| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
Emergency department visit for the evaluation and management, high severity |
61,703 |
53,492 |
$2.82M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
68,387 |
61,249 |
$2.27M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
27,076 |
24,135 |
$1.98M |
| A0430 |
Ambulance service, conventional air services, transport, one way (fixed wing) |
1,098 |
957 |
$1.62M |
| A0435 |
Fixed wing air mileage, per statute mile |
1,105 |
959 |
$1.37M |
| A0431 |
Ambulance service, conventional air services, transport, one way (rotary wing) |
522 |
481 |
$744K |
| A0436 |
Rotary wing air mileage, per statute mile |
523 |
481 |
$460K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
2,880 |
2,598 |
$279K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
4,141 |
3,666 |
$234K |
| G0378 |
Hospital observation service, per hour |
13,578 |
7,385 |
$227K |
| 70450 |
Computed tomography, head or brain; without contrast material |
7,072 |
6,085 |
$81K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
5,815 |
5,354 |
$68K |
| 0202U |
Oncology (prostate), multianalyte, gene expression profiling |
1,235 |
1,163 |
$59K |
| A0425 |
Ground mileage, per statute mile |
1,252 |
1,024 |
$53K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,674 |
1,406 |
$53K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
23,451 |
19,490 |
$52K |
| 99215 |
Prolong outpt/office vis |
470 |
416 |
$50K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
3,493 |
3,261 |
$48K |
| 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 |
11,320 |
10,701 |
$44K |
| 95886 |
|
1,120 |
1,038 |
$38K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
26,245 |
9,499 |
$31K |
| J3490 |
Unclassified drugs |
120,756 |
44,626 |
$29K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
4,165 |
3,136 |
$29K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
1,195 |
1,104 |
$28K |
| 71046 |
Radiologic examination, chest; 2 views |
7,126 |
6,511 |
$27K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
882 |
768 |
$27K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
13,546 |
12,707 |
$26K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
3,225 |
3,055 |
$26K |
| 80053 |
Comprehensive metabolic panel |
73,501 |
60,684 |
$22K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
1,522 |
1,284 |
$22K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
2,579 |
2,190 |
$22K |
| 64615 |
|
2,210 |
1,955 |
$22K |
| 74018 |
|
1,579 |
1,406 |
$21K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
71,944 |
56,974 |
$21K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
12,218 |
10,902 |
$21K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
255 |
213 |
$20K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
9,580 |
7,601 |
$20K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
18,919 |
14,742 |
$19K |
| A0428 |
Ambulance service, basic life support, non-emergency transport, (bls) |
256 |
212 |
$19K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
2,182 |
2,013 |
$17K |
| 71045 |
Radiologic examination, chest; single view |
8,631 |
7,721 |
$17K |
| 95810 |
