| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
Emergency department visit for the evaluation and management, high severity |
30,919 |
28,082 |
$4.87M |
| J2323 |
Injection, natalizumab, 1 mg |
447 |
416 |
$2.94M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
13,939 |
13,115 |
$2.14M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
10,514 |
9,953 |
$1.76M |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
2,605 |
1,320 |
$1.53M |
| 70450 |
Computed tomography, head or brain; without contrast material |
6,034 |
5,660 |
$1.51M |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
8,233 |
7,091 |
$1.31M |
| 96361 |
Intravenous infusion, hydration; each additional hour |
5,326 |
4,747 |
$1.11M |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
4,602 |
4,489 |
$1.01M |
| G0378 |
Hospital observation service, per hour |
2,540 |
2,449 |
$998K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
4,709 |
3,835 |
$972K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
996 |
985 |
$632K |
| C1889 |
Implantable/insertable device, not otherwise classified |
1,500 |
1,378 |
$433K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
541 |
540 |
$378K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,615 |
2,184 |
$369K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
979 |
964 |
$361K |
| 93975 |
|
618 |
601 |
$332K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
1,441 |
1,397 |
$319K |
| 80053 |
Comprehensive metabolic panel |
13,929 |
10,757 |
$318K |
| U0004 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc, making use of high throughput technologies as described by cms-2020-01-r |
3,801 |
3,660 |
$305K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
22,777 |
19,708 |
$292K |
| 80076 |
|
13,858 |
12,462 |
$271K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
1,272 |
1,208 |
$237K |
| 12001 |
|
470 |
467 |
$222K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
751 |
744 |
$220K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
1,363 |
1,309 |
$216K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
1,036 |
1,003 |
$167K |
| 86850 |
|
4,259 |
4,115 |
$156K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
8,612 |
7,285 |
$150K |
| 36416 |
|
6,710 |
4,880 |
$144K |
| 83880 |
|
4,392 |
4,213 |
$121K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
8,971 |
8,263 |
$114K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
816 |
764 |
$108K |
| 93970 |
|
161 |
159 |
$103K |
| 86900 |
|
4,277 |
4,117 |
$84K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
841 |
613 |
$73K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
842 |
837 |
$66K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
566 |
555 |
$64K |
| 36415 |
Collection of venous blood by venipuncture |
22,041 |
19,295 |
$62K |
| C1713 |
Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) |
42 |
42 |
$61K |
| H0050 |
Alcohol and/or drug services, brief intervention, per 15 minutes |
1,070 |
923 |
$52K |
| H0049 |
Alcohol and/or drug screening |
1,179 |
1,017 |
$52K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
1,424 |
1,328 |
$51K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
1,196 |
1,171 |
$46K |
| 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 |
2,275 |
2,110 |
$44K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
288 |
280 |
$39K |
| 85610 |
|
12,479 |
11,762 |
$37K |
| 90715 |
|
1,367 |
1,356 |
$36K |
| 82803 |
|
1,528 |
1,401 |
$34K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
2,218 |
2,110 |
$30K |
| J7050 |
Infusion, normal saline solution, 250 cc |
4,827 |
4,186 |
$29K |
| 93971 |
|
294 |
288 |
$27K |
| 86901 |
|
1,669 |
1,603 |
$27K |
| 76770 |
|
48 |
46 |
$27K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
10,564 |
9,807 |
$26K |
| 80061 |
Lipid panel |
1,345 |
1,320 |
$25K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
19,296 |
17,349 |
$25K |
| 76801 |
|
191 |
175 |
$25K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
2,403 |
2,267 |
$23K |
| 70496 |
|
77 |
76 |
$19K |
| J3490 |
Unclassified drugs |
3,021 |
2,177 |
$17K |
| 70486 |
|
712 |
700 |
$17K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
114 |
101 |
$17K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
413 |
406 |
$15K |
| 88304 |
|
336 |
335 |
$15K |
| 71250 |
|
230 |
224 |
$14K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
8,296 |
7,674 |
$14K |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
