|
1,515 |
1,439 |
$16K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
2,647 |
1,572 |
$15K |
| 82803 |
|
2,883 |
2,449 |
$15K |
| 83735 |
|
8,835 |
6,966 |
$15K |
| 90837 |
Psychotherapy, 53 minutes with patient |
700 |
308 |
$15K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
1,355 |
747 |
$15K |
| 84702 |
|
2,622 |
2,146 |
$14K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
706 |
519 |
$12K |
| 86900 |
|
3,779 |
3,404 |
$12K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
4,603 |
3,974 |
$12K |
| 83690 |
|
7,900 |
6,953 |
$11K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
1,771 |
1,485 |
$11K |
| 73080 |
|
230 |
209 |
$11K |
| 90674 |
|
759 |
750 |
$10K |
| 87807 |
|
2,402 |
2,303 |
$10K |
| 84100 |
|
6,376 |
5,011 |
$10K |
| 86481 |
|
272 |
249 |
$9K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
10,104 |
7,231 |
$9K |
| 96367 |
|
157 |
138 |
$9K |
| 72114 |
|
337 |
291 |
$9K |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
4,941 |
2,672 |
$8K |
| 29580 |
|
246 |
63 |
$8K |
| 76770 |
|
114 |
110 |
$8K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
211 |
204 |
$8K |
| 83605 |
|
3,050 |
2,546 |
$8K |
| 0012A |
|
356 |
355 |
$8K |
| 88342 |
|
351 |
317 |
$7K |
| 87536 |
|
863 |
727 |
$7K |
| 82607 |
|
1,641 |
1,398 |
$7K |
| 90686 |
|
872 |
796 |
$7K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
189 |
63 |
$6K |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
1,362 |
908 |
$6K |
| 0011A |
|
370 |
367 |
$6K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
25 |
25 |
$6K |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
360 |
87 |
$6K |
| 90698 |
|
92 |
92 |
$6K |
| 97162 |
|
372 |
278 |
$6K |
| A9502 |
Technetium tc-99m tetrofosmin, diagnostic, per study dose |
390 |
343 |
$5K |
| 90833 |
Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) |
159 |
153 |
$5K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
27 |
26 |
$5K |
| 90677 |
|
52 |
42 |
$5K |
| 29581 |
|
119 |
26 |
$5K |
| 86360 |
|
834 |
705 |
$5K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
794 |
741 |
$4K |
| 87181 |
|
1,783 |
1,638 |
$4K |
| J2704 |
Injection, propofol, 10 mg |
2,753 |
1,699 |
$4K |
| 74022 |
|
121 |
116 |
$4K |
| 93225 |
|
16 |
13 |
$3K |
| 93226 |
|
16 |
13 |
$3K |
| 86592 |
|
1,134 |
988 |
$3K |
| 59425 |
|
567 |
430 |
$3K |
| 82728 |
|
541 |
449 |
$3K |
| 80329 |
|
126 |
114 |
$3K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
3,843 |
3,524 |
$3K |
| 72131 |
|
77 |
67 |
$3K |
| 77080 |
|
59 |
59 |
$2K |
| 86803 |
|
499 |
434 |
$2K |
| 94150 |
|
198 |
160 |
$2K |
| 85378 |
|
1,827 |
1,667 |
$2K |
| Q9966 |
Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml |
172 |
167 |
$2K |
| 72100 |
|
57 |
55 |
$2K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
15 |
12 |
$2K |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
1,182 |
838 |
$2K |
| 82746 |
|
433 |
366 |
$2K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
139 |
132 |
$2K |
| 84439 |
|
606 |
527 |
$2K |
| 12001 |
|
25 |
24 |
$2K |
| J2060 |
Injection, lorazepam, 2 mg |
1,362 |
737 |
$2K |
| 29125 |
|
139 |
131 |
$2K |
| 74018 |
|
40 |
38 |
$2K |
| 90656 |
|
143 |
142 |
$2K |
| 86703 |
|
202 |
171 |
$2K |
| 72082 |
|
12 |
12 |
$2K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
97 |
87 |
$1K |
| 84436 |
|
523 |
428 |
$1K |
| 73140 |
|
107 |
103 |
$1K |
| 73590 |
|
79 |
74 |
$1K |
| 97116 |
|
81 |
37 |
$1K |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
1,322 |
783 |
$1K |
| 86580 |
|
234 |
231 |
$1K |
| 59426 |
|
366 |
181 |
$1K |
| OP271 |
|
254 |
232 |
$1K |
| 0001A |
|
41 |
41 |
$1K |
| 90671 |
|
12 |
12 |
$1K |
| 82570 |
|
856 |
732 |
$1K |
| 73090 |
|
29 |
26 |
$839.57 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
406 |
381 |
$831.37 |
| 82043 |
|
584 |
502 |
$824.53 |
| 85651 |
|
1,021 |
942 |
$819.04 |
| 83550 |
|
352 |
280 |
$787.03 |
| 86140 |
|
690 |
615 |
