| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
37,912 |
35,171 |
$10.05M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
30,939 |
27,748 |
$9.54M |
| G0378 |
Hospital observation service, per hour |
16,619 |
8,044 |
$8.13M |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
14,221 |
13,095 |
$7.28M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
18,693 |
16,740 |
$7.00M |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
5,121 |
4,798 |
$5.82M |
| OP710 |
|
37,406 |
30,475 |
$4.09M |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
108,498 |
28,394 |
$3.50M |
| J1745 |
Injection, infliximab, excludes biosimilar, 10 mg |
677 |
607 |
$3.13M |
| 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 |
25,462 |
22,052 |
$2.53M |
| J9271 |
Injection, pembrolizumab, 1 mg |
424 |
288 |
$2.44M |
| 64483 |
|
1,982 |
1,735 |
$2.31M |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
63,455 |
18,037 |
$2.19M |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
9,995 |
6,543 |
$2.14M |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
8,140 |
7,438 |
$2.08M |
| 96375 |
Therapeutic injection; each additional sequential IV push |
18,796 |
13,545 |
$2.07M |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
2,744 |
2,582 |
$1.90M |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
1,893 |
1,811 |
$1.73M |
| OP370 |
|
11,565 |
9,839 |
$1.70M |
| 93017 |
|
6,936 |
6,255 |
$1.66M |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
9,163 |
8,833 |
$1.60M |
| 94060 |
|
6,148 |
5,921 |
$1.59M |
| OP270 |
|
49,256 |
39,178 |
$1.54M |
| OP272 |
|
36,414 |
29,666 |
$1.44M |
| 95800 |
|
3,897 |
3,629 |
$1.43M |
| 0202U |
Oncology (prostate), multianalyte, gene expression profiling |
9,716 |
8,989 |
$1.42M |
| 96361 |
Intravenous infusion, hydration; each additional hour |
17,145 |
14,982 |
$1.38M |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
37,488 |
31,676 |
$1.30M |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
2,824 |
1,168 |
$1.29M |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
13,161 |
9,217 |
$1.25M |
| C1713 |
Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) |
1,120 |
999 |
$1.22M |
| J2505 |
Injection, pegfilgrastim, 6 mg |
270 |
208 |
$1.21M |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
1,800 |
1,718 |
$1.20M |
| 41899 |
Unlisted procedure, dentoalveolar structures |
608 |
587 |
$1.19M |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
12,843 |
11,906 |
$1.18M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
18,936 |
15,705 |
$1.06M |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
1,936 |
1,816 |
$1.04M |
| 45378 |
Colonoscopy, flexible; diagnostic, including collection of specimen(s) |
1,257 |
1,194 |
$1.03M |
| OP250 |
|
209,968 |
79,040 |
$990K |
| OP278 |
|
2,206 |
1,900 |
$956K |
| 70450 |
Computed tomography, head or brain; without contrast material |
8,371 |
7,364 |
$890K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
3,307 |
2,905 |
$848K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
1,648 |
1,538 |
$842K |
| 93458 |
|
313 |
291 |
$840K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
6,583 |
6,379 |
$820K |
| 93970 |
|
3,776 |
3,434 |
$785K |
| 93325 |
|
3,482 |
3,227 |
$785K |
| 97161 |
|
11,858 |
10,898 |
$761K |
| 71046 |
Radiologic examination, chest; 2 views |
21,458 |
19,548 |
$743K |
| 80053 |
Comprehensive metabolic panel |
72,279 |
57,484 |
$739K |
| 45385 |
Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) |
1,588 |
1,439 |
$721K |
| 78815 |
Positron emission tomography (PET) for limited area imaging |
506 |
440 |
$688K |
| C1776 |
Joint device (implantable) |
467 |
331 |
$682K |
| 95810 |
Polysomnography; sleep staging with 4 or more additional parameters |
764 |
725 |
$655K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
12,532 |
5,596 |
$632K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
7,426 |
6,556 |
$629K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
6,062 |
3,725 |
$618K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
5,689 |
5,371 |
$614K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
