| Code | Description | Claims | Beneficiaries | Total Paid |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
52,928 |
45,783 |
$2.87M |
| J0585 |
Injection, onabotulinumtoxina, 1 unit |
4,513 |
2,746 |
$2.36M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
46,712 |
40,550 |
$1.73M |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
23,353 |
21,655 |
$1.22M |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
13,208 |
12,311 |
$1.07M |
| 99215 |
Prolong outpt/office vis |
12,482 |
11,138 |
$1.03M |
| 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 |
3,798 |
3,585 |
$329K |
| 99205 |
Prolong outpt/office vis |
2,744 |
2,628 |
$313K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
1,667 |
1,602 |
$276K |
| 71250 |
|
2,532 |
2,420 |
$201K |
| 36415 |
Collection of venous blood by venipuncture |
47,726 |
41,311 |
$188K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
1,932 |
1,851 |
$188K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
1,909 |
1,894 |
$164K |
| 97803 |
|
4,639 |
4,419 |
$151K |
| 80053 |
Comprehensive metabolic panel |
14,813 |
13,714 |
$147K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
713 |
693 |
$145K |
| 99443 |
|
3,420 |
2,737 |
$132K |
| 94729 |
|
4,258 |
4,058 |
$131K |
| 94375 |
|
7,070 |
6,563 |
$117K |
| 90837 |
Psychotherapy, 53 minutes with patient |
1,217 |
843 |
$113K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
4,401 |
4,052 |
$111K |
| 99442 |
|
3,836 |
3,019 |
$109K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
1,159 |
1,122 |
$106K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
2,270 |
2,167 |
$93K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
1,295 |
1,106 |
$93K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
11,569 |
9,893 |
$92K |
| 94726 |
|
2,930 |
2,818 |
$90K |
| 71046 |
Radiologic examination, chest; 2 views |
5,529 |
5,179 |
$89K |
| 85027 |
|
14,157 |
12,498 |
$86K |
| 99000 |
|
13,742 |
12,271 |
$82K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
10,819 |
10,117 |
$78K |
| 84443 |
Thyroid stimulating hormone (TSH) |
4,778 |
4,582 |
$73K |
| 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 |
2,663 |
2,520 |
$67K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
736 |
716 |
$67K |
| A9585 |
Injection, gadobutrol, 0.1 ml |
2,801 |
2,673 |
$65K |
| 80061 |
Lipid panel |
5,049 |
4,940 |
$65K |
| 31231 |
|
517 |
499 |
$62K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
2,210 |
2,137 |
$60K |
| 83880 |
|
1,522 |
1,448 |
$58K |
| 64615 |
|
670 |
654 |
$56K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
6,287 |
5,966 |
$50K |
| 83970 |
|
1,235 |
1,195 |
$50K |
| 92507 |
Treatment of speech, language, voice, communication, and/or auditory processing disorder |
978 |
740 |
$49K |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
1,104 |
490 |
$48K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
5,426 |
5,143 |
$47K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
685 |
675 |
$46K |
| 95951 |
|
242 |
72 |
$46K |
| 73562 |
|
1,746 |
1,310 |
$45K |
| 95874 |
|
1,096 |
1,019 |
$39K |
| G0108 |
Diabetes outpatient self-management training services, individual, per 30 minutes |
856 |
734 |
$39K |
| 86833 |
|
113 |
100 |
$38K |
| 86832 |
|
113 |
100 |
$37K |
| 76642 |
|
685 |
598 |
$36K |
| 80050 |
General health panel |
696 |
674 |
$33K |
| 97802 |
|
646 |
632 |
$30K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
206 |
203 |
$30K |
| 82728 |
|
2,307 |
2,220 |
$30K |
| 20610 |
|
833 |
785 |
$29K |
| 93970 |
|
259 |
246 |
$29K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
377 |
371 |
$28K |
| 87536 |
|
320 |
308 |
$28K |
| 86481 |
|
288 |
272 |
$28K |
| 31575 |
|
421 |
388 |
$28K |
| 99441 |
|
1,729 |
1,329 |
$28K |
| 85610 |
|
6,905 |
5,716 |
