| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| X4011 |
State-specific procedure code |
8,245 |
7,601 |
$2.82M |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
35,859 |
29,866 |
$2.45M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
10,443 |
9,803 |
$1.88M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
11,277 |
10,594 |
$1.39M |
| H2018 |
Psychosocial rehabilitation services, per diem |
18,394 |
651 |
$946K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
37,403 |
32,789 |
$935K |
| 80053 |
Comprehensive metabolic panel |
31,540 |
27,981 |
$802K |
| 81002 |
|
23,611 |
18,802 |
$552K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
7,469 |
7,218 |
$469K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
13,241 |
10,916 |
$432K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
5,045 |
4,498 |
$403K |
| 76818 |
|
6,305 |
4,140 |
$360K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
3,869 |
3,593 |
$315K |
| X4003 |
|
2,837 |
1,955 |
$284K |
| X4006 |
|
137 |
107 |
$284K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
2,107 |
1,975 |
$238K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
2,316 |
2,285 |
$204K |
| 59025 |
Fetal non-stress test |
1,956 |
1,270 |
$197K |
| 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 |
3,765 |
3,458 |
$194K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
4,676 |
4,586 |
$172K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
4,617 |
4,527 |
$172K |
| 86850 |
|
4,776 |
4,722 |
$163K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
3,431 |
3,109 |
$158K |
| 85027 |
|
6,303 |
6,143 |
$154K |
| 86592 |
|
4,900 |
4,860 |
$137K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
5,798 |
5,611 |
$136K |
| Y7506 |
|
934 |
424 |
$110K |
| 81025 |
|
1,450 |
1,402 |
$95K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
2,015 |
1,852 |
$91K |
| 71045 |
Radiologic examination, chest; single view |
1,832 |
1,710 |
$83K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
1,192 |
932 |
$82K |
| 76820 |
|
1,106 |
705 |
$75K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
1,321 |
1,313 |
$72K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
2,644 |
2,623 |
$72K |
| 81003 |
|
2,677 |
2,460 |
$72K |
| 77386 |
|
296 |
24 |
$71K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
518 |
279 |
$68K |
| 86803 |
|
3,480 |
3,455 |
$68K |
| 84443 |
Thyroid stimulating hormone (TSH) |
5,851 |
5,737 |
$66K |
| 84484 |
|
1,093 |
965 |
$63K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
1,428 |
1,409 |
$63K |
| 81513 |
|
558 |
545 |
$61K |
| 86900 |
|
2,002 |
1,984 |
$57K |
| 80061 |
Lipid panel |
4,881 |
4,788 |
$54K |
| 86901 |
|
2,004 |
1,985 |
$50K |
| 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 |
2,771 |
2,604 |
$49K |
| 77334 |
|
101 |
85 |
$46K |
| 87340 |
|
2,032 |
2,017 |
$43K |
| 87801 |
Infectious agent detection by nucleic acid; amplified probe, multiple organisms |
877 |
866 |
$40K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
1,968 |
1,935 |
$39K |
| 83690 |
|
470 |
454 |
$38K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
1,611 |
1,443 |
$36K |
| 80081 |
|
657 |
653 |
$35K |
| 77412 |
|
161 |
26 |
$34K |
| 86762 |
|
1,157 |
1,149 |
$31K |
| 82950 |
|
2,143 |
2,131 |
$30K |
| 81001 |
|
783 |
717 |
$29K |
| 86481 |
|
394 |
389 |
$28K |
| 62323 |
|
94 |
86 |
$28K |
| 87660 |
|
2,169 |
2,115 |
$27K |
| 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 |
321 |
266 |
$27K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
3,151 |
3,097 |
$24K |
| 80305 |
|
234 |
149 |
$24K |
| 77336 |
|
379 |
191 |
$23K |
| 87480 |
|
1,669 |
1,634 |
$22K |
| 82728 |
|
2,125 |
2,099 |
$21K |
| 84702 |
|
333 |
313 |
$20K |
| 82607 |
|
1,890 |
1,873 |
$19K |
| 86480 |
|
383 |
379 |
$18K |
| 84466 |
|
1,918 |
1,900 |
$17K |
| 86780 |
|
1,900 |
1,876 |
$16K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
261 |
227 |
$16K |
| 87481 |
|
534 |
522 |
$15K |
| 87081 |
|
2,285 |
2,264 |
$14K |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
170 |
158 |
$13K |
| 87497 |
