| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
127,778 |
117,510 |
$14.65M |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
165,317 |
134,825 |
$12.96M |
| 96361 |
Intravenous infusion, hydration; each additional hour |
30,694 |
24,625 |
$8.74M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
89,812 |
80,495 |
$7.89M |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
28,678 |
27,536 |
$2.89M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
38,854 |
35,222 |
$2.77M |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
14,615 |
14,009 |
$2.28M |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
21,345 |
12,569 |
$2.09M |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
34,891 |
21,070 |
$2.02M |
| G0382 |
Level 3 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room or emergency department; (2) it is held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment; or (3) during the calendar year immediately preceding the calendar year in which a determination under 42 cfr 489.24 is being made, based on a representative sample of patient visits that occurred during that calendar year, it provides at least one-third of all of its outpatient visits for the treatment of emergency medical conditions on an urgent basis without requiring a previously scheduled appointment) |
15,561 |
15,124 |
$1.88M |
| 47562 |
|
810 |
780 |
$1.74M |
| 59025 |
Fetal non-stress test |
11,517 |
8,542 |
$1.71M |
| 42820 |
Tonsillectomy and adenoidectomy; younger than age 12 |
948 |
945 |
$1.61M |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
7,426 |
4,121 |
$1.61M |
| 70450 |
Computed tomography, head or brain; without contrast material |
11,871 |
11,177 |
$1.49M |
| J2357 |
Injection, omalizumab, 5 mg |
2,987 |
1,203 |
$1.43M |
| 95810 |
Polysomnography; sleep staging with 4 or more additional parameters |
2,603 |
2,565 |
$1.39M |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
11,731 |
9,204 |
$1.38M |
| 52000 |
|
2,720 |
2,670 |
$1.33M |
| 92507 |
Treatment of speech, language, voice, communication, and/or auditory processing disorder |
21,620 |
12,198 |
$999K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
5,192 |
5,067 |
$895K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
9,624 |
9,159 |
$866K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
5,288 |
5,097 |
$847K |
| 95811 |
|
1,766 |
1,722 |
$701K |
| 44970 |
|
217 |
206 |
$682K |
| 96415 |
|
3,343 |
2,430 |
$677K |
| 69436 |
Tympanostomy (requiring insertion of ventilating tube), general anesthesia |
431 |
430 |
$614K |
| G0378 |
Hospital observation service, per hour |
17,671 |
11,013 |
$611K |
| 12001 |
|
2,881 |
2,837 |
$589K |
| 96367 |
|
7,334 |
4,583 |
$588K |
| 76830 |
Ultrasound, transvaginal |
7,031 |
6,903 |
$579K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
2,075 |
1,954 |
$567K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
10,467 |
6,304 |
$565K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
6,005 |
5,935 |
$559K |
| 77412 |
|
1,652 |
169 |
$543K |
| G0381 |
Level 2 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room or emergency department; (2) it is held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment; or (3) during the calendar year immediately preceding the calendar year in which a determination under 42 cfr 489.24 is being made, based on a representative sample of patient visits that occurred during that calendar year, it provides at least one-third of all of its outpatient visits for the treatment of emergency medical conditions on an urgent basis without requiring a previously scheduled appointment) |
5,138 |
5,041 |
$530K |
| 64483 |
|
1,443 |
1,416 |
$497K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
2,747 |
2,684 |
$480K |
| 76642 |
|
5,228 |
4,991 |
$460K |
| 12011 |
|
1,845 |
1,815 |
$429K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
8,291 |
8,144 |
$398K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
1,780 |
1,749 |
$369K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
3,193 |
3,146 |
$366K |
| 10060 |
|
1,794 |
1,715 |
$360K |
| 80047 |
|
90,318 |
78,246 |
$357K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
8,292 |
8,236 |
$345K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
2,290 |
2,206 |
$337K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
11,812 |
4,753 |
$331K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
4,609 |
4,557 |
$309K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
