| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
105,754 |
93,557 |
$10.46M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
72,229 |
60,503 |
$2.33M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
19,508 |
16,853 |
$2.16M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
40,538 |
34,655 |
$2.10M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
8,955 |
7,654 |
$903K |
| 92507 |
Treatment of speech, language, voice, communication, and/or auditory processing disorder |
9,525 |
1,681 |
$743K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
8,439 |
1,431 |
$495K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
6,815 |
5,328 |
$494K |
| 36415 |
Collection of venous blood by venipuncture |
30,802 |
26,233 |
$413K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
6,629 |
5,844 |
$278K |
| 99215 |
Prolong outpt/office vis |
2,785 |
2,422 |
$229K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
3,705 |
3,085 |
$219K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
2,907 |
2,447 |
$205K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
2,177 |
1,955 |
$194K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
3,192 |
2,559 |
$185K |
| 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 |
2,758 |
2,569 |
$185K |
| 99309 |
Subsequent nursing facility care, per day, low to moderate complexity |
2,771 |
2,482 |
$179K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
8,458 |
7,958 |
$176K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
1,137 |
946 |
$174K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
3,030 |
2,735 |
$156K |
| C9803 |
Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
4,435 |
4,097 |
$135K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
2,737 |
2,530 |
$130K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
1,074 |
943 |
$127K |
| 80053 |
Comprehensive metabolic panel |
14,584 |
12,395 |
$122K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,969 |
1,783 |
$109K |
| 64450 |
|
478 |
241 |
$101K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
3,093 |
2,973 |
$97K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
6,761 |
6,509 |
$97K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
5,238 |
4,681 |
$93K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
1,297 |
1,137 |
$76K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
1,072 |
927 |
$73K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
2,695 |
2,464 |
$73K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
4,713 |
4,417 |
$72K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
4,872 |
4,728 |
$68K |
| V2020 |
Frames, purchases |
2,515 |
2,104 |
$68K |
| 92015 |
Determination of refractive state |
5,455 |
5,145 |
$61K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
1,018 |
929 |
$58K |
| 64405 |
|
478 |
241 |
$56K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
674 |
591 |
$55K |
| 0202U |
Oncology (prostate), multianalyte, gene expression profiling |
158 |
151 |
$55K |
| 70450 |
Computed tomography, head or brain; without contrast material |
1,569 |
1,412 |
$55K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
15,941 |
13,384 |
$53K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
657 |
614 |
$50K |
| S0281 |
Medical home program, comprehensive care coordination and planning, maintenance of plan |
2,889 |
2,846 |
$49K |
| X5622 |
|
1,972 |
1,871 |
$47K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
846 |
810 |
$46K |
| 20553 |
|
617 |
313 |
$44K |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
7,777 |
6,377 |
$41K |
| 97535 |
Self-care/home management training, each 15 minutes |
729 |
232 |
$41K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,131 |
1,856 |
$40K |
| 59025 |
Fetal non-stress test |
508 |
176 |
$39K |
| 99308 |
Subsequent nursing facility care, per day, straightforward |
948 |
787 |
$39K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
4,303 |
4,118 |
$36K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
558 |
432 |
$35K |
| 71046 |
Radiologic examination, chest; 2 views |
5,092 |
4,492 |
$31K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
3,139 |
2,730 |
$31K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
208 |
141 |
$31K |
| 99310 |
Prolong nursin fac eval 15m |
395 |
349 |
$29K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
1,153 |
1,106 |
$27K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
255 |
248 |
$26K |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