Polysomnography; sleep staging with 4 or more additional parameters |
569 |
544 |
$17K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
4,034 |
2,476 |
$16K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
3,638 |
3,409 |
$16K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
6,138 |
5,385 |
$16K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
10,359 |
9,491 |
$15K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
10,316 |
9,450 |
$15K |
| C1713 |
Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) |
1,017 |
863 |
$15K |
| A0427 |
Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) |
69 |
61 |
$15K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
15,221 |
12,837 |
$14K |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
18,398 |
14,255 |
$14K |
| 87081 |
|
8,626 |
8,137 |
$13K |
| 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 |
11,306 |
10,691 |
$12K |
| 84443 |
Thyroid stimulating hormone (TSH) |
28,797 |
26,886 |
$12K |
| C9290 |
Injection, bupivacaine liposome, 1 mg |
985 |
817 |
$12K |
| 87633 |
Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets |
237 |
219 |
$11K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
5,355 |
3,035 |
$11K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
14,724 |
10,904 |
$10K |
| 94762 |
|
4,095 |
2,371 |
$10K |
| 12001 |
|
522 |
492 |
$10K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
7,630 |
5,335 |
$10K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
6,037 |
2,422 |
$8K |
| 73610 |
|
1,503 |
1,360 |
$8K |
| 82728 |
|
7,524 |
6,878 |
$8K |
| 73130 |
|
2,139 |
1,873 |
$7K |
| J7050 |
Infusion, normal saline solution, 250 cc |
15,763 |
10,973 |
$7K |
| 80061 |
Lipid panel |
21,098 |
20,168 |
$7K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
2,402 |
1,474 |
$7K |
| 84439 |
|
7,893 |
7,444 |
$6K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
13,336 |
5,452 |
$6K |
| G0379 |
Direct admission of patient for hospital observation care |
2,099 |
1,573 |
$6K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
20,375 |
19,282 |
$6K |
| A9577 |
Injection, gadobenate dimeglumine (multihance), per ml |
2,584 |
2,260 |
$6K |
| 87088 |
|
11,518 |
10,153 |
$5K |
| 86900 |
|
4,203 |
3,612 |
$5K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
14,783 |
13,368 |
$5K |
| 81001 |
|
30,531 |
26,346 |
$5K |
| 97161 |
|
4,616 |
4,069 |
$5K |
| 73110 |
|
693 |
624 |
$5K |
| 72141 |
|
1,023 |
905 |
$5K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
17,994 |
14,547 |
$5K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
1,899 |
1,709 |
$5K |
| J2704 |
Injection, propofol, 10 mg |
12,763 |
10,483 |
$5K |
| 93975 |
|
199 |
183 |
$5K |
| 73630 |
|
1,927 |
1,698 |
$5K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
37 |
37 |
$4K |
| 95819 |
|
45 |
40 |
$4K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
1,567 |
1,436 |
$4K |
| 83550 |
|
6,565 |
6,010 |
$4K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
12,671 |
9,887 |
$4K |
| A0434 |
Specialty care transport (sct) |
13 |
12 |
$4K |
| 73030 |
|
1,522 |
1,324 |
$4K |
| 83690 |
|
13,641 |
11,738 |
$4K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
4,859 |
4,624 |
