| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
Emergency department visit for the evaluation and management, high severity |
39,353 |
35,394 |
$7.29M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
20,774 |
18,941 |
$7.06M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
32,556 |
29,978 |
$3.76M |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
25,828 |
23,091 |
$2.38M |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
7,767 |
7,480 |
$1.13M |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
60,359 |
52,447 |
$966K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
24,643 |
19,643 |
$741K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
2,359 |
2,319 |
$726K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
25,493 |
21,014 |
$720K |
| 70450 |
Computed tomography, head or brain; without contrast material |
7,871 |
7,491 |
$717K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
8,909 |
7,481 |
$698K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
6,654 |
6,304 |
$627K |
| 71046 |
Radiologic examination, chest; 2 views |
17,918 |
16,695 |
$593K |
| 45385 |
Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) |
1,217 |
1,197 |
$570K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
1,291 |
1,271 |
$547K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
2,810 |
2,694 |
$506K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
7,395 |
7,068 |
$502K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
4,661 |
4,513 |
$477K |
| 87637 |
Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV |
6,026 |
5,876 |
$414K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
845 |
822 |
$406K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
620 |
587 |
$372K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
2,608 |
1,558 |
$362K |
| 82947 |
|
12,067 |
7,822 |
$326K |
| 95810 |
Polysomnography; sleep staging with 4 or more additional parameters |
653 |
647 |
$318K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
5,280 |
5,220 |
$250K |
| 76830 |
Ultrasound, transvaginal |
3,976 |
3,882 |
$221K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
2,517 |
2,419 |
$220K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
3,887 |
3,802 |
$209K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
1,087 |
662 |
$195K |
| 71045 |
Radiologic examination, chest; single view |
5,657 |
5,338 |
$182K |
| 76801 |
|
2,946 |
2,650 |
$167K |
| G0378 |
Hospital observation service, per hour |
6,527 |
4,192 |
$162K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
19,721 |
18,950 |
$151K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
19,761 |
18,974 |
$148K |
| 94060 |
|
1,189 |
1,159 |
$144K |
| 80061 |
Lipid panel |
17,741 |
17,400 |
$144K |
| 45378 |
Colonoscopy, flexible; diagnostic, including collection of specimen(s) |
442 |
437 |
$140K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
6,626 |
6,360 |
$136K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
724 |
687 |
$133K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
2,378 |
2,310 |
$128K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
2,367 |
2,299 |
$127K |
| 93971 |
|
2,503 |
2,271 |
$124K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
6,891 |
2,014 |
$121K |
| 59025 |
Fetal non-stress test |
1,210 |
862 |
$111K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
1,068 |
1,047 |
$109K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
1,176 |
1,152 |
$108K |
| 95811 |
|
227 |
221 |
$107K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
4,224 |
4,158 |
$103K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
17,119 |
14,549 |
$93K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
700 |
659 |
$83K |
| 93970 |
|
912 |
803 |
$80K |
| 41899 |
Unlisted procedure, dentoalveolar structures |
381 |
373 |
$77K |
| 64450 |
|
257 |
155 |
$68K |
| J0585 |
Injection, onabotulinumtoxina, 1 unit |
257 |
154 |
$65K |
| 71250 |
|
