| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
Emergency department visit for the evaluation and management, high severity |
40,639 |
39,046 |
$9.38M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
37,059 |
35,870 |
$5.71M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
10,147 |
9,600 |
$3.31M |
| 20610 |
|
14,300 |
11,803 |
$2.51M |
| G0260 |
Injection procedure for sacroiliac joint; provision of anesthetic, steroid and/or other therapeutic agent, with or without arthrography |
9,714 |
4,433 |
$2.36M |
| S9123 |
Nursing care, in the home; by registered nurse, per hour (use for general nursing care only, not to be used when cpt codes 99500-99602 can be used) |
26,433 |
9,856 |
$2.02M |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
11,830 |
11,176 |
$1.48M |
| 92507 |
Treatment of speech, language, voice, communication, and/or auditory processing disorder |
22,879 |
6,990 |
$1.46M |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
97,376 |
93,755 |
$1.21M |
| J0585 |
Injection, onabotulinumtoxina, 1 unit |
1,421 |
1,141 |
$1.08M |
| 20553 |
|
7,784 |
6,977 |
$972K |
| H0015 |
Alcohol and/or drug services; intensive outpatient (treatment program that operates at least 3 hours/day and at least 3 days/week and is based on an individualized treatment plan), including assessment, counseling; crisis intervention, and activity therapies or education |
8,125 |
1,385 |
$649K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
7,943 |
7,142 |
$621K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
1,225 |
1,160 |
$426K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
4,628 |
4,357 |
$286K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
5,715 |
2,221 |
$188K |
| 64644 |
|
697 |
574 |
$146K |
| D1206 |
Topical application of fluoride varnish |
4,268 |
4,168 |
$139K |
| D1120 |
Prophylaxis - child |
2,642 |
2,605 |
$139K |
| 90791 |
Psychiatric diagnostic evaluation |
1,242 |
1,174 |
$137K |
| 59025 |
Fetal non-stress test |
953 |
713 |
$118K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
3,009 |
2,831 |
$117K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
4,437 |
1,650 |
$112K |
| G0330 |
Facility services for dental rehabilitation procedure(s) performed on a patient who requires monitored anesthesia (e.g., general, intravenous sedation (monitored anesthesia care) and use of an operating room |
64 |
63 |
$110K |
| 0202U |
Oncology (prostate), multianalyte, gene expression profiling |
280 |
276 |
$90K |
| 71046 |
Radiologic examination, chest; 2 views |
1,592 |
1,529 |
$86K |
| D0120 |
Periodic oral evaluation - established patient |
3,471 |
3,423 |
$84K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
155 |
148 |
$64K |
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
1,577 |
392 |
$60K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
8,511 |
8,320 |
$60K |
| D1110 |
Prophylaxis - adult |
1,155 |
1,108 |
$56K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
1,814 |
1,804 |
$56K |
| 62323 |
|
159 |
156 |
$56K |
| 36415 |
Collection of venous blood by venipuncture |
47,783 |
43,483 |
$51K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
1,855 |
1,486 |
$46K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
386 |
379 |
$46K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
1,682 |
663 |
$44K |
| 71045 |
Radiologic examination, chest; single view |
773 |
745 |
$42K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
416 |
410 |
$39K |
| 0240U |
|
339 |
333 |
$39K |
| D2930 |
Prefabricated stainless steel crown - primary tooth |
346 |
185 |
$39K |
| 64450 |
|
83 |
78 |
$36K |
| G0379 |
Direct admission of patient for hospital observation care |
15 |
14 |
$35K |
| 64616 |
|
171 |
157 |
$30K |
| G0481 |
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; 8-14 drug class(es), including metabolite(s) if performed |
420 |
339 |
$25K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
306 |
285 |
$24K |
| 64642 |
|
98 |
91 |
$23K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
132 |
73 |
$23K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
5,533 |
3,223 |
$22K |
| 45385 |
Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) |
38 |
38 |
$21K |
| 93308 |
|
105 |
100 |
$20K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
28 |
26 |
$17K |
| D0274 |
Bitewings - four radiographic images |
594 |
584 |
$15K |
| 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 |
242 |
235 |
$14K |
| D1351 |
Sealant - per tooth |
598 |
155 |
$14K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
301 |
299 |
$14K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
519 |
513 |
$13K |
| 70450 |
Computed tomography, head or brain; without contrast material |
82 |
79 |
$12K |
| 64646 |
|
38 |
37 |
$11K |
| D0272 |
Bitewings - two radiographic images |
505 |
500 |
$10K |
| 99408 |
|
167 |
131 |
$10K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
35 |
33 |
$9K |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
4,621 |
4,359 |
$9K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
57 |
56 |
$8K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
8,443 |
7,623 |
$7K |
| 94060 |
|
42 |
40 |
$6K |
| 80053 |
Comprehensive metabolic panel |
30,501 |
29,100 |
$6K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
2,728 |
2,583 |
$6K |
| D7140 |
Extraction, erupted tooth or exposed root |
89 |
57 |
$6K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
52 |
52 |
$6K |
| 93296 |
|
427 |
412 |
$6K |
| 86480 |
|
95 |
95 |
$6K |
| 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 |
215 |
209 |
$5K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
43,254 |
41,199 |
$5K |
| J2175 |
Injection, meperidine hydrochloride, per 100 mg |
2,280 |
2,152 |
$5K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
79 |
76 |
$5K |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
1,477 |
1,211 |
$4K |
| 76825 |
|
20 |
14 |
$4K |
| D0140 |
Limited oral evaluation - problem focused |
132 |
128 |
$4K |
| 99170 |
|
35 |
30 |
$4K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
182 |
70 |
$3K |
| 87801 |
Infectious agent detection by nucleic acid; amplified probe, multiple organisms |
51 |
51 |
$3K |
| 92526 |
|
45 |
31 |
$3K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
50 |
45 |
$3K |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
25 |
25 |
$3K |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
808 |
674 |
$3K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
32 |
30 |
$3K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
62 |
38 |
$3K |
| 70310 |
|
25 |
24 |
$3K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
52 |
52 |
$2K |
| 80061 |
Lipid panel |
213 |
211 |
$2K |
| 84443 |
Thyroid stimulating hormone (TSH) |
199 |
196 |
$2K |
| 20552 |
|
25 |
24 |
$2K |
| 97161 |
|
33 |
33 |
$2K |
| D0220 |
Intraoral - periapical first radiographic image |
223 |
217 |
$2K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
2,297 |
2,159 |
$2K |
| G0396 |
Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and brief intervention 15 to 30 minutes |
81 |
75 |
$2K |
| 77336 |
|
32 |
12 |
$2K |
| 96116 |
|
12 |
12 |
$2K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
12 |
12 |
$2K |
| G0249 |
Provision of test materials and equipment for home inr monitoring of patient with either mechanical heart valve(s), chronic atrial fibrillation, or venous thromboembolism who meets medicare coverage criteria; includes: provision of materials for use in the home and reporting of test results to physician; testing not occurring more frequently than once a week; testing materials, billing units of service include 4 tests |
409 |
398 |
$1K |
| 86738 |
|
135 |
135 |
$1K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
59 |
59 |
$1K |
| D0190 |
|
125 |
125 |
$1K |
| 97162 |
|
20 |
19 |
$1K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
882 |
839 |
$1K |
| D0240 |
|
91 |
49 |
$1K |
| 76830 |
Ultrasound, transvaginal |
12 |
12 |
$1K |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
46 |
43 |
$1K |
| 72100 |
|
13 |
13 |
$978.63 |
| D3220 |
Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction |
16 |
12 |
$945.28 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
562 |
515 |
$774.88 |
| 64405 |
|
33 |
28 |
$773.35 |
| 83655 |
|
68 |
68 |
$770.50 |
| 87581 |
|
