| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
27,204 |
25,238 |
$8.11M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
9,244 |
8,784 |
$2.16M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
7,735 |
7,431 |
$1.23M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
1,201 |
1,095 |
$422K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
3,804 |
3,607 |
$405K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
3,798 |
3,601 |
$405K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
2,949 |
2,706 |
$385K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
2,280 |
2,047 |
$369K |
| 84443 |
Thyroid stimulating hormone (TSH) |
5,850 |
5,581 |
$288K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
1,397 |
1,133 |
$191K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
6,589 |
6,365 |
$186K |
| 80061 |
Lipid panel |
3,909 |
3,768 |
$154K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
4,451 |
4,390 |
$147K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
1,987 |
1,918 |
$146K |
| 80053 |
Comprehensive metabolic panel |
14,991 |
13,794 |
$146K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
22,361 |
20,435 |
$145K |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
1,184 |
1,140 |
$125K |
| 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 |
651 |
616 |
$113K |
| 88142 |
|
1,855 |
1,793 |
$113K |
| 71046 |
Radiologic examination, chest; 2 views |
1,672 |
1,580 |
$93K |
| 86780 |
|
2,214 |
2,121 |
$88K |
| 85027 |
|
5,072 |
4,725 |
$86K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
2,109 |
2,016 |
$77K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
1,055 |
1,021 |
$77K |
| 86003 |
|
263 |
246 |
$76K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
256 |
240 |
$76K |
| 87506 |
|
119 |
114 |
$75K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
301 |
298 |
$74K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
3,168 |
2,841 |
$67K |
| 82728 |
|
2,144 |
2,075 |
$66K |
| 86803 |
|
1,508 |
1,450 |
$65K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
2,095 |
1,947 |
$64K |
| 82607 |
|
1,398 |
1,359 |
$61K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
1,070 |
1,056 |
$55K |
| 87340 |
|
1,679 |
1,620 |
$53K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
214 |
212 |
$50K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
2,080 |
1,908 |
$49K |
| 84702 |
|
1,065 |
838 |
$48K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
164 |
153 |
$44K |
| 87653 |
|
397 |
384 |
$39K |
| 82565 |
|
2,571 |
2,389 |
$38K |
| 87077 |
|
1,432 |
1,334 |
$37K |
| 81001 |
|
4,751 |
4,412 |
$36K |
| 76801 |
|
131 |
126 |
$35K |
| 82274 |
|
680 |
680 |
$33K |
| 0502F |
|
427 |
364 |
$32K |
| 81025 |
|
1,684 |
1,600 |
$31K |
| 87186 |
|
1,117 |
1,055 |
$29K |
| 83550 |
|
1,100 |
1,063 |
$29K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
81 |
77 |
$28K |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
1,906 |
1,750 |
$28K |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
234 |
225 |
$25K |
| 87081 |
|
1,233 |
1,188 |
$24K |
| G0328 |
Colorectal cancer screening; fecal occult blood test, immunoassay, 1-3 simultaneous |
429 |
395 |
$24K |
| 84460 |
|
1,561 |
1,489 |
$24K |
| 85610 |
|
2,192 |
1,439 |
$24K |
| 90834 |
Psychotherapy, 45 minutes with patient |
144 |
137 |
$23K |
| 87637 |
Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV |
523 |
485 |
$22K |
| 83540 |
|
1,100 |
1,066 |
$21K |
| 88342 |
|
119 |
99 |
$21K |
