| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| G0378 |
Hospital observation service, per hour |
1,676 |
1,462 |
$2.41M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
8,290 |
7,838 |
$1.55M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
4,586 |
4,396 |
$960K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
2,871 |
2,719 |
$498K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
1,263 |
1,194 |
$244K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
2,864 |
2,662 |
$176K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
723 |
700 |
$141K |
| 45378 |
Colonoscopy, flexible; diagnostic, including collection of specimen(s) |
72 |
70 |
$112K |
| S5000 |
Prescription drug, generic |
11,174 |
4,479 |
$97K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
83 |
77 |
$90K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
774 |
765 |
$86K |
| 62323 |
|
131 |
125 |
$82K |
| T1015 |
Clinic visit/encounter, all-inclusive |
1,092 |
880 |
$67K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
473 |
470 |
$66K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
653 |
577 |
$47K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
135 |
126 |
$47K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
465 |
439 |
$45K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
780 |
556 |
$45K |
| 99215 |
Prolong outpt/office vis |
381 |
324 |
$44K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
7,662 |
6,098 |
$34K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
383 |
354 |
$30K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
146 |
140 |
$29K |
| 36415 |
Collection of venous blood by venipuncture |
1,676 |
1,378 |
$27K |
| 76801 |
|
451 |
442 |
$27K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
182 |
114 |
$26K |
| 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 |
1,296 |
1,191 |
$26K |
| 76830 |
Ultrasound, transvaginal |
421 |
405 |
$23K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
774 |
765 |
$22K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
512 |
302 |
$21K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
273 |
270 |
$20K |
| 59025 |
Fetal non-stress test |
1,504 |
751 |
$20K |
| 80053 |
Comprehensive metabolic panel |
2,987 |
2,465 |
$20K |
| 76813 |
|
262 |
260 |
$20K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
228 |
224 |
$17K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
52 |
52 |
$16K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
228 |
200 |
$15K |
| 76642 |
|
202 |
174 |
$12K |
| 76536 |
|
161 |
154 |
$11K |
| 77066 |
Tomosynthesis, mammo |
93 |
89 |
$9K |
| 71250 |
|
144 |
132 |
$9K |
| 72141 |
|
28 |
27 |
$9K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
2,317 |
2,017 |
$9K |
| 70450 |
Computed tomography, head or brain; without contrast material |
399 |
368 |
$9K |
| 71046 |
Radiologic examination, chest; 2 views |
884 |
824 |
$8K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
149 |
135 |
$7K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
100 |
97 |
$7K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
214 |
205 |
$7K |
| 73564 |
|
286 |
218 |
$7K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
27 |
27 |
$6K |
| 85027 |
|
1,412 |
1,082 |
$6K |
| 77065 |
Tomosynthesis, mammo |
72 |
66 |
$6K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
655 |
594 |
$6K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
2,003 |
1,563 |
$6K |
| 73030 |
|
310 |
267 |
$5K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
494 |
343 |
$5K |
| 83880 |
|
215 |
194 |
$5K |
| 95886 |
|
75 |
72 |
$4K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
38 |
37 |
$4K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
278 |
259 |
$3K |
| 73610 |
|
177 |
162 |
$3K |
| 77080 |
|
48 |
47 |
$3K |
| 72110 |
|
113 |
109 |
$3K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
30 |
29 |
$3K |
| 73630 |
|
253 |
216 |
$3K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
27 |
26 |
$3K |
| 93971 |
|
80 |
72 |
$3K |
| 82248 |
|
1,056 |
916 |
$3K |
| 76770 |
|
47 |
47 |
$3K |
| 84443 |
Thyroid stimulating hormone (TSH) |
249 |
227 |
$3K |
| 86850 |
|
326 |
302 |
$3K |
| 71045 |
Radiologic examination, chest; single view |
758 |
704 |
$3K |
| 73130 |
|
217 |
176 |
$3K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
309 |
224 |
$3K |
| 96367 |
|
57 |
40 |
$2K |
| 83735 |
|
1,712 |
1,441 |
$2K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
27 |
27 |
$2K |
| 72114 |
|
77 |
69 |
$2K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
575 |
443 |
$2K |
| Q3014 |
Telehealth originating site facility fee |
148 |
141 |
$2K |
| 84484 |
|
1,072 |
895 |
$2K |
| G0399 |