1,197 |
1,177 |
$303K |
| 76770 |
|
2,714 |
2,667 |
$291K |
| 12002 |
|
1,533 |
1,506 |
$274K |
| 93017 |
|
2,760 |
2,689 |
$260K |
| 92523 |
|
1,941 |
1,927 |
$255K |
| C9803 |
Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
28,042 |
25,782 |
$255K |
| G0383 |
Level 4 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room or emergency department; (2) it is held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment; or (3) during the calendar year immediately preceding the calendar year in which a determination under 42 cfr 489.24 is being made, based on a representative sample of patient visits that occurred during that calendar year, it provides at least one-third of all of its outpatient visits for the treatment of emergency medical conditions on an urgent basis without requiring a previously scheduled appointment) |
2,130 |
2,094 |
$253K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
1,666 |
1,637 |
$247K |
| 29581 |
|
2,490 |
714 |
$247K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
3,729 |
3,553 |
$243K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
5,130 |
4,647 |
$233K |
| J2469 |
Injection, palonosetron hcl, 25 mcg |
4,048 |
2,392 |
$231K |
| 76536 |
|
2,691 |
2,648 |
$231K |
| 76801 |
|
4,063 |
3,769 |
$213K |
| J1453 |
Injection, fosaprepitant, 1 mg |
2,488 |
1,570 |
$209K |
| 83605 |
|
50,351 |
42,354 |
$209K |
| P9016 |
Red blood cells, leukocytes reduced, each unit |
1,038 |
687 |
$203K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
812 |
764 |
$199K |
| 62323 |
|
956 |
938 |
$199K |
| J1745 |
Injection, infliximab, excludes biosimilar, 10 mg |
188 |
180 |
$195K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
9,533 |
4,180 |
$194K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
1,497 |
1,122 |
$187K |
| 92526 |
|
3,594 |
2,599 |
$184K |
| 29125 |
|
1,029 |
991 |
$177K |
| 80053 |
Comprehensive metabolic panel |
36,092 |
29,059 |
$176K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
12,635 |
10,656 |
$174K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
1,546 |
1,493 |
$174K |
| 71046 |
Radiologic examination, chest; 2 views |
17,383 |
16,715 |
$169K |
| 95886 |
|
1,307 |
1,191 |
$167K |
| C8929 |
Transthoracic echocardiography with contrast, or without contrast followed by with contrast, real-time with image documentation (2d), includes m-mode recording, when performed, complete, with spectral doppler echocardiography, and with color flow doppler echocardiography |
947 |
927 |
$165K |
| 76870 |
|
1,683 |
1,632 |
$164K |
| 31575 |
|
1,048 |
1,016 |
$161K |
| 93971 |
|
1,844 |
1,788 |
$149K |
| 36430 |
|
1,679 |
1,234 |
$144K |
| 76882 |
|
1,650 |
1,587 |
$139K |
| J0585 |
Injection, onabotulinumtoxina, 1 unit |
828 |
791 |
$135K |
| 78815 |
Positron emission tomography (PET) for limited area imaging |
326 |
323 |
$130K |
| 70496 |
|
1,152 |
1,111 |
$130K |
| 72141 |
|
1,183 |
1,167 |
$129K |
| 19083 |
|
212 |
194 |
$126K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
3,598 |
3,512 |
$126K |
| 87633 |
Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets |
1,574 |
1,524 |
$112K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
6,674 |
6,061 |
$111K |
| J9271 |
Injection, pembrolizumab, 1 mg |
33 |
26 |
$107K |
| T1002 |
Rn services, up to 15 minutes |
1,148 |
894 |
$106K |
| 77336 |
|
2,172 |
924 |
$105K |
| 96523 |
|
2,781 |
1,978 |
$104K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
61,794 |
53,732 |
$104K |
| 20610 |
|
859 |
772 |
$100K |
| 77386 |
|
258 |
25 |
$99K |
| 84484 |
|
30,602 |
25,291 |
$98K |
| 36415 |
Collection of venous blood by venipuncture |
92,847 |
79,397 |
$97K |
| 70491 |
|
907 |
879 |
$97K |
| 71250 |
|
2,156 |
2,120 |
$97K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
7,702 |
7,528 |
$95K |
| 96416 |
|
1,010 |
561 |
$94K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
116,751 |
94,575 |
$92K |
| 31231 |
|
437 |
432 |
$89K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
2,541 |
2,425 |
$86K |
| 73221 |
|
640 |
627 |
$85K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
3,016 |
2,680 |
$84K |
| 97162 |
|
2,158 |
2,091 |
$83K |
| 45378 |
Colonoscopy, flexible; diagnostic, including collection of specimen(s) |
199 |
193 |
$81K |
| 45385 |
Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) |
267 |
244 |
$80K |
| 92552 |
|
1,594 |
1,575 |
$79K |
| 76942 |
|
1,353 |
1,286 |
$79K |
| 96417 |
|
3,151 |
1,911 |