525 |
203 |
$26K |
| 71045 |
Radiologic examination, chest; single view |
2,866 |
2,431 |
$23K |
| 94010 |
|
200 |
108 |
$21K |
| 99239 |
Hospital discharge day management, more than 30 minutes |
295 |
267 |
$21K |
| 92551 |
|
3,024 |
2,871 |
$18K |
| 96127 |
|
845 |
804 |
$18K |
| Q3014 |
Telehealth originating site facility fee |
1,486 |
1,384 |
$18K |
| 20610 |
|
370 |
293 |
$17K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
968 |
782 |
$17K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
808 |
707 |
$15K |
| 87633 |
Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets |
112 |
110 |
$14K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
635 |
613 |
$12K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
326 |
290 |
$12K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
263 |
94 |
$12K |
| 90662 |
|
250 |
241 |
$11K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
64 |
25 |
$10K |
| 80061 |
Lipid panel |
1,109 |
1,047 |
$10K |
| 95117 |
|
353 |
172 |
$10K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
412 |
383 |
$9K |
| 99223 |
Prolong inpt eval add15 m |
99 |
90 |
$9K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
390 |
363 |
$8K |
| 99188 |
|
1,782 |
1,735 |
$8K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
64 |
59 |
$8K |
| G0123 |
Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, screening by cytotechnologist under physician supervision |
386 |
376 |
$7K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
911 |
747 |
$7K |
| 88342 |
|
204 |
181 |
$7K |
| 84484 |
|
1,870 |
1,563 |
$7K |
| 90686 |
|
2,101 |
1,913 |
$6K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
101 |
93 |
$6K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
882 |
771 |
$5K |
| 76830 |
Ultrasound, transvaginal |
238 |
219 |
$5K |
| 99380 |
|
440 |
429 |
$5K |
| 73564 |
|
771 |
602 |
$5K |
| 99379 |
|
237 |
148 |
$5K |
| G0008 |
Administration of influenza virus vaccine |
391 |
376 |
$5K |
| 0001A |
|
216 |
208 |
$5K |
| 0002A |
|
203 |
194 |
$5K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
137 |
127 |
$5K |
| 84443 |
Thyroid stimulating hormone (TSH) |
368 |
349 |
$4K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
66 |
62 |
$4K |
| G0476 |
Infectious agent detection by nucleic acid (dna or rna); human papillomavirus (hpv), high-risk types (e.g., 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68) for cervical cancer screening, must be performed in addition to pap test |
143 |
139 |
$4K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
100 |
88 |
$3K |
| 82728 |
|
295 |
289 |
$3K |
| 73630 |
|
664 |
556 |
$3K |
| 99173 |
|
2,820 |
2,688 |
$3K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
259 |
248 |
$3K |
| 88307 |
|
45 |
40 |
$3K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
546 |
521 |
$3K |
| 11721 |
|
153 |
116 |
$3K |
| 88304 |
|
284 |
263 |
$3K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
21 |
12 |
$3K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
103 |
89 |
$3K |
| 91322 |
|
43 |
43 |
$3K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
111 |
106 |
$3K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
67 |
66 |
$3K |
| 99233 |
Prolong inpt eval add15 m |
79 |
26 |
$3K |
| 11719 |
|
304 |
233 |
$3K |
| 92557 |
|
35 |
24 |
$2K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
72 |
68 |
$2K |
| 17110 |
|
52 |
50 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
540 |
454 |
$2K |
| 11102 |
|
26 |
15 |
$2K |
| 85060 |
|
96 |
76 |
$2K |
| 90474 |
|
577 |
557 |
$2K |
| 83550 |
|
278 |
271 |
$2K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
32 |
30 |
$2K |
| J0702 |
Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg |
287 |
259 |
$2K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
112 |
82 |
$2K |
| 83540 |
|
278 |
271 |
$2K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
13 |
12 |
$2K |
| 73610 |
|
358 |
304 |
$2K |
| 85018 |
|
186 |
172 |
$1K |
| 99217 |
|
29 |
25 |
$1K |
| 92593 |
|
31 |
27 |
$1K |
| 99442 |
|
79 |
41 |
$1K |
| 83655 |
|
127 |
123 |
$1K |
| 11720 |
|
114 |
81 |
$1K |
| 90480 |
|
51 |
51 |
$1K |
| 93975 |
|
42 |
39 |
$1K |
| 90715 |
|
316 |
301 |
$1K |
| 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) |
187 |
172 |
$1K |
| 86003 |
|
13 |
13 |
$1K |
| 81001 |
|
1,224 |
1,110 |
$1K |
| 92567 |
|
68 |
50 |
$1K |
| 84703 |
|
384 |
360 |
$1K |
| 90670 |
|
1,126 |
1,085 |
$1K |
| 36591 |
|
54 |
