| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
136,534 |
90,718 |
$9.28M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
54,302 |
50,387 |
$6.08M |
| 96361 |
Intravenous infusion, hydration; each additional hour |
20,111 |
16,177 |
$5.34M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
38,318 |
35,204 |
$3.50M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
42,790 |
38,530 |
$3.14M |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
9,909 |
9,440 |
$1.63M |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
13,135 |
12,462 |
$1.36M |
| 70450 |
Computed tomography, head or brain; without contrast material |
8,890 |
8,398 |
$1.19M |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
13,523 |
10,145 |
$1.13M |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
5,931 |
3,179 |
$832K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
3,961 |
3,825 |
$651K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
1,983 |
1,957 |
$596K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
5,378 |
4,702 |
$591K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
18,724 |
17,528 |
$562K |
| 45385 |
Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) |
1,352 |
1,328 |
$562K |
| C8929 |
Transthoracic echocardiography with contrast, or without contrast followed by with contrast, real-time with image documentation (2d), includes m-mode recording, when performed, complete, with spectral doppler echocardiography, and with color flow doppler echocardiography |
2,757 |
2,699 |
$536K |
| 87631 |
|
7,664 |
7,331 |
$471K |
| 10060 |
|
2,072 |
1,947 |
$397K |
| 12001 |
|
1,779 |
1,746 |
$376K |
| 95810 |
Polysomnography; sleep staging with 4 or more additional parameters |
862 |
853 |
$356K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
2,187 |
2,134 |
$347K |
| 76830 |
Ultrasound, transvaginal |
3,735 |
3,682 |
$322K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
3,832 |
3,741 |
$316K |
| J9271 |
Injection, pembrolizumab, 1 mg |
108 |
80 |
$311K |
| 78815 |
Positron emission tomography (PET) for limited area imaging |
593 |
582 |
$286K |
| 59025 |
Fetal non-stress test |
2,825 |
1,441 |
$285K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
1,066 |
1,052 |
$275K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
1,044 |
1,026 |
$260K |
| 80053 |
Comprehensive metabolic panel |
59,823 |
51,108 |
$245K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
5,778 |
5,755 |
$232K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
4,268 |
3,903 |
$231K |
| 96367 |
|
3,955 |
2,445 |
$229K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
4,051 |
2,378 |
$223K |
| 93321 |
|
1,078 |
1,061 |
$216K |
| 93971 |
|
2,399 |
2,315 |
$205K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
4,121 |
4,056 |
$187K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
2,618 |
2,546 |
$183K |
| 70496 |
|
1,185 |
1,144 |
$175K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
2,268 |
2,256 |
$160K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
1,465 |
1,381 |
$160K |
| C9803 |
Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
6,663 |
5,658 |
$148K |
| G0378 |
Hospital observation service, per hour |
