| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
49,680 |
46,360 |
$6.21M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
32,018 |
29,167 |
$6.18M |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
84,905 |
73,058 |
$4.74M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
9,607 |
9,008 |
$2.76M |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
23,569 |
21,346 |
$1.85M |
| G0378 |
Hospital observation service, per hour |
5,261 |
3,906 |
$1.74M |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
16,539 |
16,063 |
$1.38M |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
6,897 |
6,757 |
$930K |
| 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 |
15,480 |
14,703 |
$811K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
1,870 |
1,793 |
$695K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
7,080 |
4,566 |
$616K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
22,245 |
18,614 |
$592K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
18,278 |
5,387 |
$534K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
1,398 |
1,393 |
$510K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
19,014 |
16,210 |
$483K |
| 87637 |
Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV |
7,051 |
6,914 |
$461K |
| 71045 |
Radiologic examination, chest; single view |
13,394 |
12,647 |
$424K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
5,017 |
4,641 |
$421K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
2,278 |
1,417 |
$391K |
| 70450 |
Computed tomography, head or brain; without contrast material |
5,991 |
5,814 |
$384K |
| 71046 |
Radiologic examination, chest; 2 views |
10,410 |
10,098 |
$341K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
574 |
572 |
$309K |
| 59025 |
Fetal non-stress test |
3,889 |
2,077 |
$305K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
1,321 |
1,316 |
$299K |
| 20610 |
|
2,175 |
2,109 |
$282K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
18,894 |
18,374 |
$281K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
18,895 |
18,375 |
$281K |
| 84443 |
Thyroid stimulating hormone (TSH) |
35,872 |
35,101 |
$252K |
| 80061 |
Lipid panel |
27,612 |
27,461 |
$248K |
| 80053 |
Comprehensive metabolic panel |
86,659 |
77,862 |
$246K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
4,871 |
4,852 |
$238K |
| 86900 |
|
7,689 |
7,193 |
$238K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
4,615 |
4,561 |
$236K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
18,042 |
17,594 |
$233K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
3,911 |
3,862 |
$230K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
2,452 |
2,418 |
$227K |
| 76801 |
|
4,276 |
3,973 |
$223K |
| 76830 |
Ultrasound, transvaginal |
4,032 |
3,985 |
$218K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
3,902 |
3,854 |
$212K |
| 36415 |
Collection of venous blood by venipuncture |
142,090 |
119,122 |
$202K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
1,141 |
725 |
$195K |
| 93975 |
|
1,859 |
1,834 |
$194K |
| 95810 |
Polysomnography; sleep staging with 4 or more additional parameters |
403 |
403 |