1,364 |
1,321 |
$64K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
3,503 |
2,279 |
$63K |
| 96367 |
|
2,205 |
1,722 |
$59K |
| 47562 |
|
26 |
25 |
$54K |
| 76642 |
|
1,436 |
1,333 |
$50K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
883 |
848 |
$49K |
| 76536 |
|
995 |
969 |
$46K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
3,604 |
3,588 |
$44K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
3,267 |
1,208 |
$42K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
310 |
306 |
$40K |
| 43235 |
|
109 |
109 |
$40K |
| 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 |
2,070 |
1,969 |
$36K |
| 93975 |
|
298 |
292 |
$35K |
| 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 |
10,003 |
5,859 |
$35K |
| 87480 |
|
10,480 |
10,141 |
$35K |
| 87510 |
|
10,479 |
10,141 |
$35K |
| 87660 |
|
10,473 |
10,135 |
$34K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
3,671 |
3,499 |
$33K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
1,684 |
672 |
$32K |
| 52356 |
|
12 |
12 |
$31K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
1,748 |
731 |
$31K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
3,064 |
3,007 |
$30K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
87,223 |
72,409 |
$30K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
2,024 |
2,002 |
$30K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
26,550 |
23,257 |
$29K |
| 66984 |
Extracapsular cataract removal with insertion of intraocular lens prosthesis |
44 |
40 |
$29K |
| 80053 |
Comprehensive metabolic panel |
77,477 |
67,458 |
$29K |
| 64405 |
|
319 |
212 |
$29K |
| 72141 |
|
211 |
210 |
$28K |
| 93017 |
|
1,500 |
1,456 |
$27K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
12,428 |
12,171 |
$27K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
653 |
615 |
$26K |
| 97161 |
|
441 |
408 |
$26K |
| 76770 |
|
510 |
499 |
$26K |
| 36415 |
Collection of venous blood by venipuncture |
61,219 |
53,159 |
$25K |
| 73564 |
|
1,541 |
1,255 |
$25K |
| 72100 |
|
1,005 |
986 |
$24K |
| 84443 |
Thyroid stimulating hormone (TSH) |
27,316 |
26,196 |
$23K |
| G0121 |
Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk |
55 |
54 |
$23K |
| G0145 |
Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system and manual rescreening under physician supervision |
2,868 |
2,693 |
$22K |
| 70486 |
|
844 |
809 |
$22K |
| 90686 |
|
1,448 |
1,418 |
$22K |
| J1439 |
Injection, ferric carboxymaltose, 1 mg |
61 |
41 |
$21K |
| 73030 |
|
2,446 |
2,212 |
$21K |
| 77065 |
Tomosynthesis, mammo |
507 |
469 |
$21K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
2,639 |
2,551 |
$21K |
| 73221 |
|
167 |
161 |
$20K |
| G0482 |
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; 15-21 drug class(es), including metabolite(s) if performed |
1,627 |
1,542 |
$20K |
| 87390 |
|
6,131 |
5,995 |
$20K |
| G0008 |
Administration of influenza virus vaccine |
2,235 |
2,192 |
$20K |
| 72110 |
|
1,328 |
1,298 |
$19K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
8,008 |
7,481 |
$19K |
| 77066 |
Tomosynthesis, mammo |
329 |
328 |
$18K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
22,245 |
20,816 |
$17K |
| 97535 |
Self-care/home management training, each 15 minutes |
777 |
605 |
$15K |
| M0245 |
Intravenous infusion, bamlanivimab and etesevimab, includes infusion and post administration monitoring |
58 |
58 |
$15K |
| 93798 |
|
227 |
41 |
$14K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
114 |
112 |
$13K |
| 73630 |
|
2,671 |
2,330 |
$13K |
| 86900 |
|
5,802 |
5,359 |
$13K |
| 64493 |
|
24 |
24 |
$13K |
| 73130 |
|
2,473 |
2,030 |
$13K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
7,814 |
7,523 |
$12K |
| 29881 |
|
15 |
15 |
$12K |
| 99460 |
|
224 |
224 |
$12K |
| 70491 |
|
107 |
105 |
$11K |
| 86702 |
|
6,185 |
6,037 |
$11K |
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
14 |
13 |
$11K |
| G0108 |
Diabetes outpatient self-management training services, individual, per 30 minutes |