4,142 |
3,645 |
$134K |
| 12011 |
|
547 |
536 |
$127K |
| 71046 |
Radiologic examination, chest; 2 views |
17,918 |
16,856 |
$126K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
590 |
579 |
$126K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
2,026 |
1,752 |
$125K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
1,003 |
986 |
$124K |
| 76801 |
|
2,202 |
1,874 |
$118K |
| 96415 |
|
583 |
421 |
$115K |
| 29125 |
|
638 |
622 |
$113K |
| 84484 |
|
31,149 |
19,737 |
$112K |
| 76642 |
|
1,240 |
1,128 |
$102K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
753 |
734 |
$102K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
34,284 |
30,765 |
$96K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
338 |
328 |
$95K |
| 95811 |
|
264 |
261 |
$91K |
| 12002 |
|
514 |
505 |
$90K |
| 93017 |
|
909 |
886 |
$81K |
| 90715 |
|
5,134 |
4,929 |
$80K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
1,692 |
1,666 |
$78K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
25,124 |
18,181 |
$68K |
| J7298 |
Levonorgestrel-releasing intrauterine contraceptive system (mirena), 52 mg |
191 |
189 |
$67K |
| 94726 |
|
1,612 |
1,592 |
$62K |
| 71250 |
|
1,446 |
1,425 |
$60K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
1,936 |
1,658 |
$57K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
6,796 |
5,055 |
$57K |
| 83605 |
|
10,635 |
9,585 |
$55K |
| 70491 |
|
368 |
352 |
$54K |
| 45378 |
Colonoscopy, flexible; diagnostic, including collection of specimen(s) |
164 |
163 |
$50K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
1,830 |
938 |
$49K |
| 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 |
8,943 |
7,973 |
$46K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
3,802 |
3,650 |
$46K |
| 58300 |
|
410 |
401 |
$46K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
22,861 |
20,163 |
$46K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
3,635 |
3,518 |
$44K |
| 73630 |
|
4,223 |
4,102 |
$42K |
| 93976 |
|
1,102 |
1,062 |
$41K |
| 92507 |
Treatment of speech, language, voice, communication, and/or auditory processing disorder |
973 |
330 |
$40K |
| 70486 |
|
1,320 |
1,272 |
$39K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
9,725 |
9,423 |
$39K |
| J2469 |
Injection, palonosetron hcl, 25 mcg |
752 |
457 |
$38K |
| 73610 |
|
3,703 |
3,575 |
$37K |
| 95806 |
|
191 |
184 |
$37K |
| 29515 |
|
153 |
144 |
$35K |
| 73564 |
|
2,810 |
2,740 |
$35K |
| 73030 |
|
3,303 |
3,195 |
$35K |
| 64400 |
|
115 |
102 |
$33K |
| 94729 |
|
1,640 |
1,619 |
$32K |
| 70498 |
|
1,192 |
1,155 |
$31K |
| 90686 |
|
4,181 |
4,133 |
$31K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
21,740 |
17,739 |
$31K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
845 |
842 |
$31K |
| 72100 |
|
2,034 |
1,991 |
$31K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
472 |
465 |
$30K |
| 93225 |
|
850 |
841 |
$30K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
1,284 |
612 |
$29K |
| 73130 |
|
3,425 |
3,336 |
$27K |
| 83880 |
|
5,817 |
5,351 |
$27K |
| 74018 |
|
1,871 |
1,785 |
$26K |
| 94060 |
|
1,365 |
1,350 |
$26K |
| 76536 |
|
313 |
309 |
$24K |
| 90670 |
|
2,681 |
2,649 |