550 |
527 |
$764.85 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
125 |
125 |
$706.67 |
| 97535 |
Self-care/home management training, each 15 minutes |
26 |
15 |
$697.11 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
267 |
254 |
$689.36 |
| 85027 |
|
116 |
115 |
$676.50 |
| D0330 |
Panoramic radiographic image |
27 |
26 |
$665.90 |
| 90832 |
Psychotherapy, 30 minutes with patient |
88 |
40 |
$661.34 |
| 87081 |
|
448 |
422 |
$647.53 |
| 80048 |
Basic metabolic panel (calcium, ionized) |
2,806 |
2,679 |
$636.42 |
| 73562 |
|
17 |
16 |
$616.48 |
| 73630 |
|
31 |
29 |
$616.48 |
| 97113 |
|
24 |
12 |
$543.32 |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
469 |
449 |
$534.31 |
| 86780 |
|
38 |
38 |
$478.04 |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
13 |
13 |
$433.42 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
135 |
123 |
$342.64 |
| 84439 |
|
42 |
42 |
$319.81 |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
1,093 |
597 |
$243.30 |
| 88304 |
|
13 |
12 |
$202.08 |
| 81001 |
|
2,879 |
2,740 |
$193.14 |
| 83690 |
|
2,539 |
2,428 |
$173.31 |
| D0230 |
Intraoral - periapical each additional radiographic image |
25 |
12 |
$166.13 |
| J2704 |
Injection, propofol, 10 mg |
41 |
39 |
$161.66 |
| 84703 |
|
1,604 |
1,532 |
$136.23 |
| 96127 |
|
118 |
113 |
$129.06 |
| 87486 |
|
529 |
506 |
$113.78 |
| 88300 |
|
12 |
12 |
$112.53 |
| G0500 |
Moderate sedation services provided by the same physician or other qualified health care professional performing a gastrointestinal endoscopic service that sedation supports, requiring the presence of an independent trained observer to assist in the monitoring of the patient's level of consciousness and physiological status; initial 15 minutes of intra-service time; patient age 5 years or older (additional time may be reported with 99153, as appropriate) |
2,356 |
2,221 |
$106.08 |
| J2003 |
Injection, lidocaine hydrochloride, 1 mg |
172 |
165 |
$105.67 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
64 |
53 |
$100.81 |
| 85610 |
|
24 |
13 |
$94.49 |
| 84484 |
|
1,800 |
1,356 |
$81.71 |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
196 |
168 |
$61.17 |
| 85018 |
|
50 |
48 |
$51.75 |
| 95874 |
|
2,010 |
1,751 |
$46.90 |
| 95886 |
|
434 |
426 |
$45.47 |
| 94726 |
|
42 |
40 |
$36.09 |
| J1790 |
Injection, droperidol, up to 5 mg |
16 |
14 |
$35.53 |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
13 |
13 |
$33.34 |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
13 |
13 |
$33.34 |
| G0378 |
Hospital observation service, per hour |
352 |
335 |
$28.74 |
| 81003 |
|
1,063 |
1,022 |
$21.41 |
| Q9966 |
Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml |
196 |
187 |
$21.01 |
| 87633 |
Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets |
529 |
506 |
$15.73 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
39 |
37 |
$15.42 |
| 80320 |
|
49 |
43 |
$13.62 |
| 83605 |
|
808 |
726 |
$12.86 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
149 |
74 |
$10.19 |
| 82962 |
|
39 |
28 |
$9.36 |
| 99153 |
Mod sedat endo service >5yrs |
522 |
492 |
$7.01 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
28 |
27 |
$4.16 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
13 |
13 |
$4.07 |
| 64643 |
|
935 |
797 |
$0.00 |
| 93325 |
|
204 |
186 |
$0.00 |
| 76821 |
|
36 |
28 |
$0.00 |
| D1999 |
|
488 |
474 |
$0.00 |
| 93321 |
|
104 |
100 |
$0.00 |
| 98926 |
|
22 |
17 |
$0.00 |
| 80179 |
|
13 |
13 |
$0.00 |
| 94729 |
|
55 |
53 |
$0.00 |
| 76827 |
|
20 |
14 |
$0.00 |
| 98927 |
|
14 |
14 |
$0.00 |
| 80143 |
|
13 |
13 |
$0.00 |
| 82077 |
|
102 |
98 |
$0.00 |
| 0352U |
|
45 |
43 |
$0.00 |
| Q9965 |
Low osmolar contrast material, 100-199 mg/ml iodine concentration, per ml |
1,242 |
1,192 |
$0.00 |
| 64645 |
|
37 |
26 |
$0.00 |
| 76820 |
|
36 |
28 |
$0.00 |
| A9270 |
Non-covered item or service |
549 |
173 |
$0.00 |
| 82803 |
|
27 |
25 |
$0.00 |
| 83735 |
|
25 |
24 |
$0.00 |
| 82728 |
|
12 |
12 |
$0.00 |
| 96376 |
|
13 |
12 |
$0.00 |
| 36416 |
|
26 |
24 |
$0.00 |
| 98928 |
|
12 |
12 |
$0.00 |
| 85379 |
|
25 |
25 |
$0.00 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
14 |
13 |
$0.00 |