2,805 |
2,577 |
$608K |
| J0897 |
Injection, denosumab, 1 mg |
523 |
463 |
$602K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
17,786 |
15,754 |
$602K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
4,678 |
2,886 |
$581K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
1,927 |
1,890 |
$546K |
| 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 |
19,723 |
17,764 |
$536K |
| 73221 |
|
858 |
781 |
$524K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
70,472 |
56,454 |
$510K |
| 76830 |
Ultrasound, transvaginal |
3,996 |
3,830 |
$508K |
| 93320 |
|
2,047 |
1,925 |
$504K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
10,928 |
9,356 |
$495K |
| 96376 |
|
7,198 |
4,483 |
$488K |
| 96417 |
|
2,271 |
1,384 |
$480K |
| 93303 |
Transthoracic echocardiography for congenital cardiac anomalies, follow-up or limited study |
1,497 |
1,440 |
$478K |
| 76770 |
|
3,910 |
3,719 |
$478K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
2,458 |
2,237 |
$464K |
| 76641 |
|
4,068 |
3,006 |
$463K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
2,058 |
1,870 |
$462K |
| J2506 |
Injection, pegfilgrastim, excludes biosimilar, 0.5 mg |
253 |
169 |
$451K |
| 90834 |
Psychotherapy, 45 minutes with patient |
15,024 |
5,475 |
$442K |
| 92507 |
Treatment of speech, language, voice, communication, and/or auditory processing disorder |
7,475 |
3,222 |
$434K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
5,379 |
5,000 |
$394K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
12,192 |
8,358 |
$391K |
| 19083 |
|
310 |
291 |
$374K |
| 96415 |
|
1,816 |
1,361 |
$345K |
| 93880 |
|
1,851 |
1,625 |
$332K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
2,739 |
2,594 |
$318K |
| 00731 |
|
2,309 |
2,246 |
$306K |
| 0002A |
|
9,173 |
9,144 |
$303K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
6,503 |
6,311 |
$296K |
| 75561 |
|
526 |
484 |
$294K |
| 94010 |
|
2,249 |
2,064 |
$292K |
| 0001A |
|
8,890 |
8,866 |
$276K |
| 71250 |
|
1,647 |
1,435 |
$273K |
| 72197 |
|
341 |
306 |
$268K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
3,742 |
3,346 |
$267K |
| G0108 |
Diabetes outpatient self-management training services, individual, per 30 minutes |
3,583 |
3,059 |
$266K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
2,462 |
2,080 |
$256K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
3,077 |
2,655 |
$247K |
| 87633 |
Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets |
1,199 |
1,185 |
$242K |
| 93226 |
|
1,414 |
1,329 |
$241K |
| 72141 |
|
509 |
470 |
$234K |
| 75574 |
|
595 |
529 |
$232K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
421 |
412 |
$229K |
| 64484 |
|
1,836 |
1,400 |
$228K |
| 92587 |
|
2,402 |
2,379 |
$223K |
| 74183 |
|
290 |
258 |
$221K |
| 92557 |
|
1,847 |
1,767 |
$221K |
| 93225 |
|
1,470 |
1,380 |
$218K |
| 73562 |
|
4,294 |
4,058 |
$218K |
| 76536 |
|
2,051 |
1,927 |
$216K |
| 96367 |
|
3,930 |
2,649 |
$214K |
| 92579 |
|
1,607 |
1,587 |
$211K |
| 99215 |
Prolong outpt/office vis |
2,542 |
2,193 |
$208K |
| 76813 |
|
1,648 |
1,617 |
$198K |
| C9290 |
Injection, bupivacaine liposome, 1 mg |
1,585 |
1,401 |
$195K |
| 00813 |
|
1,097 |
1,065 |
$194K |
| 76642 |
|
2,251 |
2,059 |
$192K |
| 00840 |
|
781 |
733 |
$190K |
| 90791 |
Psychiatric diagnostic evaluation |
5,203 |
3,299 |
$186K |
| 36415 |
Collection of venous blood by venipuncture |
106,222 |
88,003 |
$184K |
| 71045 |
Radiologic examination, chest; single view |
6,232 |
5,573 |
$179K |
| 59426 |
|
3,184 |
1,842 |
$176K |
| J2785 |
Injection, regadenoson, 0.1 mg |
1,750 |
1,706 |
$171K |
| 97165 |
|
2,997 |
2,710 |
$170K |
| 93971 |
|
540 |
474 |
$166K |
| 77066 |
Tomosynthesis, mammo |
1,178 |
1,111 |
$166K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
23,747 |
19,197 |
$164K |
| 77065 |
Tomosynthesis, mammo |
1,713 |
1,568 |
$163K |
| 84443 |
Thyroid stimulating hormone (TSH) |
18,075 |
16,033 |
$163K |
| 59425 |
|
3,100 |
2,183 |
$162K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
5,259 |
4,614 |
$161K |
| 86850 |
|
15,216 |
12,975 |
$160K |
| 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 |