| 83516 |
|
603 |
582 |
$21K |
| 88307 |
|
56 |
48 |
$20K |
| 86140 |
|
1,276 |
1,194 |
$20K |
| 87522 |
Neg quan hep c or qual rna |
152 |
134 |
$19K |
| 87536 |
|
75 |
65 |
$19K |
| 87529 |
|
81 |
78 |
$18K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
31 |
31 |
$17K |
| 90686 |
|
2,210 |
2,207 |
$17K |
| 80076 |
|
672 |
620 |
$16K |
| 87070 |
|
614 |
586 |
$16K |
| 84439 |
|
577 |
509 |
$16K |
| 84132 |
|
1,176 |
1,109 |
$15K |
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
367 |
171 |
$15K |
| 84403 |
|
302 |
289 |
$14K |
| 83690 |
|
3,082 |
2,882 |
$14K |
| 82042 |
|
870 |
843 |
$14K |
| 90837 |
Psychotherapy, 53 minutes with patient |
55 |
43 |
$14K |
| 82570 |
|
905 |
808 |
$13K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
54 |
54 |
$13K |
| 83880 |
|
543 |
502 |
$13K |
| 87210 |
|
987 |
945 |
$13K |
| 80069 |
|
509 |
393 |
$12K |
| 92015 |
Determination of refractive state |
428 |
414 |
$12K |
| 88341 |
|
23 |
19 |
$12K |
| 81003 |
|
1,621 |
1,547 |
$11K |
| 84153 |
|
206 |
197 |
$11K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
86 |
86 |
$11K |
| 99354 |
|
35 |
34 |
$10K |
| 86850 |
|
1,243 |
1,068 |
$10K |
| 82746 |
|
227 |
214 |
$9K |
| 86787 |
|
241 |
236 |
$9K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
118 |
101 |
$9K |
| 87631 |
|
70 |
67 |
$8K |
| 82670 |
|
98 |
89 |
$8K |
| 84146 |
|
144 |
137 |
$8K |
| 90670 |
|
78 |
78 |
$8K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
30 |
27 |
$8K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
65 |
59 |
$8K |
| 84450 |
|
519 |
486 |
$8K |
| 86762 |
|
181 |
177 |
$8K |
| 92227 |
|
259 |
249 |
$7K |
| 84550 |
|
565 |
528 |
$7K |
| 76642 |
|
67 |
66 |
$7K |
| 87205 |
|
564 |
542 |
$7K |
| 86706 |
|
222 |
215 |
$7K |
| 82784 |
|
276 |
257 |
$7K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
47 |
45 |
$7K |
| 83001 |
|
121 |
116 |
$7K |
| 88141 |
|
87 |
82 |
$6K |
| 86704 |
|
169 |
161 |
$6K |
| 83735 |
|
307 |
230 |
$6K |
| 59025 |
Fetal non-stress test |
59 |
55 |
$6K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
15 |
15 |
$6K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
30 |
26 |
$5K |
| 99215 |
Prolong outpt/office vis |
16 |
16 |
$5K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
428 |
398 |
$5K |
| 86200 |
|
133 |
125 |
$5K |
| 83993 |
|
93 |
89 |
$5K |
| 76830 |
Ultrasound, transvaginal |
18 |
18 |
$5K |
| 82105 |
|
219 |
204 |
$5K |
| 86038 |
|
122 |
114 |
$4K |
| 81220 |
CFTR (cystic fibrosis transmembrane conductance regulator) gene analysis; common variants |
67 |
65 |
$4K |
| 86480 |
|
106 |
96 |
$4K |
| 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 |
14 |
12 |
$4K |
| U0004 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc, making use of high throughput technologies as described by cms-2020-01-r |
240 |
223 |
$4K |
| 84156 |
|
375 |
289 |
$4K |
| 86255 |
|
40 |
39 |
$4K |
| 85652 |
|
473 |
455 |
$4K |
| 86765 |
|
104 |
94 |
$4K |
| 87517 |
|
34 |
28 |
$4K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
13 |
13 |
$3K |
| 73630 |
|
47 |
39 |
$3K |
| 88304 |
|
62 |
50 |
$3K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
15 |
15 |
$3K |
| A7035 |
Headgear used with positive airway pressure device |
66 |
60 |
$3K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
30 |
30 |
$3K |
| 86431 |
|
188 |
179 |
$3K |
| 83002 |
|
54 |
50 |
$3K |
| 82950 |
|
207 |
202 |
$3K |
| 84165 |
|
70 |
63 |
$3K |
| 82550 |
|
163 |
144 |