$77K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
9,898 |
8,993 |
$75K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
8,299 |
8,243 |
$72K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
16,929 |
12,886 |
$69K |
| 74181 |
|
324 |
310 |
$68K |
| 87400 |
|
11,183 |
10,867 |
$68K |
| 93458 |
|
82 |
81 |
$67K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
42,823 |
32,132 |
$67K |
| 97535 |
Self-care/home management training, each 15 minutes |
4,281 |
2,467 |
$65K |
| 80076 |
|
27,954 |
25,409 |
$64K |
| 70486 |
|
1,240 |
1,217 |
$64K |
| 77066 |
Tomosynthesis, mammo |
2,361 |
2,331 |
$62K |
| 97161 |
|
1,730 |
1,639 |
$62K |
| 93271 |
|
1,043 |
1,029 |
$61K |
| 96368 |
|
2,316 |
1,416 |
$61K |
| 72100 |
|
4,152 |
4,063 |
$60K |
| 94060 |
|
1,321 |
1,303 |
$59K |
| 74420 |
|
536 |
506 |
$57K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
6,448 |
6,201 |
$57K |
| 96125 |
|
985 |
981 |
$56K |
| 74178 |
|
430 |
423 |
$54K |
| 93320 |
|
320 |
315 |
$51K |
| 73700 |
|
788 |
743 |
$50K |
| 73030 |
|
4,795 |
4,602 |
$47K |
| 87040 |
|
7,171 |
4,714 |
$47K |
| 80050 |
General health panel |
8,402 |
7,788 |
$46K |
| 74230 |
|
579 |
564 |
$44K |
| 92609 |
|
754 |
307 |
$44K |
| 73562 |
|
3,129 |
2,996 |
$43K |
| 96152 |
|
574 |
410 |
$43K |
| Q3014 |
Telehealth originating site facility fee |
2,457 |
2,310 |
$42K |
| 77334 |
|
557 |
409 |
$42K |
| 93225 |
|
1,555 |
1,535 |
$42K |
| 73630 |
|
5,054 |
4,885 |
$41K |
| 29105 |
|
184 |
179 |
$41K |
| 87510 |
|
4,846 |
4,648 |
$41K |
| 76775 |
|
592 |
574 |
$40K |
| 87641 |
|
3,528 |
3,339 |
$40K |
| 73610 |
|
5,437 |
5,254 |
$40K |
| 74018 |
|
4,280 |
4,114 |
$40K |
| 87505 |
|
1,370 |
1,252 |
$40K |
| 52310 |
|
75 |
73 |
$39K |
| J9263 |
Injection, oxaliplatin, 0.5 mg |
40 |
14 |
$39K |
| 87420 |
|
3,870 |
3,748 |
$37K |
| 90714 |
|
2,087 |
2,048 |
$37K |
| 70498 |
|
1,140 |
1,101 |
$37K |
| 95912 |
|
431 |
413 |
$36K |
| 73560 |
|
3,725 |
3,601 |
$36K |
| 97163 |
|
945 |
908 |
$36K |
| 96521 |
|
732 |
123 |
$36K |
| Q5104 |
Injection, infliximab-abda, biosimilar, (renflexis), 10 mg |
38 |
37 |
$35K |
| 96112 |
|
450 |
448 |
$35K |
| 92557 |
|
903 |
882 |
$35K |
| 93976 |
|
492 |
477 |
$35K |
| 10061 |
|
331 |
320 |
$32K |
| 84443 |
Thyroid stimulating hormone (TSH) |
9,951 |
9,519 |
$32K |
| 90715 |
|
2,402 |
2,347 |
$32K |
| 58661 |
|
12 |
12 |
$32K |
| 93296 |
|
3,673 |
3,632 |
$32K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
2,801 |
2,710 |
$32K |
| 73130 |
|
4,205 |
4,060 |
$31K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
1,760 |
1,728 |
$31K |
| 92567 |
|
3,377 |
3,316 |
$31K |
| 36591 |
|
7,603 |
4,608 |
$31K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
9,526 |
9,214 |
$29K |
| 72110 |
|
1,480 |
1,449 |
$29K |
| 93270 |
|
1,043 |
1,029 |
$29K |
| 97803 |
|
586 |
521 |
$28K |
| 72040 |
|
1,768 |
1,734 |
$28K |
| 94726 |
|
1,233 |
1,213 |
$28K |
| 83880 |
|
8,815 |
7,882 |
$26K |
| 73110 |
|
3,155 |
3,040 |
$26K |
| 71045 |
Radiologic examination, chest; single view |
26,719 |
24,383 |
$26K |
| 69210 |
|
704 |
666 |
$26K |
| 20680 |
|
13 |
12 |
$25K |
| 95910 |
|
339 |
318 |
$25K |
| 73502 |
|
2,729 |
2,637 |
$25K |
| 96158 |
|
406 |
308 |
$23K |
| 52356 |
|
15 |
15 |
$23K |
| J1750 |
Injection, iron dextran, 50 mg |
555 |
364 |
$23K |
| 92555 |
|
1,593 |
1,579 |
$22K |
| 94729 |
|
1,348 |
1,327 |
$22K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
6,449 |
6,202 |
$22K |
| 72070 |
|
1,512 |
1,479 |
$22K |
| 73140 |
|
1,983 |
1,914 |
$22K |
| 84702 |
|
23,717 |
21,018 |
$22K |
| 77080 |
|
416 |
413 |
$22K |
| 93226 |
|
1,554 |
1,534 |
$22K |
| G0108 |
Diabetes outpatient self-management training services, individual, per 30 minutes |
678 |
603 |
$21K |
| 80061 |
Lipid panel |
6,712 |
6,536 |
$20K |
| Q5107 |
Injection, bevacizumab-awwb, biosimilar, (mvasi), 10 mg |
62 |
24 |
$20K |
| 97166 |
|
398 |
395 |
$20K |
| 97763 |
|
265 |
246 |
$20K |
| 87660 |
|
4,846 |
4,648 |
$19K |
| 88307 |
|
1,274 |
1,150 |
$19K |
| J0561 |
Injection, penicillin g benzathine, 100,000 units |
596 |
562 |
$19K |
| 85379 |
|
4,087 |
3,895 |
$18K |
| 54161 |
|
14 |
12 |
$18K |
| 74019 |
|
1,343 |
1,305 |
$18K |
| 52332 |
|
52 |
50 |
$17K |
| 93970 |
|
217 |
213 |
$17K |
| 93242 |
|
399 |
392 |
$15K |
| 82728 |
|
4,093 |
3,862 |
$15K |
| 90686 |
|
1,877 |
1,836 |
$14K |
| 49083 |
|
60 |
37 |
$14K |
| 83735 |
|
13,595 |
9,922 |
$14K |
| 84439 |
|
2,575 |
2,477 |
$14K |
| 73590 |
|
1,657 |
1,584 |
$13K |
| 64450 |
|
147 |
142 |
$13K |
