| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 87633 |
Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets |
15,068 |
14,032 |
$7.16M |
| 41899 |
Unlisted procedure, dentoalveolar structures |
3,943 |
3,863 |
$3.84M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
9,783 |
9,075 |
$3.38M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
38,769 |
33,601 |
$2.28M |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
74,786 |
73,166 |
$1.81M |
| 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 |
16,354 |
15,688 |
$1.76M |
| 80050 |
General health panel |
27,776 |
27,165 |
$1.69M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
5,414 |
4,776 |
$1.51M |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
10,728 |
8,438 |
$1.49M |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
20,607 |
19,217 |
$1.35M |
| 80061 |
Lipid panel |
116,723 |
114,199 |
$1.34M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
18,168 |
16,578 |
$1.28M |
| 84443 |
Thyroid stimulating hormone (TSH) |
92,326 |
89,838 |
$1.27M |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
30,758 |
29,962 |
$1.21M |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
30,610 |
29,822 |
$1.20M |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
2,822 |
2,741 |
$1.20M |
| 76819 |
Fetal biophysical profile; without non-stress testing |
11,365 |
8,090 |
$1.17M |
| 80053 |
Comprehensive metabolic panel |
138,601 |
129,221 |
$1.12M |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
25,105 |
5,482 |
$1.09M |
| 87581 |
|
21,347 |
19,828 |
$944K |
| 87486 |
|
21,330 |
19,817 |
$943K |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
35,558 |
19,437 |
$818K |
| 86850 |
|
25,369 |
24,245 |
$762K |
| 87631 |
|
4,072 |
3,676 |
$744K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
5,466 |
4,925 |
$721K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
77,539 |
75,552 |
$610K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
102,735 |
92,952 |
$597K |
| 76820 |
|
10,517 |
6,893 |
$591K |
| 86703 |
|
37,147 |
36,006 |
$568K |
| 86780 |
|
38,238 |
36,778 |
$562K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
9,413 |
8,912 |
$530K |
| 84439 |
|
58,923 |
57,442 |
$522K |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
17,929 |
17,708 |
$521K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
15,966 |
4,029 |
$473K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
16,934 |
4,263 |
$457K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
4,013 |
3,616 |
$430K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
7,384 |
6,844 |
$415K |
| 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 |
12,018 |
11,569 |
$394K |
| 87088 |
|
49,940 |
47,263 |
$391K |
| 83525 |
|
28,427 |
27,681 |
$386K |
| G0378 |
Hospital observation service, per hour |
2,432 |
2,085 |
$363K |
| 87340 |
|
33,199 |
32,256 |
$348K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
15,031 |
7,448 |
$329K |
| 86003 |
|
4,338 |
1,987 |
$313K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
1,500 |
1,422 |
$298K |
| 85027 |
|
50,231 |
47,545 |
$287K |
| 86762 |
|
18,145 |
17,742 |
$282K |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
8,162 |
8,070 |
$279K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