4,849 |
3,968 |
$159K |
| 76801 |
|
1,681 |
1,606 |
$158K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
2,219 |
2,206 |
$156K |
| 92526 |
|
2,810 |
1,729 |
$155K |
| 92567 |
|
3,380 |
3,298 |
$155K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
2,319 |
2,275 |
$152K |
| 73630 |
|
3,397 |
3,162 |
$150K |
| 73610 |
|
3,464 |
3,196 |
$149K |
| 88341 |
|
1,232 |
1,077 |
$148K |
| 73030 |
|
3,698 |
3,384 |
$148K |
| 00811 |
|
822 |
805 |
$145K |
| 73130 |
|
3,273 |
3,047 |
$142K |
| 76821 |
|
1,627 |
1,067 |
$141K |
| 00920 |
|
657 |
627 |
$141K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
1,173 |
1,161 |
$141K |
| 77080 |
|
1,545 |
1,513 |
$138K |
| 86900 |
|
16,819 |
13,963 |
$138K |
| 00170 |
Anesthesia for intraoral procedures, including biopsy |
716 |
696 |
$131K |
| J1453 |
Injection, fosaprepitant, 1 mg |
1,039 |
653 |
$128K |
| C9399 |
Unclassified drugs or biologicals |
1,689 |
1,526 |
$128K |
| 86901 |
|
16,888 |
13,964 |
$123K |
| 97162 |
|
1,774 |
1,623 |
$120K |
| 99241 |
|
1,857 |
1,578 |
$117K |
| C1769 |
Guide wire |
4,288 |
3,544 |
$116K |
| 94726 |
|
1,026 |
949 |
$116K |
| 73110 |
|
2,685 |
2,405 |
$113K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
3,253 |
2,606 |
$113K |
| 97802 |
|
1,476 |
1,466 |
$111K |
| 73560 |
|
2,666 |
2,383 |
$111K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
2,908 |
2,781 |
$110K |
| 29405 |
|
262 |
80 |
$109K |
| G0279 |
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) |
2,578 |
2,368 |
$108K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
1,350 |
1,286 |
$106K |
| 64721 |
|
70 |
67 |
$106K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,316 |
1,312 |
$106K |
| 76820 |
|
1,730 |
1,101 |
$104K |
| A9585 |
Injection, gadobutrol, 0.1 ml |
2,577 |
2,409 |
$102K |
| 73502 |
|
2,188 |
1,962 |
$102K |
| J1756 |
Injection, iron sucrose, 1 mg |
1,749 |
707 |
$101K |
| 93976 |
|
457 |
422 |
$100K |
| 99153 |
Mod sedat endo service >5yrs |
1,200 |
1,130 |
$92K |
| 94729 |
|
1,932 |
1,780 |
$92K |
| 84484 |
|
13,002 |
10,356 |
$92K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
2,208 |
2,017 |
$91K |
| 64447 |
|
376 |
287 |
$90K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
5,646 |
4,380 |
$89K |
| 74018 |
|
2,050 |
1,928 |
$88K |
| 00812 |
|
581 |
555 |
$87K |
| 88342 |
|
2,562 |
2,333 |
$82K |
| 73590 |
|
1,829 |
1,672 |
$81K |
| OP258 |
|
47,176 |
29,697 |
$80K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
9,645 |
9,282 |
$78K |
| 70486 |
|
556 |
503 |
$77K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
2,996 |
2,835 |
$76K |
| 72100 |
|
1,783 |
1,660 |
$76K |
| J2704 |
Injection, propofol, 10 mg |
22,031 |
20,998 |
$76K |
| 96401 |
|
1,058 |
760 |
$75K |
| 88307 |
|
1,249 |
1,137 |
$73K |
| 99152 |
|
1,642 |
1,557 |
$73K |
| 85055 |
|
1,627 |
1,175 |
$73K |
| 88304 |
|
2,486 |
2,325 |
$69K |
| 85027 |
|
15,878 |
12,461 |
$68K |
| 76825 |
|
384 |
375 |
$68K |
| 83735 |
|
16,902 |
12,873 |
$68K |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
2,066 |
1,894 |
$67K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
3,749 |
3,281 |
$67K |
| 82962 |
|
17,776 |
12,197 |
$66K |
| J1561 |
Injection, immune globulin, (gamunex-c/gammaked), non-lyophilized (e.g., liquid), 500 mg |
52 |
12 |
$66K |
| 77072 |
|
1,076 |
1,074 |
$65K |
| 97803 |
|
1,420 |
1,391 |
$64K |
| 80061 |
Lipid panel |
11,465 |
10,632 |
$64K |
| 36902 |
|
109 |
90 |
$64K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
2,991 |
2,829 |
$63K |
| C1725 |
Catheter, transluminal angioplasty, non-laser (may include guidance, infusion/perfusion capability) |
1,382 |
1,085 |
$62K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
2,960 |
1,231 |
$62K |
| 62321 |
|
63 |
52 |
$61K |
| 01400 |
|
232 |
224 |
$61K |
| 77336 |
|
532 |
233 |
$61K |
| 83880 |
|
5,137 |
4,383 |
$61K |
| 73140 |
|
1,463 |
1,362 |
$61K |
| 73564 |
|
1,472 |
1,388 |
$60K |
| 85610 |
|
17,815 |
15,352 |
$59K |
| 96409 |
|
246 |
126 |
$59K |
| A9500 |
Technetium tc-99m sestamibi, diagnostic, per study dose |
3,221 |
2,720 |
$58K |
| 93296 |
|
3,357 |
2,935 |
$58K |
| 96523 |