| 86780 |
|
1,819 |
1,738 |
$13K |
| 73522 |
|
515 |
507 |
$13K |
| G0279 |
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) |
2,684 |
2,650 |
$13K |
| J1439 |
Injection, ferric carboxymaltose, 1 mg |
179 |
121 |
$13K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
39,536 |
34,485 |
$13K |
| 25600 |
|
25 |
25 |
$12K |
| 82607 |
|
2,488 |
2,383 |
$12K |
| 93880 |
|
386 |
378 |
$12K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
470 |
298 |
$12K |
| 97165 |
|
407 |
393 |
$12K |
| 78227 |
|
51 |
51 |
$12K |
| 84112 |
|
1,508 |
1,420 |
$12K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
18,155 |
17,036 |
$12K |
| 73080 |
|
2,197 |
2,111 |
$11K |
| 73620 |
|
649 |
632 |
$11K |
| 52287 |
|
27 |
26 |
$11K |
| 93308 |
|
40 |
40 |
$11K |
| 82247 |
|
1,576 |
1,081 |
$11K |
| 76857 |
|
136 |
125 |
$11K |
| 86140 |
|
10,366 |
9,414 |
$11K |
| 85027 |
|
12,741 |
11,045 |
$10K |
| 78264 |
|
47 |
47 |
$10K |
| 73120 |
|
623 |
596 |
$9K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
1,897 |
1,850 |
$9K |
| 73090 |
|
1,310 |
1,251 |
$9K |
| 81001 |
|
58,651 |
53,481 |
$9K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
1,944 |
1,875 |
$9K |
| 97802 |
|
124 |
122 |
$8K |
| 86870 |
|
1,057 |
983 |
$8K |
| 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 |
1,182 |
1,077 |
$8K |
| 93243 |
|
399 |
392 |
$8K |
| 87480 |
|
4,794 |
4,596 |
$8K |
| 95911 |
|
200 |
195 |
$7K |
| 93978 |
|
338 |
308 |
$7K |
| 83540 |
|
3,898 |
3,716 |
$7K |
| 20553 |
|
71 |
70 |
$7K |
| 86850 |
|
6,725 |
5,776 |
$7K |
| 77300 |
|
157 |
148 |
$7K |
| 93922 |
|
225 |
213 |
$7K |
| J3489 |
Injection, zoledronic acid, 1 mg |
248 |
236 |
$7K |
| 97150 |
Therapeutic procedure(s), group (2 or more individuals) |
559 |
324 |
$6K |
| T1017 |
Targeted case management, each 15 minutes |
125 |
107 |
$6K |
| 97116 |
|
762 |
522 |
$6K |
| 87077 |
|
12,878 |
11,067 |
$6K |
| 71271 |
|
83 |
83 |
$6K |
| 82570 |
|
2,333 |
2,134 |
$6K |
| 64415 |
|
66 |
65 |
$6K |
| J0475 |
Injection, baclofen, 10 mg |
26 |
25 |
$6K |
| 86803 |
|
1,565 |
1,499 |
$6K |
| 96376 |
|
12,142 |
8,783 |
$6K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
2,831 |
2,708 |
$6K |
| 36592 |
|
1,778 |
1,509 |
$6K |
| 72050 |
|
293 |
285 |
$6K |
| 92610 |
|
107 |
106 |
$6K |
| 74183 |
|
29 |
29 |
$6K |
| 73100 |
|
501 |
484 |
$5K |
| 87081 |
|
2,191 |
2,145 |
$5K |
| 85610 |
|
13,739 |
11,240 |
$5K |
| 82105 |
|
787 |
727 |
$5K |
| 97597 |
|
154 |
128 |
$5K |
| 82565 |
|
3,708 |
3,538 |
$5K |
| 82803 |
|
48,664 |
42,231 |
$5K |
| 62321 |
|
13 |
13 |
$5K |
| C1776 |
Joint device (implantable) |
143 |
129 |
$5K |
| 94010 |
|
209 |
208 |
$5K |
| 95990 |
|
218 |
214 |
$5K |
| 17110 |
|
13 |
13 |
$5K |
| 87522 |
Neg quan hep c or qual rna |
464 |
408 |
$5K |
| 74220 |
|
169 |
164 |
$5K |
| 20550 |
|
27 |
27 |
$5K |
| 86753 |
|
765 |
748 |
$5K |
| 87340 |
|
1,767 |
1,681 |
$5K |
| 92504 |
|
149 |
137 |
$5K |
| 85652 |
|
5,278 |
4,722 |
$5K |
| G0384 |
Level 5 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room or emergency department; (2) it is held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment; or (3) during the calendar year immediately preceding the calendar year in which a determination under 42 cfr 489.24 is being made, based on a representative sample of patient visits that occurred during that calendar year, it provides at least one-third of all of its outpatient visits for the treatment of emergency medical conditions on an urgent basis without requiring a previously scheduled appointment) |
44 |
43 |
$5K |
| 82378 |
|
2,039 |
1,766 |
$5K |
| 76981 |
|
350 |
343 |
$5K |
| 72170 |
|
824 |
793 |
$4K |
| 97032 |
|
655 |
260 |
$4K |
| C1713 |
Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) |
2,720 |
2,597 |
$4K |
| 0124A |
|
165 |
162 |
$4K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
24,433 |
23,022 |
$4K |
| G0008 |
Administration of influenza virus vaccine |
1,852 |
1,801 |
$4K |
| J2805 |
Injection, sincalide, 5 micrograms |
39 |
39 |
$4K |
| 86901 |
|
7,903 |
6,865 |
$4K |
| 86762 |
|
1,054 |
1,012 |
$4K |
| 77295 |
|
15 |
13 |
$4K |
| 95909 |
|
89 |
88 |
$4K |
| 77065 |
Tomosynthesis, mammo |
137 |
132 |
$4K |
| 31500 |
|
14 |
13 |
$4K |
| 90674 |
|
301 |
300 |
$4K |
| 97035 |
|
471 |
233 |
$3K |
| 70360 |
|
266 |
259 |
$3K |
| 80074 |
|
1,082 |
1,049 |
$3K |
| 0001A |
|
86 |
85 |
$3K |
| 86900 |
|
7,012 |
6,034 |
$3K |
| 83615 |
|
3,827 |
3,245 |
$3K |
| 72131 |
|
80 |
78 |
$3K |
| 94618 |