$24K |
| J1453 |
Injection, fosaprepitant, 1 mg |
344 |
218 |
$23K |
| 73110 |
|
2,605 |
2,516 |
$23K |
| 93970 |
|
274 |
270 |
$23K |
| J7307 |
Etonogestrel (contraceptive) implant system, including implant and supplies |
57 |
54 |
$22K |
| 95910 |
|
148 |
129 |
$22K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
1,123 |
561 |
$22K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
64,251 |
53,968 |
$21K |
| 36415 |
Collection of venous blood by venipuncture |
59,010 |
47,197 |
$21K |
| 72141 |
|
148 |
143 |
$20K |
| 73502 |
|
2,008 |
1,939 |
$20K |
| 93325 |
|
1,069 |
1,050 |
$20K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
7,545 |
6,119 |
$20K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
2,037 |
1,975 |
$20K |
| 76770 |
|
233 |
226 |
$19K |
| 90647 |
|
1,508 |
1,485 |
$18K |
| 77336 |
|
387 |
152 |
$18K |
| 92551 |
|
180 |
179 |
$18K |
| 74174 |
|
181 |
176 |
$17K |
| 93798 |
|
2,916 |
627 |
$17K |
| 87040 |
|
2,282 |
2,104 |
$17K |
| 20610 |
|
201 |
149 |
$16K |
| 73562 |
|
1,227 |
1,193 |
$16K |
| 93226 |
|
850 |
841 |
$15K |
| 11981 |
|
37 |
37 |
$15K |
| 87633 |
Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets |
299 |
295 |
$15K |
| 66984 |
Extracapsular cataract removal with insertion of intraocular lens prosthesis |
32 |
24 |
$15K |
| 76813 |
|
195 |
192 |
$14K |
| 71045 |
Radiologic examination, chest; single view |
12,148 |
11,222 |
$13K |
| 97162 |
|
441 |
430 |
$13K |
| 85379 |
|
2,300 |
2,246 |
$13K |
| 97161 |
|
425 |
402 |
$12K |
| 73140 |
|
1,267 |
1,234 |
$11K |
| 76870 |
|
143 |
136 |
$11K |
| 73080 |
|
1,529 |
1,485 |
$11K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
117 |
117 |
$11K |
| 43235 |
|
27 |
27 |
$10K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
2,507 |
2,455 |
$10K |
| 96376 |
|
6,960 |
4,804 |
$10K |
| 95908 |
|
131 |
116 |
$10K |
| 77066 |
Tomosynthesis, mammo |
274 |
271 |
$10K |
| 71271 |
|
107 |
107 |
$9K |
| 81025 |
|
14,114 |
13,428 |
$8K |
| 72040 |
|
382 |
370 |
$8K |
| 17110 |
|
39 |
38 |
$8K |
| 83690 |
|
20,968 |
19,036 |
$8K |
| 97165 |
|
286 |
277 |
$7K |
| J0585 |
Injection, onabotulinumtoxina, 1 unit |
25 |
24 |
$7K |
| 64615 |
|
24 |
24 |
$7K |
| 72131 |
|
240 |
233 |
$7K |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
386 |
379 |
$6K |
| 90651 |
|
403 |
402 |
$6K |
| 72110 |
|
213 |
208 |
$6K |
| 72072 |
|
299 |
288 |
$6K |
| 73590 |
|
1,125 |
1,087 |
$5K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
218 |
147 |
$5K |
| 93880 |
|
119 |
115 |
$5K |
| J2704 |
Injection, propofol, 10 mg |
13,279 |
10,269 |
$5K |
| 85018 |
|
1,616 |
1,425 |
$5K |
| 80305 |
|
6,364 |
5,872 |
$5K |
| C1713 |
Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) |
1,141 |
1,110 |
$5K |
| 90677 |
|
724 |
711 |
$5K |
| 87641 |
|
475 |
468 |
$5K |
| 85027 |
|
3,266 |
2,894 |
$5K |
| 81001 |
|
25,869 |
23,938 |
$5K |
| 62323 |
|
24 |
24 |
$5K |
| J1750 |
Injection, iron dextran, 50 mg |
81 |
81 |
$5K |
| 83735 |
|
12,397 |
10,066 |
$4K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
20,110 |
16,704 |
$4K |
| 93296 |
|
334 |
328 |
$4K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
6,061 |
5,835 |
$4K |
| 73090 |