|
920 |
646 |
$56K |
| 85730 |
|
15,264 |
13,296 |
$54K |
| 95812 |
|
154 |
150 |
$54K |
| 81001 |
|
21,436 |
19,050 |
$54K |
| C1894 |
Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser |
3,653 |
2,998 |
$53K |
| 70491 |
|
224 |
203 |
$53K |
| 81025 |
|
16,966 |
15,651 |
$52K |
| OP251 |
|
5,221 |
1,929 |
$52K |
| 76827 |
|
382 |
375 |
$52K |
| 72110 |
|
693 |
660 |
$51K |
| 83605 |
|
5,995 |
5,182 |
$51K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
3,168 |
3,040 |
$51K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
2,770 |
2,691 |
$51K |
| 92610 |
|
510 |
476 |
$50K |
| J1439 |
Injection, ferric carboxymaltose, 1 mg |
74 |
48 |
$49K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
11,858 |
10,869 |
$49K |
| 92523 |
|
578 |
551 |
$49K |
| 73080 |
|
1,150 |
1,067 |
$46K |
| 95782 |
|
38 |
38 |
$46K |
| J0585 |
Injection, onabotulinumtoxina, 1 unit |
80 |
72 |
$46K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
4,619 |
4,295 |
$45K |
| C1887 |
Catheter, guiding (may include infusion/perfusion capability) |
1,530 |
1,301 |
$45K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
19,481 |
16,610 |
$45K |
| 70498 |
|
201 |
167 |
$45K |
| 97116 |
|
2,488 |
1,215 |
$45K |
| 72131 |
|
443 |
369 |
$44K |
| A4648 |
Tissue marker, implantable, any type, each |
754 |
656 |
$43K |
| 72170 |
|
909 |
862 |
$43K |
| 87507 |
|
236 |
201 |
$42K |
| 84466 |
|
6,414 |
5,755 |
$41K |
| 36430 |
|
410 |
291 |
$41K |
| 76870 |
|
440 |
406 |
$41K |
| 82728 |
|
6,485 |
5,801 |
$40K |
| 70496 |
|
149 |
129 |
$40K |
| 73120 |
|
735 |
711 |
$39K |
| 90715 |
|
2,709 |
2,584 |
$39K |
| 47562 |
|
34 |
24 |
$39K |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
3,538 |
3,202 |
$39K |
| 83690 |
|
12,081 |
10,703 |
$39K |
| J0690 |
Injection, cefazolin sodium, 500 mg |
9,342 |
7,872 |
$39K |
| 77049 |
|
60 |
56 |
$39K |
| 84702 |
|
4,027 |
3,486 |
$38K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
749 |
517 |
$38K |
| 87040 |
|
4,715 |
4,214 |
$38K |
| 54161 |
|
46 |
39 |
$38K |
| 80076 |
|
6,611 |
5,834 |
$37K |
| 73521 |
|
577 |
542 |
$37K |
| 96411 |
|
142 |
92 |
$36K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
803 |
742 |
$36K |
| 71271 |
|
217 |
212 |
$35K |
| 84145 |
|
3,096 |
2,675 |
$34K |
| 84100 |
|
11,934 |
9,371 |
$34K |
| 00400 |
|
170 |
156 |
$34K |
| 82607 |
|
5,291 |
4,803 |
$34K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
765 |
663 |
$32K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
748 |
701 |
$31K |
| 73100 |
|
550 |
518 |
$31K |
| 82803 |
|
2,436 |
2,089 |
$31K |
| 73090 |
|
676 |
621 |
$30K |
| 59430 |
|
875 |
661 |
$30K |
| 87631 |
|
464 |
462 |
$30K |
| 97750 |
|
1,657 |
1,445 |
$30K |
| 81003 |
|
15,090 |
13,668 |
$30K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
9,711 |
9,029 |
$30K |
| 90832 |
Psychotherapy, 30 minutes with patient |
1,158 |
640 |
$29K |
| 92611 |
|
124 |
115 |
$28K |
| 87581 |
|
1,215 |
1,200 |
$27K |
| 90833 |
Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) |
739 |
541 |
$27K |
| 87186 |
|
4,159 |
3,766 |
$26K |
| 84439 |
|
4,401 |
4,001 |
$26K |
| 87486 |
|
1,214 |
1,199 |
$26K |
| A9575 |
Injection, gadoterate meglumine, 0.1 ml |
3,385 |
2,979 |
$26K |
| 88142 |
|
1,176 |
1,149 |
$25K |
| 76818 |
|
233 |
133 |
$24K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
241 |
239 |
$24K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
16,609 |
13,698 |
$24K |
| Q9956 |
Injection, octafluoropropane microspheres, per ml |
410 |
340 |
$24K |
| 87077 |
|
4,558 |
4,126 |
$24K |
| 93280 |
|
949 |
822 |
$24K |
| 0004A |
|
695 |
694 |
$24K |
| 74021 |
|
639 |
613 |
$23K |
| A9552 |
Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries |
744 |
629 |
$23K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
327 |
320 |
$23K |
| C1781 |
Mesh (implantable) |
89 |
74 |
$23K |
| 93923 |
|
137 |
104 |
$23K |
| 86803 |
|
1,980 |
1,868 |
$22K |
| 77334 |
|
47 |
39 |
$22K |
| 64415 |
|
95 |
78 |
$21K |
| 82746 |
|
4,117 |
3,700 |
$21K |
| 76775 |
|
172 |
172 |
$21K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
1,238 |
1,198 |
$20K |
| 51600 |
