| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
21,925 |
19,472 |
$1.67M |
| 96361 |
Intravenous infusion, hydration; each additional hour |
7,568 |
4,984 |
$815K |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
12,037 |
10,372 |
$647K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
8,127 |
6,763 |
$499K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
3,484 |
2,888 |
$345K |
| 36415 |
Collection of venous blood by venipuncture |
38,590 |
22,161 |
$341K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
1,832 |
1,567 |
$300K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
1,903 |
1,687 |
$258K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
3,728 |
870 |
$243K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
1,821 |
1,545 |
$238K |
| 80053 |
Comprehensive metabolic panel |
28,510 |
21,081 |
$232K |
| 70450 |
Computed tomography, head or brain; without contrast material |
3,477 |
2,812 |
$214K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
3,173 |
2,854 |
$191K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
2,384 |
1,634 |
$183K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
8,314 |
6,617 |
$164K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
5,555 |
3,836 |
$159K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
3,959 |
3,059 |
$133K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
903 |
757 |
$89K |
| 59025 |
Fetal non-stress test |
907 |
332 |
$85K |
| 71046 |
Radiologic examination, chest; 2 views |
7,728 |
6,837 |
$82K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
11,841 |
9,851 |
$81K |
| J3490 |
Unclassified drugs |
8,056 |
3,847 |
$73K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
1,180 |
1,119 |
$68K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
610 |
523 |
$66K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
755 |
673 |
$60K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
4,404 |
4,065 |
$56K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
7,970 |
4,717 |
$52K |
| C9803 |
Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
2,892 |
2,449 |
$46K |
| H1000 |
Prenatal care, at-risk assessment |
717 |
471 |
$44K |
| 87070 |
|
832 |
718 |
$41K |
| G0378 |
Hospital observation service, per hour |
2,906 |
1,853 |
$39K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
2,220 |
1,084 |
$34K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
515 |
487 |
$33K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
2,508 |
2,355 |
$30K |
| 73610 |
|
704 |
644 |
$30K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
10,290 |
8,100 |
$28K |
| 81003 |
|
17,314 |
14,309 |
$28K |
| 82962 |
|
4,502 |
2,036 |
$25K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
25,947 |
19,494 |
$23K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
324 |
245 |
$23K |
| 87420 |
|
890 |
823 |
$23K |
| 76801 |
|
864 |
749 |
$22K |
| 71045 |
Radiologic examination, chest; single view |
6,300 |
5,129 |
$22K |
| 73630 |
|
932 |
844 |
$20K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
5,540 |
4,418 |
$20K |
| A9270 |
Non-covered item or service |
14,372 |
9,511 |
$20K |
| 85027 |
|
10,691 |
6,432 |
$20K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
1,291 |
628 |
$19K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
1,480 |
965 |
$19K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
242 |
222 |
$19K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
1,375 |
980 |
$19K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
6,115 |
4,193 |
$19K |
| 73130 |
|
523 |
467 |
$18K |
| 85610 |
|
7,601 |
5,292 |
$17K |
| 85730 |
|
6,019 |
4,854 |
$17K |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
1,610 |
1,226 |
$16K |