1,746 |
1,382 |
$13K |
| G0396 |
Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and brief intervention 15 to 30 minutes |
97 |
24 |
$13K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
112 |
104 |
$11K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
98 |
98 |
$10K |
| 72131 |
|
197 |
194 |
$10K |
| 81025 |
|
3,102 |
3,013 |
$10K |
| 29125 |
|
51 |
51 |
$9K |
| 29580 |
|
26 |
12 |
$9K |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
1,777 |
1,609 |
$9K |
| 45378 |
Colonoscopy, flexible; diagnostic, including collection of specimen(s) |
12 |
12 |
$9K |
| 71045 |
Radiologic examination, chest; single view |
12,172 |
11,500 |
$8K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
26,384 |
23,564 |
$8K |
| 85730 |
|
11,417 |
10,837 |
$8K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
413 |
406 |
$8K |
| 90832 |
Psychotherapy, 30 minutes with patient |
64 |
44 |
$7K |
| 93976 |
|
12 |
12 |
$7K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
582 |
579 |
$7K |
| 71046 |
Radiologic examination, chest; 2 views |
2,387 |
2,358 |
$7K |
| 12002 |
|
12 |
12 |
$7K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
922 |
873 |
$7K |
| 29515 |
|
27 |
26 |
$6K |
| 85027 |
|
5,380 |
4,711 |
$6K |
| 12011 |
|
12 |
12 |
$6K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
1,664 |
1,386 |
$5K |
| 70498 |
|
62 |
61 |
$5K |
| 84703 |
|
4,414 |
4,261 |
$4K |
| 86359 |
|
119 |
117 |
$4K |
| 84484 |
|
13,428 |
11,028 |
$4K |
| 97162 |
|
39 |
37 |
$4K |
| 76830 |
Ultrasound, transvaginal |
166 |
163 |
$4K |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
1,063 |
1,030 |
$3K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
7,440 |
6,957 |
$3K |
| 83735 |
|
14,030 |
12,590 |
$3K |
| J0690 |
Injection, cefazolin sodium, 500 mg |
1,576 |
1,522 |
$2K |
| J2704 |
Injection, propofol, 10 mg |
1,863 |
1,256 |
$2K |
| 84702 |
|
7,221 |
6,852 |
$2K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
13 |
13 |
$2K |
| 86360 |
|
119 |
117 |
$2K |
| 87040 |
|
2,915 |
2,137 |
$2K |
| Q9963 |
High osmolar contrast material, 350-399 mg/ml iodine concentration, per ml |
339 |
336 |
$2K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
3,414 |
2,550 |
$2K |
| 84443 |
Thyroid stimulating hormone (TSH) |
3,425 |
3,295 |
$2K |
| 73130 |
|
1,248 |
1,176 |
$2K |
| 73630 |
|
1,251 |
1,193 |
$2K |
| 72128 |
|
27 |
25 |
$2K |
| 82948 |
|
4,325 |
2,732 |
$2K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
827 |
806 |
$2K |
| J1170 |
Injection, hydromorphone, up to 4 mg |
477 |
422 |
$2K |
| 87088 |
|
6,673 |
6,365 |
$1K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
3,657 |
3,567 |
$1K |
| 83690 |
|
11,930 |
11,171 |
$1K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
12 |
12 |
$1K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
3,799 |
3,668 |
$1K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,210 |
1,196 |
$1K |
| 73562 |
|
1,185 |
1,137 |
$1K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
1,259 |
1,170 |
$1K |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
2,611 |
2,217 |
$1K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
1,284 |
1,138 |
$1K |
| 84100 |
|
6,242 |
5,828 |
$995.45 |
| 73030 |
|
923 |
890 |
$990.33 |
| 86480 |
|
15 |
15 |
$986.58 |
| J3535 |
Drug administered through a metered dose inhaler |
632 |
554 |
$968.14 |
| 96376 |
|
1,193 |
1,114 |
$944.90 |
| 82947 |
|
3,542 |
2,558 |
$930.31 |
| 84439 |
|
2,151 |
2,087 |
$858.37 |
| 73610 |
|
1,138 |
1,093 |
$849.39 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
1,761 |
1,640 |
$839.81 |
| 81003 |
|
9,134 |
8,673 |
$828.44 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
6,075 |
5,443 |
$802.60 |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
277 |
273 |
$762.00 |
| J2543 |
Injection, piperacillin sodium/tazobactam sodium, 1 gram/0.125 grams (1.125 grams) |
455 |
363 |
$748.69 |
| 76641 |
|
26 |
25 |
$692.56 |
| J0136 |
Injection, acetaminophen (b braun), not therapeutically equivalent to j0131, 10 mg |
131 |
122 |
$685.20 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
2,306 |
2,152 |
$670.16 |
| 87070 |
|
1,875 |
1,474 |
$642.62 |
| 99406 |
|
13 |
13 |
$628.01 |
| 87186 |
|
1,387 |
1,351 |
$600.26 |
| 80305 |
|
1,384 |
1,298 |
$591.56 |
| Q2038 |
Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (fluzone) |
20 |
20 |
$539.44 |
| J1630 |
Injection, haloperidol, up to 5 mg |
996 |
878 |
$493.20 |
| 73110 |
|
312 |
305 |
$487.65 |