|
12 |
12 |
$20K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
21,994 |
17,595 |
$20K |
| 93321 |
|
161 |
146 |
$20K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
1,109 |
1,064 |
$20K |
| 99242 |
|
368 |
324 |
$20K |
| 86140 |
|
7,761 |
6,906 |
$19K |
| 86923 |
|
1,033 |
856 |
$19K |
| 27447 |
|
68 |
39 |
$18K |
| 73552 |
|
390 |
350 |
$18K |
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
925 |
133 |
$18K |
| 88143 |
|
671 |
635 |
$18K |
| 29881 |
|
13 |
13 |
$17K |
| C1874 |
Stent, coated/covered, with delivery system |
56 |
39 |
$17K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
3,060 |
2,305 |
$17K |
| 81002 |
|
6,550 |
4,601 |
$17K |
| 74230 |
|
233 |
211 |
$16K |
| 87070 |
|
2,613 |
2,432 |
$16K |
| 72081 |
|
232 |
232 |
$16K |
| 96137 |
|
541 |
341 |
$16K |
| 72082 |
|
158 |
157 |
$15K |
| J3490 |
Unclassified drugs |
31,451 |
14,114 |
$15K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,888 |
1,856 |
$15K |
| 97535 |
Self-care/home management training, each 15 minutes |
817 |
495 |
$15K |
| C9600 |
Percutaneous transcatheter placement of drug eluting intracoronary stent(s), with coronary angioplasty when performed; single major coronary artery or branch |
15 |
12 |
$15K |
| 82248 |
|
2,293 |
1,812 |
$15K |
| 29125 |
|
389 |
350 |
$15K |
| 82378 |
|
1,976 |
1,497 |
$15K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
12,270 |
9,895 |
$14K |
| OP255 |
|
5,942 |
4,822 |
$14K |
| 96130 |
|
509 |
328 |
$14K |
| 00910 |
|
85 |
75 |
$14K |
| 73070 |
|
248 |
223 |
$14K |
| 96136 |
|
510 |
328 |
$14K |
| J1170 |
Injection, hydromorphone, up to 4 mg |
5,548 |
3,630 |
$14K |
| 83540 |
|
6,416 |
5,753 |
$14K |
| J1644 |
Injection, heparin sodium, per 1000 units |
7,792 |
4,444 |
$14K |
| 72040 |
|
319 |
305 |
$13K |
| J1642 |
Injection, heparin sodium, (heparin lock flush), per 10 units |
4,617 |
2,454 |
$13K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
14,872 |
12,041 |
$13K |
| 12001 |
|
222 |
207 |
$13K |
| 85378 |
|
3,545 |
3,256 |
$13K |
| 51701 |
|
443 |
393 |
$12K |
| 87641 |
|
1,201 |
989 |
$12K |
| 72070 |
|
262 |
246 |
$12K |
| 58558 |
|
13 |
12 |
$11K |
| 96402 |
|
199 |
166 |
$11K |
| 12011 |
|
207 |
188 |
$11K |
| 95700 |
|
12 |
12 |
$11K |
| 86618 |
|
796 |
759 |
$11K |
| J7050 |
Infusion, normal saline solution, 250 cc |
4,291 |
2,754 |
$11K |
| 72050 |
|
134 |
130 |
$11K |
| 76882 |
|
155 |
144 |
$11K |
| 83037 |
|
2,257 |
2,221 |
$11K |
| C7900 |
Service for diagnosis, evaluation, or treatment of a mental health or substance use disorder, 15-29 minutes, provided remotely by hospital staff who are licensed to provide mental health services under applicable state law(s), when the patient is in their home, and there is no associated professional service |
3,023 |
2,342 |
$11K |
| 85652 |
|
6,443 |
5,721 |
$10K |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
68 |
65 |
$10K |
| 83615 |
|
2,703 |
2,172 |
$10K |
| 80320 |
|
212 |
194 |
$10K |
| 96416 |
|
40 |
24 |
$10K |
| 90674 |
|
421 |
411 |
$9K |
| 82784 |
|
1,187 |
1,025 |
$9K |
| 81220 |
CFTR (cystic fibrosis transmembrane conductance regulator) gene analysis; common variants |
27 |
27 |
$9K |
| 82550 |
|
2,909 |
2,478 |
$9K |
| 0071A |
|
228 |
228 |
$9K |
| 87205 |
|
2,008 |
1,821 |
$9K |
| 85014 |
|
2,298 |
1,946 |
$8K |
| 84153 |
|
1,110 |
984 |
$8K |
| 74174 |
|
29 |
25 |
$8K |
| 93926 |
|
53 |
46 |
$8K |
| J0136 |
Injection, acetaminophen (b braun), not therapeutically equivalent to j0131, 10 mg |
2,764 |
2,319 |
$8K |
| 82330 |
|
1,218 |
1,061 |
$8K |
| 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 |
210 |
192 |
$8K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
175 |
171 |
$8K |
| 0072A |
|
205 |
205 |
$8K |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
2,645 |
1,910 |
$7K |
| 99201 |
|
109 |
108 |
$7K |
| 87075 |
|
1,091 |
977 |
$7K |
| 92550 |
|
298 |
278 |
$7K |
| C1760 |
Closure device, vascular (implantable/insertable) |
132 |
93 |
$7K |
| 87801 |
Infectious agent detection by nucleic acid; amplified probe, multiple organisms |
228 |
220 |
$7K |
| 80074 |
|
415 |
351 |
$7K |
| 96450 |