3,430 |
3,336 |
$262K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
2,774 |
2,717 |
$259K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
2,969 |
1,681 |
$258K |
| 76770 |
|
2,352 |
2,304 |
$258K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
3,103 |
2,570 |
$256K |
| 87507 |
|
693 |
667 |
$245K |
| 87070 |
|
23,089 |
20,775 |
$239K |
| 84480 |
|
15,227 |
14,883 |
$225K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
2,170 |
2,142 |
$215K |
| 92588 |
|
2,384 |
2,286 |
$208K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
9,235 |
9,050 |
$205K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
35,214 |
29,031 |
$194K |
| 82105 |
|
10,557 |
10,247 |
$185K |
| 87498 |
|
4,058 |
3,665 |
$183K |
| 84481 |
|
11,249 |
10,997 |
$180K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
504 |
472 |
$167K |
| 82607 |
|
18,252 |
17,844 |
$161K |
| 90834 |
Psychotherapy, 45 minutes with patient |
2,285 |
1,766 |
$159K |
| 86738 |
|
9,352 |
6,068 |
$156K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
5,563 |
5,110 |
$153K |
| 0002A |
|
4,218 |
4,051 |
$151K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
2,329 |
2,251 |
$144K |
| 92567 |
|
4,562 |
4,416 |
$140K |
| 74270 |
|
587 |
580 |
$136K |
| 84702 |
|
8,319 |
6,576 |
$132K |
| 87503 |
|
4,013 |
3,616 |
$131K |
| 76818 |
|
1,025 |
763 |
$130K |
| 69436 |
Tympanostomy (requiring insertion of ventilating tube), general anesthesia |
232 |
206 |
$122K |
| 87800 |
|
2,649 |
2,576 |
$118K |
| 0001A |
|
3,253 |
3,052 |
$114K |
| 70450 |
Computed tomography, head or brain; without contrast material |
1,988 |
1,900 |
$110K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
2,825 |
2,798 |
$110K |
| 83516 |
|
5,042 |
3,403 |
$110K |
| 74246 |
|
526 |
523 |
$109K |
| 76801 |
|
1,064 |
941 |
$108K |
| 51702 |
|
932 |
810 |
$108K |
| 90832 |
Psychotherapy, 30 minutes with patient |
2,834 |
2,016 |
$108K |
| 76641 |
|
1,109 |
1,039 |
$105K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
5,605 |
1,518 |
$103K |
| 97162 |
|
1,513 |
1,452 |
$103K |
| 84436 |
|
25,765 |
25,209 |
$101K |
| 88142 |
|
4,525 |
4,460 |
$100K |
| Q3014 |
Telehealth originating site facility fee |
4,359 |
4,178 |
$97K |
| 74018 |
|
2,471 |
2,425 |
$96K |
| 87081 |
|
12,123 |
11,864 |
$93K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
860 |
834 |
$93K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
7,579 |
6,604 |
$92K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
2,819 |
2,792 |
$91K |
| 84403 |
|
4,047 |
3,958 |
$91K |
| 82728 |
|
9,803 |
9,419 |
$91K |
| 83970 |
|
3,794 |
3,652 |
$87K |
| 71045 |
Radiologic examination, chest; single view |
4,829 |
4,424 |
$85K |
| 66984 |
Extracapsular cataract removal with insertion of intraocular lens prosthesis |
492 |
411 |
$83K |
| 87807 |
|
4,883 |
4,434 |
$83K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
18,980 |
16,854 |
$80K |
| 86900 |
|
24,947 |
23,807 |
$78K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
265 |
260 |
$78K |
| 30901 |
|
118 |
116 |
$77K |
| 86901 |
|
24,927 |
23,792 |
$77K |
| 86318 |
|
2,908 |
2,872 |
$74K |
| 86787 |
|
5,313 |
5,064 |
$73K |
| 71046 |
Radiologic examination, chest; 2 views |
3,052 |
2,888 |