| 81025 |
|
3,894 |
3,469 |
$13K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
499 |
162 |
$13K |
| 84484 |
|
6,738 |
4,474 |
$12K |
| 73110 |
|
376 |
335 |
$12K |
| 73030 |
|
401 |
347 |
$10K |
| J1644 |
Injection, heparin sodium, per 1000 units |
200 |
78 |
$9K |
| 83735 |
|
4,694 |
3,308 |
$8K |
| 73560 |
|
385 |
330 |
$8K |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
3,261 |
1,967 |
$8K |
| 96376 |
|
2,659 |
1,318 |
$8K |
| 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 |
262 |
213 |
$7K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
5,252 |
3,745 |
$7K |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
1,337 |
1,093 |
$7K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
394 |
348 |
$7K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
1,328 |
1,128 |
$7K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
270 |
212 |
$7K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
2,062 |
1,772 |
$6K |
| 84443 |
Thyroid stimulating hormone (TSH) |
6,129 |
5,119 |
$6K |
| 76642 |
|
125 |
115 |
$6K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
48 |
42 |
$6K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
74 |
36 |
$6K |
| 45385 |
Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) |
15 |
15 |
$6K |
| 84702 |
|
1,507 |
1,207 |
$6K |
| 83690 |
|
4,851 |
4,095 |
$5K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
134 |
127 |
$5K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
3,639 |
3,004 |
$5K |
| 80061 |
Lipid panel |
5,008 |
4,146 |
$5K |
| 74018 |
|
211 |
182 |
$4K |
| 76830 |
Ultrasound, transvaginal |
124 |
118 |
$4K |
| 94760 |
|
1,095 |
693 |
$4K |
| 97163 |
|
154 |
121 |
$4K |
| J2704 |
Injection, propofol, 10 mg |
1,323 |
932 |
$4K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
3,629 |
2,938 |
$3K |
| 84703 |
|
2,701 |
2,430 |
$3K |
| 82607 |
|
2,057 |
1,744 |
$3K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
484 |
442 |
$3K |
| 86850 |
|
901 |
740 |
$3K |
| 72100 |
|
195 |
152 |
$3K |
| 86900 |
|
1,413 |
1,137 |
$3K |
| 82043 |
|
1,407 |
1,160 |
$3K |
| 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 |
2,157 |
1,957 |
$3K |
| 83880 |
|
1,452 |
1,118 |
$3K |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
1,420 |
558 |
$3K |
| 87186 |
|
2,699 |
2,183 |
$3K |
| 97161 |
|
65 |
55 |
$3K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
1,052 |
963 |
$3K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
1,043 |
954 |
$2K |
| 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 |
1,545 |
1,028 |
$2K |
| G8978 |
Mobility: walking & moving around functional limitation, current status, at therapy episode outset and at reporting intervals |
30 |
28 |
$2K |
| G8979 |
Mobility: walking & moving around functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting |
32 |
30 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
101 |
84 |
$2K |
| 97535 |
Self-care/home management training, each 15 minutes |
18 |
14 |
$2K |
| 97597 |
|
20 |
12 |
$2K |
| 86901 |
|
1,403 |
1,128 |
$2K |
| 12001 |
|
43 |
40 |
$2K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
12 |
12 |
$2K |
| 97162 |
|
47 |
42 |
$2K |
| 87088 |
|
2,395 |
1,940 |
$2K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
1,951 |
1,247 |
$2K |
| 82550 |
|
73 |
53 |
$2K |
| J1170 |
Injection, hydromorphone, up to 4 mg |
1,348 |
724 |
$2K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
531 |
457 |
$2K |
| 84439 |
|
1,281 |
1,064 |
$2K |
| 10060 |
|
14 |
14 |
$1K |
| 87040 |
|
990 |
812 |
$1K |
| 85379 |
|
1,226 |
1,062 |
$1K |
| J0690 |
Injection, cefazolin sodium, 500 mg |
389 |
272 |
$1K |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
320 |
278 |
