| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
80,226 |
75,070 |
$6.81M |
| 90834 |
Psychotherapy, 45 minutes with patient |
36,304 |
19,088 |
$2.97M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
33,695 |
31,365 |
$1.98M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
51,548 |
45,829 |
$1.73M |
| 92507 |
Treatment of speech, language, voice, communication, and/or auditory processing disorder |
5,821 |
1,682 |
$314K |
| 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 |
5,333 |
5,086 |
$290K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
2,436 |
2,302 |
$280K |
| 99215 |
Prolong outpt/office vis |
2,605 |
2,502 |
$239K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
4,433 |
3,721 |
$204K |
| X5622 |
|
3,856 |
3,676 |
$197K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
463 |
427 |
$175K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
3,764 |
3,071 |
$139K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
9,969 |
9,604 |
$128K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
2,678 |
2,149 |
$124K |
| Q3014 |
Telehealth originating site facility fee |
5,825 |
5,472 |
$124K |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
1,026 |
947 |
$123K |
| 90791 |
Psychiatric diagnostic evaluation |
1,076 |
996 |
$112K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
4,104 |
4,023 |
$104K |
| 90832 |
Psychotherapy, 30 minutes with patient |
1,366 |
1,034 |
$70K |
| 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 |
4,390 |
4,175 |
$70K |
| C9803 |
Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
3,003 |
2,802 |
$68K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
1,556 |
1,513 |
$65K |
| 11721 |
|
2,845 |
2,530 |
$59K |
| 90837 |
Psychotherapy, 53 minutes with patient |
900 |
698 |
$59K |
| 90461 |
|
2,223 |
2,173 |
$57K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
1,825 |
1,792 |
$47K |
| 99309 |
Subsequent nursing facility care, per day, low to moderate complexity |
823 |
761 |
$43K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
834 |
302 |
$39K |
| 99308 |
Subsequent nursing facility care, per day, straightforward |
1,185 |
1,097 |
$39K |
| 99239 |
Hospital discharge day management, more than 30 minutes |
671 |
644 |
$39K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
742 |
663 |
$38K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
287 |
262 |
$33K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
2,206 |
2,048 |
$33K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
401 |
381 |
$30K |
| 36415 |
Collection of venous blood by venipuncture |
17,871 |
15,768 |
$30K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
191 |
189 |
$29K |
| 92551 |
|
5,007 |
4,930 |
$28K |
| 99188 |
|
4,056 |
4,030 |
$27K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
461 |
456 |
$27K |
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
1,228 |
497 |
$23K |
| 99223 |
Prolong inpt eval add15 m |
157 |
151 |
$22K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
341 |
338 |
$20K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,740 |
1,702 |
$20K |
| H2035 |
Alcohol and/or other drug treatment program, per hour |
214 |
36 |
$20K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
264 |
257 |
$20K |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
476 |
200 |
$18K |
| 99233 |
Prolong inpt eval add15 m |
255 |
104 |
$15K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
1,788 |
1,759 |
$9K |
| 90686 |
|
2,537 |
2,502 |
$8K |
| 0002A |
|
252 |
250 |
$7K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
123 |
111 |
$7K |
| 0001A |
|
294 |
275 |
$7K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
183 |
163 |
$7K |
| 99417 |
Prolong home eval add 15m |
144 |
136 |
$6K |
| 99205 |
Prolong outpt/office vis |
39 |
39 |
$5K |
| 80061 |
Lipid panel |
611 |
595 |
$5K |
| 99173 |
|
4,884 |
4,817 |
$5K |
| 96127 |
|
1,447 |
1,430 |
$5K |
| 91320 |
|
70 |
67 |
$4K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
433 |
342 |
$4K |
| 71046 |
Radiologic examination, chest; 2 views |
76 |
76 |
$4K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
97 |
95 |
$4K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
120 |
115 |
$3K |
| 59025 |
Fetal non-stress test |
39 |
12 |
$3K |
| 80053 |