$73K |
| 76536 |
|
764 |
749 |
$73K |
| 82746 |
|
8,691 |
8,505 |
$73K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
829 |
780 |
$72K |
| 81001 |
|
37,487 |
35,012 |
$72K |
| 86803 |
|
6,526 |
6,377 |
$72K |
| 83013 |
|
1,229 |
1,183 |
$71K |
| 92557 |
|
1,276 |
1,259 |
$68K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
637 |
620 |
$68K |
| 52000 |
|
403 |
395 |
$68K |
| 0071A |
|
1,465 |
1,407 |
$63K |
| 83001 |
|
3,464 |
3,375 |
$62K |
| 84146 |
|
3,060 |
2,989 |
$56K |
| 78815 |
Positron emission tomography (PET) for limited area imaging |
87 |
83 |
$56K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
681 |
651 |
$55K |
| 87077 |
|
10,124 |
8,799 |
$53K |
| 83655 |
|
3,412 |
3,293 |
$52K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
490 |
484 |
$49K |
| 86376 |
|
3,289 |
3,222 |
$49K |
| A9500 |
Technetium tc-99m sestamibi, diagnostic, per study dose |
722 |
692 |
$48K |
| 83002 |
|
2,539 |
2,462 |
$48K |
| 69210 |
|
1,100 |
937 |
$48K |
| 80076 |
|
8,317 |
8,077 |
$48K |
| 0072A |
|
1,042 |
1,010 |
$48K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
279 |
271 |
$47K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
984 |
852 |
$45K |
| 96450 |
|
219 |
193 |
$45K |
| 93925 |
|
559 |
541 |
$44K |
| 93970 |
|
667 |
637 |
$44K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
459 |
430 |
$44K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
1,052 |
998 |
$44K |
| 82670 |
|
1,678 |
1,644 |
$43K |
| 42820 |
Tonsillectomy and adenoidectomy; younger than age 12 |
13 |
13 |
$42K |
| 82627 |
|
2,256 |
2,214 |
$42K |
| 82677 |
|
1,485 |
1,446 |
$41K |
| 86696 |
|
2,235 |
1,641 |
$40K |
| 87186 |
|
8,202 |
7,048 |
$39K |
| 82785 |
|
2,127 |
1,995 |
$39K |
| 84270 |
|
1,896 |
1,858 |
$37K |
| 83735 |
|
12,382 |
11,039 |
$37K |
| 82570 |
|
14,486 |
12,979 |
$36K |
| 86140 |
|
8,053 |
7,725 |
$36K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
424 |
383 |
$35K |
| 90791 |
Psychiatric diagnostic evaluation |
262 |
258 |
$34K |
| 82950 |
|
6,035 |
5,903 |
$33K |
| 0003A |
|
1,720 |
1,671 |
$33K |
| 82947 |
|
7,709 |
7,406 |
$33K |
| 93880 |
|
642 |
623 |
$32K |
| 82784 |
|
3,190 |
2,861 |
$31K |
| 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 |
709 |
582 |
$30K |
| 87625 |
|
884 |
868 |
$30K |
| 93017 |
|
1,184 |
1,134 |
$30K |
| 93458 |
|
89 |
76 |
$30K |
| 85730 |
|
11,438 |
9,946 |
$29K |
| 90833 |
Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) |
828 |
795 |
$29K |
| 86800 |
|
1,491 |
1,433 |
$29K |
| 86695 |
|
2,238 |
1,640 |
$29K |
| 84460 |
|
4,440 |
4,332 |
$29K |
| 71250 |
|
649 |
637 |
$27K |
| 73560 |
|
1,214 |
1,032 |
$27K |
| 86336 |
|
1,527 |
1,488 |
$27K |
| 82140 |
|
2,307 |
2,186 |
$27K |
| 85610 |
|
13,515 |
11,832 |
$27K |
| 83880 |
|
2,731 |
2,594 |
$27K |
| 88313 |
|
705 |
568 |
$27K |
| 84153 |
|
4,400 |
4,317 |
$26K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
2,375 |
1,926 |
$26K |
| 83540 |
|
7,616 |
7,380 |
$26K |
| 86225 |
|
2,747 |
2,665 |
$26K |
| 87480 |
|
1,333 |
1,274 |
$25K |
| 84450 |
|
3,896 |
3,799 |
$25K |
| 84484 |
|
3,861 |
3,166 |
$25K |
| 87510 |
|
1,333 |
1,274 |
$24K |
| 87660 |
|
1,333 |
1,274 |
$24K |
| 83498 |
|
714 |
694 |
$24K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