|
879 |
663 |
$13K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
202 |
194 |
$13K |
| 92507 |
Treatment of speech, language, voice, communication, and/or auditory processing disorder |
213 |
78 |
$12K |
| 87799 |
|
842 |
599 |
$12K |
| 84439 |
|
1,967 |
1,929 |
$12K |
| 82746 |
|
1,118 |
1,109 |
$11K |
| Y7507 |
|
135 |
65 |
$11K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
29 |
28 |
$11K |
| 83540 |
|
2,142 |
2,117 |
$10K |
| 87510 |
|
804 |
786 |
$10K |
| 85610 |
|
1,282 |
943 |
$10K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
248 |
236 |
$9K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
323 |
321 |
$9K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
264 |
256 |
$9K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
196 |
186 |
$8K |
| 87077 |
|
1,304 |
1,254 |
$8K |
| 70450 |
Computed tomography, head or brain; without contrast material |
69 |
64 |
$7K |
| 83735 |
|
2,178 |
1,658 |
$6K |
| 80069 |
|
1,778 |
1,280 |
$6K |
| 71046 |
Radiologic examination, chest; 2 views |
51 |
48 |
$5K |
| 80197 |
|
1,179 |
842 |
$5K |
| 84403 |
|
230 |
227 |
$5K |
| 82105 |
|
203 |
202 |
$4K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
89 |
87 |
$4K |
| 83021 |
|
28 |
28 |
$4K |
| 87186 |
|
639 |
607 |
$4K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
13 |
12 |
$3K |
| 84481 |
|
245 |
242 |
$3K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
67 |
66 |
$3K |
| J3490 |
Unclassified drugs |
435 |
177 |
$3K |
| 83001 |
|
192 |
185 |
$3K |
| 82570 |
|
719 |
713 |
$2K |
| 82670 |
|
114 |
109 |
$2K |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
171 |
170 |
$2K |
| 82043 |
|
592 |
589 |
$2K |
| 86140 |
|
570 |
527 |
$2K |
| 20610 |
|
14 |
13 |
$2K |
| 86038 |
|
232 |
231 |
$2K |
| 84156 |
|
1,402 |
1,030 |
$2K |
| A9552 |
Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries |
27 |
27 |
$2K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
44 |
25 |
$2K |
| 84153 |
|
131 |
130 |
$2K |
| 76801 |
|
52 |
52 |
$2K |
| 86336 |
|
25 |
25 |
$2K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
40 |
38 |
$2K |
| 86300 |
|
41 |
36 |
$1K |
| 77300 |
|
15 |
12 |
$1K |
| 87015 |
|
208 |
207 |
$1K |
| Q3014 |
Telehealth originating site facility fee |
139 |
136 |
$1K |
| 85652 |
|
466 |
442 |
$913.16 |
| 82677 |
|
12 |
12 |
$880.32 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
33 |
27 |
$870.10 |
| 83605 |
|
81 |
78 |
$657.90 |
| 83020 |
|
159 |
156 |
$616.35 |
| 36591 |
|
14 |
12 |
$581.00 |
| 84146 |
|
42 |
41 |
$577.94 |
| 84163 |
|
13 |
13 |
$445.76 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
16 |
16 |
$389.80 |
| 84425 |
|
25 |
25 |
$377.63 |
| 83880 |
|
13 |
12 |
$302.23 |
| 82977 |
|
71 |
62 |
$297.75 |
| 81015 |
|
133 |
130 |
$294.18 |
| 82951 |
|
26 |
26 |
$255.81 |
| 86706 |
|
32 |
32 |
$241.51 |
| 80076 |
|
43 |
39 |
$235.01 |
| 84144 |
|
18 |
13 |
$234.17 |
| 36415 |
Collection of venous blood by venipuncture |
4,265 |
3,509 |
$201.13 |
| 84100 |
|
72 |
62 |
$200.86 |
| 86696 |
|
12 |
12 |
$171.44 |
| 82784 |
|
13 |
13 |
$167.96 |
| 83002 |
|
12 |
12 |
$162.91 |
| 86376 |
|
13 |
13 |
$151.32 |
| 85384 |
|
17 |
14 |
$138.52 |
| J7030 |
Infusion, normal saline solution , 1000 cc |
42 |
38 |
$134.88 |
| 85730 |
|
29 |
28 |
$120.98 |
| 86695 |
|
12 |
12 |
$116.84 |
| 87147 |
|
12 |
12 |
$111.78 |
| 82962 |
|
52 |
31 |
$103.53 |
| 86431 |
|
14 |
14 |
$63.42 |
| 82550 |
|
23 |
20 |
$60.94 |
| 87210 |
|
12 |
12 |
$51.15 |
| 82952 |
|
13 |
13 |
$37.56 |
| 84460 |
|
24 |
24 |
$26.55 |
| 84075 |
|
24 |
24 |
$25.95 |
| 84450 |
|
24 |
24 |
$25.94 |
| 82248 |
|
12 |
12 |
$25.15 |
| 82247 |
|
24 |
24 |
$25.15 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
35 |
29 |
$21.34 |
| 84155 |
|
24 |
24 |
$18.50 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
13 |
12 |
$10.60 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
18 |
12 |
$3.61 |
| A9270 |
Non-covered item or service |
30 |
28 |
$0.00 |
| J2704 |
Injection, propofol, 10 mg |
13 |
12 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
47 |
44 |
$0.00 |