$27K |
| 99222 |
Initial hospital care, per day, moderate complexity |
449 |
395 |
$27K |
| 92557 |
|
1,323 |
1,257 |
$27K |
| 80197 |
|
1,728 |
1,153 |
$25K |
| 77066 |
Tomosynthesis, mammo |
227 |
213 |
$24K |
| 95044 |
|
119 |
65 |
$22K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
514 |
507 |
$19K |
| T1013 |
Sign language or oral interpretive services, per 15 minutes |
331 |
275 |
$18K |
| 92015 |
Determination of refractive state |
1,565 |
1,516 |
$18K |
| 95004 |
Percutaneous tests with allergenic extracts, immediate type reaction |
307 |
289 |
$17K |
| 83550 |
|
1,978 |
1,892 |
$17K |
| 86360 |
|
338 |
328 |
$16K |
| 81001 |
|
5,334 |
5,060 |
$16K |
| 83735 |
|
2,399 |
1,745 |
$16K |
| 82248 |
|
2,986 |
2,602 |
$15K |
| 93971 |
|
190 |
179 |
$15K |
| 84439 |
|
1,790 |
1,705 |
$14K |
| 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 |
847 |
826 |
$14K |
| 72082 |
|
345 |
326 |
$14K |
| 99221 |
|
250 |
232 |
$14K |
| G0279 |
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) |
433 |
411 |
$14K |
| 86140 |
|
2,677 |
2,575 |
$14K |
| 92504 |
|
781 |
729 |
$13K |
| 86359 |
|
337 |
327 |
$13K |
| 90834 |
Psychotherapy, 45 minutes with patient |
176 |
139 |
$13K |
| 52000 |
|
100 |
96 |
$13K |
| 94618 |
|
662 |
627 |
$12K |
| 80076 |
|
1,588 |
1,493 |
$12K |
| 80069 |
|
1,323 |
1,250 |
$12K |
| 81025 |
|
1,334 |
1,305 |
$12K |
| 92550 |
|
1,099 |
1,048 |
$12K |
| 73030 |
|
596 |
509 |
$11K |
| 83540 |
|
1,745 |
1,664 |
$11K |
| V5266 |
Battery for use in hearing device |
634 |
626 |
$11K |
| 77073 |
|
403 |
381 |
$11K |
| 87517 |
|
230 |
215 |
$10K |
| 72100 |
|
389 |
375 |
$10K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
150 |
149 |
$10K |
| 74183 |
|
64 |
64 |
$10K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
82 |
79 |
$9K |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
2,430 |
2,235 |
$9K |
| 84156 |
|
2,449 |
2,329 |
$9K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
123 |
123 |
$9K |
| 87799 |
|
200 |
156 |
$8K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
76 |
71 |
$8K |
| 77080 |
|
354 |
348 |
$8K |
| 82565 |
|
1,528 |
1,464 |
$8K |
| 84100 |
|
1,755 |
1,279 |
$8K |
| 90662 |
|
231 |
206 |
$8K |
| 82607 |
|
545 |
535 |
$8K |
| 93922 |
|
161 |
144 |
$7K |
| 86803 |
|
464 |
451 |
$7K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
638 |
621 |
$7K |
| 73630 |
|
357 |
285 |
$7K |
| 90686 |
|
650 |
601 |
$7K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
827 |
775 |
$6K |
| 86850 |
|
739 |
698 |
$6K |
| 31615 |
|
69 |
53 |
$6K |
| 85652 |
|
1,946 |
1,895 |
$5K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
212 |
202 |
$5K |
| 86780 |
|
338 |
316 |
$5K |
| 92524 |
|
53 |
53 |
$5K |
| 17110 |
|
61 |
58 |
$5K |
| 93000 |
|
688 |
648 |
$5K |
| 99233 |
Prolong inpt eval add15 m |
89 |
43 |
$5K |
| 99417 |
Prolong home eval add 15m |
127 |
124 |
$5K |
| 76536 |
|
53 |
52 |
$4K |
| 87340 |
|
409 |
393 |
$4K |
| 99231 |
Subsequent hospital care, per day, straightforward or low complexity |
167 |
97 |
$4K |
| G0008 |
Administration of influenza virus vaccine |
586 |
513 |
$4K |
| 86706 |
|
329 |
315 |
$4K |
| 73502 |
|
114 |
112 |
$4K |
| 86704 |
|
293 |
281 |
$4K |
| 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 |
174 |
121 |
$4K |
| 82043 |
|
580 |
567 |
$3K |
| 84403 |
|
117 |
114 |
$3K |
| 76770 |
|
40 |
39 |
$3K |
| 73110 |
|
199 |
147 |
$3K |
| G0472 |
Hepatitis c antibody screening, for individual at high risk and other covered indication(s) |
68 |
68 |
$3K |
| 72197 |
|
13 |
12 |
$3K |
| 31237 |
|
13 |
12 |
$3K |
| 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) |
1,072 |
1,023 |
$3K |
| 91320 |
|
36 |
29 |
$3K |
| 99152 |
|
479 |
420 |
$2K |
| 76942 |
|
116 |
108 |
$2K |
| 71271 |
|
26 |
25 |
$2K |