|
13 |
12 |
$7K |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
166 |
166 |
$7K |
| 93298 |
|
200 |
172 |
$7K |
| 82077 |
|
1,392 |
1,055 |
$6K |
| 81401 |
|
55 |
53 |
$6K |
| 01810 |
|
37 |
37 |
$6K |
| J1456 |
Injection, fosaprepitant (teva), not therapeutically equivalent to j1453, 1 mg |
334 |
202 |
$6K |
| 0011A |
|
187 |
187 |
$6K |
| 90670 |
|
1,423 |
1,404 |
$6K |
| 0012A |
|
184 |
182 |
$6K |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
9,710 |
9,004 |
$6K |
| P9016 |
Red blood cells, leukocytes reduced, each unit |
51 |
37 |
$6K |
| OP229 |
|
112 |
89 |
$6K |
| J3370 |
Injection, vancomycin hcl, 500 mg |
736 |
477 |
$6K |
| 94664 |
|
262 |
254 |
$6K |
| 85046 |
|
1,493 |
1,212 |
$6K |
| 84132 |
|
1,976 |
1,648 |
$6K |
| 77001 |
|
92 |
75 |
$5K |
| 36591 |
|
644 |
398 |
$5K |
| 87640 |
|
990 |
778 |
$5K |
| 73565 |
|
89 |
77 |
$5K |
| 87653 |
|
147 |
144 |
$5K |
| 84295 |
|
1,876 |
1,560 |
$5K |
| 86334 |
|
933 |
810 |
$5K |
| J0694 |
Injection, cefoxitin sodium, 1 gm |
267 |
182 |
$5K |
| J0330 |
Injection, succinylcholine chloride, up to 20 mg |
1,567 |
1,194 |
$5K |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
4,075 |
2,945 |
$5K |
| 86038 |
|
908 |
808 |
$5K |
| A9577 |
Injection, gadobenate dimeglumine (multihance), per ml |
89 |
87 |
$5K |
| 93308 |
|
17 |
14 |
$5K |
| 90686 |
|
2,850 |
2,823 |
$5K |
| 93299 |
|
115 |
114 |
$5K |
| 0064A |
|
148 |
148 |
$5K |
| J3480 |
Injection, potassium chloride, per 2 meq |
1,845 |
1,193 |
$5K |
| 87340 |
|
661 |
631 |
$5K |
| M0222 |
Intravenous injection, bebtelovimab, includes injection and post administration monitoring |
28 |
24 |
$4K |
| 80143 |
|
933 |
746 |
$4K |
| 93304 |
|
27 |
24 |
$4K |
| 86304 |
|
535 |
354 |
$4K |
| G1004 |
Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program |
25,846 |
18,648 |
$4K |
| 80179 |
|
917 |
732 |
$4K |
| 0124A |
|
182 |
168 |
$4K |
| 64999 |
|
57 |
36 |
$4K |
| J2543 |
Injection, piperacillin sodium/tazobactam sodium, 1 gram/0.125 grams (1.125 grams) |
566 |
301 |
$4K |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
2,429 |
2,034 |
$4K |
| J2060 |
Injection, lorazepam, 2 mg |
1,786 |
1,210 |
$4K |
| 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 |
4,359 |
3,929 |
$4K |
| 90682 |
|
71 |
66 |
$4K |
| 85018 |
|
2,111 |
1,775 |
$4K |
| 73060 |
|
99 |
91 |
$4K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
288 |
262 |
$3K |
| 86769 |
|
122 |
119 |
$3K |
| 90474 |
|
444 |
444 |
$3K |
| 84481 |
|
821 |
741 |
$3K |
| J2469 |
Injection, palonosetron hcl, 25 mcg |
683 |
372 |
$3K |
| 86480 |
|
224 |
198 |
$3K |
| 73000 |
|
61 |
56 |
$3K |
| J1815 |
Injection, insulin, per 5 units |
2,914 |
1,207 |
$3K |
| 0054A |
|
109 |
103 |
$3K |
| 73700 |
|
14 |
12 |
$3K |
| 0031A |
|
102 |
102 |
$3K |
| 51702 |
|
149 |
128 |
$3K |
| 87076 |
|
226 |
221 |
$3K |
| 0003A |
|
90 |
90 |
$3K |
| 82043 |
|
1,996 |
1,852 |
$3K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
325 |
299 |
$3K |
| 91320 |
|
31 |
26 |
$3K |
| 96368 |
|
62 |
40 |
$3K |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
525 |
407 |
$3K |
| 82977 |
|
1,079 |
742 |
$3K |
| 88112 |
|
215 |
173 |
$3K |
| 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 |
1,929 |
1,519 |
$3K |
| 83970 |
|
193 |
169 |
$3K |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
91 |
90 |
$3K |
| 86592 |
|
1,359 |
1,294 |
$3K |
| 90677 |
|
212 |
209 |
$2K |
| 84550 |
|
1,591 |
1,403 |
$2K |
| OP720 |
|
14 |
13 |
$2K |
| 84425 |
|
162 |
134 |
$2K |
| J9190 |
Injection, fluorouracil, 500 mg |
93 |
48 |
$2K |
| 84134 |
|
458 |
327 |
$2K |
| C1751 |
Catheter, infusion, inserted peripherally, centrally or midline (other than hemodialysis) |
179 |
160 |
$2K |
| 84165 |
|
1,096 |
961 |
$2K |
| M0247 |
Intravenous infusion, sotrovimab, includes infusion and post administration monitoring |
14 |
14 |
$2K |
| 86300 |
|
283 |
219 |
$2K |
| 72083 |
|
16 |
16 |
$2K |
| J9045 |
Injection, carboplatin, 50 mg |
132 |
63 |
$2K |
| OP279 |
|
612 |
417 |
$2K |
| 76885 |
|
13 |
13 |
$2K |
| 96101 |
|
26 |
15 |
$2K |
| 86701 |
|
161 |
160 |
$2K |
| 83020 |
|
383 |
341 |