$4K |
| 81025 |
|
12,845 |
11,187 |
$4K |
| 82784 |
|
2,619 |
2,344 |
$4K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
8,532 |
3,309 |
$4K |
| 83516 |
|
2,236 |
1,649 |
$4K |
| 83605 |
|
8,186 |
6,478 |
$4K |
| 12002 |
|
285 |
263 |
$4K |
| 83540 |
|
7,406 |
6,786 |
$4K |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
1,880 |
1,356 |
$4K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
9,877 |
7,953 |
$4K |
| 96415 |
|
1,972 |
1,292 |
$3K |
| 73562 |
|
1,983 |
1,766 |
$3K |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
384 |
350 |
$3K |
| 95812 |
|
12 |
12 |
$3K |
| 36415 |
Collection of venous blood by venipuncture |
45,306 |
33,141 |
$3K |
| 87186 |
|
7,330 |
6,505 |
$3K |
| 76830 |
Ultrasound, transvaginal |
1,287 |
1,202 |
$3K |
| 86140 |
|
8,448 |
7,225 |
$3K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
817 |
759 |
$3K |
| A0429 |
Ambulance service, basic life support, emergency transport (bls-emergency) |
14 |
14 |
$3K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
1,546 |
1,431 |
$3K |
| G0432 |
Infectious agent antibody detection by enzyme immunoassay (eia) technique, hiv-1 and/or hiv-2, screening |
7,607 |
7,168 |
$3K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
1,335 |
679 |
$3K |
| 76770 |
|
419 |
390 |
$3K |
| 0352U |
|
1,179 |
1,084 |
$3K |
| 29125 |
|
185 |
164 |
$3K |
| 96376 |
|
6,363 |
4,639 |
$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) |
219 |
208 |
$3K |
| G0472 |
Hepatitis c antibody screening, for individual at high risk and other covered indication(s) |
6,243 |
5,888 |
$2K |
| 83735 |
|
9,242 |
7,232 |
$2K |
| 12011 |
|
120 |
103 |
$2K |
| 95811 |
|
382 |
354 |
$2K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
20,638 |
16,311 |
$2K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
14,067 |
11,433 |
$2K |
| 90715 |
|
1,118 |
1,004 |
$2K |
| 86850 |
|
4,239 |
3,705 |
$2K |
| 72040 |
|
1,301 |
1,098 |
$2K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
1,832 |
1,707 |
$2K |
| C1769 |
Guide wire |
1,608 |
1,417 |
$2K |
| 87070 |
|
3,362 |
2,945 |
$2K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
522 |
484 |
$2K |
| 99223 |
Prolong inpt eval add15 m |
12 |
12 |
$2K |
| 94664 |
|
1,463 |
1,001 |
$2K |
| 86901 |
|
4,279 |
3,670 |
$2K |
| 72100 |
|
2,037 |
1,816 |
$2K |
| 95911 |
|
30 |
27 |
$2K |
| 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 |
5,020 |
4,148 |
$2K |
| 85027 |
|
17,202 |
15,280 |
$2K |
| 95909 |
|
27 |
24 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,395 |
1,220 |
$2K |
| 76536 |
|
454 |
423 |
$2K |
| 87040 |
|
4,544 |
2,476 |
$2K |
| 64616 |
|
423 |
381 |
$2K |
| 87077 |
|
3,253 |
2,766 |
$2K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
15,279 |
11,858 |
$2K |
| 85652 |
|
7,902 |
6,772 |
$1K |
| 87486 |
|
237 |
219 |
$1K |
| 87581 |
|
236 |
218 |
$1K |
| 97162 |
|
1,333 |
1,242 |
$1K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
544 |
500 |
$1K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
5,054 |
2,592 |
$1K |
| 84146 |
|
891 |
809 |
$1K |
| 86364 |
|
1,062 |
795 |
$1K |
| 82607 |
|
4,513 |
4,165 |
$1K |
| 93971 |
|
1,429 |
1,291 |