69 |
69 |
$24K |
| 77066 |
Tomosynthesis, mammo |
488 |
482 |
$24K |
| 80069 |
|
5,207 |
4,995 |
$23K |
| 83550 |
|
5,993 |
5,790 |
$23K |
| 86038 |
|
2,845 |
2,666 |
$23K |
| 86769 |
|
418 |
230 |
$23K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
1,580 |
1,185 |
$23K |
| 82043 |
|
10,701 |
10,059 |
$23K |
| 82310 |
|
6,057 |
5,793 |
$22K |
| 76825 |
|
82 |
66 |
$22K |
| 82274 |
|
1,888 |
1,532 |
$22K |
| 85652 |
|
10,877 |
10,532 |
$22K |
| 77072 |
|
614 |
609 |
$22K |
| 84550 |
|
10,181 |
9,792 |
$21K |
| 96417 |
|
467 |
301 |
$20K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
930 |
873 |
$20K |
| 87653 |
|
558 |
534 |
$20K |
| 84156 |
|
7,992 |
7,465 |
$19K |
| 49083 |
|
218 |
121 |
$19K |
| 84482 |
|
924 |
900 |
$19K |
| 80051 |
|
2,841 |
2,722 |
$19K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
192 |
190 |
$19K |
| 99215 |
Prolong outpt/office vis |
209 |
170 |
$18K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
301 |
293 |
$18K |
| 72100 |
|
675 |
648 |
$18K |
| 82247 |
|
3,295 |
2,879 |
$18K |
| 82951 |
|
1,362 |
1,314 |
$18K |
| 82565 |
|
5,114 |
4,553 |
$18K |
| 73562 |
|
772 |
714 |
$18K |
| 97803 |
|
1,597 |
1,561 |
$17K |
| 84479 |
|
4,758 |
4,673 |
$17K |
| 83690 |
|
3,512 |
3,316 |
$17K |
| 87040 |
|
1,731 |
1,290 |
$16K |
| 96409 |
|
119 |
110 |
$16K |
| 93975 |
|
68 |
67 |
$16K |
| 0054A |
|
417 |
404 |
$16K |
| 77080 |
|
937 |
929 |
$15K |
| 73030 |
|
808 |
743 |
$14K |
| 83605 |
|
2,201 |
1,887 |
$14K |
| 84703 |
|
2,062 |
1,902 |
$14K |
| 51798 |
|
1,214 |
1,106 |
$14K |
| 84144 |
|
761 |
648 |
$14K |
| J1756 |
Injection, iron sucrose, 1 mg |
189 |
103 |
$13K |
| 86704 |
|
1,723 |
1,693 |
$13K |
| 76821 |
|
151 |
80 |
$13K |
| 84075 |
|
1,953 |
1,899 |
$13K |
| 96415 |
|
294 |
194 |
$13K |
| 82040 |
|
1,937 |
1,876 |
$12K |
| 86008 |
|
141 |
135 |
$12K |
| 82248 |
|
3,107 |
2,689 |
$12K |
| J2785 |
Injection, regadenoson, 0.1 mg |
810 |
780 |
$11K |
| 84466 |
|
865 |
844 |
$11K |
| 87899 |
|
758 |
359 |
$11K |
| 73100 |
|
429 |
296 |
$11K |
| 93971 |
|
191 |
183 |
$11K |
| 20610 |
|
607 |
464 |
$11K |
| 82397 |
|
634 |
630 |
$11K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
2,270 |
1,189 |
$10K |
| 86141 |
|
1,152 |
1,130 |
$10K |
| 84520 |
|
2,174 |
2,115 |
$10K |
| 72170 |
|
635 |
605 |
$10K |
| 0202U |
Oncology (prostate), multianalyte, gene expression profiling |
5,021 |
4,718 |
$9K |
| 84155 |
|
2,016 |
1,960 |
$9K |
| 86794 |
|
445 |
439 |
$9K |
| 81025 |
|
1,231 |
1,145 |
$9K |
| 36430 |
|
189 |
132 |
$9K |
| 86592 |
|
2,083 |
2,038 |
$9K |
| 72110 |
|
326 |
316 |
$9K |
| 83090 |
|
1,228 |
1,204 |
$8K |
| 86709 |
|
1,137 |
1,121 |
$8K |
| 97116 |
|
1,236 |
415 |
$8K |
| 87102 |
|
787 |
774 |
$8K |
| 73610 |
|
269 |
257 |
$8K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
282 |
269 |
$8K |
| 82977 |
|
997 |
981 |
$8K |
| 73502 |
|
321 |
296 |
$8K |
| 95886 |
|
36 |
36 |
$7K |
| 82626 |
|
237 |
231 |
$7K |
| 86304 |
|
422 |
370 |
$7K |
| 84305 |
|
298 |
293 |
$7K |
| 73630 |
|
293 |
280 |
$7K |
| 73130 |
|
319 |
284 |
$7K |
| 76827 |
|
97 |
80 |
$7K |
| J1642 |
Injection, heparin sodium, (heparin lock flush), per 10 units |
2,644 |
1,572 |
$7K |
| 76830 |
Ultrasound, transvaginal |
73 |
65 |
$7K |