|
878 |
853 |
$4K |
| 82803 |
|
4,659 |
4,308 |
$4K |
| 83655 |
|
240 |
237 |
$4K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
18,813 |
16,326 |
$4K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
16,975 |
15,973 |
$4K |
| 97803 |
|
102 |
66 |
$4K |
| 85610 |
|
12,373 |
10,565 |
$4K |
| 88307 |
|
186 |
181 |
$4K |
| 84703 |
|
8,984 |
8,474 |
$4K |
| 97535 |
Self-care/home management training, each 15 minutes |
327 |
233 |
$3K |
| 58301 |
|
29 |
29 |
$3K |
| 83050 |
|
1,371 |
1,318 |
$3K |
| J1170 |
Injection, hydromorphone, up to 4 mg |
8,216 |
6,232 |
$3K |
| 95812 |
|
12 |
12 |
$3K |
| 0124A |
|
137 |
133 |
$3K |
| 11982 |
|
12 |
12 |
$3K |
| 84443 |
Thyroid stimulating hormone (TSH) |
7,544 |
7,138 |
$3K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
8,926 |
8,438 |
$3K |
| 0054A |
|
106 |
105 |
$3K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
3,133 |
3,068 |
$3K |
| C8930 |
Transthoracic echocardiography, with contrast, or without contrast followed by with contrast, real-time with image documentation (2d), includes m-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or pharmacologically induced stress, with interpretation and report; including performance of continuous electrocardiographic monitoring, with physician supervision |
413 |
405 |
$3K |
| 87486 |
|
261 |
257 |
$3K |
| 74019 |
|
124 |
122 |
$3K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
92 |
89 |
$2K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
7,168 |
5,883 |
$2K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
13 |
13 |
$2K |
| 96368 |
|
1,917 |
1,411 |
$2K |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
338 |
333 |
$2K |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
6,558 |
5,314 |
$2K |
| 87581 |
|
300 |
296 |
$2K |
| 93246 |
|
40 |
40 |
$2K |
| 86850 |
|
2,826 |
2,646 |
$2K |
| 90685 |
|
111 |
110 |
$2K |
| 87081 |
|
3,819 |
3,738 |
$2K |
| 86140 |
|
2,838 |
2,472 |
$2K |
| 83060 |
|
1,289 |
1,240 |
$2K |
| 90656 |
|
240 |
240 |
$2K |
| 81002 |
|
4,592 |
4,321 |
$2K |
| 86900 |
|
2,948 |
2,763 |
$2K |
| 97035 |
|
249 |
151 |
$2K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
2,037 |
1,975 |
$2K |
| 84702 |
|
2,388 |
2,173 |
$2K |
| 93242 |
|
41 |
41 |
$2K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
10,766 |
9,107 |
$1K |
| 77065 |
Tomosynthesis, mammo |
50 |
50 |
$1K |
| J2060 |
Injection, lorazepam, 2 mg |
2,776 |
2,412 |
$1K |
| J0561 |
Injection, penicillin g benzathine, 100,000 units |
21 |
19 |
$1K |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
4,126 |
2,318 |
$1K |
| 87430 |
|
3,858 |
3,780 |
$1K |
| J1756 |
Injection, iron sucrose, 1 mg |
240 |
78 |
$1K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
10,390 |
8,992 |
$1K |
| 72128 |
|
26 |
24 |
$1K |
| 81003 |
|
4,752 |
4,298 |
$1K |
| 87147 |
|
1,791 |
1,696 |
$1K |
| 71101 |
|
492 |
484 |
$1K |
| 93924 |
|
13 |
13 |
$1K |
| P9016 |
Red blood cells, leukocytes reduced, each unit |
14 |
12 |
$1K |
| 73560 |
|
60 |
58 |
$1K |
| 87186 |
|
3,781 |
3,620 |
$1K |
| G0108 |
Diabetes outpatient self-management training services, individual, per 30 minutes |
67 |
37 |
$1K |
| 90461 |
|
77 |
74 |
