| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
Emergency department visit for the evaluation and management, high severity |
24,403 |
22,246 |
$19.60M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
66,247 |
63,927 |
$6.75M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
2,692 |
2,481 |
$4.65M |
| 87428 |
|
22,824 |
22,260 |
$1.49M |
| 41899 |
Unlisted procedure, dentoalveolar structures |
706 |
679 |
$1.31M |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
17,273 |
16,905 |
$1.27M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
7,186 |
6,649 |
$812K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
14,801 |
13,941 |
$687K |
| 71045 |
Radiologic examination, chest; single view |
13,756 |
12,910 |
$677K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
15,804 |
15,452 |
$665K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
3,902 |
3,480 |
$494K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
11,086 |
5,445 |
$465K |
| 92507 |
Treatment of speech, language, voice, communication, and/or auditory processing disorder |
3,280 |
716 |
$445K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
6,443 |
5,849 |
$437K |
| 80053 |
Comprehensive metabolic panel |
23,379 |
21,247 |
$358K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
1,168 |
1,117 |
$351K |
| 42820 |
Tonsillectomy and adenoidectomy; younger than age 12 |
79 |
78 |
$338K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
28,828 |
25,079 |
$312K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
1,539 |
378 |
$272K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
181 |
174 |
$253K |
| 87081 |
|
12,777 |
12,526 |
$202K |
| G0378 |
Hospital observation service, per hour |
377 |
338 |
$148K |
| 70450 |
Computed tomography, head or brain; without contrast material |
1,639 |
1,540 |
$133K |
| 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 |
907 |
894 |
$124K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
1,102 |
492 |
$119K |
| 81025 |
|
7,553 |
7,085 |
$119K |
| 69436 |
Tympanostomy (requiring insertion of ventilating tube), general anesthesia |
96 |
88 |
$110K |
| 81001 |
|
20,993 |
19,733 |
$107K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
125 |
121 |
$105K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
1,362 |
1,251 |
$86K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
665 |
659 |
$67K |
| 87807 |
|
1,629 |
1,612 |
$67K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
1,061 |
1,013 |
$64K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
1,061 |
1,013 |
$64K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
690 |
131 |
$58K |
| 83880 |
|
2,079 |
1,877 |
$58K |
| 84484 |
|
4,840 |
3,224 |
$51K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
1,027 |
908 |
$47K |
| 87430 |
|
2,369 |
2,278 |
$47K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
10,413 |
8,706 |
$46K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
258 |
243 |
$44K |
| 86850 |
|
657 |
626 |
$43K |
| 71046 |
Radiologic examination, chest; 2 views |
789 |
763 |
$38K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
798 |
687 |
$32K |
| 87420 |
|
993 |
975 |
$27K |
| 87800 |
|
337 |
318 |
$26K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
348 |
280 |
$24K |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
798 |
578 |
$23K |
| 83690 |
|
2,793 |
2,578 |
$23K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
662 |
634 |
$23K |
| 73610 |
|
228 |
201 |
$22K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
646 |
640 |
$22K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
899 |
822 |
$18K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
70 |
64 |
$18K |
| 84443 |
Thyroid stimulating hormone (TSH) |
1,651 |
1,617 |
$16K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
2,205 |
2,071 |
$16K |
| 73630 |
|
237 |
201 |
$15K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
139 |
132 |
$14K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
228 |
219 |
$14K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
2,617 |
2,176 |
$14K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
2,569 |
2,359 |
$13K |
| 86780 |
|
585 |
553 |
$12K |
| 82805 |
|
216 |
184 |
$11K |
| 80061 |
Lipid panel |
1,761 |
1,722 |
$11K |
| 83605 |
|
1,161 |
943 |
$10K |
| C9803 |
Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
428 |
399 |
$9K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
1,774 |
1,750 |
$8K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
468 |
430 |