| 31231 |
|
25 |
25 |
$7K |
| 74178 |
|
55 |
55 |
$7K |
| 81003 |
|
3,993 |
3,384 |
$7K |
| 82150 |
|
1,440 |
1,392 |
$6K |
| J0885 |
Injection, epoetin alfa, (for non-esrd use), 1000 units |
164 |
77 |
$6K |
| 82533 |
|
424 |
379 |
$6K |
| 85014 |
|
3,192 |
2,621 |
$6K |
| 97597 |
|
119 |
113 |
$6K |
| 88108 |
|
124 |
112 |
$6K |
| 85018 |
|
2,446 |
2,313 |
$6K |
| 87662 |
|
88 |
86 |
$6K |
| 72082 |
|
63 |
62 |
$6K |
| 86431 |
|
1,693 |
1,654 |
$6K |
| 83615 |
|
1,207 |
1,066 |
$5K |
| 86160 |
|
638 |
321 |
$5K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
2,363 |
1,604 |
$5K |
| 0081A |
|
132 |
129 |
$5K |
| 87147 |
|
983 |
930 |
$5K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
18 |
17 |
$5K |
| 84100 |
|
3,122 |
2,525 |
$5K |
| 85007 |
|
5,877 |
4,945 |
$5K |
| 87073 |
|
1,029 |
795 |
$5K |
| 45385 |
Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) |
53 |
49 |
$4K |
| 82952 |
|
1,131 |
1,076 |
$4K |
| 73110 |
|
218 |
188 |
$4K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
193 |
183 |
$4K |
| 86480 |
|
167 |
165 |
$4K |
| 84154 |
|
701 |
695 |
$4K |
| 87205 |
|
1,687 |
1,551 |
$4K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
5,762 |
4,404 |
$4K |
| J7050 |
Infusion, normal saline solution, 250 cc |
2,128 |
1,445 |
$4K |
| 0074A |
|
98 |
98 |
$4K |
| 87045 |
|
446 |
407 |
$4K |
| 86706 |
|
435 |
423 |
$3K |
| 97163 |
|
113 |
109 |
$3K |
| 86200 |
|
765 |
756 |
$3K |
| 83519 |
|
154 |
151 |
$3K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
149 |
94 |
$3K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
2,226 |
1,835 |
$3K |
| G0279 |
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) |
254 |
252 |
$3K |
| 0124A |
|
150 |
145 |
$3K |
| P9016 |
Red blood cells, leukocytes reduced, each unit |
29 |
24 |
$3K |
| J0690 |
Injection, cefazolin sodium, 500 mg |
2,034 |
1,566 |
$3K |
| G0257 |
Unscheduled or emergency dialysis treatment for an esrd patient in a hospital outpatient department that is not certified as an esrd facility |
50 |
12 |
$3K |
| 82550 |
|
815 |
744 |
$3K |
| J1644 |
Injection, heparin sodium, per 1000 units |
2,253 |
1,330 |
$3K |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
2,466 |
2,003 |
$3K |
| J0702 |
Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg |
169 |
105 |
$2K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
39 |
34 |
$2K |
| 86923 |
|
61 |
50 |
$2K |
| 93923 |
|
78 |
78 |
$2K |
| 97161 |
|
113 |
93 |
$2K |
| 31575 |
|
12 |
12 |
$2K |
| 0082A |
|
59 |
58 |
$2K |
| 82378 |
|
318 |
275 |
$2K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
395 |
335 |
$2K |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
513 |
400 |
$2K |
| 80197 |
|
1,603 |
1,068 |
$2K |
| 89051 |
|
341 |
306 |
$2K |
| J1453 |
Injection, fosaprepitant, 1 mg |
24 |
15 |
$2K |
| 86235 |
|
229 |
75 |
$2K |
| 87220 |
|
428 |
422 |
$2K |
| 85378 |
|
514 |
479 |
$2K |
| J9370 |
Vincristine sulfate, 1 mg |
86 |
84 |
$2K |
| 90837 |
Psychotherapy, 53 minutes with patient |
26 |
25 |
$2K |
| 83520 |
|
182 |
178 |
$2K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
3,540 |
3,034 |
$2K |
| 95816 |
|
15 |
15 |
$2K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
1,628 |
1,346 |
$2K |
| 85045 |
|
938 |
915 |