$1K |
| 84439 |
|
1,626 |
1,558 |
$1K |
| 76000 |
|
201 |
194 |
$1K |
| 99496 |
|
68 |
40 |
$978.54 |
| J0515 |
Injection, benztropine mesylate, per 1 mg |
15 |
15 |
$956.07 |
| 84100 |
|
1,773 |
1,634 |
$947.58 |
| 87077 |
|
2,637 |
2,518 |
$926.85 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
3,250 |
2,839 |
$898.31 |
| 86901 |
|
3,390 |
3,176 |
$873.63 |
| C8924 |
Transthoracic echocardiography with contrast, or without contrast followed by with contrast, real-time with image documentation (2d), includes m-mode recording, when performed, follow-up or limited study |
24 |
24 |
$873.20 |
| J1630 |
Injection, haloperidol, up to 5 mg |
2,228 |
1,971 |
$849.68 |
| 76882 |
|
13 |
12 |
$817.39 |
| 97116 |
|
92 |
63 |
$793.69 |
| 77080 |
|
13 |
13 |
$781.68 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
3,718 |
3,050 |
$751.15 |
| 94375 |
|
26 |
26 |
$728.31 |
| 87210 |
|
1,460 |
1,418 |
$710.10 |
| 99195 |
|
18 |
12 |
$690.04 |
| J1642 |
Injection, heparin sodium, (heparin lock flush), per 10 units |
6,441 |
2,316 |
$661.05 |
| 93990 |
|
12 |
12 |
$637.72 |
| 85652 |
|
1,988 |
1,709 |
$621.06 |
| 85730 |
|
2,207 |
2,111 |
$610.66 |
| 99152 |
|
918 |
867 |
$608.65 |
| 0071A |
|
15 |
15 |
$600.00 |
| 90480 |
|
21 |
21 |
$598.50 |
| J0897 |
Injection, denosumab, 1 mg |
17 |
12 |
$596.65 |
| 87070 |
|
1,210 |
1,149 |
$584.96 |
| 93922 |
|
14 |
14 |
$581.95 |
| 82550 |
|
1,346 |
1,249 |
$580.42 |
| 82728 |
|
98 |
85 |
$554.75 |
| 0072A |
|
13 |
13 |
$520.00 |
| Q9957 |
Injection, perflutren lipid microspheres, per ml |
3,721 |
3,625 |
$516.33 |
| 87205 |
|
2,043 |
1,913 |
$507.38 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
1,883 |
1,598 |
$488.27 |
| 0081A |
|
14 |
13 |
$480.00 |
| 87075 |
|
890 |
852 |
$479.88 |
| J0689 |
Injection, cefazolin sodium (baxter), not therapeutically equivalent to j0690, 500 mg |
1,051 |
1,005 |
$476.27 |
| 74022 |
|
116 |
116 |
$473.68 |
| 93270 |
|
12 |
12 |
$470.46 |
| J1644 |
Injection, heparin sodium, per 1000 units |
4,428 |
2,617 |
$465.74 |
| 90688 |
|
68 |
68 |
$452.71 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
2,315 |
2,169 |
$446.60 |
| 80061 |
Lipid panel |
123 |
120 |
$418.89 |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
2,326 |
2,155 |
$408.28 |
| 0051A |
|
12 |
12 |
$400.00 |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
2,829 |
1,236 |
$388.90 |
| 87420 |
|
20 |
18 |
$387.20 |
| 51702 |
|
49 |
39 |
$368.19 |
| 0052A |
|
12 |
12 |
$360.00 |
| 88304 |
|
461 |
457 |
$351.55 |
| 84112 |
|
27 |
24 |
$343.12 |
| 83550 |
|
68 |
63 |
$339.17 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
6,630 |
6,298 |
$337.79 |
| 90734 |
|
111 |
111 |
$331.91 |
| 88342 |
|
1,584 |
1,502 |
$324.17 |
| 74230 |
|
12 |
12 |
$323.42 |
| 97166 |
|
15 |
14 |
$313.86 |
| 87808 |
|
1,207 |
1,171 |
$313.13 |
| 73523 |
|
12 |
12 |
$289.96 |
| 87088 |
|
715 |
691 |
$283.61 |
| 84132 |
|
90 |
77 |
$269.66 |
| 83540 |
|
70 |
65 |
$263.43 |
| 99495 |
|
22 |
12 |
$260.08 |
| 82330 |
|
1,444 |
1,386 |
$246.42 |
| 72170 |
|
140 |
134 |
$232.31 |
| J2360 |
Injection, orphenadrine citrate, up to 60 mg |
1,278 |
1,203 |
$228.48 |
| 82140 |
|
732 |
689 |
