| Code | Description | Claims | Beneficiaries | Total Paid |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
150,992 |
142,556 |
$4.60M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
75,812 |
71,756 |
$3.31M |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
16,447 |
15,457 |
$1.12M |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
11,906 |
11,612 |
$1.11M |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
15,041 |
14,689 |
$1.07M |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
37,347 |
11,804 |
$946K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
17,396 |
16,672 |
$855K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
3,168 |
3,047 |
$558K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
7,189 |
7,098 |
$541K |
| 99223 |
Prolong inpt eval add15 m |
4,782 |
4,419 |
$402K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
1,238 |
1,204 |
$390K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
5,492 |
4,722 |
$333K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
4,361 |
2,032 |
$306K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
15,429 |
15,068 |
$304K |
| J2357 |
Injection, omalizumab, 5 mg |
209 |
119 |
$291K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
5,452 |
5,224 |
$283K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
8,222 |
7,455 |
$272K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
4,865 |
3,052 |
$261K |
| 99233 |
Prolong inpt eval add15 m |
8,100 |
3,003 |
$258K |
| 76801 |
|
2,592 |
2,404 |
$252K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
5,215 |
4,924 |
$252K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
2,393 |
2,264 |
$248K |
| J0585 |
Injection, onabotulinumtoxina, 1 unit |
393 |
241 |
$227K |
| 99239 |
Hospital discharge day management, more than 30 minutes |
3,912 |
3,566 |
$217K |
| 99460 |
|
3,321 |
3,136 |
$210K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
2,726 |
2,694 |
$208K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
1,269 |
1,195 |
$204K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
3,418 |
3,103 |
$194K |
| 69436 |
Tympanostomy (requiring insertion of ventilating tube), general anesthesia |
1,123 |
1,097 |
$177K |
| 99309 |
Subsequent nursing facility care, per day, low to moderate complexity |
19,555 |
16,378 |
$151K |
| 95720 |
|
1,838 |
908 |
$130K |
| 59400 |
Routine obstetric care including antepartum care, vaginal delivery, and postpartum care |
104 |
103 |
$127K |
| 92567 |
|
8,224 |
8,071 |
$122K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
4,224 |
3,342 |
$105K |
| 76813 |
|
844 |
813 |
$75K |
| 95951 |
|
670 |
265 |
$73K |
| 99215 |
Prolong outpt/office vis |
1,229 |
1,158 |
$68K |
| 42820 |
Tonsillectomy and adenoidectomy; younger than age 12 |
312 |
309 |
$68K |
| 90833 |
Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) |
3,467 |
3,097 |
$67K |
| 31231 |
|
706 |
684 |
$67K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
982 |
840 |
$66K |
| 90677 |
|
905 |
894 |
$40K |
| 94010 |
|
1,886 |
1,786 |
$38K |
| 95819 |
|
306 |
301 |
$29K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
810 |
760 |
$28K |
| 93000 |
|
2,023 |
1,859 |
$24K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
275 |
256 |
$23K |
| 90474 |
|
1,155 |
1,133 |