$2K |
| 86481 |
|
25 |
25 |
$2K |
| 77061 |
|
55 |
53 |
$2K |
| 83521 |
|
472 |
400 |
$2K |
| 81243 |
|
27 |
27 |
$2K |
| 97164 |
|
34 |
28 |
$2K |
| 90651 |
|
27 |
27 |
$2K |
| J2916 |
Injection, sodium ferric gluconate complex in sucrose injection, 12.5 mg |
46 |
18 |
$2K |
| 86706 |
|
270 |
241 |
$1K |
| 84436 |
|
278 |
263 |
$1K |
| P9604 |
Travel allowance one way in connection with medically necessary laboratory specimen collection drawn from home bound or nursing home bound patient; prorated trip charge |
751 |
362 |
$1K |
| 74420 |
|
12 |
12 |
$1K |
| G0379 |
Direct admission of patient for hospital observation care |
15 |
15 |
$1K |
| 84520 |
|
123 |
121 |
$1K |
| G0009 |
Administration of pneumococcal vaccine |
154 |
150 |
$1K |
| 88185 |
|
16 |
12 |
$1K |
| 86665 |
|
54 |
49 |
$1K |
| G0008 |
Administration of influenza virus vaccine |
154 |
154 |
$1K |
| 74455 |
|
12 |
12 |
$1K |
| 82947 |
|
51 |
50 |
$1K |
| C7901 |
Service for diagnosis, evaluation, or treatment of a mental health or substance use disorder, 30-60 minutes, provided remotely by hospital staff who are licensed to provided mental health services under applicable state law(s), when the patient is in their home, and there is no associated professional service |
147 |
86 |
$1K |
| 86308 |
|
342 |
334 |
$1K |
| 87536 |
|
16 |
14 |
$1K |
| C1729 |
Catheter, drainage |
99 |
75 |
$999.85 |
| 84156 |
|
763 |
628 |
$981.47 |
| 90647 |
|
1,012 |
1,000 |
$981.37 |
| 80164 |
|
237 |
197 |
$971.91 |
| 81244 |
|
27 |
27 |
$969.57 |
| 84207 |
|
90 |
67 |
$965.51 |
| 88173 |
|
43 |
37 |
$949.23 |
| 90734 |
|
39 |
39 |
$900.23 |
| 95886 |
|
12 |
12 |
$887.61 |
| 76937 |
|
30 |
24 |
$860.29 |
| 82570 |
|
753 |
625 |
$858.45 |
| 72202 |
|
13 |
13 |
$850.32 |
| 83883 |
|
44 |
42 |
$845.29 |
| 90723 |
|
1,108 |
1,093 |
$834.71 |
| 97014 |
|
38 |
12 |
$820.06 |
| 90480 |
|
31 |
26 |
$811.07 |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
270 |
139 |
$795.79 |
| C9113 |
Injection, pantoprazole sodium, per vial |
425 |
223 |
$793.03 |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
146 |
137 |
$785.08 |
| 86762 |
|
164 |
161 |
$779.27 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
1,213 |
1,057 |
$773.44 |
| J2003 |
Injection, lidocaine hydrochloride, 1 mg |
331 |
326 |
$724.95 |
| 90632 |
|
101 |
101 |
$724.03 |
| C1758 |
Catheter, ureteral |
63 |
63 |
$723.77 |
| J0702 |
Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg |
121 |
95 |
$704.35 |
| 0134A |
|
30 |
27 |
$702.10 |
| J2919 |
Injection, methylprednisolone sodium succinate, 5 mg |
231 |
178 |
$669.42 |
| 86360 |
|
17 |
15 |
$626.23 |
| A9541 |
Technetium tc-99m sulfur colloid, diagnostic, per study dose, up to 20 millicuries |
16 |
12 |
$622.30 |
| J9267 |
Injection, paclitaxel, 1 mg |
23 |
12 |
$606.30 |
| G8978 |
Mobility: walking & moving around functional limitation, current status, at therapy episode outset and at reporting intervals |
330 |
303 |
$577.16 |
| G8979 |
Mobility: walking & moving around functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting |
342 |
313 |
$577.16 |
| 82105 |
|
54 |
52 |
$571.59 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
924 |
730 |
$536.55 |
| 82010 |
|
101 |
88 |
$535.11 |
| 86328 |
|
18 |
18 |
$532.24 |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
328 |
202 |
$523.80 |
| 90661 |
|
38 |
38 |
$519.14 |
| J2272 |
Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg |
357 |
290 |
$514.36 |
| 86664 |
|
54 |
49 |
$499.11 |
| 86355 |
|
17 |
15 |
$491.11 |
| 86357 |
|
17 |
15 |
$491.11 |
| 89051 |
|
240 |
212 |
$482.04 |
| 86359 |
|
17 |
15 |
$477.25 |
| 83520 |
|
58 |
57 |
$455.79 |
| 85347 |
|
192 |
140 |
$442.38 |
| 87430 |
|
58 |
57 |
$423.10 |
| 90688 |
|
77 |
77 |
$414.48 |
| J1630 |
Injection, haloperidol, up to 5 mg |
322 |
210 |
$394.47 |
| 90681 |
|
434 |
430 |
$391.59 |
| 96377 |
|
17 |
12 |
$374.07 |
| 86663 |
|
54 |
49 |
$366.68 |
| 86301 |
|
74 |
52 |
$358.62 |
| 87081 |
|
62 |
61 |
$347.50 |
| 88331 |
|
31 |
25 |
$336.89 |
| J0134 |
Injection, acetaminophen (fresenius kabi), not therapeutically equivalent to j0131, 10 mg |