$223.88 |
| J2785 |
Injection, regadenoson, 0.1 mg |
263 |
256 |
$210.00 |
| 96380 |
|
12 |
12 |
$188.18 |
| A9270 |
Non-covered item or service |
8,748 |
5,916 |
$168.41 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,318 |
1,287 |
$166.61 |
| 90707 |
|
49 |
49 |
$165.75 |
| 82247 |
|
30 |
24 |
$164.07 |
| 82565 |
|
38 |
36 |
$163.35 |
| 93282 |
|
13 |
13 |
$159.57 |
| A9500 |
Technetium tc-99m sestamibi, diagnostic, per study dose |
415 |
368 |
$157.00 |
| J0330 |
Injection, succinylcholine chloride, up to 20 mg |
722 |
693 |
$155.35 |
| A9575 |
Injection, gadoterate meglumine, 0.1 ml |
1,713 |
1,662 |
$153.90 |
| 73660 |
|
28 |
28 |
$148.88 |
| L1830 |
Knee orthosis, immobilizer, canvas longitudinal, prefabricated, off-the-shelf |
193 |
191 |
$145.57 |
| J2310 |
Injection, naloxone hydrochloride, per 1 mg |
24 |
16 |
$143.64 |
| 82010 |
|
677 |
618 |
$114.85 |
| 93280 |
|
26 |
24 |
$113.96 |
| J3360 |
Injection, diazepam, up to 5 mg |
239 |
142 |
$109.53 |
| G0008 |
Administration of influenza virus vaccine |
676 |
662 |
$107.54 |
| A4565 |
Slings |
650 |
639 |
$95.48 |
| J3370 |
Injection, vancomycin hcl, 500 mg |
621 |
315 |
$86.59 |
| Q3014 |
Telehealth originating site facility fee |
106 |
48 |
$74.49 |
| 85014 |
|
125 |
96 |
$72.19 |
| 87899 |
|
277 |
270 |
$68.60 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
843 |
813 |
$52.31 |
| 99153 |
Mod sedat endo service >5yrs |
363 |
347 |
$52.11 |
| P9612 |
Catheterization for collection of specimen, single patient, all places of service |
541 |
505 |
$45.00 |
| 73552 |
|
39 |
38 |
$41.51 |
| 73060 |
|
26 |
26 |
$38.61 |
| Q0162 |
Ondansetron 1 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen |
5,249 |
4,889 |
$35.77 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
1,938 |
1,923 |
$33.50 |
| A9585 |
Injection, gadobutrol, 0.1 ml |
291 |
284 |
$32.00 |
| J1030 |
Injection, methylprednisolone acetate, 40 mg |
693 |
650 |
$25.88 |
| A9552 |
Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries |
614 |
602 |
$25.77 |
| 87807 |
|
84 |
81 |
$21.24 |
| 82375 |
|
1,404 |
1,350 |
$21.02 |
| J0171 |
Injection, adrenalin, epinephrine, 0.1 mg |
140 |
127 |
$19.00 |
| 76376 |
|
545 |
331 |
$16.63 |
| J1790 |
Injection, droperidol, up to 5 mg |
768 |
697 |
$15.54 |
| 86703 |
|
113 |
112 |
$11.26 |
| 80076 |
|
89 |
83 |
$9.03 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
3,700 |
3,112 |
$8.60 |
| 84450 |
|
614 |
567 |
$6.93 |
| J2272 |
Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg |
1,436 |
1,223 |
$6.12 |
| Q4049 |
Finger splint, static |
29 |
29 |
$6.00 |
| 82810 |
|
1,111 |
1,064 |
$4.56 |
| 82570 |
|
14 |
12 |
$3.55 |
| 84460 |
|
613 |
567 |
$3.46 |
| Q9966 |
Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml |
1,327 |
1,193 |
$3.19 |
| 86780 |
|
84 |
84 |
$1.50 |
| J2919 |
Injection, methylprednisolone sodium succinate, 5 mg |
256 |
186 |
$0.94 |
| J0735 |
Injection, clonidine hydrochloride, 1 mg |
154 |
150 |
$0.52 |
| 90723 |
|
1,454 |
1,432 |
$0.00 |
| J3420 |
Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg |
337 |
281 |
$0.00 |
| 90680 |
|
2,028 |
1,991 |
$0.00 |
| C1769 |
Guide wire |
239 |
226 |
$0.00 |