$1K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
835 |
796 |
$1K |
| 80076 |
|
3,561 |
3,162 |
$1K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
1,150 |
933 |
$1K |
| 84484 |
|
10,964 |
7,276 |
$1K |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
6,942 |
5,435 |
$1K |
| 84481 |
|
2,876 |
2,747 |
$1K |
| 84702 |
|
3,431 |
2,425 |
$1K |
| 83880 |
|
3,406 |
3,050 |
$1K |
| J0330 |
Injection, succinylcholine chloride, up to 20 mg |
1,353 |
1,183 |
$1K |
| J0585 |
Injection, onabotulinumtoxina, 1 unit |
3,917 |
2,748 |
$1K |
| 76642 |
|
1,569 |
1,487 |
$993.61 |
| 83001 |
|
648 |
617 |
$943.19 |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
613 |
531 |
$942.02 |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
345 |
325 |
$941.83 |
| 73080 |
|
145 |
136 |
$916.69 |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
2,434 |
2,006 |
$911.48 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
55 |
43 |
$862.82 |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
129 |
124 |
$845.65 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
13 |
13 |
$844.10 |
| 84100 |
|
3,485 |
2,658 |
$840.16 |
| 82670 |
|
272 |
257 |
$814.35 |
| 86376 |
|
1,095 |
1,038 |
$808.21 |
| J3480 |
Injection, potassium chloride, per 2 meq |
948 |
560 |
$807.48 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
5,184 |
3,780 |
$805.72 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
6,387 |
4,443 |
$775.61 |
| 87338 |
|
453 |
430 |
$773.65 |
| 87205 |
|
2,805 |
2,438 |
$761.98 |
| J3370 |
Injection, vancomycin hcl, 500 mg |
1,910 |
1,542 |
$756.13 |
| 87653 |
|
4,193 |
3,790 |
$746.67 |
| 82247 |
|
1,382 |
739 |
$731.84 |
| 82962 |
|
6,367 |
2,881 |
$717.10 |
| 10060 |
|
195 |
168 |
$711.43 |
| 84403 |
|
1,028 |
952 |
$702.02 |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
55 |
55 |
$684.16 |
| 84145 |
|
1,275 |
1,162 |
$652.96 |
| 97116 |
|
3,667 |
1,801 |
$637.07 |
| 82150 |
|
2,270 |
2,028 |
$633.76 |
| 80055 |
|
2,729 |
2,597 |
$618.24 |
| 87147 |
|
1,351 |
1,198 |
$613.23 |
| 87075 |
|
742 |
614 |
$605.27 |
| 82805 |
|
60 |
53 |
$567.50 |
| J2710 |
Injection, neostigmine methylsulfate, up to 0.5 mg |
1,504 |
1,235 |
$549.75 |
| 99152 |
|
824 |
764 |
$540.91 |
| C1894 |
Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser |
997 |
915 |
$522.59 |
| 73560 |
|
142 |
116 |
$515.64 |
| 85379 |
|
2,740 |
2,545 |
$499.84 |
| A9585 |
Injection, gadobutrol, 0.1 ml |
99 |
88 |
$497.62 |
| 85610 |
|
11,323 |
8,564 |
$481.35 |
| 87899 |
|
687 |
360 |
$473.11 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
8,119 |
6,944 |
$471.95 |
| 84402 |
|
547 |
515 |
$471.04 |
| 83615 |
|
1,403 |
1,121 |
$470.57 |
| 82570 |
|
4,584 |
4,148 |
$460.09 |
| 83970 |
|
324 |
290 |
$452.37 |
| 36416 |
|
1,274 |
1,104 |
$425.07 |
| 87507 |
|
229 |
210 |
$411.63 |
| 87209 |
|
185 |
173 |
$403.91 |
| 80074 |
|
730 |
670 |
$393.99 |
| 87480 |
|
1,179 |
1,091 |
$392.31 |
| 87510 |
|
1,179 |
1,091 |
$392.28 |
| 87660 |
|
1,179 |
1,091 |
$392.28 |
| 86038 |
|
1,282 |
1,230 |
$387.43 |
| 74019 |
|
40 |
38 |
$381.15 |
| 73090 |
|
25 |
24 |
$379.78 |
| 73502 |
|
411 |
365 |
$368.66 |
| 80069 |
|
1,328 |
1,116 |
$355.21 |
| 84703 |
|
665 |