|
38 |
37 |
$3K |
| 93925 |
|
72 |
68 |
$3K |
| 72114 |
|
106 |
105 |
$3K |
| 83690 |
|
21,409 |
19,257 |
$3K |
| 87070 |
|
3,470 |
3,262 |
$3K |
| G0380 |
Level 1 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room or emergency department; (2) it is held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment; or (3) during the calendar year immediately preceding the calendar year in which a determination under 42 cfr 489.24 is being made, based on a representative sample of patient visits that occurred during that calendar year, it provides at least one-third of all of its outpatient visits for the treatment of emergency medical conditions on an urgent basis without requiring a previously scheduled appointment) |
25 |
24 |
$3K |
| 84153 |
|
513 |
491 |
$3K |
| 74174 |
|
26 |
25 |
$3K |
| 93288 |
|
372 |
367 |
$3K |
| 96156 |
|
25 |
25 |
$3K |
| 77290 |
|
15 |
13 |
$3K |
| 73600 |
|
89 |
86 |
$2K |
| 95165 |
Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy, multiple dose vials |
126 |
122 |
$2K |
| 90378 |
|
16 |
12 |
$2K |
| J0897 |
Injection, denosumab, 1 mg |
16 |
13 |
$2K |
| 0004A |
|
73 |
72 |
$2K |
| 12013 |
|
15 |
15 |
$2K |
| 97760 |
|
73 |
57 |
$2K |
| 87046 |
|
981 |
954 |
$2K |
| 96150 |
|
25 |
25 |
$2K |
| J3370 |
Injection, vancomycin hcl, 500 mg |
3,871 |
1,363 |
$2K |
| 87186 |
|
8,925 |
8,085 |
$2K |
| 95117 |
|
138 |
49 |
$2K |
| 43762 |
|
12 |
12 |
$2K |
| 71101 |
|
998 |
983 |
$2K |
| D0220 |
Intraoral - periapical first radiographic image |
12 |
12 |
$2K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
34,414 |
27,330 |
$2K |
| 20552 |
|
14 |
13 |
$2K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
6,910 |
5,990 |
$2K |
| J2997 |
Injection, alteplase recombinant, 1 mg |
63 |
52 |
$2K |
| 82731 |
|
182 |
177 |
$2K |
| J2704 |
Injection, propofol, 10 mg |
22,184 |
19,915 |
$2K |
| 87430 |
|
8,322 |
8,120 |
$2K |
| 90670 |
|
666 |
662 |
$2K |
| 84100 |
|
1,776 |
1,316 |
$2K |
| 92553 |
|
18 |
17 |
$2K |
| 82043 |
|
940 |
903 |
$2K |
| 73200 |
|
28 |
27 |
$2K |
| 30901 |
|
41 |
39 |
$2K |
| 85007 |
|
4,998 |
4,413 |
$2K |
| 86592 |
|
1,434 |
1,382 |
$2K |
| 85014 |
|
24,745 |
21,318 |
$2K |
| 84156 |
|
1,389 |
1,220 |
$2K |
| 85730 |
|
4,608 |
4,278 |
$2K |
| 73552 |
|
175 |
165 |
$1K |
| 51701 |
|
668 |
656 |
$1K |
| 82950 |
|
469 |
459 |
$1K |
| 69200 |
|
15 |
13 |
$1K |
| 88304 |
|
3,303 |
3,184 |
$1K |
| 82746 |
|
815 |
767 |
$1K |
| G0297 |
Low dose ct scan (ldct) for lung cancer screening |
12 |
12 |
$1K |
| 82947 |
|
702 |
666 |
$1K |
| 73660 |
|
127 |
127 |
$1K |
| 82248 |
|
544 |
428 |
$1K |
| Q2038 |
Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (fluzone) |
163 |
148 |
$1K |
| 81025 |
|
11,517 |
11,009 |
$1K |
| 0002A |
|
26 |
26 |
$1K |
| 80306 |
|
6,199 |
5,709 |
$1K |
| 86304 |
|
222 |
176 |
$1K |
| 84145 |
|
111 |
99 |
$1K |
| 86480 |
|
104 |
103 |
$1K |
| 82077 |
|
4,803 |
4,261 |
$1K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
26,454 |
20,201 |
$1K |
| 84703 |
|
2,358 |
2,237 |
$1K |
| 82550 |
|
1,441 |
1,242 |
$1K |
| 83001 |
|
125 |
122 |
$1K |
| 92611 |
|
69 |
67 |
$1K |
| 99490 |
Ccm add 20min |
54 |
53 |
$1K |
| M0243 |
Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring |
14 |
13 |
$1K |
| 76000 |
|
272 |
266 |
$963.31 |
| 97167 |
|
16 |
16 |
$945.37 |
| 87205 |
|
4,098 |
3,762 |
$927.91 |
| 85384 |
|
692 |
658 |
$919.59 |
| 94770 |
|
12 |
12 |
$900.58 |
| 86706 |
|
413 |
391 |
$878.53 |
| 73060 |
|
140 |
132 |
$858.51 |
| 82784 |
|
244 |
181 |
$856.94 |
| 85018 |
|
20,104 |
17,046 |
$856.88 |
| S9436 |
Childbirth preparation/lamaze classes, non-physician provider, per session |
14 |
14 |
$840.00 |
| 92579 |
|
44 |
43 |
$827.88 |
| 81003 |
|
4,978 |
4,805 |
$812.73 |
| 73070 |
|
58 |
55 |
$805.18 |
| 72081 |
|
15 |
15 |
$797.54 |
| 85045 |
|
660 |
607 |
$793.56 |
| G2066 |
Interrogation device evaluation(s), (remote) up to 30 days; implantable cardiovascular physiologic monitor system, implantable loop recorder system, or subcutaneous cardiac rhythm monitor system, remote data acquisition(s), receipt of transmissions and technician review, technical support and distribution of results |
51 |
51 |
$788.60 |
| 97014 |
|
102 |
59 |
$779.93 |
| G0379 |
Direct admission of patient for hospital observation care |
27 |
27 |
$675.22 |
| 90677 |
|
232 |
231 |
$666.35 |
| 92522 |
|
13 |
13 |
$659.64 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
15,749 |
13,684 |
$636.70 |
| J2791 |