$189K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
2,078 |
2,039 |
$188K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
1,421 |
1,417 |
$160K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
460 |
458 |
$159K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
97,511 |
83,738 |
$157K |
| C9803 |
Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
13,641 |
12,988 |
$151K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
9,900 |
9,828 |
$139K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
1,031 |
1,027 |
$138K |
| 94060 |
|
902 |
893 |
$128K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
12,355 |
12,286 |
$122K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
563 |
562 |
$115K |
| 72100 |
|
3,269 |
3,247 |
$104K |
| 87507 |
|
511 |
508 |
$94K |
| Q3014 |
Telehealth originating site facility fee |
5,558 |
5,207 |
$92K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
5,922 |
2,098 |
$92K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
19,910 |
19,780 |
$91K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
1,659 |
1,654 |
$87K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
18,721 |
16,263 |
$87K |
| 97161 |
|
1,793 |
1,771 |
$87K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
2,939 |
1,902 |
$86K |
| 93971 |
|
1,696 |
1,658 |
$86K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
2,032 |
1,950 |
$85K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
1,186 |
1,181 |
$85K |
| 76770 |
|
1,488 |
1,476 |
$80K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
681 |
679 |
$77K |
| 76642 |
|
1,822 |
1,803 |
$72K |
| 76536 |
|
1,354 |
1,348 |
$72K |
| 86780 |
|
9,240 |
9,178 |
$69K |
| 73630 |
|
4,923 |
4,692 |
$69K |
| 71250 |
|
1,028 |
1,025 |
$64K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
6,380 |
6,291 |
$63K |
| 93017 |
|
1,369 |
1,360 |
$63K |
| 73610 |
|
4,256 |
3,937 |
$61K |
| 73562 |
|
3,638 |
3,553 |
$61K |
| G0145 |
Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system and manual rescreening under physician supervision |
4,079 |
4,048 |
$60K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
2,918 |
2,856 |
$59K |
| 73030 |
|
4,083 |
3,878 |
$59K |
| 73110 |
|
3,447 |
3,090 |
$57K |
| 73130 |
|
4,380 |
4,064 |
$54K |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
2,949 |
2,937 |
$50K |
| 77066 |
Tomosynthesis, mammo |
809 |
800 |
$47K |
| 97162 |
|
1,027 |
1,018 |
$46K |
| 80074 |
|
2,124 |
2,110 |
$46K |
| 86803 |
|
7,715 |
7,659 |
$46K |
| 83013 |
|
1,304 |
1,300 |
$45K |
| 74018 |
|
3,213 |
3,045 |
$45K |
| 97535 |
Self-care/home management training, each 15 minutes |
2,092 |
1,219 |
$44K |
| 82728 |
|
7,018 |
6,888 |
$44K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
20,700 |
18,263 |
$44K |
| 10060 |
|
544 |
532 |
$43K |
| 87631 |
|
1,698 |
1,681 |
$41K |
| 86003 |
|
835 |
799 |
$40K |
| 82607 |
|
5,685 |
5,633 |
$38K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
1,346 |
1,335 |
$38K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
1,357 |
1,169 |
$37K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
12,085 |
10,469 |
$37K |
| 85027 |
|
14,098 |
13,645 |