$23K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
234 |
220 |
$21K |
| 95816 |
|
491 |
453 |
$21K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
288 |
274 |
$19K |
| 90837 |
Psychotherapy, 53 minutes with patient |
238 |
134 |
$19K |
| 99318 |
|
871 |
812 |
$18K |
| 76642 |
|
694 |
651 |
$17K |
| 99308 |
Subsequent nursing facility care, per day, straightforward |
2,985 |
2,611 |
$17K |
| 00126 |
|
146 |
146 |
$15K |
| 99231 |
Subsequent hospital care, per day, straightforward or low complexity |
945 |
276 |
$15K |
| 88342 |
|
508 |
342 |
$15K |
| 54150 |
|
111 |
94 |
$15K |
| 99337 |
|
969 |
736 |
$14K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
421 |
410 |
$13K |
| 95004 |
Percutaneous tests with allergenic extracts, immediate type reaction |
199 |
168 |
$12K |
| 93298 |
|
969 |
944 |
$12K |
| 31575 |
|
220 |
210 |
$12K |
| 78815 |
Positron emission tomography (PET) for limited area imaging |
32 |
26 |
$12K |
| 95117 |
|
875 |
595 |
$11K |
| 64615 |
|
175 |
159 |
$10K |
| 00170 |
Anesthesia for intraoral procedures, including biopsy |
64 |
64 |
$10K |
| 90686 |
|
7,880 |
7,723 |
$10K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
690 |
675 |
$10K |
| 97802 |
|
551 |
469 |
$9K |
| 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 |
1,015 |
989 |
$9K |
| 92587 |
|
200 |
198 |
$9K |
| 99462 |
|
567 |
429 |
$8K |
| 99220 |
|
91 |
86 |
$8K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
115 |
62 |
$8K |
| 93296 |
|
743 |
691 |
$8K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
375 |
306 |
$7K |
| 88304 |
|
310 |
179 |
$7K |
| 95970 |
|
555 |
540 |
$7K |
| 51798 |
|
951 |
860 |
$6K |
| 99383 |
|
105 |
102 |
$6K |
| 92555 |
|
479 |
470 |
$6K |
| 94060 |
|
150 |
141 |
$6K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
921 |
865 |
$5K |
| 71046 |
Radiologic examination, chest; 2 views |
526 |
515 |
$5K |
| 92588 |
|
74 |
74 |
$5K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
46 |
38 |
$4K |
| 76820 |
|
67 |
37 |
$4K |
| 92504 |
|
322 |
302 |
$4K |
| 92552 |
|
264 |
262 |
$4K |
| 99225 |
|
171 |
113 |
$4K |
| 99217 |
|
112 |
97 |
$4K |
| 94729 |
|
311 |
301 |
$4K |
| 99236 |
Prolong inpt eval add15 m |
32 |
30 |
$4K |
| 95974 |
|
72 |
63 |
$3K |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
49 |
47 |
$3K |
| 77066 |
Tomosynthesis, mammo |
105 |
97 |
$3K |
| 99336 |
|
366 |
319 |
$3K |
| 64642 |
|
89 |
87 |
$3K |
| 94726 |
|
200 |
193 |
$3K |
| 71271 |
|
103 |
97 |
$3K |
| 93015 |
|
83 |
82 |
$3K |
| 95811 |
|
15 |
13 |
$3K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
86 |
53 |
$3K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
133 |
128 |
$3K |
| 64643 |
|
70 |
68 |
$2K |
| 93295 |
|
115 |
106 |
$2K |
| 69210 |
|
108 |
96 |
$2K |
| 99305 |
|
199 |
186 |
$2K |
| 90715 |
|
253 |
243 |
$2K |
| 73030 |
|
297 |
274 |
$2K |
| 99310 |
Prolong nursin fac eval 15m |
241 |
206 |
$2K |
| 92557 |
|
57 |
57 |
$2K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
132 |
129 |
$2K |
| 90834 |
Psychotherapy, 45 minutes with patient |
23 |
16 |
$2K |
| 20610 |
|
45 |
39 |
$1K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
99 |
95 |
$1K |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
216 |
198 |
$1K |
| 99222 |
Initial hospital care, per day, moderate complexity |
25 |
25 |
$1K |
| 95910 |
|
13 |