605 |
$345.48 |
| 82550 |
|
1,228 |
1,005 |
$339.86 |
| 76870 |
|
42 |
40 |
$337.46 |
| J1815 |
Injection, insulin, per 5 units |
3,035 |
1,245 |
$312.98 |
| 87420 |
|
120 |
112 |
$301.99 |
| 86431 |
|
1,800 |
1,625 |
$301.43 |
| 86780 |
|
1,051 |
935 |
$293.34 |
| 82248 |
|
761 |
635 |
$289.46 |
| 82947 |
|
7,182 |
3,515 |
$284.26 |
| 86665 |
|
72 |
37 |
$282.13 |
| 86592 |
|
2,719 |
2,567 |
$280.44 |
| 87340 |
|
2,071 |
1,885 |
$271.18 |
| Q9969 |
Tc-99m from non-highly enriched uranium source, full cost recovery add-on, per study dose |
736 |
713 |
$270.81 |
| 96367 |
|
422 |
239 |
$254.34 |
| 87045 |
|
472 |
457 |
$250.40 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
3,521 |
2,385 |
$249.10 |
| 82746 |
|
1,327 |
1,219 |
$247.28 |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
114 |
101 |
$242.20 |
| 82043 |
|
3,372 |
3,216 |
$240.92 |
| 86200 |
|
544 |
472 |
$217.96 |
| 87493 |
|
371 |
360 |
$216.81 |
| 83002 |
|
53 |
52 |
$216.00 |
| 31720 |
|
14 |
13 |
$215.89 |
| 87503 |
|
127 |
123 |
$213.91 |
| 70486 |
|
346 |
296 |
$207.46 |
| 72070 |
|
113 |
93 |
$205.23 |
| 87177 |
|
185 |
173 |
$200.03 |
| 70491 |
|
15 |
13 |
$198.85 |
| 87427 |
|
98 |
86 |
$193.27 |
| 81003 |
|
4,002 |
2,828 |
$191.39 |
| 85730 |
|
798 |
660 |
$187.93 |
| 99153 |
Mod sedat endo service >5yrs |
249 |
238 |
$173.52 |
| 74220 |
|
28 |
27 |
$166.78 |
| 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 |
2,088 |
1,484 |
$165.71 |
| 80050 |
General health panel |
8,799 |
8,476 |
$157.97 |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
557 |
466 |
$157.91 |
| 82565 |
|
907 |
826 |
$154.82 |
| 83993 |
|
32 |
32 |
$152.64 |
| 97165 |
|
1,158 |
1,010 |
$147.55 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
4,941 |
3,999 |
$147.34 |
| 87634 |
|
31 |
30 |
$136.47 |
| 87529 |
|
61 |
52 |
$136.43 |
| 82274 |
|
68 |
64 |
$135.27 |
| 82977 |
|
86 |
67 |
$134.95 |
| 82803 |
|
17 |
12 |
$131.99 |
| 84460 |
|
152 |
118 |
$124.91 |
| 86706 |
|
938 |
852 |
$124.83 |
| J8540 |
Dexamethasone, oral, 0.25 mg |
2,552 |
1,688 |
$120.78 |
| 86664 |
|
38 |
37 |
$118.88 |
| 94729 |
|
149 |
143 |
$113.50 |
| 85046 |
|
39 |
31 |
$109.96 |
| 87046 |
|
76 |
72 |
$109.81 |
| J2060 |
Injection, lorazepam, 2 mg |
3,931 |
3,246 |
$108.82 |
| 84550 |
|
2,995 |
2,470 |
$104.19 |
| 86663 |
|
38 |
37 |
$102.00 |
| 87210 |
|
1,735 |
1,571 |
$100.48 |
| 85014 |
|
4,081 |
3,520 |
$96.20 |
| 82533 |
|
88 |
80 |
$95.07 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
2,402 |
2,086 |
$89.47 |
| 84295 |
|
911 |
810 |
$88.07 |
| 86141 |
|
84 |
73 |
$84.63 |
| 84132 |
|
1,154 |
1,018 |
$83.14 |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
2,956 |
1,628 |
$81.32 |
| 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 |
4,582 |
3,889 |
$80.01 |
| 93017 |
|
199 |
180 |
$79.78 |
| 86039 |
|
218 |
180 |
$79.24 |
| A9270 |
Non-covered item or service |
7,204 |
2,291 |
$75.77 |
| 85018 |
|
673 |
503 |
$73.86 |
| 86762 |
|
739 |
648 |
$70.59 |
| 83655 |
|
17 |
15 |
$70.11 |
| 77080 |
|
163 |
163 |
$69.71 |
| J1790 |
Injection, droperidol, up to 5 mg |
1,017 |
953 |
$66.57 |
| 94760 |
|
279 |
239 |
$64.68 |
| 84156 |
|
911 |
721 |
$63.89 |