$37K |
| 95811 |
|
80 |
80 |
$37K |
| 90677 |
|
288 |
288 |
$36K |
| 96367 |
|
1,095 |
785 |
$35K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
17,106 |
16,250 |
$34K |
| 87633 |
Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets |
473 |
471 |
$33K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
2,494 |
2,493 |
$32K |
| 97597 |
|
333 |
240 |
$32K |
| 93970 |
|
287 |
284 |
$31K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
568 |
423 |
$31K |
| 84439 |
|
7,008 |
6,900 |
$31K |
| 94726 |
|
936 |
925 |
$30K |
| 76882 |
|
653 |
649 |
$30K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
22,671 |
20,154 |
$30K |
| 72141 |
|
233 |
230 |
$29K |
| 84466 |
|
5,324 |
5,220 |
$29K |
| G0451 |
Development testing, with interpretation and report, per standardized instrument form |
1,198 |
1,188 |
$29K |
| 73502 |
|
2,293 |
2,220 |
$29K |
| 84702 |
|
6,907 |
5,189 |
$29K |
| 73560 |
|
1,837 |
1,756 |
$28K |
| 87340 |
|
7,576 |
7,512 |
$25K |
| 87522 |
Neg quan hep c or qual rna |
1,073 |
1,035 |
$23K |
| 73140 |
|
1,838 |
1,710 |
$23K |
| 87150 |
|
1,730 |
1,671 |
$22K |
| 70486 |
|
782 |
778 |
$22K |
| 95910 |
|
144 |
142 |
$21K |
| 83540 |
|
6,816 |
6,685 |
$20K |
| 83970 |
|
979 |
965 |
$19K |
| 83880 |
|
3,135 |
2,896 |
$19K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
2,126 |
2,074 |
$17K |
| G0103 |
Prostate cancer screening; prostate specific antigen test (psa) |
1,557 |
1,555 |
$17K |
| 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 |
54 |
54 |
$17K |
| 82570 |
|
7,110 |
6,888 |
$16K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
794 |
781 |
$16K |
| 73564 |
|
1,147 |
1,140 |
$16K |
| 82043 |
|
5,293 |
5,266 |
$16K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
903 |
902 |
$15K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
453 |
450 |
$15K |
| 86696 |
|
1,387 |
1,377 |
$14K |
| 86038 |
|
2,843 |
2,770 |
$14K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
591 |
239 |
$13K |
| 64400 |
|
122 |
112 |
$13K |
| 86665 |
|
1,467 |
740 |
$13K |
| 81001 |
|
38,042 |
34,930 |
$13K |
| 83735 |
|
10,526 |
9,137 |
$13K |
| 86140 |
|
8,164 |
7,368 |
$13K |
| L4350 |
Ankle control orthosis, stirrup style, rigid, includes any type interface (e.g., pneumatic, gel), prefabricated, off-the-shelf |
349 |
348 |
$13K |
| 91320 |
|
104 |
104 |
$13K |
| 83001 |
|
1,442 |
1,433 |
$12K |
| 84403 |
|
995 |
984 |
$12K |
| 87081 |
|
3,297 |
3,261 |
$12K |
| 90686 |
|
876 |
872 |
$12K |
| 82746 |
|
1,958 |
1,928 |
$12K |
| 82670 |
|
941 |
930 |
$12K |
| 76870 |
|
555 |
549 |
$12K |
| 87077 |
|
5,579 |
5,394 |
$12K |
| 84481 |
|
1,475 |
1,447 |
$12K |
| 90688 |
|
656 |
656 |
$11K |
| 87186 |
|
4,942 |
4,781 |
$11K |
| 70491 |
|
107 |
105 |
$11K |
| 92557 |
|
270 |
270 |
$11K |
| 84146 |
|
1,185 |
1,173 |
$11K |
| 85610 |
|
10,170 |
8,116 |
$11K |
| 93225 |
|
458 |
452 |
$11K |
| 99406 |
|
674 |
657 |
$10K |
| 71271 |
|
193 |
193 |
$10K |
| 72040 |
|
599 |
595 |
$10K |
| 82950 |
|
3,950 |
3,936 |
$10K |
| G0279 |
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) |
836 |
836 |
$10K |
| 73590 |
|
830 |
759 |
$10K |
| 86695 |
|
1,387 |
1,377 |