| 84460 |
|
440 |
426 |
$2K |
| 82784 |
|
172 |
158 |
$2K |
| 82962 |
|
559 |
508 |
$2K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
66 |
63 |
$2K |
| 82550 |
|
356 |
337 |
$2K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
66 |
62 |
$2K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
301 |
282 |
$2K |
| 84450 |
|
402 |
391 |
$2K |
| 86900 |
|
782 |
734 |
$2K |
| 86901 |
|
774 |
731 |
$2K |
| 49452 |
|
28 |
27 |
$2K |
| 51798 |
|
291 |
282 |
$2K |
| 94060 |
|
86 |
81 |
$2K |
| 69436 |
Tympanostomy (requiring insertion of ventilating tube), general anesthesia |
15 |
15 |
$2K |
| 73560 |
|
107 |
79 |
$2K |
| 43235 |
|
25 |
25 |
$2K |
| G0103 |
Prostate cancer screening; prostate specific antigen test (psa) |
110 |
103 |
$2K |
| 46600 |
|
25 |
25 |
$2K |
| 83690 |
|
273 |
251 |
$2K |
| 72141 |
|
12 |
12 |
$2K |
| 82105 |
|
109 |
103 |
$2K |
| 93975 |
|
13 |
13 |
$2K |
| 95886 |
|
29 |
28 |
$2K |
| 76937 |
|
241 |
212 |
$2K |
| 92612 |
|
15 |
12 |
$2K |
| 84153 |
|
79 |
77 |
$2K |
| 86038 |
|
130 |
126 |
$2K |
| 99254 |
|
13 |
13 |
$2K |
| 90791 |
Psychiatric diagnostic evaluation |
16 |
16 |
$2K |
| 82040 |
|
307 |
299 |
$2K |
| 11900 |
|
41 |
40 |
$2K |
| 85018 |
|
637 |
588 |
$2K |
| 87186 |
|
113 |
102 |
$2K |
| 69210 |
|
59 |
54 |
$1K |
| 0124A |
|
45 |
41 |
$1K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
12 |
12 |
$1K |
| 64643 |
|
43 |
41 |
$1K |
| Q9966 |
Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml |
64 |
62 |
$1K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
24 |
24 |
$1K |
| 85730 |
|
189 |
171 |
$1K |
| 73610 |
|
60 |
52 |
$1K |
| 99253 |
|
12 |
12 |
$1K |
| 86160 |
|
47 |
47 |
$1K |
| 51600 |
|
13 |
12 |
$1K |
| 11104 |
|
14 |
12 |
$980.11 |
| 94150 |
|
69 |
69 |
$980.05 |
| 95024 |
|
40 |
39 |
$939.78 |
| 81003 |
|
397 |
382 |
$847.68 |
| G0475 |
Hiv antigen/antibody, combination assay, screening |
34 |
34 |
$820.79 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
14 |
14 |
$819.88 |
| 11721 |
|
29 |
27 |
$801.60 |
| 20611 |
|
12 |
12 |
$769.47 |
| 87070 |
|
72 |
68 |
$756.25 |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
13 |
13 |
$737.14 |
| 86364 |
|
26 |
25 |
$731.23 |
| 90480 |
|
28 |
25 |
$696.17 |
| 86225 |
|
47 |
47 |
$672.87 |
| 0054A |
|
12 |
12 |
$534.18 |
| 95885 |
|
13 |
12 |
$532.22 |
| 11100 |
|
33 |
32 |
$477.54 |
| 64642 |
|
12 |
12 |
$447.07 |
| 83615 |
|
62 |
57 |
$366.37 |
| 76776 |
|
14 |
12 |
$350.31 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
17 |
13 |
$314.15 |
| 92613 |
|
15 |
12 |
$287.64 |
| 83516 |
|
14 |
13 |
$278.38 |
| 80051 |
|
35 |
35 |
$254.63 |
| 82310 |
|
47 |
44 |
$237.25 |
| 86665 |
|
13 |
13 |
$222.65 |
| 92285 |
|
15 |
14 |
$221.93 |
| 87088 |
|
16 |
14 |
$194.11 |
| 85390 |
|
12 |
12 |
$184.06 |
| 86644 |
|
13 |
13 |
$176.55 |
| 86431 |
|
28 |
28 |
$169.07 |
| 84550 |
|
39 |
39 |
$167.84 |
| 51784 |
|
13 |
12 |
$167.74 |
| 84703 |
|
26 |
24 |
$167.47 |
| 84520 |
|
37 |
37 |
$152.02 |
| 84155 |
|
46 |
43 |
$151.81 |
| 86039 |
|
13 |
13 |
$148.18 |
| 77001 |
|
13 |
12 |
$134.12 |
| 85007 |
|
31 |
28 |
$119.65 |
| 85613 |
|
13 |
12 |
$113.87 |
| 82150 |
|
15 |
13 |
$93.05 |
| 84075 |
|
18 |
15 |
$80.93 |
| 82570 |
|
188 |
183 |
$79.91 |
| 86592 |
|
15 |
15 |
$69.34 |
| 85045 |
|
17 |
15 |
$66.72 |
| 82247 |
|
12 |
12 |
$59.92 |
| 85014 |
|
15 |
13 |
$38.09 |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
14 |
14 |
$18.42 |
| X5622 |
|
16,569 |
9,460 |
$0.00 |
| 73130 |
|
39 |
31 |
$0.00 |
| 98968 |
|
24 |
23 |
$0.00 |
| G1004 |
Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program |
253 |
214 |
$0.00 |
| G1010 |
Clinical decision support mechanism stanson, as defined by the medicare appropriate use criteria program |
41 |
38 |
$0.00 |
| 98967 |
|
15 |
15 |
$0.00 |