Injection, rho(d) immune globulin (human), (rhophylac), intramuscular or intravenous, 100 iu |
12 |
12 |
$626.29 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
29,110 |
24,250 |
$625.35 |
| 97016 |
|
133 |
51 |
$619.54 |
| 98967 |
|
15 |
12 |
$615.73 |
| 36593 |
|
30 |
24 |
$614.51 |
| 97542 |
|
13 |
12 |
$609.18 |
| 0072A |
|
13 |
13 |
$592.00 |
| 96040 |
|
13 |
13 |
$590.70 |
| 90651 |
|
326 |
323 |
$573.40 |
| 83883 |
|
67 |
43 |
$552.33 |
| 86300 |
|
132 |
101 |
$552.03 |
| 51741 |
|
345 |
342 |
$545.76 |
| J3490 |
Unclassified drugs |
725 |
666 |
$530.86 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
1,627 |
1,232 |
$527.20 |
| 90636 |
|
24 |
24 |
$503.71 |
| 83550 |
|
234 |
225 |
$486.32 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
28,381 |
26,995 |
$478.81 |
| 83516 |
|
109 |
67 |
$474.20 |
| 11721 |
|
30 |
30 |
$472.72 |
| 97550 |
|
15 |
12 |
$457.93 |
| 90480 |
|
68 |
67 |
$441.54 |
| 93975 |
|
46 |
45 |
$428.91 |
| 90656 |
|
156 |
154 |
$421.96 |
| 84146 |
|
59 |
56 |
$413.46 |
| 82670 |
|
61 |
59 |
$403.27 |
| 73000 |
|
39 |
37 |
$401.36 |
| 90662 |
|
426 |
416 |
$399.80 |
| 84550 |
|
552 |
466 |
$396.68 |
| 84403 |
|
55 |
53 |
$392.96 |
| 86920 |
|
1,791 |
993 |
$377.80 |
| 82652 |
|
69 |
66 |
$376.46 |
| J2310 |
Injection, naloxone hydrochloride, per 1 mg |
14 |
13 |
$357.43 |
| 86038 |
|
168 |
151 |
$352.42 |
| J0330 |
Injection, succinylcholine chloride, up to 20 mg |
7,029 |
6,688 |
$329.49 |
| 91322 |
|
48 |
47 |
$318.36 |
| 72220 |
|
40 |
40 |
$317.56 |
| 87075 |
|
561 |
507 |
$317.37 |
| 84132 |
|
772 |
547 |
$301.41 |
| 92556 |
|
282 |
280 |
$260.38 |
| 80051 |
|
27 |
27 |
$257.88 |
| 86923 |
|
101 |
74 |
$254.37 |
| 93325 |
|
321 |
316 |
$226.84 |
| 82140 |
|
410 |
350 |
$225.46 |
| J2710 |
Injection, neostigmine methylsulfate, up to 0.5 mg |
2,628 |
2,504 |
$209.32 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
8,565 |
5,389 |
$205.02 |
| 87209 |
|
37 |
35 |
$196.59 |
| 86703 |
|
59 |
58 |
$188.41 |
| 83970 |
|
14 |
12 |
$187.42 |
| 84460 |
|
96 |
84 |
$182.94 |
| J0360 |
Injection, hydralazine hcl, up to 20 mg |
636 |
542 |
$180.38 |
| 99152 |
|
669 |
647 |
$175.69 |
| 76937 |
|
127 |
121 |
$168.57 |
| 94664 |
|
38 |
37 |
$145.34 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
69 |
69 |
$128.15 |
| 82977 |
|
87 |
76 |
$127.40 |
| 80202 |
|
14 |
12 |
$126.02 |
| 51702 |
|
633 |
601 |
$123.19 |
| Q9957 |
Injection, perflutren lipid microspheres, per ml |
1,267 |
1,242 |
$120.99 |
| 82677 |
|
14 |
13 |
$119.88 |
| 84450 |
|
44 |
40 |
$119.57 |
| 88342 |
|
1,528 |
1,415 |
$118.90 |
| 86787 |
|
29 |
29 |
$117.40 |
| 96159 |
|
153 |
117 |
$116.13 |
| J0500 |
Injection, dicyclomine hcl, up to 20 mg |
1,290 |
1,245 |
$113.76 |
| 94660 |
|
12 |
12 |
$110.62 |
| 51798 |
|
746 |
731 |
$109.63 |
| 82533 |
|
31 |
27 |
$107.82 |
| 86336 |
|
15 |
14 |
$107.27 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
19,569 |
18,109 |
$106.62 |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
6,025 |
2,772 |
$105.48 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
35,559 |
30,624 |
$105.47 |
| 87177 |
|
37 |
35 |
$104.61 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
16,761 |
15,749 |
$102.97 |
| 90632 |
|
14 |
13 |
$94.67 |
| 80164 |
|
14 |
13 |
$87.66 |
| 89050 |
|
90 |
77 |
$79.33 |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
24 |
18 |
$68.55 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
9,203 |
7,897 |
$68.06 |
| 85046 |
|
69 |
54 |
$63.54 |
| 88360 |
|
16 |
12 |
$61.88 |
| J1040 |
Injection, methylprednisolone acetate, 80 mg |
2,165 |
2,108 |
$59.94 |
| 86308 |
|
198 |
193 |
$54.11 |
| 74022 |
|
12 |
12 |
$53.78 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
15,691 |
12,093 |
$53.09 |
| J2060 |
Injection, lorazepam, 2 mg |
4,362 |
3,702 |
$50.17 |
| C1769 |
Guide wire |
1,307 |
1,210 |
$48.70 |
| 85004 |
|
126 |
117 |
$47.23 |
| 84134 |
|
99 |
96 |
$46.30 |
| J1630 |
Injection, haloperidol, up to 5 mg |
1,252 |
1,089 |
$41.50 |
| 86200 |
|
13 |
13 |
$37.84 |
| 99153 |
Mod sedat endo service >5yrs |
221 |
213 |
$36.08 |
| 82274 |
|
14 |
12 |
$31.88 |
| 86160 |
|
15 |
14 |
$25.66 |
| 90648 |
|
78 |
77 |
$24.87 |
| 84520 |
|
16 |
14 |
$22.85 |
| 88341 |
|
143 |
89 |
$21.73 |
| 94760 |
|
5,666 |
4,441 |
$20.72 |
| 87529 |
|
16 |
15 |
$20.54 |
| 90694 |
|
70 |
68 |
$19.84 |
| 82310 |
|
15 |
13 |
$18.98 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
11,031 |
9,407 |
$15.96 |
| 80305 |
|
35 |
32 |
$15.48 |