Comprehensive metabolic panel |
2,013 |
1,872 |
$3K |
| 96130 |
|
21 |
13 |
$3K |
| 97535 |
Self-care/home management training, each 15 minutes |
76 |
25 |
$3K |
| 20610 |
|
214 |
169 |
$3K |
| 90847 |
Family psychotherapy with the patient present, 50 minutes |
30 |
12 |
$3K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
57 |
54 |
$2K |
| 17110 |
|
88 |
82 |
$2K |
| S0281 |
Medical home program, comprehensive care coordination and planning, maintenance of plan |
1,312 |
1,311 |
$2K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
3,148 |
2,877 |
$2K |
| 90480 |
|
93 |
88 |
$2K |
| 86780 |
|
157 |
154 |
$2K |
| 90674 |
|
335 |
330 |
$2K |
| 96131 |
|
21 |
13 |
$1K |
| 96137 |
|
21 |
13 |
$1K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
397 |
391 |
$1K |
| 99222 |
Initial hospital care, per day, moderate complexity |
13 |
13 |
$1K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
277 |
273 |
$1K |
| 99442 |
|
38 |
37 |
$1K |
| 96136 |
|
21 |
13 |
$874.25 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
12 |
12 |
$824.58 |
| G0008 |
Administration of influenza virus vaccine |
42 |
41 |
$793.62 |
| 84443 |
Thyroid stimulating hormone (TSH) |
103 |
99 |
$701.53 |
| 90661 |
|
133 |
133 |
$665.90 |
| 85027 |
|
198 |
191 |
$626.70 |
| 99443 |
|
17 |
15 |
$538.76 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
52 |
50 |
$526.53 |
| G0378 |
Hospital observation service, per hour |
15 |
13 |
$495.99 |
| 99441 |
|
45 |
45 |
$490.24 |
| 96161 |
|
52 |
50 |
$462.92 |
| 0071A |
|
12 |
12 |
$451.52 |
| 80048 |
Basic metabolic panel (calcium, ionized) |
443 |
396 |
$429.68 |
| 71045 |
Radiologic examination, chest; single view |
12 |
12 |
$419.11 |
| 0124A |
|
29 |
29 |
$411.38 |
| G2211 |
Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established) |
147 |
144 |
$349.43 |
| 98968 |
|
68 |
49 |
$345.22 |
| 86850 |
|
39 |
39 |
$288.46 |
| 90670 |
|
537 |
522 |
$281.02 |
| G0179 |
Physician or allowed practitioner re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and allowed practitioners to affirm the initial implementation of the plan of care |
13 |
13 |
$270.00 |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
204 |
200 |
$244.49 |
| 81001 |
|
417 |
387 |
$192.51 |
| 84484 |
|
347 |
241 |
$162.23 |
| 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) |
71 |
67 |
$146.70 |
| 98967 |
|
35 |
28 |
$146.16 |
| 87081 |
|
62 |
62 |
$145.42 |
| 36416 |
|
12 |
12 |
$144.50 |
| 70450 |
Computed tomography, head or brain; without contrast material |
13 |
12 |
$120.55 |
| J7030 |
Infusion, normal saline solution , 1000 cc |
518 |
411 |
$101.56 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
14 |
14 |
$89.21 |
| 82565 |
|
14 |
14 |
$75.32 |
| 99383 |
|
12 |
12 |
$60.99 |
| 83605 |
|
190 |
161 |
$51.42 |
| 83690 |
|
100 |
85 |
$44.95 |
| 90647 |
|
146 |
135 |
$31.45 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
40 |
39 |
$20.33 |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
42 |
41 |
$19.83 |
| 83735 |
|
58 |
50 |
$16.88 |
| 81003 |
|
47 |
44 |
$15.20 |
| 96160 |
|
14 |
13 |
$10.70 |
| A9270 |
Non-covered item or service |
278 |
125 |
$4.04 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
14 |
12 |
$2.19 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
34 |
25 |
$0.71 |
| J1642 |
Injection, heparin sodium, (heparin lock flush), per 10 units |
17 |
16 |
$0.36 |
| 1111F |
|
519 |
501 |
$0.00 |
| 90680 |
|
107 |
102 |
$0.00 |
| 90723 |
|
127 |
119 |
$0.00 |
| 90677 |
|
35 |
33 |
$0.00 |
| 87503 |
|
24 |
24 |
$0.00 |
| 99460 |
|
14 |
13 |
$0.00 |
| 90651 |
|
41 |
39 |
$0.00 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
12 |
12 |
$0.00 |
| 85379 |
|
12 |
12 |
$0.00 |
| 90648 |
|
265 |
254 |
$0.00 |
| G1004 |
Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program |
157 |
139 |
$0.00 |
| 80306 |
|
26 |
25 |
$0.00 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
12 |
12 |
$0.00 |
| 90734 |
|
26 |
24 |
$0.00 |
| 91300 |
|
19 |
14 |
$0.00 |
| 81025 |
|
14 |
14 |
$0.00 |
| 90633 |
|
56 |
55 |
$0.00 |
| Q9966 |
Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml |
24 |
12 |
$0.00 |
| 82248 |
|
56 |
52 |
$0.00 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
14 |
12 |
$0.00 |
| 90715 |
|
14 |
14 |
$0.00 |