$3K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
12 |
12 |
$3K |
| 82248 |
|
222 |
210 |
$3K |
| 84480 |
|
61 |
50 |
$3K |
| 86708 |
|
65 |
65 |
$2K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
42 |
39 |
$2K |
| 82627 |
|
35 |
35 |
$2K |
| 83615 |
|
127 |
107 |
$2K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
154 |
139 |
$2K |
| 86160 |
|
40 |
32 |
$2K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
3,105 |
2,820 |
$2K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
12 |
12 |
$2K |
| 86360 |
|
13 |
13 |
$2K |
| 81507 |
|
170 |
164 |
$2K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
90 |
90 |
$2K |
| 71250 |
|
12 |
12 |
$2K |
| 82951 |
|
80 |
75 |
$2K |
| 82533 |
|
37 |
34 |
$2K |
| 95806 |
|
15 |
15 |
$2K |
| 83970 |
|
15 |
14 |
$2K |
| 82247 |
|
126 |
106 |
$2K |
| 86696 |
|
27 |
27 |
$2K |
| 86735 |
|
41 |
40 |
$2K |
| 86709 |
|
44 |
43 |
$2K |
| 83021 |
|
28 |
25 |
$2K |
| 90698 |
|
13 |
13 |
$2K |
| 82040 |
|
116 |
102 |
$2K |
| 86376 |
|
35 |
33 |
$1K |
| 87329 |
|
41 |
40 |
$1K |
| 87209 |
|
25 |
21 |
$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 |
180 |
171 |
$1K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
131 |
125 |
$1K |
| 84100 |
|
106 |
77 |
$1K |
| 72100 |
|
14 |
12 |
$1K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
12 |
12 |
$1K |
| 73030 |
|
19 |
19 |
$1K |
| 84295 |
|
93 |
84 |
$1K |
| 86695 |
|
28 |
28 |
$1K |
| 82947 |
|
97 |
85 |
$1K |
| 84075 |
|
75 |
67 |
$1K |
| 81002 |
|
135 |
81 |
$1K |
| 73502 |
|
12 |
12 |
$978.00 |
| 87449 |
|
29 |
26 |
$977.00 |
| 87324 |
|
28 |
25 |
$962.00 |
| 80178 |
|
51 |
45 |
$960.00 |
| 85730 |
|
60 |
55 |
$954.00 |
| 86592 |
|
76 |
69 |
$931.00 |
| 74018 |
|
13 |
13 |
$898.00 |
| 92504 |
|
15 |
15 |
$882.00 |
| 87338 |
|
112 |
110 |
$878.00 |
| J3490 |
Unclassified drugs |
13,579 |
7,947 |
$856.74 |
| 99441 |
|
26 |
26 |
$840.00 |
| 86361 |
|
17 |
12 |
$825.00 |
| 86900 |
|
255 |
219 |
$773.51 |
| 86901 |
|
255 |
219 |
$762.63 |
| 87101 |
|
31 |
31 |
$759.00 |
| 81050 |
|
67 |
58 |
$751.00 |
| 11721 |
|
16 |
16 |
$737.00 |
| 87177 |
|
25 |
21 |
$702.00 |
| 86308 |
|
41 |
40 |
$661.00 |
| 73610 |
|
14 |
14 |
$642.00 |
| 87040 |
|
14 |
12 |
$640.00 |
| 87075 |
|
20 |
18 |
$557.00 |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
336 |
279 |
$546.74 |
| A7037 |
Tubing used with positive airway pressure device |
46 |
41 |
$545.00 |
| 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 |
14 |
12 |
$512.00 |
| 82390 |
|
14 |
14 |
$462.00 |
| 83655 |
|
88 |
83 |
$446.00 |
| 82340 |
|
29 |
27 |
$432.00 |
| 84402 |
|
67 |
66 |
$402.00 |
| 85014 |
|
60 |
52 |
$399.00 |
| 85018 |
|
58 |
50 |
$385.00 |
| 84520 |
|
32 |
27 |
$360.00 |
| 71045 |
Radiologic examination, chest; single view |
14 |
12 |
$293.00 |
| 82465 |
|
27 |
24 |
$286.00 |
| 82103 |
|
35 |
34 |
$245.00 |
| 82435 |
|
16 |
12 |
$210.00 |
| 85007 |
|
17 |
17 |
$165.00 |
| 85045 |
|
12 |
12 |
$144.00 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
68 |
63 |
$69.81 |
| J7030 |
Infusion, normal saline solution , 1000 cc |
661 |
572 |
$50.58 |
| 84484 |
|
683 |
611 |
$49.38 |
| G1004 |
Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program |
235 |
204 |
$0.07 |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
77 |
74 |
$0.00 |
| 96152 |
|
18 |
12 |
$0.00 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
173 |
166 |
$0.00 |
| A9270 |
Non-covered item or service |
319 |
101 |
$0.00 |
| 83605 |
|
17 |
17 |
$0.00 |