| 82330 |
|
183 |
165 |
$14.79 |
| 87449 |
|
12 |
12 |
$13.88 |
| J1790 |
Injection, droperidol, up to 5 mg |
250 |
222 |
$13.41 |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
1,085 |
1,053 |
$13.02 |
| 88720 |
|
50 |
41 |
$11.00 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
4,410 |
3,767 |
$10.58 |
| 95012 |
|
40 |
39 |
$8.77 |
| 84478 |
|
13 |
12 |
$7.44 |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
1,880 |
1,609 |
$7.05 |
| 85049 |
|
12 |
12 |
$6.10 |
| 36416 |
|
1,259 |
928 |
$6.06 |
| 84295 |
|
166 |
152 |
$5.04 |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
2,676 |
2,513 |
$5.00 |
| J1836 |
Injection, metronidazole, 10 mg |
304 |
210 |
$4.44 |
| J1644 |
Injection, heparin sodium, per 1000 units |
4,348 |
1,911 |
$3.77 |
| 81002 |
|
978 |
961 |
$3.15 |
| 85347 |
|
155 |
114 |
$2.68 |
| J2175 |
Injection, meperidine hydrochloride, per 100 mg |
1,348 |
1,302 |
$1.67 |
| J1940 |
Injection, furosemide, up to 20 mg |
1,002 |
632 |
$1.32 |
| A9585 |
Injection, gadobutrol, 0.1 ml |
2,770 |
2,697 |
$0.01 |
| J2919 |
Injection, methylprednisolone sodium succinate, 5 mg |
263 |
209 |
$0.00 |
| A9502 |
Technetium tc-99m tetrofosmin, diagnostic, per study dose |
880 |
865 |
$0.00 |
| C9113 |
Injection, pantoprazole sodium, per vial |
1,173 |
690 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
799 |
786 |
$0.00 |
| J9190 |
Injection, fluorouracil, 500 mg |
1,664 |
681 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,066 |
1,052 |
$0.00 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
998 |
963 |
$0.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
505 |
500 |
$0.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,028 |
1,011 |
$0.00 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
1,138 |
1,081 |
$0.00 |
| Q9966 |
Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml |
634 |
607 |
$0.00 |
| 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 |
284 |
275 |
$0.00 |
| J1953 |
Injection, levetiracetam, 10 mg |
271 |
229 |
$0.00 |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
2,773 |
1,622 |
$0.00 |
| 80143 |
|
339 |
313 |
$0.00 |
| G1004 |
Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program |
793 |
765 |
$0.00 |
| J0295 |
Injection, ampicillin sodium/sulbactam sodium, per 1.5 gm |
492 |
288 |
$0.00 |
| 90633 |
|
381 |
378 |
$0.00 |
| A9537 |
Technetium tc-99m mebrofenin, diagnostic, per study dose, up to 15 millicuries |
63 |
63 |
$0.00 |
| J0694 |
Injection, cefoxitin sodium, 1 gm |
559 |
395 |
$0.00 |
| G8990 |
Other physical or occupational therapy primary functional limitation, current status, at therapy episode outset and at reporting intervals |
149 |
114 |
$0.00 |
| J1596 |
Injection, glycopyrrolate, 0.1 mg |
535 |
529 |
$0.00 |
| J0640 |
Injection, leucovorin calcium, per 50 mg |
1,536 |
566 |
$0.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
361 |
354 |
$0.00 |
| J1171 |
Injection, hydromorphone, 0.1 mg |
360 |
281 |
$0.00 |
| 90710 |
|
171 |
169 |
$0.00 |
| A9552 |
Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries |
320 |
309 |
$0.00 |
| 80179 |
|
298 |
276 |
$0.00 |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
1,923 |
1,872 |
$0.00 |
| 90473 |
|
13 |
13 |
$0.00 |
| J0688 |
Injection, cefazolin sodium (hikma), not therapeutically equivalent to j0690, 500 mg |
608 |
581 |
$0.00 |
| 90700 |
|
85 |
85 |
$0.00 |
| A4649 |
Surgical supply; miscellaneous |
598 |
520 |
$0.00 |
| C1894 |
Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser |
107 |
90 |
$0.00 |
| J1580 |
Injection, garamycin, gentamicin, up to 80 mg |
148 |
136 |
$0.00 |
| G0390 |
Trauma response team associated with hospital critical care service |
39 |
39 |
$0.00 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
701 |
644 |
$0.00 |
| C1887 |
Catheter, guiding (may include infusion/perfusion capability) |
57 |
30 |
$0.00 |
| G0500 |
Moderate sedation services provided by the same physician or other qualified health care professional performing a gastrointestinal endoscopic service that sedation supports, requiring the presence of an independent trained observer to assist in the monitoring of the patient's level of consciousness and physiological status; initial 15 minutes of intra-service time; patient age 5 years or older (additional time may be reported with 99153, as appropriate) |
70 |
68 |
$0.00 |
| 87324 |
|
12 |
12 |
$0.00 |
| Q9950 |
Injection, sulfur hexafluoride lipid microspheres, per ml |
77 |
77 |
