| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
3,866 |
3,035 |
$690K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
5,500 |
4,572 |
$686K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
2,291 |
1,255 |
$594K |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
4,403 |
3,076 |
$552K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,718 |
3,213 |
$415K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
2,499 |
2,174 |
$275K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
2,015 |
1,304 |
$207K |
| 70450 |
Computed tomography, head or brain; without contrast material |
1,061 |
858 |
$204K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
360 |
313 |
$96K |
| 90834 |
Psychotherapy, 45 minutes with patient |
971 |
497 |
$76K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
451 |
369 |
$74K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
2,550 |
924 |
$64K |
| 80053 |
Comprehensive metabolic panel |
6,482 |
4,874 |
$37K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
1,133 |
953 |
$26K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
7,251 |
5,379 |
$26K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
172 |
78 |
$25K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
920 |
618 |
$22K |
| 87637 |
Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV |
275 |
236 |
$21K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
103 |
51 |
$14K |
| 84484 |
|
2,707 |
1,885 |
$14K |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
219 |
199 |
$13K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
67 |
59 |
$13K |
| 85610 |
|
1,933 |
1,281 |
$12K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
228 |
188 |
$11K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,029 |
907 |
$10K |
| 71046 |
Radiologic examination, chest; 2 views |
556 |
482 |
$10K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
3,423 |
2,412 |
$9K |
| 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 |
140 |
123 |
$8K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
1,999 |
1,408 |
$8K |
| 83880 |
|
636 |
523 |
$6K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
427 |
184 |
$6K |
| G0378 |
Hospital observation service, per hour |
123 |
81 |
$6K |
| 81001 |
|
2,646 |
2,241 |
$6K |
| 83690 |
|
1,351 |
1,084 |
$5K |
| 83605 |
|
1,076 |
817 |
$5K |
| 71045 |
Radiologic examination, chest; single view |
2,605 |
2,139 |
$4K |
| 87081 |
|
679 |
616 |
$3K |
| 80306 |
|
289 |
238 |
$3K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
588 |
500 |
$3K |
| 97162 |
|
88 |
79 |
$3K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
3,028 |
2,384 |
$2K |
| 86140 |
|
1,094 |
824 |
$2K |
| 82077 |
|
316 |
234 |
$2K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
12 |
12 |
$2K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
545 |
373 |
$2K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
28 |
25 |
$2K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
53 |
41 |
$2K |
| 84443 |
Thyroid stimulating hormone (TSH) |
197 |
166 |
$2K |
| 36415 |
Collection of venous blood by venipuncture |
6,830 |
4,790 |
$2K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
15 |
12 |
$1K |
| 87631 |
|
17 |
16 |
$1K |
| 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 |
140 |
123 |
$1K |
| 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 |
43 |
38 |
$1K |
| 83735 |
|
422 |
315 |
$1K |
| 87077 |
|
265 |
219 |
$985.65 |
| 72125 |
Computed tomography, cervical spine; without contrast material |
13 |
13 |
$977.46 |
| 85379 |
|
221 |
186 |
$943.86 |
| 96375 |
Therapeutic injection; each additional sequential IV push |
2,105 |
1,326 |
$909.47 |
| 87040 |
|
150 |
115 |
$892.60 |
| 81025 |
|
142 |
123 |
$798.04 |
| 80179 |
|
80 |
64 |
$686.35 |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
28 |
25 |
$635.71 |
| 81003 |
|
461 |
396 |
$552.41 |
| 87186 |
|
134 |
110 |
$480.82 |
| 80143 |
|
46 |
41 |
$462.70 |
| 85730 |
|
179 |
147 |
$371.57 |
| 73610 |
|
16 |
14 |
$291.42 |
| 73564 |
|
12 |
12 |
$117.90 |
| J7030 |
Infusion, normal saline solution , 1000 cc |
3,874 |
2,143 |
$96.21 |
| 84703 |
|
13 |
12 |
$77.70 |
| 85027 |
|
34 |
26 |
$73.59 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
1,684 |
1,364 |
$73.31 |
| 80051 |
|
27 |
21 |
$50.68 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
1,449 |
1,202 |
$50.54 |
| 85378 |
|
14 |
13 |
$50.15 |
| 82565 |
|
28 |
22 |
$37.03 |
| 96376 |
|
145 |
77 |
$34.79 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
1,325 |
994 |
$30.31 |
| 82947 |
|
28 |
22 |
$28.42 |
| J7050 |
Infusion, normal saline solution, 250 cc |
1,457 |
929 |
$13.47 |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
265 |
206 |
$4.44 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
223 |
155 |
$2.83 |
| G1004 |
Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program |
733 |
486 |
$0.02 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
193 |
139 |
$0.00 |
| A9270 |
Non-covered item or service |
44 |
38 |
$0.00 |
| J2704 |
Injection, propofol, 10 mg |
48 |
37 |
$0.00 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
14 |
13 |
$0.00 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
120 |
96 |
$0.00 |
| J2060 |
Injection, lorazepam, 2 mg |
28 |
13 |
$0.00 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
18 |
15 |
$0.00 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
36 |
26 |
$0.00 |