25 |
$1K |
| 86592 |
|
107 |
103 |
$993.14 |
| 73030 |
|
189 |
157 |
$992.17 |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
312 |
292 |
$963.06 |
| 80306 |
|
244 |
186 |
$942.13 |
| 87634 |
|
43 |
43 |
$928.32 |
| 76801 |
|
28 |
26 |
$918.19 |
| 99383 |
|
14 |
13 |
$887.90 |
| 99238 |
Hospital discharge day management, 30 minutes or less |
16 |
12 |
$885.15 |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
79 |
70 |
$856.43 |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
113 |
110 |
$852.45 |
| 73110 |
|
157 |
116 |
$777.19 |
| 92002 |
|
12 |
12 |
$736.44 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
101 |
90 |
$712.60 |
| 99443 |
|
55 |
18 |
$669.26 |
| 0124A |
|
31 |
30 |
$668.79 |
| 41899 |
Unlisted procedure, dentoalveolar structures |
24 |
24 |
$667.16 |
| G0279 |
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) |
38 |
37 |
$656.48 |
| 95004 |
Percutaneous tests with allergenic extracts, immediate type reaction |
22 |
12 |
$655.71 |
| A9270 |
Non-covered item or service |
1,699 |
1,538 |
$588.87 |
| G0108 |
Diabetes outpatient self-management training services, individual, per 30 minutes |
13 |
12 |
$575.01 |
| 76642 |
|
29 |
25 |
$571.22 |
| P3000 |
Screening papanicolaou smear, cervical or vaginal, up to three smears, by technician under physician supervision |
52 |
51 |
$553.76 |
| G0148 |
Screening cytopathology smears, cervical or vaginal, performed by automated system with manual rescreening |
25 |
25 |
$522.30 |
| 85610 |
|
154 |
98 |
$512.48 |
| J2704 |
Injection, propofol, 10 mg |
106 |
91 |
$494.61 |
| 90673 |
|
13 |
13 |
$471.86 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
369 |
316 |
$464.98 |
| 83690 |
|
318 |
282 |
$463.52 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
100 |
87 |
$384.39 |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
14 |
12 |
$364.63 |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
16 |
16 |
$350.25 |
| 90656 |
|
67 |
67 |
$322.50 |
| 86850 |
|
13 |
13 |
$312.46 |
| 87581 |
|
112 |
110 |
$292.55 |
| 87486 |
|
112 |
110 |
$286.44 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
442 |
398 |
$270.57 |
| 83605 |
|
58 |
50 |
$265.14 |
| 74019 |
|
63 |
53 |
$262.39 |
| 85027 |
|
232 |
201 |
$260.80 |
| G0127 |
Trimming of dystrophic nails, any number |
17 |
12 |
$254.12 |
| 82077 |
|
26 |
24 |
$245.85 |
| 86900 |
|
12 |
12 |
$245.41 |
| 81003 |
|
540 |
506 |
$229.42 |
| 90682 |
|
13 |
13 |
$222.44 |
| 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 |
65 |
57 |
$219.96 |
| 93971 |
|
14 |
14 |
$218.94 |
| 86901 |
|
12 |
12 |
$197.35 |
| 93016 |
|
14 |
14 |
$193.34 |
| 86738 |
|
25 |
25 |
$167.60 |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
13 |
12 |
$147.41 |
| 82607 |
|
13 |
12 |
$146.36 |
| 99490 |
Ccm add 20min |
12 |
12 |
$134.88 |
| 91312 |
|
21 |
20 |
$130.05 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
14 |
14 |
$123.62 |
| 90734 |
|
210 |
201 |
$118.64 |
| 93018 |
|
14 |
14 |
$118.36 |
| 81025 |
|
13 |
13 |
$117.36 |
| 91300 |
|
14 |
14 |
$104.04 |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
13 |
12 |
$96.74 |
| 90680 |
|
495 |
472 |
$91.65 |
| 90648 |
|
1,186 |
1,126 |
$90.30 |
| 90707 |
|
78 |
76 |
$76.54 |
| 90723 |
|
731 |
690 |
$76.06 |
| 85007 |
|
101 |
93 |
$69.04 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
56 |
39 |
$66.46 |
| 90633 |
|
666 |
655 |
$63.79 |
| 86308 |
|
12 |
12 |
$63.24 |
| 74018 |
|
12 |
12 |
$62.16 |
| 73562 |
|
13 |
12 |
$55.70 |
| 51741 |
|
16 |
14 |
$54.31 |
| 51798 |
|
29 |
24 |
$52.25 |
| 86803 |
|
27 |
25 |
$43.05 |
| 85651 |
|
16 |
14 |
$31.64 |
| 83735 |
|
12 |
12 |
$25.23 |
| 36416 |
|
38 |
37 |
$15.68 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
28 |
14 |
$13.08 |
| 87186 |
|
27 |
26 |
$0.00 |
| 90710 |
|
145 |
141 |
$0.00 |
| 90685 |
|
122 |
119 |
$0.00 |
| 90700 |
|
70 |
69 |
$0.00 |
| 00170 |
Anesthesia for intraoral procedures, including biopsy |
15 |
13 |
$0.00 |
| 99201 |
|
13 |
13 |
$0.00 |
| G1004 |
Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program |
16 |
16 |
$0.00 |
| 92341 |
|
13 |
13 |
$0.00 |
| L3908 |
Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf |
15 |
12 |
$0.00 |
| 12001 |
|
13 |
13 |
$0.00 |
| 90716 |
|
73 |
71 |
$0.00 |
| 90677 |
|
52 |
41 |
$0.00 |
| 1157F |
|
27 |
22 |
$0.00 |
| 90696 |
|
78 |
75 |
$0.00 |
| 90651 |
|
136 |
128 |
$0.00 |
| 87077 |
|
27 |
26 |
$0.00 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
25 |
25 |
$0.00 |