| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
6,795 |
5,455 |
$1.12M |
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
5,784 |
1,067 |
$938K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
23,994 |
18,415 |
$924K |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
5,266 |
4,173 |
$772K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
15,905 |
10,169 |
$692K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
4,387 |
3,170 |
$578K |
| 90834 |
Psychotherapy, 45 minutes with patient |
6,995 |
3,452 |
$500K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
1,132 |
923 |
$497K |
| 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 |
5,673 |
5,041 |
$413K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
2,150 |
1,802 |
$297K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
810 |
692 |
$213K |
| 99215 |
Prolong outpt/office vis |
3,228 |
2,280 |
$156K |
| 97597 |
|
1,721 |
469 |
$139K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
638 |
415 |
$111K |
| 70450 |
Computed tomography, head or brain; without contrast material |
274 |
245 |
$82K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
2,124 |
1,257 |
$76K |
| C9803 |
Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
3,606 |
3,245 |
$73K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
2,136 |
1,926 |
$66K |
| 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 |
4,088 |
3,585 |
$50K |
| 96127 |
|
6,145 |
4,811 |
$49K |
| 71046 |
Radiologic examination, chest; 2 views |
1,872 |
1,662 |
$39K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
5,738 |
4,709 |
$38K |
| 80053 |
Comprehensive metabolic panel |
4,542 |
3,755 |
$37K |
| H0005 |
Alcohol and/or drug services; group counseling by a clinician |
190 |
38 |
$35K |
| 90791 |
Psychiatric diagnostic evaluation |
407 |
336 |
$32K |
| 73630 |
|
793 |
627 |
$30K |
| 84443 |
Thyroid stimulating hormone (TSH) |
2,393 |
2,173 |
$30K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
2,601 |
896 |
$30K |
| 90832 |
Psychotherapy, 30 minutes with patient |
470 |
249 |
$29K |
| 85610 |
|
4,356 |
2,506 |
$28K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
5,452 |
4,346 |
$25K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,323 |
1,226 |
$24K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
355 |
308 |
$23K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
1,007 |
902 |
$22K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
315 |
182 |
$20K |
| 85027 |
|
5,011 |
4,169 |
$19K |
| 80061 |
Lipid panel |
1,776 |
1,628 |
$18K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
441 |
384 |
$16K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
3,494 |
2,960 |
$16K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
2,395 |
2,215 |
$15K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
495 |
434 |
$15K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
216 |
156 |
$14K |
| 81025 |
|
1,777 |
1,568 |
$14K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
468 |
408 |
$14K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
68 |
25 |
$13K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
1,566 |
1,355 |
$12K |
| 90686 |
|
988 |
935 |
$11K |
| 81001 |
|
3,633 |
3,085 |
$11K |
| 92551 |
|
402 |
392 |
$10K |
| 84484 |
|
2,182 |
1,570 |
$10K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
889 |
734 |
$8K |
| 83605 |
|
1,660 |
1,257 |
$8K |
| 83735 |
|
2,288 |
1,833 |
$8K |
| 36415 |
Collection of venous blood by venipuncture |
15,102 |
11,964 |
$7K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
287 |
267 |
$7K |
| 71045 |
Radiologic examination, chest; single view |
1,006 |
866 |
$7K |
| 82248 |
|
2,858 |
2,328 |
$6K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,552 |
1,459 |
$6K |
| 83690 |
|
1,362 |
1,139 |
$5K |
| 80076 |
|
590 |
449 |
$5K |
| 86140 |
|
1,650 |
1,326 |
$5K |
| 36592 |
|
1,453 |
1,239 |
$5K |
| 99233 |
Prolong inpt eval add15 m |
296 |
105 |
$5K |
| 73562 |
|
102 |
83 |
$4K |
| 87070 |
|
677 |
597 |
$4K |
| 87077 |
|
766 |
696 |
$4K |
| 0011A |
|
113 |
108 |
$4K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
73 |
65 |
$4K |
| 0012A |
|
98 |
97 |
$4K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
47 |
38 |
$4K |
| 87186 |
|
717 |
637 |
$3K |
| 87081 |
|
268 |
252 |
$3K |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
208 |
61 |
$3K |
| 99173 |
|
184 |
178 |
$3K |
| 81003 |
|
939 |
829 |
$3K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
1,575 |
1,266 |
$2K |
| 83880 |
|
198 |
163 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
47 |
46 |
$2K |
| 80306 |
|
213 |
186 |
$2K |
| 36416 |
|
1,781 |
989 |
$2K |
| 82565 |
|
641 |
557 |
$2K |