148 |
147 |
$11K |
| 74018 |
|
1,392 |
1,324 |
$10K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
265 |
258 |
$10K |
| 73562 |
|
1,511 |
1,327 |
$10K |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
2,555 |
2,440 |
$10K |
| 73610 |
|
1,938 |
1,793 |
$9K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,671 |
1,666 |
$9K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
253 |
242 |
$9K |
| G0279 |
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) |
831 |
824 |
$9K |
| 86803 |
|
4,039 |
4,009 |
$9K |
| 78815 |
Positron emission tomography (PET) for limited area imaging |
12 |
12 |
$9K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
1,519 |
1,502 |
$8K |
| 64721 |
|
14 |
13 |
$8K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
1,404 |
1,389 |
$8K |
| 80055 |
|
1,264 |
1,226 |
$8K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
15,168 |
14,867 |
$8K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
251 |
202 |
$8K |
| C9803 |
Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
734 |
706 |
$8K |
| 86701 |
|
6,165 |
6,025 |
$7K |
| 73502 |
|
755 |
733 |
$7K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
5,844 |
4,440 |
$7K |
| G0123 |
Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, screening by cytotechnologist under physician supervision |
876 |
857 |
$7K |
| 64400 |
|
55 |
50 |
$7K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
500 |
437 |
$6K |
| 82607 |
|
5,045 |
4,945 |
$6K |
| 73110 |
|
907 |
835 |
$6K |
| 10060 |
|
70 |
65 |
$6K |
| 82728 |
|
5,274 |
5,120 |
$6K |
| 87186 |
|
6,075 |
5,813 |
$6K |
| 72131 |
|
140 |
138 |
$6K |
| 94726 |
|
1,186 |
1,161 |
$6K |
| 87077 |
|
5,977 |
5,721 |
$6K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
2,423 |
2,184 |
$6K |
| 80074 |
|
1,027 |
1,003 |
$5K |
| 87340 |
|
2,986 |
2,959 |
$5K |
| 70496 |
|
187 |
181 |
$5K |
| 97165 |
|
83 |
81 |
$5K |
| 87070 |
|
3,639 |
3,446 |
$5K |
| 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 |
578 |
568 |
$5K |
| 84702 |
|
6,237 |
5,064 |
$5K |
| 71271 |
|
81 |
81 |
$5K |
| 90670 |
|
200 |
193 |
$5K |
| 64615 |
|
37 |
36 |
$5K |
| 87529 |
|
276 |
270 |
$4K |
| 90688 |
|
270 |
268 |
$4K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
772 |
772 |
$4K |
| 86706 |
|
1,541 |
1,527 |
$4K |
| 10061 |
|
28 |
27 |
$4K |
| G0103 |
Prostate cancer screening; prostate specific antigen test (psa) |
1,786 |
1,760 |
$4K |
| 90651 |
|
31 |
31 |
$4K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
26,299 |
21,671 |
$3K |
| 84439 |
|
5,290 |
5,066 |
$3K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
13,257 |
12,516 |
$3K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
12,290 |
9,509 |
$3K |
| 81025 |
|
16,625 |
15,560 |
$3K |
| 83550 |
|
3,751 |
3,655 |
$3K |
| 29505 |
|
41 |
40 |
$3K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
627 |
627 |
$3K |
| Q9969 |
Tc-99m from non-highly enriched uranium source, full cost recovery add-on, per study dose |
440 |
430 |
$3K |
| 86592 |
|
2,908 |
2,874 |
$3K |
| 99406 |
|
189 |
187 |
$3K |
| 83540 |
|
4,919 |
4,762 |
$3K |
| G0481 |
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; 8-14 drug class(es), including metabolite(s) if performed |
783 |
778 |
$3K |
| 77080 |
|
45 |
45 |
$3K |
| 83880 |
|
5,794 |
5,433 |
$2K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
138 |
134 |
$2K |
| 72050 |
|
149 |
139 |
$2K |
| 74022 |
|
829 |
800 |
$2K |
| 82746 |
|
1,712 |
1,686 |
$2K |
| 74019 |
|
148 |
144 |
$2K |
| 94660 |
|
33 |
28 |
$2K |
| 70498 |
|
178 |
170 |
$2K |
| 85027 |
|
6,560 |
6,047 |
$2K |
| 88342 |
|
543 |
524 |
$2K |
| 81001 |
|
27,028 |
24,688 |
$2K |
| 99462 |
|
77 |
69 |
$2K |
| 83735 |
|
23,004 |
20,273 |
$2K |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
20,376 |
16,928 |
$2K |
| 99496 |
|
170 |
162 |
$2K |
| 88341 |
|
137 |
134 |
$2K |
| 74420 |
|
287 |
268 |
$2K |
| 87081 |
|
4,271 |