$2K |
| 87493 |
|
46 |
44 |
$2K |
| 96523 |
|
65 |
53 |
$2K |
| 87177 |
|
245 |
197 |
$2K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
816 |
678 |
$2K |
| 78306 |
|
12 |
12 |
$1K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
2,338 |
2,025 |
$1K |
| P9046 |
Infusion, albumin (human), 25%, 20 ml |
53 |
29 |
$1K |
| 85384 |
|
131 |
116 |
$1K |
| 94761 |
|
94 |
86 |
$1K |
| 96367 |
|
554 |
286 |
$1K |
| J0360 |
Injection, hydralazine hcl, up to 20 mg |
406 |
329 |
$1K |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
3,860 |
3,253 |
$1K |
| 77065 |
Tomosynthesis, mammo |
52 |
52 |
$1K |
| 0052A |
|
35 |
34 |
$1K |
| 87338 |
|
143 |
143 |
$1K |
| 72070 |
|
68 |
66 |
$1K |
| 86317 |
|
128 |
124 |
$1K |
| 87799 |
|
299 |
225 |
$1K |
| 76813 |
|
13 |
12 |
$1K |
| 88312 |
|
578 |
482 |
$1K |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
160 |
107 |
$1K |
| 86308 |
|
226 |
198 |
$1K |
| 73090 |
|
27 |
26 |
$1K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
277 |
185 |
$1K |
| 76937 |
|
105 |
91 |
$1K |
| 72080 |
|
45 |
43 |
$1K |
| 82542 |
|
39 |
25 |
$968.86 |
| Q5105 |
Injection, epoetin alfa-epbx, biosimilar, (retacrit) (for esrd on dialysis), 100 units |
297 |
106 |
$946.26 |
| 87350 |
|
61 |
61 |
$905.69 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
1,043 |
708 |
$870.88 |
| 85055 |
|
43 |
24 |
$864.41 |
| 76000 |
|
57 |
54 |
$848.48 |
| 88304 |
|
65 |
55 |
$807.63 |
| 84145 |
|
26 |
25 |
$792.97 |
| 87184 |
|
135 |
83 |
$744.14 |
| 86060 |
|
90 |
88 |
$724.90 |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
40 |
38 |
$711.71 |
| 70220 |
|
13 |
12 |
$657.32 |
| 82330 |
|
44 |
40 |
$647.47 |
| 82962 |
|
12,538 |
6,867 |
$621.00 |
| J2710 |
Injection, neostigmine methylsulfate, up to 0.5 mg |
400 |
343 |
$601.38 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
1,864 |
1,172 |
$591.31 |
| 0154A |
|
16 |
15 |
$583.85 |
| 97802 |
|
80 |
76 |
$570.09 |
| 94760 |
|
57 |
42 |
$561.22 |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
2,433 |
2,167 |
$551.87 |
| 87107 |
|
41 |
39 |
$522.10 |
| 75716 |
|
14 |
13 |
$497.06 |
| 80185 |
|
105 |
96 |
$457.80 |
| 51797 |
|
13 |
12 |
$455.01 |
| 72040 |
|
24 |
24 |
$450.48 |
| 84425 |
|
37 |
37 |
$447.87 |
| 88341 |
|
82 |
31 |
$413.37 |
| J2543 |
Injection, piperacillin sodium/tazobactam sodium, 1 gram/0.125 grams (1.125 grams) |
58 |
39 |
$412.69 |
| 86665 |
|
26 |
13 |
$402.24 |
| 72050 |
|
13 |
12 |
$383.13 |
| 77336 |
|
28 |
12 |
$379.65 |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
14 |
12 |
$361.56 |
| 73140 |
|
22 |
15 |
$355.74 |
| 82575 |
|
39 |
39 |
$345.83 |
| 88342 |
|
93 |
77 |
$312.98 |
| 51705 |
|
14 |
12 |
$308.36 |
| 87209 |
|
20 |
15 |
$300.00 |
| 87185 |
|
56 |
53 |
$299.11 |
| 87425 |
|
17 |
17 |
$269.73 |
| 73080 |
|
14 |
13 |
$269.34 |
| 36600 |
|
22 |
12 |
$267.75 |
| 85049 |
|
38 |
38 |
$256.98 |
| A9270 |
Non-covered item or service |
15,161 |
10,949 |
$244.14 |
| 86708 |
|
26 |
26 |
$229.35 |
| J1030 |
Injection, methylprednisolone acetate, 40 mg |
148 |
129 |
$217.75 |
| 36415 |
Collection of venous blood by venipuncture |
23,990 |
20,813 |
$210.84 |
| 73552 |
|
15 |
12 |
$200.79 |
| 83921 |
|
76 |
75 |
$173.94 |
| 90686 |
|
12 |
12 |
$170.98 |
| 86664 |