| J1596 |
Injection, glycopyrrolate, 0.1 mg |
271 |
214 |
$63.51 |
| 82950 |
|
2,931 |
2,634 |
$63.23 |
| 82010 |
|
30 |
27 |
$62.42 |
| 86769 |
|
13 |
13 |
$60.65 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
2,766 |
1,959 |
$59.92 |
| 84112 |
|
804 |
633 |
$56.62 |
| J2370 |
Injection, phenylephrine hcl, up to 1 ml |
34 |
27 |
$50.32 |
| 90686 |
|
121 |
112 |
$48.72 |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
19 |
17 |
$46.81 |
| J1644 |
Injection, heparin sodium, per 1000 units |
4,525 |
2,253 |
$44.32 |
| 83721 |
|
588 |
551 |
$43.08 |
| J2550 |
Injection, promethazine hcl, up to 50 mg |
623 |
508 |
$42.27 |
| 84270 |
|
254 |
238 |
$42.25 |
| 82140 |
|
354 |
283 |
$37.57 |
| 80164 |
|
81 |
73 |
$34.91 |
| 83520 |
|
127 |
101 |
$33.32 |
| 86800 |
|
58 |
48 |
$30.93 |
| 86308 |
|
57 |
52 |
$28.53 |
| 84165 |
|
487 |
392 |
$20.88 |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
31,086 |
23,621 |
$19.58 |
| 87015 |
|
14 |
14 |
$17.22 |
| J2919 |
Injection, methylprednisolone sodium succinate, 5 mg |
143 |
117 |
$17.17 |
| Q0177 |
Hydroxyzine pamoate, 25 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 |
1,337 |
753 |
$6.46 |
| J2003 |
Injection, lidocaine hydrochloride, 1 mg |
36 |
36 |
$1.77 |
| A4217 |
Sterile water/saline, 500 ml |
196 |
174 |
$0.00 |
| 97535 |
Self-care/home management training, each 15 minutes |
1,609 |
1,075 |
$0.00 |
| 86225 |
|
149 |
95 |
$0.00 |
| 84144 |
|
71 |
64 |
$0.00 |
| 97113 |
|
451 |
134 |
$0.00 |
| G0103 |
Prostate cancer screening; prostate specific antigen test (psa) |
1,901 |
1,848 |
$0.00 |
| 80178 |
|
38 |
36 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
178 |
163 |
$0.00 |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
5,037 |
4,760 |
$0.00 |
| 36591 |
|
1,668 |
899 |
$0.00 |
| 82952 |
|
31 |
28 |
$0.00 |
| 97035 |
|
129 |
65 |
$0.00 |
| J2469 |
Injection, palonosetron hcl, 25 mcg |
706 |
335 |
$0.00 |
| M0243 |
Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring |
77 |
72 |
$0.00 |
| 87522 |
Neg quan hep c or qual rna |
699 |
654 |
$0.00 |
| 99234 |
|
1,543 |
987 |
$0.00 |
| 86704 |
|
91 |
83 |
$0.00 |
| 86160 |
|
190 |
96 |
$0.00 |
| J1040 |
Injection, methylprednisolone acetate, 80 mg |
429 |
369 |
$0.00 |
| 45378 |
Colonoscopy, flexible; diagnostic, including collection of specimen(s) |
310 |
290 |
$0.00 |
| 82378 |
|
355 |
230 |
$0.00 |
| J7060 |
5% dextrose/water (500 ml = 1 unit) |
81 |
24 |
$0.00 |
| 86300 |
|
19 |
12 |
$0.00 |
| J0185 |
Injection, aprepitant, 1 mg |
58 |
36 |
$0.00 |
| 84153 |
|
43 |
42 |
$0.00 |
| J7999 |
Compounded drug, not otherwise classified |
139 |
83 |
$0.00 |
| 11045 |
|
60 |
26 |
$0.00 |
| 20553 |
|
16 |
13 |
$0.00 |
| 84478 |
|
14 |
14 |
$0.00 |
| 82105 |
|
194 |
180 |
$0.00 |
| 64405 |
|
59 |
56 |
$0.00 |
| 80177 |
|
31 |
30 |
$0.00 |
| J3411 |
Injection, thiamine hcl, 100 mg |
43 |
27 |
$0.00 |
| 93458 |
|
15 |
12 |
$0.00 |
| J1940 |
Injection, furosemide, up to 20 mg |
13 |
12 |
$0.00 |
| 72170 |
|
13 |
12 |
$0.00 |
| 74183 |
|
65 |
61 |
$0.00 |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
118 |
112 |
$0.00 |
| 82951 |
|
45 |
41 |
$0.00 |
| A9698 |