| 90474 |
|
52 |
51 |
$0.00 |
| J1010 |
Injection, methylprednisolone acetate, 1 mg |
82 |
76 |
$0.00 |
| 99406 |
|
248 |
235 |
$0.00 |
| G0009 |
Administration of pneumococcal vaccine |
50 |
50 |
$0.00 |
| 88341 |
|
65 |
61 |
$0.00 |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
282 |
278 |
$0.00 |
| 90697 |
|
846 |
827 |
$0.00 |
| 96411 |
|
87 |
62 |
$0.00 |
| A9609 |
Fludeoxyglucose f18 up to 15 millicuries |
13 |
12 |
$0.00 |
| 90716 |
|
38 |
38 |
$0.00 |
| 90619 |
|
85 |
85 |
$0.00 |
| 90696 |
|
153 |
153 |
$0.00 |
| 45381 |
|
13 |
13 |
$0.00 |
| J2175 |
Injection, meperidine hydrochloride, per 100 mg |
77 |
75 |
$0.00 |
| L4360 |
Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
89 |
89 |
$0.00 |
| 87340 |
|
45 |
39 |
$0.00 |
| J1940 |
Injection, furosemide, up to 20 mg |
395 |
270 |
$0.00 |
| G8982 |
Changing & maintaining body position functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting |
13 |
13 |
$0.00 |
| G0283 |
Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care |
162 |
78 |
$0.00 |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
13 |
13 |
$0.00 |
| A4648 |
Tissue marker, implantable, any type, each |
14 |
13 |
$0.00 |
| 86803 |
|
15 |
12 |
$0.00 |
| J0360 |
Injection, hydralazine hcl, up to 20 mg |
29 |
24 |
$0.00 |
| V2632 |
Posterior chamber intraocular lens |
35 |
27 |
$0.00 |
| 36430 |
|
14 |
12 |
$0.00 |
| J1040 |
Injection, methylprednisolone acetate, 80 mg |
13 |
13 |
$0.00 |
| G8987 |
Self care functional limitation, current status, at therapy episode outset and at reporting intervals |
12 |
12 |
$0.00 |
| G8980 |
Mobility: walking & moving around functional limitation, discharge status, at discharge from therapy or to end reporting |
14 |
14 |
$0.00 |
| G8988 |
Self care functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting |
12 |
12 |
$0.00 |
| 77001 |
|
15 |
14 |
$0.00 |
| 90473 |
|
358 |
355 |
$0.00 |
| 90710 |
|
592 |
592 |
$0.00 |
| 90633 |
|
1,138 |
1,134 |
$0.00 |
| C1894 |
Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser |
497 |
476 |
$0.00 |
| C1758 |
Catheter, ureteral |
64 |
63 |
$0.00 |
| 90662 |
|
101 |
95 |
$0.00 |
| 90700 |
|
263 |
263 |
$0.00 |
| G8978 |
Mobility: walking & moving around functional limitation, current status, at therapy episode outset and at reporting intervals |
290 |
284 |
$0.00 |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
246 |
245 |
$0.00 |
| G8979 |
Mobility: walking & moving around functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting |
313 |
305 |
$0.00 |
| J7510 |
Prednisolone oral, per 5 mg |
14 |
14 |
$0.00 |
| 90648 |
|
161 |
161 |
$0.00 |
| J1171 |
Injection, hydromorphone, 0.1 mg |
121 |
86 |
$0.00 |
| L3908 |
Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf |
62 |
58 |
$0.00 |
| 96417 |
|
175 |
101 |
$0.00 |
| 87150 |
|
25 |
24 |
$0.00 |
| 77062 |
|
15 |
15 |
$0.00 |
| J0688 |
Injection, cefazolin sodium (hikma), not therapeutically equivalent to j0690, 500 mg |
21 |
14 |
$0.00 |
| G8985 |
Carrying, moving and handling objects, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting |
36 |
36 |
$0.00 |
| 85007 |
|
15 |
15 |
$0.00 |
| 51701 |
|
12 |
12 |
$0.00 |