Home sleep test (hst) with type iii portable monitor, unattended; minimum of 4 channels: 2 respiratory movement/airflow, 1 ecg/heart rate and 1 oxygen saturation |
12 |
12 |
$2K |
| J3490 |
Unclassified drugs |
787 |
598 |
$2K |
| 84100 |
|
1,583 |
1,351 |
$2K |
| J1170 |
Injection, hydromorphone, up to 4 mg |
404 |
279 |
$2K |
| 73110 |
|
115 |
98 |
$1K |
| 73502 |
|
64 |
61 |
$1K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
85 |
81 |
$1K |
| 77062 |
|
38 |
38 |
$1K |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
861 |
784 |
$1K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
352 |
319 |
$1K |
| 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 |
842 |
776 |
$1K |
| 85610 |
|
754 |
655 |
$1K |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
217 |
212 |
$1K |
| 85730 |
|
506 |
451 |
$1K |
| 84702 |
|
102 |
86 |
$994.26 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
775 |
706 |
$983.71 |
| 86900 |
|
422 |
392 |
$982.28 |
| 76819 |
Fetal biophysical profile; without non-stress testing |
13 |
13 |
$945.29 |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
326 |
277 |
$912.50 |
| 96376 |
|
271 |
212 |
$896.22 |
| 70496 |
|
12 |
12 |
$887.04 |
| 72040 |
|
47 |
47 |
$882.39 |
| 83690 |
|
769 |
688 |
$862.69 |
| 81001 |
|
785 |
723 |
$789.61 |
| C1769 |
Guide wire |
70 |
61 |
$767.93 |
| 81003 |
|
749 |
690 |
$702.86 |
| 73562 |
|
33 |
24 |
$653.57 |
| 76820 |
|
22 |
13 |
$649.17 |
| 76775 |
|
16 |
15 |
$609.31 |
| 99241 |
|
12 |
12 |
$591.10 |
| 86901 |
|
366 |
340 |
$589.85 |
| 82962 |
|
1,174 |
842 |
$587.10 |
| 72125 |
Computed tomography, cervical spine; without contrast material |
46 |
43 |
$560.04 |
| A9577 |
Injection, gadobenate dimeglumine (multihance), per ml |
266 |
249 |
$443.90 |
| J2704 |
Injection, propofol, 10 mg |
1,639 |
1,498 |
$430.11 |
| 84703 |
|
166 |
160 |
$422.21 |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
22 |
12 |
$419.80 |
| 76000 |
|
26 |
26 |
$367.06 |
| 83605 |
|
271 |
238 |
$355.44 |
| 82247 |
|
35 |
25 |
$350.72 |
| 77061 |
|
13 |
12 |
$341.14 |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
14 |
14 |
$312.40 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
1,126 |
882 |
$305.18 |
| 82728 |
|
49 |
46 |
$299.17 |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
38 |
37 |
$287.38 |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
12 |
12 |
$285.26 |
| 96361 |
Intravenous infusion, hydration; each additional hour |
30 |
27 |
$283.22 |
| 73560 |
|
24 |
16 |
$246.95 |
| 80061 |
Lipid panel |
68 |
67 |
$246.82 |
| 72100 |
|
14 |
12 |
$241.16 |
| 83540 |
|
52 |
50 |
$199.07 |
| 81025 |
|
870 |
806 |
$192.74 |
| 74018 |
|
16 |
13 |
$189.88 |
| 82607 |
|
46 |
43 |
$172.97 |
| 80320 |
|
64 |
61 |
$169.85 |
| 73080 |
|
16 |
13 |
$157.60 |
| 72020 |
|
22 |
20 |
$157.40 |
| 73590 |
|
13 |
12 |
$152.32 |
| 88342 |
|
25 |
25 |
$146.60 |
| J1644 |
Injection, heparin sodium, per 1000 units |
265 |
157 |
$136.30 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
512 |
391 |
$120.97 |
| 83550 |
|
41 |
38 |
$105.22 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
1,540 |
1,324 |
$100.56 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
657 |
552 |
$91.76 |
| 82746 |
|
16 |
13 |
$74.02 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
1,308 |
1,213 |
$62.74 |
| 87205 |
|
44 |
37 |
$59.88 |
| 87186 |
|
29 |
26 |
$58.96 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
233 |
179 |
$41.78 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
1,808 |
1,590 |
$39.61 |
| 82550 |
|
38 |
31 |
$35.95 |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
302 |
275 |
$35.64 |
| 87070 |
|
15 |
12 |
$32.10 |
| 87040 |
|
15 |
13 |
$28.00 |
| 85652 |
|
25 |
24 |
$25.51 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
1,311 |
1,240 |
$20.86 |
| J2710 |
Injection, neostigmine methylsulfate, up to 0.5 mg |
29 |
24 |
$17.50 |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
81 |
75 |
$15.34 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
277 |
242 |
$6.33 |
| J2060 |
Injection, lorazepam, 2 mg |
46 |
28 |
$1.21 |
| 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 |
167 |
151 |
$0.00 |
| J2370 |
Injection, phenylephrine hcl, up to 1 ml |
32 |
29 |
$0.00 |
| J7050 |
Infusion, normal saline solution, 250 cc |
90 |
89 |
$0.00 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
16 |
12 |
$0.00 |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
171 |
157 |
$0.00 |
| J1815 |
Injection, insulin, per 5 units |
38 |
18 |
$0.00 |
| J1756 |
Injection, iron sucrose, 1 mg |
446 |
191 |
$0.00 |
| S0028 |
Injection, famotidine, 20 mg |
38 |
36 |
$0.00 |
| J1171 |
Injection, hydromorphone, 0.1 mg |
23 |
18 |
$0.00 |