Non-radioactive contrast imaging material, not otherwise classified, per study |
16 |
16 |
$0.00 |
| J2785 |
Injection, regadenoson, 0.1 mg |
54 |
47 |
$0.00 |
| G8980 |
Mobility: walking & moving around functional limitation, discharge status, at discharge from therapy or to end reporting |
29 |
14 |
$0.00 |
| Q5115 |
Injection, rituximab-abbs, biosimilar, (truxima), 10 mg |
18 |
12 |
$0.00 |
| 82040 |
|
31 |
21 |
$0.00 |
| G0515 |
Development of cognitive skills to improve attention, memory, problem solving (includes compensatory training), direct (one-on-one) patient contact, each 15 minutes |
39 |
12 |
$0.00 |
| 82626 |
|
12 |
12 |
$0.00 |
| 83090 |
|
17 |
17 |
$0.00 |
| 71250 |
|
972 |
890 |
$0.00 |
| G0279 |
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) |
1,783 |
1,703 |
$0.00 |
| J0702 |
Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg |
365 |
317 |
$0.00 |
| 45385 |
Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) |
928 |
875 |
$0.00 |
| 94060 |
|
29 |
27 |
$0.00 |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
5,176 |
4,889 |
$0.00 |
| A9502 |
Technetium tc-99m tetrofosmin, diagnostic, per study dose |
137 |
129 |
$0.00 |
| G8978 |
Mobility: walking & moving around functional limitation, current status, at therapy episode outset and at reporting intervals |
297 |
188 |
$0.00 |
| J2323 |
Injection, natalizumab, 1 mg |
263 |
224 |
$0.00 |
| 77066 |
Tomosynthesis, mammo |
651 |
633 |
$0.00 |
| 78815 |
Positron emission tomography (PET) for limited area imaging |
42 |
41 |
$0.00 |
| 77065 |
Tomosynthesis, mammo |
651 |
601 |
$0.00 |
| 86146 |
|
16 |
12 |
$0.00 |
| 86480 |
|
248 |
228 |
$0.00 |
| G1004 |
Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program |
2,117 |
1,762 |
$0.00 |
| 86235 |
|
99 |
51 |
$0.00 |
| 96417 |
|
93 |
61 |
$0.00 |
| A9552 |
Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries |
58 |
57 |
$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 |
343 |
207 |
$0.00 |
| 72110 |
|
130 |
109 |
$0.00 |
| C1776 |
Joint device (implantable) |
199 |
182 |
$0.00 |
| 76942 |
|
66 |
55 |
$0.00 |
| 86147 |
|
20 |
12 |
$0.00 |
| 43235 |
|
98 |
78 |
$0.00 |
| 73590 |
|
29 |
26 |
$0.00 |
| L3650 |
Shoulder orthosis, figure of eight design abduction restrainer, prefabricated, off-the-shelf |
13 |
12 |
$0.00 |
| J1756 |
Injection, iron sucrose, 1 mg |
132 |
64 |
$0.00 |
| C1729 |
Catheter, drainage |
38 |
25 |
$0.00 |
| 71271 |
|
13 |
12 |
$0.00 |
| J7510 |
Prednisolone oral, per 5 mg |
13 |
12 |
$0.00 |
| J1580 |
Injection, garamycin, gentamicin, up to 80 mg |
38 |
32 |
$0.00 |
| 84450 |
|
41 |
27 |
$0.00 |
| 83525 |
|
18 |
18 |
$0.00 |
| 86328 |
|
15 |
13 |
$0.00 |
| 84425 |
|
41 |
39 |
$0.00 |
| 76981 |
|
14 |
12 |
$0.00 |
| 84155 |
|
33 |
30 |
$0.00 |
| 84520 |
|
31 |
20 |
$0.00 |
| 85007 |
|
14 |
14 |
$0.00 |
| 93798 |
|
187 |
36 |
$0.00 |
| J1171 |
Injection, hydromorphone, 0.1 mg |
49 |
49 |
$0.00 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
16 |
13 |
$0.00 |
| J3260 |
Injection, tobramycin sulfate, up to 80 mg |
14 |
13 |
$0.00 |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
19 |
14 |
$0.00 |
| 72131 |
|
14 |
13 |
$0.00 |
| 80175 |
|
15 |
12 |
$0.00 |