$0.00 |
| J2272 |
Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg |
123 |
109 |
$0.00 |
| 90734 |
|
101 |
101 |
$0.00 |
| 96402 |
|
43 |
30 |
$0.00 |
| 95874 |
|
40 |
37 |
$0.00 |
| J3105 |
Injection, terbutaline sulfate, up to 1 mg |
61 |
52 |
$0.00 |
| 51610 |
|
15 |
12 |
$0.00 |
| A9541 |
Technetium tc-99m sulfur colloid, diagnostic, per study dose, up to 20 millicuries |
47 |
47 |
$0.00 |
| J0735 |
Injection, clonidine hydrochloride, 1 mg |
16 |
14 |
$0.00 |
| A9577 |
Injection, gadobenate dimeglumine (multihance), per ml |
20 |
20 |
$0.00 |
| J1756 |
Injection, iron sucrose, 1 mg |
41 |
13 |
$0.00 |
| J1642 |
Injection, heparin sodium, (heparin lock flush), per 10 units |
8,671 |
4,330 |
$0.00 |
| J8540 |
Dexamethasone, oral, 0.25 mg |
3,336 |
3,181 |
$0.00 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
2,582 |
2,479 |
$0.00 |
| J3480 |
Injection, potassium chloride, per 2 meq |
1,885 |
1,152 |
$0.00 |
| 90680 |
|
531 |
528 |
$0.00 |
| J2795 |
Injection, ropivacaine hydrochloride, 1 mg |
1,261 |
1,221 |
$0.00 |
| 90474 |
|
118 |
116 |
$0.00 |
| 96411 |
|
1,789 |
1,116 |
$0.00 |
| J1626 |
Injection, granisetron hydrochloride, 100 mcg |
2,076 |
1,000 |
$0.00 |
| J0461 |
Injection, atropine sulfate, 0.01 mg |
421 |
303 |
$0.00 |
| J1815 |
Injection, insulin, per 5 units |
7,650 |
2,869 |
$0.00 |
| 99406 |
|
563 |
552 |
$0.00 |
| J2785 |
Injection, regadenoson, 0.1 mg |
1,061 |
1,045 |
$0.00 |
| A9270 |
Non-covered item or service |
10,855 |
7,691 |
$0.00 |
| J1010 |
Injection, methylprednisolone acetate, 1 mg |
335 |
328 |
$0.00 |
| J8501 |
Aprepitant, oral, 5 mg |
1,578 |
1,506 |
$0.00 |
| A9500 |
Technetium tc-99m sestamibi, diagnostic, per study dose |
359 |
346 |
$0.00 |
| J3411 |
Injection, thiamine hcl, 100 mg |
155 |
133 |
$0.00 |
| J0574 |
Buprenorphine/naloxone, oral, greater than 6 mg, but less than or equal to 10 mg buprenorphine |
285 |
259 |
$0.00 |
| J0571 |
Buprenorphine, oral, 1 mg |
135 |
110 |
$0.00 |
| C2617 |
Stent, non-coronary, temporary, without delivery system |
489 |
455 |
$0.00 |
| J3420 |
Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg |
347 |
270 |
$0.00 |
| J9045 |
Injection, carboplatin, 50 mg |
157 |
100 |
$0.00 |
| J1920 |
Injection, labetalol hydrochloride, 5 mg |
28 |
26 |
$0.00 |
| 90697 |
|
307 |
303 |
$0.00 |
| J2371 |
Injection, phenylephrine hydrochloride, 20 micrograms |
703 |
668 |
$0.00 |
| J0687 |
Injection, cefazolin sodium (wg critical care), not therapeutically equivalent to j0690, 500 mg |
12 |
12 |
$0.00 |
| A9579 |
Injection, gadolinium-based magnetic resonance contrast agent, not otherwise specified (nos), per ml |
274 |
266 |
$0.00 |
| 90619 |
|
114 |
113 |
$0.00 |
| J2543 |
Injection, piperacillin sodium/tazobactam sodium, 1 gram/0.125 grams (1.125 grams) |
630 |
208 |
$0.00 |
| Q9965 |
Low osmolar contrast material, 100-199 mg/ml iodine concentration, per ml |
122 |
117 |
$0.00 |
| J9267 |
Injection, paclitaxel, 1 mg |
138 |
61 |
$0.00 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
477 |
450 |
$0.00 |
| J2920 |
Injection, methylprednisolone sodium succinate, up to 40 mg |
127 |
92 |
$0.00 |
| J3360 |
Injection, diazepam, up to 5 mg |
73 |
69 |
$0.00 |
| A4648 |
Tissue marker, implantable, any type, each |
156 |
150 |
$0.00 |
| J2305 |
Injection, nitroglycerin, 5 mg |
45 |
44 |
$0.00 |
| J7060 |
5% dextrose/water (500 ml = 1 unit) |
182 |
87 |
$0.00 |
| A9503 |
Technetium tc-99m medronate, diagnostic, per study dose, up to 30 millicuries |
25 |
25 |
$0.00 |
| 90696 |
|
26 |
26 |
$0.00 |
| C1889 |
Implantable/insertable device, not otherwise classified |
30 |
30 |
$0.00 |
| J1805 |
Injection, esmolol hydrochloride, 10 mg |
31 |
31 |
$0.00 |
| J2003 |
Injection, lidocaine hydrochloride, 1 mg |
596 |
514 |
$0.00 |
| G8991 |
Other physical or occupational therapy primary functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting |
154 |
118 |
$0.00 |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
66 |
65 |
$0.00 |
| J2470 |
Injection, pantoprazole sodium, 40 mg |
39 |
27 |
$0.00 |
| G0283 |
Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care |
30 |
12 |
$0.00 |
| Q9969 |
Tc-99m from non-highly enriched uranium source, full cost recovery add-on, per study dose |
17 |
15 |
$0.00 |
| 94761 |
|
28 |
26 |
$0.00 |
| J7050 |
Infusion, normal saline solution, 250 cc |
324 |
207 |
$0.00 |
| 74450 |
|
15 |
12 |
$0.00 |
| 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 |
30 |
29 |
$0.00 |