13 |
$1K |
| 99382 |
|
25 |
24 |
$1K |
| 81003 |
|
1,280 |
1,115 |
$1K |
| 99304 |
|
128 |
125 |
$967.02 |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
131 |
127 |
$937.80 |
| 90670 |
|
10,035 |
9,710 |
$774.65 |
| 99381 |
|
13 |
12 |
$721.00 |
| 92551 |
|
45 |
43 |
$606.60 |
| 17110 |
|
13 |
12 |
$568.68 |
| 93297 |
|
74 |
68 |
$542.99 |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
17 |
14 |
$465.96 |
| 90651 |
|
241 |
237 |
$426.12 |
| 95886 |
|
15 |
15 |
$392.58 |
| 90661 |
|
31 |
30 |
$345.37 |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
13 |
12 |
$300.24 |
| 77065 |
Tomosynthesis, mammo |
12 |
12 |
$290.59 |
| 95977 |
|
27 |
25 |
$271.77 |
| 92553 |
|
13 |
12 |
$259.20 |
| 99070 |
|
122 |
119 |
$255.01 |
| 93294 |
|
58 |
54 |
$241.92 |
| 81002 |
|
113 |
83 |
$203.24 |
| 95885 |
|
15 |
15 |
$196.56 |
| 77062 |
|
16 |
12 |
$140.13 |
| 90647 |
|
7,490 |
7,249 |
$134.24 |
| 90734 |
|
705 |
687 |
$126.50 |
| 90716 |
|
748 |
721 |
$124.46 |
| 74018 |
|
12 |
12 |
$122.69 |
| J1040 |
Injection, methylprednisolone acetate, 80 mg |
14 |
13 |
$115.29 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
16 |
15 |
$91.80 |
| 99335 |
|
15 |
12 |
$90.61 |
| 73630 |
|
15 |
14 |
$84.01 |
| 36415 |
Collection of venous blood by venipuncture |
4,014 |
3,651 |
$68.42 |
| 99173 |
|
14 |
13 |
$63.47 |
| 82947 |
|
21 |
21 |
$46.52 |
| 90461 |
|
5,805 |
5,116 |
$43.20 |
| J3490 |
Unclassified drugs |
34 |
25 |
$36.84 |
| A4314 |
Insertion tray with drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.) |
14 |
12 |
$19.68 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
15 |
14 |
$12.08 |
| 98926 |
|
34 |
24 |
$8.88 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
185 |
154 |
$5.60 |
| A4358 |
Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each |
14 |
12 |
$5.16 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
26 |
26 |
$4.86 |
| 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) |
51 |
43 |
$3.83 |
| J7620 |
Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme |
16 |
15 |
$3.42 |
| G0008 |
Administration of influenza virus vaccine |
144 |
140 |
$0.10 |
| 90723 |
|
7,578 |
7,361 |
$0.10 |
| 90680 |
|
5,583 |
5,433 |
$0.10 |
| 99000 |
|
563 |
555 |
$0.00 |
| 90696 |
|
410 |
399 |
$0.00 |
| A9585 |
Injection, gadobutrol, 0.1 ml |
63 |
50 |
$0.00 |
| 90634 |
|
390 |
376 |
$0.00 |
| 90656 |
|
297 |
297 |
$0.00 |
| 3074F |
|
82 |
82 |
$0.00 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
13 |
13 |
$0.00 |
| 3079F |
|
36 |
36 |
$0.00 |
| 1036F |
|
47 |
40 |
$0.00 |
| 3044F |
|
12 |
12 |
$0.00 |
| 3008F |
|
15 |
13 |
$0.00 |
| A9500 |
Technetium tc-99m sestamibi, diagnostic, per study dose |
13 |
12 |
$0.00 |
| 0001A |
|
13 |
13 |
$0.00 |
| 90700 |
|
716 |
668 |
$0.00 |
| 90710 |
|
696 |
673 |
$0.00 |
| 90633 |
|
3,450 |
3,338 |
$0.00 |
| 90707 |
|
802 |
766 |
$0.00 |
| 90685 |
|
295 |
282 |
$0.00 |
| A9575 |
Injection, gadoterate meglumine, 0.1 ml |
48 |
42 |
$0.00 |
| 90681 |
|
133 |
130 |
$0.00 |
| 3078F |
|
77 |
75 |
$0.00 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
17 |
17 |
$0.00 |
| 90648 |
|
14 |
12 |
$0.00 |
| 0002A |
|
16 |
16 |
$0.00 |
| A9552 |
Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries |
45 |
39 |
$0.00 |
| 1159F |
|
13 |
12 |
$0.00 |
| 1160F |
|
13 |
12 |
$0.00 |