| 87480 |
|
75 |
66 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
40 |
40 |
$2K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
23 |
13 |
$2K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
44 |
40 |
$2K |
| 99309 |
Subsequent nursing facility care, per day, low to moderate complexity |
84 |
50 |
$2K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
15 |
13 |
$2K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
14 |
12 |
$2K |
| 90670 |
|
55 |
54 |
$2K |
| 82947 |
|
651 |
451 |
$2K |
| 82077 |
|
194 |
166 |
$2K |
| 99205 |
Prolong outpt/office vis |
36 |
25 |
$2K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
90 |
73 |
$2K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
156 |
66 |
$2K |
| 87088 |
|
244 |
210 |
$2K |
| 85018 |
|
588 |
535 |
$1K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
23 |
13 |
$1K |
| 73030 |
|
33 |
27 |
$1K |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
42 |
39 |
$1K |
| 87637 |
Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV |
30 |
24 |
$1K |
| 0064A |
|
61 |
50 |
$1K |
| 87660 |
|
75 |
66 |
$1K |
| 99239 |
Hospital discharge day management, more than 30 minutes |
14 |
12 |
$1K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
13 |
13 |
$991.40 |
| 87040 |
|
257 |
126 |
$910.86 |
| 87510 |
|
75 |
66 |
$787.36 |
| G0123 |
Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, screening by cytotechnologist under physician supervision |
48 |
40 |
$739.87 |
| G2012 |
Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related e/m service provided within the previous 7 days nor leading to an e/m service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion |
399 |
334 |
$713.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
62 |
50 |
$689.91 |
| 90715 |
|
14 |
14 |
$679.30 |
| 84460 |
|
235 |
218 |
$664.18 |
| 84145 |
|
61 |
54 |
$620.22 |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
31 |
29 |
$599.60 |
| 90647 |
|
12 |
12 |
$555.69 |
| 87205 |
|
318 |
281 |
$549.74 |
| 88142 |
|
27 |
24 |
$533.61 |
| 86803 |
|
42 |
37 |
$501.50 |
| 87210 |
|
94 |
87 |
$470.50 |
| 82570 |
|
129 |
117 |
$438.42 |
| 99310 |
Prolong nursin fac eval 15m |
35 |
27 |
$419.15 |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
13 |
12 |
$398.86 |
| 85379 |
|
59 |
55 |
$357.68 |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
754 |
677 |
$285.99 |
| J7030 |
Infusion, normal saline solution , 1000 cc |
4,641 |
2,830 |
$278.08 |
| 84466 |
|
26 |
25 |
$263.60 |
| 86850 |
|
29 |
25 |
$231.46 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
140 |
129 |
$221.47 |
| 87075 |
|
87 |
81 |
$220.56 |
| G0103 |
Prostate cancer screening; prostate specific antigen test (psa) |
13 |
12 |
$219.45 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
1,897 |
1,486 |
$189.32 |
| 84132 |
|
28 |
25 |
$161.77 |
| G0008 |
Administration of influenza virus vaccine |
237 |
227 |
$161.35 |
| 83540 |
|
27 |
26 |
$156.49 |
| 96375 |
Therapeutic injection; each additional sequential IV push |
891 |
713 |
$129.58 |
| 85652 |
|
72 |
65 |
$115.78 |
| 86780 |
|
14 |
13 |
$111.30 |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
854 |
722 |
$102.94 |
| 99334 |
|
24 |
13 |
$93.86 |
| 86901 |
|
43 |
37 |
$93.12 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
970 |
833 |
$81.65 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
1,023 |
596 |
$76.74 |
| 80050 |
General health panel |
15 |
14 |
$68.90 |
| J7050 |
Infusion, normal saline solution, 250 cc |
480 |
259 |
$63.25 |
| 85730 |
|
42 |
30 |
$62.10 |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
24 |
12 |
$61.80 |
| 86900 |
|
29 |
25 |
$55.32 |
| 82043 |
|
12 |
12 |
$41.79 |
| 84450 |
|
14 |
12 |
$31.93 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
1,577 |
1,257 |
$14.00 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
84 |
81 |
$12.28 |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
72 |
52 |
$12.12 |
| A9270 |
Non-covered item or service |
3,832 |
1,433 |
$3.22 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
101 |
54 |
$0.45 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
311 |
215 |
$0.41 |
| G1004 |
Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program |
1,217 |
1,056 |
$0.02 |
| J1642 |
Injection, heparin sodium, (heparin lock flush), per 10 units |
78 |
38 |
$0.00 |
| 0352U |
|
30 |
26 |
$0.00 |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
34 |
16 |
$0.00 |
| 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 |
43 |
32 |
$0.00 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
15 |
15 |
$0.00 |
| 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) |
121 |
107 |
$0.00 |
| 99354 |
|
20 |
12 |
$0.00 |