| 87077 |
|
1,040 |
1,012 |
$460.78 |
| 82550 |
|
3,606 |
3,261 |
$452.29 |
| 85379 |
|
1,046 |
1,036 |
$435.71 |
| 83605 |
|
1,804 |
1,697 |
$388.99 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
1,889 |
1,774 |
$386.16 |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
13 |
12 |
$369.20 |
| 76000 |
|
12 |
12 |
$363.41 |
| 87430 |
|
1,612 |
1,597 |
$350.07 |
| S0028 |
Injection, famotidine, 20 mg |
990 |
915 |
$340.74 |
| 80306 |
|
3,332 |
3,138 |
$333.88 |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
499 |
412 |
$318.45 |
| 72100 |
|
219 |
218 |
$300.57 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
617 |
519 |
$275.99 |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
104 |
71 |
$273.11 |
| G0008 |
Administration of influenza virus vaccine |
20 |
20 |
$248.76 |
| 81001 |
|
2,763 |
2,690 |
$239.47 |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
317 |
312 |
$220.69 |
| 73590 |
|
144 |
141 |
$215.45 |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
920 |
901 |
$203.00 |
| J1644 |
Injection, heparin sodium, per 1000 units |
155 |
123 |
$188.04 |
| J2060 |
Injection, lorazepam, 2 mg |
1,132 |
1,019 |
$173.86 |
| J2800 |
Injection, methocarbamol, up to 10 ml |
574 |
545 |
$166.99 |
| J1815 |
Injection, insulin, per 5 units |
347 |
235 |
$156.60 |
| 80320 |
|
917 |
846 |
$143.39 |
| J7644 |
Ipratropium bromide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per milligram |
869 |
636 |
$135.93 |
| 0012A |
|
15 |
15 |
$128.13 |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
254 |
235 |
$123.21 |
| J0574 |
Buprenorphine/naloxone, oral, greater than 6 mg, but less than or equal to 10 mg buprenorphine |
20 |
12 |
$120.36 |
| J7060 |
5% dextrose/water (500 ml = 1 unit) |
1,403 |
1,240 |
$103.04 |
| 84134 |
|
14 |
12 |
$102.48 |
| 73080 |
|
146 |
141 |
$98.33 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
658 |
624 |
$94.49 |
| 87807 |
|
382 |
381 |
$93.10 |
| 82728 |
|
279 |
272 |
$87.38 |
| 82140 |
|
69 |
68 |
$84.27 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
242 |
224 |
$77.47 |
| 80143 |
|
262 |
256 |
$71.68 |
| 73090 |
|
110 |
104 |
$66.81 |
| 80179 |
|
265 |
259 |
$63.80 |
| 74018 |
|
81 |
79 |
$61.36 |
| 0011A |
|
13 |
13 |
$59.55 |
| 86140 |
|
378 |
367 |
$46.30 |
| 72170 |
|
28 |
28 |
$41.65 |
| 86803 |
|
36 |
36 |
$36.48 |
| 87075 |
|
103 |
61 |
$32.20 |
| 87205 |
|
93 |
90 |
$29.11 |
| J0134 |
Injection, acetaminophen (fresenius kabi), not therapeutically equivalent to j0131, 10 mg |
13 |
13 |
$25.13 |
| 82607 |
|
12 |
12 |
$25.00 |
| J8540 |
Dexamethasone, oral, 0.25 mg |
12 |
12 |
$23.01 |
| 87340 |
|
26 |
25 |
$17.62 |
| 80164 |
|
46 |
40 |
$10.50 |
| 86704 |
|
13 |
12 |
$10.32 |
| 83615 |
|
298 |
287 |
$10.06 |
| 86706 |
|
13 |
12 |
$9.19 |
| 73140 |
|
75 |
75 |
$7.50 |
| 73502 |
|
25 |
25 |
$7.48 |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
310 |
238 |
$7.26 |
| A4216 |
Sterile water, saline and/or dextrose, diluent/flush, 10 ml |
187 |
180 |
$6.61 |
| 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 |
969 |
931 |
$5.49 |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
1,011 |
746 |
$4.28 |
| 85652 |
|
12 |
12 |
$2.30 |
| Q0163 |
Diphenhydramine hydrochloride, 50 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at time of chemotherapy treatment not to exceed a 48 hour dosage regimen |
161 |
157 |
$1.02 |
| J2371 |
Injection, phenylephrine hydrochloride, 20 micrograms |
14 |
14 |
$0.29 |
| 81002 |
|
125 |
122 |
$0.00 |
| J1171 |
Injection, hydromorphone, 0.1 mg |
41 |
38 |
$0.00 |
| J3370 |
Injection, vancomycin hcl, 500 mg |
14 |
13 |
$0.00 |
| J1956 |
Injection, levofloxacin, 250 mg |
16 |
16 |
$0.00 |
| 82800 |
|
56 |
54 |
$0.00 |
| C9113 |
Injection, pantoprazole sodium, per vial |
41 |
37 |
$0.00 |
| 76376 |
|
14 |
13 |
$0.00 |
| 99080 |
|
299 |
40 |
$0.00 |
| 99152 |
|
29 |
29 |
$0.00 |
| 86361 |
|
96 |
94 |
$0.00 |
| 80329 |
|
315 |
305 |
$0.00 |
| 84436 |
|
13 |
13 |
$0.00 |
| G0481 |
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; 8-14 drug class(es), including metabolite(s) if performed |
410 |
374 |
$0.00 |
| 74019 |
|
125 |
121 |
$0.00 |
| S2900 |
Surgical techniques requiring use of robotic surgical system (list separately in addition to code for primary procedure) |
12 |
12 |
$0.00 |
| J2003 |
Injection, lidocaine hydrochloride, 1 mg |
82 |
81 |
$0.00 |
| J3360 |
Injection, diazepam, up to 5 mg |
12 |
12 |
$0.00 |
| 86617 |
|
15 |
12 |
$0.00 |