$9K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
7,459 |
5,094 |
$9K |
| 83516 |
|
1,577 |
1,082 |
$9K |
| 86376 |
|
1,366 |
1,354 |
$9K |
| 73221 |
|
67 |
67 |
$9K |
| 87220 |
|
7,143 |
6,950 |
$9K |
| 93226 |
|
279 |
279 |
$9K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
2,241 |
1,999 |
$8K |
| 73080 |
|
809 |
732 |
$8K |
| 74183 |
|
37 |
37 |
$8K |
| 90682 |
|
128 |
127 |
$8K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,465 |
1,451 |
$8K |
| 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 |
4,697 |
4,276 |
$7K |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
638 |
636 |
$7K |
| 0002A |
|
218 |
217 |
$7K |
| 90673 |
|
116 |
116 |
$7K |
| 83002 |
|
840 |
832 |
$7K |
| 80076 |
|
2,574 |
2,413 |
$7K |
| 77065 |
Tomosynthesis, mammo |
172 |
161 |
$7K |
| 85652 |
|
6,975 |
6,358 |
$6K |
| 71101 |
|
408 |
404 |
$6K |
| 0001A |
|
242 |
241 |
$6K |
| 70498 |
|
39 |
39 |
$6K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
558 |
547 |
$6K |
| 73090 |
|
854 |
773 |
$6K |
| 93922 |
|
260 |
256 |
$6K |
| G0121 |
Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk |
13 |
13 |
$6K |
| 86664 |
|
707 |
702 |
$6K |
| 83690 |
|
15,186 |
13,820 |
$6K |
| 83014 |
|
1,301 |
1,297 |
$5K |
| 82785 |
|
700 |
694 |
$5K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
6,829 |
5,999 |
$5K |
| 84153 |
|
605 |
597 |
$5K |
| 86235 |
|
183 |
176 |
$5K |
| 86663 |
|
743 |
738 |
$5K |
| 86039 |
|
1,140 |
1,114 |
$5K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
288 |
188 |
$5K |
| 52000 |
|
27 |
27 |
$5K |
| 90480 |
|
126 |
126 |
$5K |
| 74022 |
|
729 |
717 |
$5K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
377 |
245 |
$5K |
| S4005 |
Interim labor facility global (labor occurring but not resulting in delivery) |
44 |
36 |
$5K |
| 87205 |
|
2,966 |
2,884 |
$4K |
| 84100 |
|
2,874 |
2,378 |
$4K |
| 45378 |
Colonoscopy, flexible; diagnostic, including collection of specimen(s) |
12 |
12 |
$4K |
| 86431 |
|
1,744 |
1,713 |
$4K |
| 81025 |
|
14,984 |
14,200 |
$4K |
| 85730 |
|
4,421 |
4,167 |
$4K |
| 80164 |
|
664 |
637 |
$3K |
| 80069 |
|
748 |
650 |
$3K |
| 82248 |
|
1,275 |
975 |
$3K |
| 83615 |
|
2,192 |
1,947 |
$3K |
| 73070 |
|
289 |
270 |
$3K |
| 82565 |
|
1,409 |
1,282 |
$3K |
| 87581 |
|
473 |
472 |
$3K |
| 87486 |
|
473 |
472 |
$3K |
| 84112 |
|
697 |
612 |
$3K |
| 74019 |
|
279 |
275 |
$3K |
| 87070 |
|
1,507 |
1,447 |
$3K |
| 85018 |
|
2,612 |
2,500 |
$3K |
| 87536 |
|
67 |
65 |
$3K |
| 36591 |
|
67 |
52 |
$3K |
| 95800 |
|
35 |
35 |
$3K |
| 86850 |
|
7,170 |
6,758 |
$3K |
| 0004A |
|
91 |
91 |
$3K |
| 0124A |
|
111 |
108 |
$2K |
| 86200 |
|
796 |
766 |
$2K |
| 84550 |
|
1,627 |
1,567 |
$2K |
| 84156 |
|
2,268 |
1,992 |
$2K |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
228 |
226 |
$2K |
| 81003 |
|
8,586 |
8,236 |
$2K |
| 83721 |
|
447 |
445 |
$2K |
| Q9969 |
Tc-99m from non-highly enriched uranium source, full cost recovery add-on, per study dose |
426 |
426 |
$2K |
| 95908 |
|
14 |
14 |
$2K |
| 72070 |
|
149 |
148 |
$2K |
| 86762 |
|
408 |
406 |
$2K |
| 96523 |
|
101 |
85 |
$2K |
| 84703 |
|
2,885 |
2,801 |
$2K |