$1K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
20 |
17 |
$896.72 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
295 |
194 |
$888.04 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
947 |
742 |
$812.59 |
| A4340 |
Indwelling catheter; specialty type, (e.g., coude, mushroom, wing, etc.), each |
82 |
64 |
$796.96 |
| J2550 |
Injection, promethazine hcl, up to 50 mg |
627 |
515 |
$784.60 |
| 29125 |
|
68 |
62 |
$761.41 |
| 87210 |
|
446 |
414 |
$738.39 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
21 |
15 |
$734.32 |
| 72110 |
|
30 |
27 |
$684.72 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
1,157 |
1,055 |
$663.81 |
| 77066 |
Tomosynthesis, mammo |
14 |
14 |
$662.89 |
| 83605 |
|
172 |
125 |
$644.79 |
| G1004 |
Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program |
622 |
389 |
$623.27 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
211 |
171 |
$622.02 |
| 73564 |
|
12 |
12 |
$539.34 |
| 76775 |
|
13 |
12 |
$497.35 |
| 90715 |
|
225 |
176 |
$493.36 |
| 73502 |
|
50 |
39 |
$463.30 |
| 99215 |
Prolong outpt/office vis |
13 |
12 |
$454.25 |
| 93017 |
|
31 |
27 |
$453.01 |
| 12011 |
|
24 |
24 |
$451.81 |
| 87075 |
|
348 |
290 |
$414.30 |
| 77080 |
|
29 |
28 |
$397.39 |
| 83550 |
|
649 |
475 |
$307.59 |
| 84550 |
|
192 |
164 |
$261.78 |
| 73090 |
|
13 |
12 |
$246.88 |
| 80164 |
|
106 |
97 |
$226.16 |
| 82140 |
|
127 |
100 |
$212.47 |
| 83540 |
|
717 |
525 |
$191.85 |
| 85652 |
|
516 |
423 |
$191.72 |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
16 |
16 |
$187.91 |
| 87081 |
|
90 |
72 |
$177.13 |
| 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 |
2,055 |
1,862 |
$164.94 |
| 82746 |
|
424 |
334 |
$155.95 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
365 |
277 |
$148.17 |
| 86735 |
|
48 |
47 |
$139.23 |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
165 |
141 |
$128.74 |
| 80055 |
|
28 |
27 |
$125.60 |
| 80076 |
|
287 |
233 |
$123.61 |
| 3008F |
|
1,011 |
722 |
$104.00 |
| 1159F |
|
247 |
189 |
$104.00 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
108 |
93 |
$74.21 |
| 82728 |
|
210 |
156 |
$64.55 |
| 86762 |
|
47 |
46 |
$53.72 |
| 86765 |
|
48 |
47 |
$53.72 |
| 86787 |
|
48 |
47 |
$53.72 |
| 86140 |
|
277 |
214 |
$52.87 |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
114 |
104 |
$43.78 |
| 86970 |
|
16 |
12 |
$42.50 |
| 82274 |
|
22 |
21 |
$40.08 |
| 94644 |
|
16 |
13 |
$35.11 |
| 82150 |
|
43 |
38 |
$28.96 |
| 86803 |
|
42 |
37 |
$27.84 |
| G0279 |
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) |
87 |
78 |
$23.53 |
| 83970 |
|
81 |
71 |
$22.61 |
| 84145 |
|
53 |
36 |
$21.62 |
| J7060 |
5% dextrose/water (500 ml = 1 unit) |
78 |
51 |
$18.34 |
| 80177 |
|
28 |
24 |
$17.10 |
| 84100 |
|
106 |
55 |
$16.62 |
| 84436 |
|
20 |
17 |
$10.05 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
320 |
239 |
$7.38 |
| 86038 |
|
17 |
14 |
$6.55 |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
28 |
25 |
$0.00 |
| J2060 |
Injection, lorazepam, 2 mg |
753 |
471 |
$0.00 |
| 3074F |
|
554 |
477 |
$0.00 |
| 3079F |
|
203 |
143 |
$0.00 |
| 86592 |
|
14 |
12 |
$0.00 |
| 1036F |
|
634 |
479 |
$0.00 |
| J0360 |
Injection, hydralazine hcl, up to 20 mg |
55 |
25 |
$0.00 |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
18 |
12 |
$0.00 |
| J7050 |
Infusion, normal saline solution, 250 cc |
37 |
28 |
$0.00 |
| 3075F |
|
12 |
12 |
$0.00 |
| 99292 |
|
12 |
12 |
$0.00 |
| 36600 |
|
18 |
12 |
$0.00 |
| 3078F |
|
451 |
345 |
$0.00 |
| 3725F |
|
519 |
324 |
$0.00 |
| 1160F |
|
246 |
188 |
$0.00 |
| 29515 |
|
14 |
13 |
$0.00 |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
168 |
99 |
$0.00 |
| C9113 |
Injection, pantoprazole sodium, per vial |
21 |
12 |
$0.00 |