|
13 |
13 |
$169.52 |
| J1815 |
Injection, insulin, per 5 units |
915 |
469 |
$146.64 |
| J0171 |
Injection, adrenalin, epinephrine, 0.1 mg |
234 |
194 |
$145.38 |
| 86334 |
|
12 |
12 |
$140.19 |
| A9503 |
Technetium tc-99m medronate, diagnostic, per study dose, up to 30 millicuries |
12 |
12 |
$136.56 |
| 87075 |
|
57 |
52 |
$136.18 |
| 81015 |
|
49 |
43 |
$130.87 |
| 90715 |
|
14 |
12 |
$108.42 |
| 87497 |
|
128 |
97 |
$93.99 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
48 |
42 |
$93.18 |
| J9260 |
Injection, methotrexate sodium, 50 mg |
20 |
19 |
$89.25 |
| 82103 |
|
12 |
12 |
$85.24 |
| J9250 |
Methotrexate sodium, 5 mg |
209 |
183 |
$71.33 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
2,851 |
2,631 |
$68.37 |
| 91200 |
|
12 |
12 |
$68.26 |
| 83014 |
|
14 |
14 |
$66.90 |
| 81002 |
|
38 |
37 |
$62.36 |
| C1725 |
Catheter, transluminal angioplasty, non-laser (may include guidance, infusion/perfusion capability) |
85 |
75 |
$55.88 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
38 |
25 |
$46.20 |
| Q9963 |
High osmolar contrast material, 350-399 mg/ml iodine concentration, per ml |
400 |
395 |
$42.08 |
| C1894 |
Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser |
1,432 |
1,173 |
$31.48 |
| 84165 |
|
12 |
12 |
$29.08 |
| J1580 |
Injection, garamycin, gentamicin, up to 80 mg |
91 |
79 |
$12.77 |
| 84132 |
|
13 |
12 |
$10.76 |
| J2704 |
Injection, propofol, 10 mg |
2,477 |
2,178 |
$6.92 |
| A9575 |
Injection, gadoterate meglumine, 0.1 ml |
753 |
723 |
$0.00 |
| C1887 |
Catheter, guiding (may include infusion/perfusion capability) |
44 |
38 |
$0.00 |
| 91312 |
|
150 |
145 |
$0.00 |
| A9552 |
Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries |
73 |
72 |
$0.00 |
| 77062 |
|
87 |
85 |
$0.00 |
| Q9966 |
Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml |
385 |
371 |
$0.00 |
| 91300 |
|
2,532 |
2,403 |
$0.00 |
| J3473 |
Injection, hyaluronidase, recombinant, 1 usp unit |
42 |
39 |
$0.00 |
| C1760 |
Closure device, vascular (implantable/insertable) |
49 |
40 |
$0.00 |
| 91308 |
|
234 |
220 |
$0.00 |
| 93356 |
|
12 |
12 |
$0.00 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
1,874 |
1,629 |
$0.00 |
| G0328 |
Colorectal cancer screening; fecal occult blood test, immunoassay, 1-3 simultaneous |
230 |
188 |
$0.00 |
| C1769 |
Guide wire |
1,250 |
1,024 |
$0.00 |
| G0103 |
Prostate cancer screening; prostate specific antigen test (psa) |
1,224 |
1,223 |
$0.00 |
| 91307 |
|
2,710 |
2,266 |
$0.00 |
| C1773 |
Retrieval device, insertable (used to retrieve fractured medical devices) |
44 |
39 |
$0.00 |
| 91305 |
|
533 |
516 |
$0.00 |
| 78492 |
|
27 |
26 |
$0.00 |
| 91315 |
|
16 |
15 |
$0.00 |
| J7042 |
5% dextrose/normal saline (500 ml = 1 unit) |
50 |
40 |
$0.00 |
| G0145 |
Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system and manual rescreening under physician supervision |
52 |
52 |
$0.00 |
| J2003 |
Injection, lidocaine hydrochloride, 1 mg |
71 |
60 |
$0.00 |
| A9555 |
Rubidium rb-82, diagnostic, per study dose, up to 60 millicuries |
27 |
26 |
$0.00 |
| 86381 |
|
12 |
12 |
$0.00 |
| J2175 |
Injection, meperidine hydrochloride, per 100 mg |
13 |
13 |
$0.00 |
| J2370 |
Injection, phenylephrine hcl, up to 1 ml |
15 |
12 |
$0.00 |