| 74174 |
|
16 |
15 |
$2K |
| 96127 |
|
483 |
482 |
$2K |
| 82150 |
|
707 |
686 |
$2K |
| J2469 |
Injection, palonosetron hcl, 25 mcg |
116 |
73 |
$2K |
| 97116 |
|
201 |
80 |
$2K |
| 82550 |
|
1,877 |
1,648 |
$2K |
| 86706 |
|
405 |
397 |
$2K |
| 72158 |
|
12 |
12 |
$2K |
| 73522 |
|
25 |
25 |
$2K |
| 82627 |
|
180 |
180 |
$2K |
| 93880 |
|
12 |
12 |
$2K |
| 82784 |
|
252 |
242 |
$2K |
| 73660 |
|
155 |
146 |
$2K |
| 0054A |
|
54 |
54 |
$2K |
| 86225 |
|
331 |
312 |
$1K |
| 85046 |
|
779 |
721 |
$1K |
| G8978 |
Mobility: walking & moving around functional limitation, current status, at therapy episode outset and at reporting intervals |
80 |
75 |
$1K |
| 90656 |
|
108 |
108 |
$1K |
| 90732 |
|
15 |
15 |
$1K |
| 88304 |
|
1,379 |
1,283 |
$1K |
| 90670 |
|
40 |
40 |
$1K |
| 82951 |
|
160 |
158 |
$1K |
| 87641 |
|
324 |
323 |
$1K |
| 82140 |
|
282 |
230 |
$1K |
| 90674 |
|
29 |
29 |
$983.13 |
| 85380 |
|
2,522 |
2,482 |
$921.23 |
| 51798 |
|
795 |
768 |
$921.01 |
| 80178 |
|
311 |
284 |
$904.99 |
| 73521 |
|
41 |
40 |
$888.52 |
| 84145 |
|
1,796 |
1,680 |
$877.31 |
| 97165 |
|
36 |
36 |
$855.48 |
| 82247 |
|
325 |
199 |
$848.37 |
| 87040 |
|
3,462 |
1,928 |
$835.92 |
| 94010 |
|
713 |
707 |
$833.37 |
| 87640 |
|
146 |
146 |
$812.68 |
| 76881 |
|
12 |
12 |
$804.00 |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
3,133 |
3,110 |
$788.58 |
| 72050 |
|
21 |
21 |
$755.86 |
| 82731 |
|
162 |
156 |
$677.18 |
| 86618 |
|
121 |
119 |
$676.05 |
| 72110 |
|
14 |
13 |
$581.96 |
| 88342 |
|
207 |
201 |
$553.17 |
| 86160 |
|
56 |
55 |
$529.45 |
| 70496 |
|
53 |
53 |
$519.30 |
| 12001 |
|
1,098 |
1,093 |
$486.49 |
| 82977 |
|
144 |
132 |
$485.60 |
| 96161 |
|
161 |
147 |
$476.38 |
| 72170 |
|
26 |
26 |
$470.20 |
| 84144 |
|
53 |
48 |
$439.15 |
| 12011 |
|
329 |
327 |
$432.00 |
| 97035 |
|
66 |
26 |
$410.62 |
| 90651 |
|
29 |
29 |
$388.93 |
| 82274 |
|
43 |
43 |
$382.60 |
| 88307 |
|
234 |
198 |
$368.86 |
| 82465 |
|
137 |
137 |
$366.11 |
| 83020 |
|
57 |
55 |
$358.34 |
| 0012A |
|
12 |
12 |
$354.12 |
| 0072A |
|
12 |
12 |
$340.65 |
| 83605 |
|
6,679 |
5,605 |
$335.66 |
| 84484 |
|
13,776 |
7,902 |
$332.06 |
| 83718 |
|
62 |
62 |
$317.31 |
| 82533 |
|
51 |
50 |
$313.73 |
| 82952 |
|
146 |
144 |
$306.11 |
| 0071A |
|
12 |
12 |
$264.95 |
| 0064U |
|
688 |
679 |
$229.10 |
| 0011A |
|
14 |
14 |
$225.70 |
| 82330 |
|
63 |
54 |
$224.54 |
| 83525 |
|
40 |
40 |
$201.29 |
| 86480 |
|
14 |
14 |
$199.37 |
| 86308 |
|
152 |
151 |
$180.92 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
13,921 |
12,105 |
$176.60 |
| 90662 |
|
15 |
15 |
$176.23 |
| G0008 |
Administration of influenza virus vaccine |
78 |
77 |
$153.34 |
| 84460 |
|
52 |
51 |
$150.57 |
| 90474 |
|
12 |
12 |
$149.44 |
| L1830 |
Knee orthosis, immobilizer, canvas longitudinal, prefabricated, off-the-shelf |
141 |
140 |
$135.98 |
| 82010 |
|
889 |
789 |
$135.49 |
| 82947 |
|
52 |
52 |
$125.96 |
| 72131 |
|
12 |
12 |
$119.28 |
| 84450 |
|
41 |
40 |
$110.78 |
| 12002 |
|
399 |
396 |
$109.56 |
| 92567 |
|
419 |
418 |
$103.29 |
| 85014 |
|
79 |
79 |
$101.04 |
| 82575 |
|
17 |
16 |
$90.08 |
| 80143 |
|
2,461 |
2,267 |
$87.14 |
| 87088 |