$8K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
2,379 |
2,086 |
$8K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
91 |
52 |
$8K |
| 73030 |
|
174 |
153 |
$8K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
294 |
284 |
$6K |
| 84702 |
|
544 |
441 |
$6K |
| 73562 |
|
110 |
99 |
$6K |
| 81003 |
|
1,703 |
1,562 |
$6K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
30 |
27 |
$6K |
| 73502 |
|
148 |
136 |
$5K |
| 87040 |
|
718 |
421 |
$5K |
| 87186 |
|
1,061 |
971 |
$5K |
| 72100 |
|
99 |
98 |
$5K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
119 |
116 |
$5K |
| 80320 |
|
211 |
175 |
$5K |
| 82077 |
|
279 |
248 |
$4K |
| 74018 |
|
144 |
139 |
$4K |
| 83735 |
|
1,141 |
959 |
$4K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
117 |
26 |
$4K |
| 85610 |
|
1,337 |
1,206 |
$4K |
| 80329 |
|
76 |
63 |
$4K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
12 |
12 |
$4K |
| 11721 |
|
249 |
248 |
$3K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
1,509 |
1,037 |
$3K |
| J0360 |
Injection, hydralazine hcl, up to 20 mg |
36 |
25 |
$3K |
| J1644 |
Injection, heparin sodium, per 1000 units |
532 |
196 |
$3K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
1,644 |
1,543 |
$3K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
788 |
768 |
$3K |
| 87077 |
|
750 |
709 |
$3K |
| 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 |
76 |
76 |
$3K |
| 80055 |
|
33 |
28 |
$3K |
| 80143 |
|
156 |
138 |
$3K |
| 74022 |
|
12 |
12 |
$3K |
| 85730 |
|
643 |
589 |
$3K |
| 80179 |
|
143 |
126 |
$2K |
| 85379 |
|
192 |
177 |
$2K |
| 90715 |
|
15 |
15 |
$2K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
1,321 |
1,144 |
$2K |
| 86900 |
|
894 |
847 |
$2K |
| 86803 |
|
215 |
211 |
$2K |
| 86901 |
|
877 |
833 |
$2K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
31 |
31 |
$2K |
| 84439 |
|
417 |
411 |
$2K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
319 |
269 |
$1K |
| 86738 |
|
124 |
117 |
$1K |
| 88142 |
|
25 |
25 |
$1K |
| 82550 |
|
266 |
218 |
$1K |
| 76801 |
|
18 |
18 |
$1K |
| 73130 |
|
19 |
17 |
$1K |
| 76642 |
|
13 |
13 |
$978.99 |
| 20610 |
|
16 |
13 |
$901.01 |
| 82043 |
|
353 |
351 |
$800.07 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
40 |
36 |
$730.18 |
| 87070 |
|
27 |
26 |
$727.45 |
| 80047 |
|
56 |
51 |
$503.97 |
| 99152 |
|
15 |
13 |
$475.67 |
| 86762 |
|
70 |
64 |
$457.12 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
17 |
12 |
$428.71 |
| 86328 |
|
27 |
26 |
$426.61 |
| 94761 |
|
16 |
12 |
$392.32 |
| 82565 |
|
122 |
114 |
$369.97 |
| 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 |
109 |
97 |
$328.06 |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
12 |
12 |
$326.82 |
| 77066 |
Tomosynthesis, mammo |
12 |
12 |
$322.21 |
| 36415 |
Collection of venous blood by venipuncture |
9,917 |
8,850 |
$320.14 |
| 90686 |
|
122 |
119 |
$296.48 |
| 87340 |
|
49 |
48 |
$287.91 |
| 82570 |
|
123 |
122 |
$279.82 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
271 |
221 |
$227.22 |
| 82950 |
|
43 |
38 |
$181.36 |
| C1769 |
Guide wire |
158 |
142 |
$176.97 |
| 93971 |
|
12 |
12 |
$151.67 |
| 81002 |
|
47 |
44 |
$144.99 |
| 84703 |
|
15 |
13 |
$123.47 |
| 96376 |
|
547 |
360 |
$121.78 |
| 82962 |
|
4,978 |
1,955 |
$119.08 |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
15 |
14 |
$105.77 |
| 86703 |
|
13 |
12 |
$94.12 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
12 |
12 |
$85.97 |
| 85014 |
|
58 |
39 |
$68.39 |
| 92567 |
|
12 |
12 |
$64.06 |
| S0020 |
Injection, bupivicaine hydrochloride, 30 ml |
29 |
26 |
$61.31 |
| 84132 |
|
13 |
13 |
$52.53 |
| 87147 |
|
27 |
24 |
$49.39 |
| 85652 |
|
28 |
26 |
$45.71 |
| 86140 |
|
16 |
13 |
$38.57 |
| 84100 |
|
13 |
13 |
$31.02 |
| 80069 |
|
36 |
12 |
$30.00 |
| A9270 |
Non-covered item or service |
294 |
156 |
$23.13 |
| C1894 |
Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser |
18 |
15 |
$17.18 |
| 88720 |
|
14 |
12 |
$16.88 |
| 85018 |
|
42 |
24 |
$9.31 |
| G1010 |
Clinical decision support mechanism stanson, as defined by the medicare appropriate use criteria program |
1,492 |
1,388 |
$0.00 |
| 90662 |
|
87 |
87 |
$0.00 |
| 97803 |
|
30 |
26 |
$0.00 |
| 80164 |
|
14 |
13 |
$0.00 |
| 36592 |
|
31 |
15 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
181 |
181 |
$0.00 |
| 0001A |
|
62 |
61 |
$0.00 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
15 |
14 |
$0.00 |
| M0243 |
Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring |
14 |
14 |
$0.00 |
| C1755 |
Catheter, intraspinal |
16 |
12 |
$0.00 |