$766.69 |
| 90680 |
|
14 |
14 |
$717.73 |
| 83540 |
|
394 |
315 |
$709.80 |
| 90685 |
|
52 |
51 |
$663.91 |
| 82550 |
|
620 |
515 |
$640.04 |
| 99222 |
Initial hospital care, per day, moderate complexity |
31 |
16 |
$622.32 |
| G0008 |
Administration of influenza virus vaccine |
637 |
573 |
$607.41 |
| 84550 |
|
304 |
263 |
$571.16 |
| G8979 |
Mobility: walking & moving around functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting |
603 |
584 |
$552.07 |
| G8978 |
Mobility: walking & moving around functional limitation, current status, at therapy episode outset and at reporting intervals |
593 |
574 |
$552.07 |
| 82248 |
|
170 |
121 |
$545.90 |
| 73502 |
|
76 |
71 |
$534.56 |
| 71250 |
|
21 |
12 |
$462.02 |
| J2543 |
Injection, piperacillin sodium/tazobactam sodium, 1 gram/0.125 grams (1.125 grams) |
279 |
113 |
$458.99 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
1,701 |
812 |
$449.52 |
| 99406 |
|
14 |
12 |
$414.45 |
| 83090 |
|
51 |
45 |
$378.09 |
| J2785 |
Injection, regadenoson, 0.1 mg |
49 |
27 |
$357.64 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
1,840 |
1,052 |
$310.20 |
| 84145 |
|
131 |
126 |
$307.06 |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
1,728 |
512 |
$302.06 |
| 99381 |
|
38 |
38 |
$292.77 |
| 90732 |
|
25 |
25 |
$275.87 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
786 |
353 |
$226.71 |
| 81002 |
|
99 |
92 |
$218.65 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
56 |
55 |
$217.84 |
| G0328 |
Colorectal cancer screening; fecal occult blood test, immunoassay, 1-3 simultaneous |
91 |
87 |
$207.29 |
| 87340 |
|
48 |
46 |
$186.44 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
1,820 |
909 |
$185.42 |
| 84480 |
|
72 |
61 |
$175.32 |
| 83615 |
|
274 |
256 |
$170.49 |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
486 |
283 |
$154.89 |
| C9113 |
Injection, pantoprazole sodium, per vial |
329 |
177 |
$146.91 |
| 84703 |
|
40 |
36 |
$123.45 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
1,472 |
959 |
$118.06 |
| 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 |
585 |
498 |
$112.20 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
1,003 |
686 |
$106.08 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
1,616 |
1,107 |
$96.06 |
| 82150 |
|
95 |
84 |
$86.24 |
| A9579 |
Injection, gadolinium-based magnetic resonance contrast agent, not otherwise specified (nos), per ml |
32 |
26 |
$75.50 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
422 |
199 |
$68.31 |
| 90694 |
|
16 |
14 |
$53.21 |
| 85044 |
|
14 |
12 |
$42.20 |
| J2710 |
Injection, neostigmine methylsulfate, up to 0.5 mg |
21 |
12 |
$34.98 |
| 87390 |
|
13 |
13 |
$30.00 |
| J0330 |
Injection, succinylcholine chloride, up to 20 mg |
190 |
93 |
$29.03 |
| 96127 |
|
24 |
21 |
$28.48 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
318 |
307 |
$26.54 |
| J2919 |
Injection, methylprednisolone sodium succinate, 5 mg |
202 |
116 |
$25.10 |
| 81001 |
|
111 |
98 |
$19.61 |
| 86308 |
|
41 |
39 |
$19.50 |
| J1630 |
Injection, haloperidol, up to 5 mg |
898 |
463 |
$18.99 |
| J7510 |
Prednisolone oral, per 5 mg |
304 |
147 |
$9.30 |
| J2470 |
Injection, pantoprazole sodium, 40 mg |
39 |
24 |
$7.40 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
319 |
285 |
$5.53 |
| 90461 |
|
12 |
12 |
$3.54 |
| J7042 |
5% dextrose/normal saline (500 ml = 1 unit) |
161 |
78 |
$2.18 |
| J2920 |
Injection, methylprednisolone sodium succinate, up to 40 mg |
26 |
12 |
$2.18 |
| J2003 |
Injection, lidocaine hydrochloride, 1 mg |
36 |
34 |
$0.00 |
| G8988 |
Self care functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting |
13 |
12 |
$0.00 |
| J1940 |
Injection, furosemide, up to 20 mg |
56 |
12 |
$0.00 |
| G8987 |
Self care functional limitation, current status, at therapy episode outset and at reporting intervals |
13 |
12 |
$0.00 |
| J1815 |
Injection, insulin, per 5 units |
48 |
13 |
$0.00 |