|
28 |
27 |
$76.63 |
| L3908 |
Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf |
177 |
174 |
$68.90 |
| 29125 |
|
151 |
149 |
$67.37 |
| 81002 |
|
51 |
49 |
$65.40 |
| 94729 |
|
956 |
945 |
$61.80 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
23,664 |
17,514 |
$59.17 |
| 84165 |
|
24 |
24 |
$58.88 |
| 86787 |
|
12 |
12 |
$57.88 |
| 84480 |
|
12 |
12 |
$55.17 |
| 73060 |
|
12 |
12 |
$48.48 |
| 80179 |
|
2,391 |
2,224 |
$43.47 |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
417 |
316 |
$38.22 |
| 73565 |
|
12 |
12 |
$37.88 |
| J7030 |
Infusion, normal saline solution , 1000 cc |
24,672 |
20,678 |
$35.22 |
| 86901 |
|
7,791 |
7,278 |
$32.90 |
| 87075 |
|
12 |
12 |
$25.00 |
| 88300 |
|
92 |
88 |
$19.50 |
| 81015 |
|
566 |
525 |
$16.39 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
18,941 |
16,423 |
$14.90 |
| 82800 |
|
811 |
725 |
$11.37 |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
14,391 |
12,725 |
$8.63 |
| 84132 |
|
12 |
12 |
$8.62 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
5,080 |
4,181 |
$6.54 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
3,418 |
3,187 |
$5.70 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
6,290 |
5,556 |
$5.54 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
10,844 |
8,543 |
$5.30 |
| J2370 |
Injection, phenylephrine hcl, up to 1 ml |
614 |
599 |
$3.82 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
4,422 |
3,924 |
$3.08 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
3,074 |
2,452 |
$2.67 |
| J2704 |
Injection, propofol, 10 mg |
15,620 |
9,562 |
$2.20 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
12,574 |
7,619 |
$1.68 |
| J1920 |
Injection, labetalol hydrochloride, 5 mg |
17 |
12 |
$1.64 |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
10,751 |
5,418 |
$0.48 |
| J1630 |
Injection, haloperidol, up to 5 mg |
2,539 |
2,181 |
$0.24 |
| J2470 |
Injection, pantoprazole sodium, 40 mg |
18 |
14 |
$0.00 |
| J3490 |
Unclassified drugs |
570 |
547 |
$0.00 |
| J2060 |
Injection, lorazepam, 2 mg |
2,622 |
2,259 |
$0.00 |
| J1040 |
Injection, methylprednisolone acetate, 80 mg |
797 |
788 |
$0.00 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
4,731 |
3,742 |
$0.00 |
| J2360 |
Injection, orphenadrine citrate, up to 60 mg |
373 |
361 |
$0.00 |
| 95886 |
|
1,045 |
1,041 |
$0.00 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
6,666 |
5,233 |
$0.00 |
| 96376 |
|
4,888 |
3,624 |
$0.00 |
| 94760 |
|
1,530 |
1,103 |
$0.00 |
| J1642 |
Injection, heparin sodium, (heparin lock flush), per 10 units |
4,481 |
1,971 |
$0.00 |
| J0330 |
Injection, succinylcholine chloride, up to 20 mg |
2,214 |
2,186 |
$0.00 |
| 36416 |
|
339 |
287 |
$0.00 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
3,306 |
2,291 |
$0.00 |
| J0500 |
Injection, dicyclomine hcl, up to 20 mg |
222 |
214 |
$0.00 |
| A9500 |
Technetium tc-99m sestamibi, diagnostic, per study dose |
415 |
414 |
$0.00 |
| J3480 |
Injection, potassium chloride, per 2 meq |
316 |
244 |
$0.00 |
| J2795 |
Injection, ropivacaine hydrochloride, 1 mg |
5,855 |
3,246 |
$0.00 |
| 64488 |
|
395 |
393 |
$0.00 |
| J7620 |
Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme |
116 |
91 |
$0.00 |
| J7050 |
Infusion, normal saline solution, 250 cc |
3,515 |
2,273 |
$0.00 |
| J2785 |
Injection, regadenoson, 0.1 mg |
332 |
330 |
$0.00 |
| J0360 |
Injection, hydralazine hcl, up to 20 mg |
47 |
36 |
$0.00 |
| 90680 |
|
26 |
26 |
$0.00 |
| J2003 |
Injection, lidocaine hydrochloride, 1 mg |
343 |
263 |
$0.00 |
| 90697 |
|
68 |
68 |
$0.00 |
| J1030 |
Injection, methylprednisolone acetate, 40 mg |
257 |
247 |
$0.00 |
| J1790 |
Injection, droperidol, up to 5 mg |
17 |
17 |
$0.00 |
| J8597 |
Antiemetic drug, oral, not otherwise specified |
15 |
15 |
$0.00 |
| J3420 |
Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg |
16 |
12 |
$0.00 |
| 73552 |
|
12 |
12 |
$0.00 |
| J1010 |
Injection, methylprednisolone acetate, 1 mg |
82 |
78 |
$0.00 |
| A9270 |
Non-covered item or service |
27 |
25 |
$0.00 |
| 64415 |
|
12 |
12 |
$0.00 |
| J0702 |
Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg |
1,020 |
937 |
$0.00 |
| 90715 |
|
3,107 |
3,092 |
$0.00 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
1,130 |
1,120 |
$0.00 |
| J1644 |
Injection, heparin sodium, per 1000 units |
1,367 |
706 |
$0.00 |
| 76942 |
|
208 |
205 |
$0.00 |
| A9577 |
Injection, gadobenate dimeglumine (multihance), per ml |
3,433 |
2,254 |
$0.00 |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
449 |
380 |
$0.00 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
1,607 |
1,469 |
$0.00 |
| 64999 |
|
145 |
143 |
$0.00 |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
977 |
871 |
$0.00 |
| J2550 |
Injection, promethazine hcl, up to 50 mg |
2,172 |
1,841 |
$0.00 |
| 0202U |
Oncology (prostate), multianalyte, gene expression profiling |
64 |
63 |
$0.00 |
| J1240 |
Injection, dimenhydrinate, up to 50 mg |
169 |
168 |
$0.00 |
| J1171 |
Injection, hydromorphone, 0.1 mg |
120 |
94 |
$0.00 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
323 |
316 |
$0.00 |
| J7510 |
Prednisolone oral, per 5 mg |
63 |
61 |
$0.00 |
| J1756 |
Injection, iron sucrose, 1 mg |
376 |
179 |
$0.00 |
| C1713 |
Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) |
112 |
110 |
$0.00 |
| 90461 |
|
31 |
31 |
$0.00 |
| Q9957 |
Injection, perflutren lipid microspheres, per ml |
81 |
81 |
$0.00 |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
268 |
154 |
$0.00 |
| 90633 |
|
12 |
12 |
$0.00 |
| J0171 |
Injection, adrenalin, epinephrine, 0.1 mg |
213 |
192 |
$0.00 |
| J2919 |
Injection, methylprednisolone sodium succinate, 5 mg |
269 |
204 |
$0.00 |
| 94664 |
|
13 |
13 |
$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 |
106 |
99 |
$0.00 |
| J1596 |
Injection, glycopyrrolate, 0.1 mg |
210 |
107 |
$0.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
22 |
14 |
$0.00 |
| 80305 |
|
92 |
80 |
$0.00 |
| Q0163 |
Diphenhydramine hydrochloride, 50 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at time of chemotherapy treatment not to exceed a 48 hour dosage regimen |
14 |
14 |
$0.00 |
| J2310 |
Injection, naloxone hydrochloride, per 1 mg |
13 |
12 |
$0.00 |
| A9552 |
Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries |
12 |
12 |
$0.00 |