93 |
83 |
$334.23 |
| 77062 |
|
12 |
12 |
$320.22 |
| 86780 |
|
42 |
42 |
$320.16 |
| Q9966 |
Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml |
72 |
62 |
$283.48 |
| 93297 |
|
79 |
76 |
$262.14 |
| J0689 |
Injection, cefazolin sodium (baxter), not therapeutically equivalent to j0690, 500 mg |
65 |
54 |
$258.80 |
| 90633 |
|
245 |
244 |
$255.48 |
| 82232 |
|
42 |
38 |
$252.90 |
| 82247 |
|
53 |
39 |
$235.78 |
| 87015 |
|
90 |
79 |
$233.09 |
| J2920 |
Injection, methylprednisolone sodium succinate, up to 40 mg |
67 |
38 |
$227.86 |
| 82553 |
|
52 |
49 |
$221.80 |
| 82525 |
|
29 |
27 |
$217.50 |
| 84446 |
|
54 |
39 |
$209.32 |
| Q9958 |
High osmolar contrast material, up to 149 mg/ml iodine concentration, per ml |
13 |
13 |
$193.07 |
| 88184 |
|
16 |
12 |
$192.24 |
| 82150 |
|
71 |
62 |
$190.03 |
| 83516 |
|
45 |
38 |
$181.07 |
| J1596 |
Injection, glycopyrrolate, 0.1 mg |
112 |
110 |
$169.42 |
| J0461 |
Injection, atropine sulfate, 0.01 mg |
19 |
12 |
$159.86 |
| 86430 |
|
106 |
95 |
$154.28 |
| 87799 |
|
23 |
15 |
$150.79 |
| 84480 |
|
35 |
31 |
$149.59 |
| 86880 |
|
68 |
56 |
$149.50 |
| A9503 |
Technetium tc-99m medronate, diagnostic, per study dose, up to 30 millicuries |
14 |
12 |
$146.87 |
| 82552 |
|
30 |
28 |
$140.68 |
| J0295 |
Injection, ampicillin sodium/sulbactam sodium, per 1.5 gm |
30 |
12 |
$134.21 |
| 36592 |
|
70 |
60 |
$132.79 |
| 90710 |
|
13 |
13 |
$130.40 |
| OP259 |
|
291 |
54 |
$125.97 |
| 86225 |
|
15 |
13 |
$125.04 |
| 88302 |
|
12 |
12 |
$120.12 |
| 87497 |
|
22 |
14 |
$114.81 |
| J1171 |
Injection, hydromorphone, 0.1 mg |
93 |
59 |
$114.14 |
| 80047 |
|
34 |
28 |
$108.49 |
| L1830 |
Knee orthosis, immobilizer, canvas longitudinal, prefabricated, off-the-shelf |
17 |
16 |
$105.28 |
| 82040 |
|
79 |
68 |
$100.25 |
| J3371 |
Injection, vancomycin hcl (mylan), not therapeutically equivalent to j3370, 500 mg |
76 |
41 |
$90.82 |
| J2371 |
Injection, phenylephrine hydrochloride, 20 micrograms |
693 |
589 |
$82.29 |
| L4350 |
Ankle control orthosis, stirrup style, rigid, includes any type interface (e.g., pneumatic, gel), prefabricated, off-the-shelf |
14 |
14 |
$66.55 |
| 82533 |
|
14 |
13 |
$64.79 |
| 84597 |
|
20 |
12 |
$61.20 |
| J1580 |
Injection, garamycin, gentamicin, up to 80 mg |
50 |
39 |
$58.86 |
| J0736 |
Injection, clindamycin phosphate, 300 mg |
31 |
27 |
$57.22 |
| 89060 |
|
14 |
14 |
$52.32 |
| J2710 |
Injection, neostigmine methylsulfate, up to 0.5 mg |
53 |
44 |
$52.12 |
| J0137 |
Injection, acetaminophen (hikma), not therapeutically equivalent to j0131, 10 mg |
28 |
26 |
$47.63 |
| J1836 |
Injection, metronidazole, 10 mg |
46 |
24 |
$45.82 |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
32 |
27 |
$43.00 |
| 82950 |
|
13 |
13 |
$42.90 |
| 82610 |
|
14 |
12 |
$39.98 |
| 82435 |
|
38 |
38 |
$38.20 |
| 86200 |
|
16 |
12 |
$25.99 |
| 80197 |
|
22 |
13 |
$24.16 |
| J7510 |
Prednisolone oral, per 5 mg |
32 |
24 |
$22.00 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
217 |
166 |
$21.50 |
| J0670 |
Injection, mepivacaine hydrochloride, per 10 ml |
14 |
13 |
$21.20 |
| 84590 |
|
20 |
12 |
$20.40 |
| J2470 |
Injection, pantoprazole sodium, 40 mg |
43 |
29 |
$19.30 |
| 90716 |
|
36 |
36 |
$17.00 |
| J0737 |
Injection, clindamycin phosphate (baxter), not therapeutically equivalent to j0736, 300 mg |
19 |
14 |
$16.12 |
| J2305 |
Injection, nitroglycerin, 5 mg |
92 |
72 |
$13.13 |
| 90707 |
|
24 |
24 |
$13.00 |
| J0687 |
Injection, cefazolin sodium (wg critical care), not therapeutically equivalent to j0690, 500 mg |
80 |
71 |
$0.61 |
| 90656 |
|
237 |
237 |
$0.54 |
| G8980 |
Mobility: walking & moving around functional limitation, discharge status, at discharge from therapy or to end reporting |
13 |
13 |
$0.00 |
| A0021 |
Ambulance service, outside state per mile, transport (medicaid only) |
18 |
12 |
$0.00 |
| G8984 |
Carrying, moving & handling objects functional limitation, current status, at therapy episode outset and at reporting intervals |
26 |
26 |
$0.00 |
| G8985 |
Carrying, moving and handling objects, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting |
25 |
25 |
$0.00 |