4,140 |
$2K |
| 97162 |
|
41 |
41 |
$2K |
| P9016 |
Red blood cells, leukocytes reduced, each unit |
15 |
12 |
$2K |
| 88307 |
|
446 |
438 |
$2K |
| 54150 |
|
29 |
29 |
$2K |
| 86140 |
|
10,215 |
9,496 |
$2K |
| 86780 |
|
520 |
504 |
$2K |
| 84481 |
|
840 |
800 |
$1K |
| 73590 |
|
290 |
258 |
$1K |
| 85610 |
|
21,919 |
19,055 |
$1K |
| 81003 |
|
16,229 |
15,320 |
$1K |
| 96127 |
|
124 |
122 |
$1K |
| 96417 |
|
46 |
29 |
$1K |
| 83615 |
|
2,072 |
1,742 |
$1K |
| 84403 |
|
634 |
614 |
$1K |
| 86038 |
|
1,589 |
1,544 |
$1K |
| 36591 |
|
54 |
40 |
$1K |
| 82043 |
|
3,393 |
3,344 |
$1K |
| 83001 |
|
674 |
663 |
$1K |
| 87205 |
|
2,358 |
2,209 |
$1K |
| 90656 |
|
61 |
61 |
$1K |
| 85046 |
|
1,325 |
1,166 |
$1K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
4,526 |
4,361 |
$1K |
| 82950 |
|
1,516 |
1,480 |
$1K |
| 87147 |
|
1,811 |
1,755 |
$995.11 |
| 83970 |
|
205 |
201 |
$967.30 |
| J2272 |
Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg |
614 |
529 |
$965.61 |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
1,597 |
1,596 |
$880.31 |
| 82570 |
|
2,264 |
2,090 |
$878.52 |
| 90662 |
|
45 |
41 |
$847.29 |
| 73080 |
|
226 |
211 |
$838.31 |
| 85730 |
|
14,943 |
13,447 |
$807.24 |
| G0009 |
Administration of pneumococcal vaccine |
114 |
113 |
$782.87 |
| 82652 |
|
333 |
330 |
$671.77 |
| 86850 |
|
5,195 |
4,801 |
$663.16 |
| 85652 |
|
3,048 |
2,804 |
$640.24 |
| 64447 |
|
71 |
66 |
$639.88 |
| 84146 |
|
246 |
234 |
$629.72 |
| 84550 |
|
1,561 |
1,450 |
$607.95 |
| 82670 |
|
259 |
248 |
$607.80 |
| 99490 |
Ccm add 20min |
15 |
15 |
$602.93 |
| 82784 |
|
146 |
137 |
$598.79 |
| 77073 |
|
12 |
12 |
$596.40 |
| 84100 |
|
2,404 |
1,979 |
$592.59 |
| 99385 |
|
59 |
54 |
$588.68 |
| 96415 |
|
19 |
12 |
$577.93 |
| 72040 |
|
52 |
52 |
$550.77 |
| 87210 |
|
4,011 |
3,839 |
$526.23 |
| 99464 |
|
12 |
12 |
$504.00 |
| 84156 |
|
1,524 |
1,319 |
$471.25 |
| 84165 |
|
297 |
276 |
$466.14 |
| 83690 |
|
16,058 |
14,548 |
$464.55 |
| 84703 |
|
3,811 |
3,662 |
$456.09 |
| Q2036 |
Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (flulaval) |
56 |
56 |
$454.74 |
| 71101 |
|
72 |
70 |
$426.16 |
| 99381 |
|
12 |
12 |
$423.90 |
| 83002 |
|
243 |
228 |
$419.66 |
| 96376 |
|
6,571 |
4,486 |
$417.70 |
| 88304 |
|
1,801 |
1,750 |
$369.20 |
| 76870 |
|
160 |
154 |
$368.45 |
| 87634 |
|
751 |
733 |
$361.35 |
| 76000 |
|
42 |
39 |
$354.75 |
| 83721 |
|
470 |
460 |
$308.21 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
2,761 |
2,685 |
$272.84 |
| 83605 |
|
12,311 |
10,394 |
$266.69 |
| 82550 |
|
2,185 |
1,990 |
$265.26 |
| 83516 |
|
223 |
187 |
$262.69 |
| 85651 |
|
3,018 |
2,877 |
$232.78 |
| 86901 |
|
5,956 |
5,486 |
$216.26 |
| 86431 |
|
608 |
592 |
$211.56 |
| C9399 |
Unclassified drugs or biologicals |
91 |
82 |
$208.32 |
| 84484 |
|
20,608 |
15,041 |
$195.32 |
| 87075 |
|
717 |
655 |
$188.35 |
| 85379 |
|
4,421 |
4,281 |
$183.23 |
| 73140 |
|
43 |
39 |
$176.28 |
| 72070 |
|
20 |
19 |
$174.78 |
| 80076 |
|
419 |
388 |
$168.56 |
| 80143 |
|
2,626 |
2,472 |
$166.25 |
| 72072 |
|
12 |
12 |
$159.15 |
| 82077 |
|
4,114 |
3,799 |
$158.08 |
| 80179 |
|
2,562 |
2,431 |
$155.16 |
| 82533 |
|
108 |
90 |
$145.64 |
| 73090 |
|
150 |
136 |
$136.62 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
5,300 |
4,423 |
$133.74 |
| 90734 |
|
12 |
12 |
$128.85 |
| 82105 |
|
65 |
64 |
$122.34 |
| 86376 |
|
110 |
109 |
$114.25 |
| 87040 |
|
3,386 |
2,168 |
$106.75 |
| 82565 |
|
90 |
86 |
$97.75 |
| 86696 |
|
32 |
27 |
$96.87 |
| 84144 |
|
42 |
42 |
$91.65 |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
775 |
766 |
$88.76 |
| 86762 |
|
183 |
182 |
$86.91 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
1,217 |
1,202 |
$84.00 |
| 82330 |
|
146 |
137 |
$74.12 |
| 82150 |
|
804 |
775 |
$66.88 |
| 86695 |
|
31 |
27 |
$58.15 |
| 87522 |
Neg quan hep c or qual rna |
12 |
12 |
$55.48 |
| 86708 |
|
49 |
48 |
$45.30 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
20,697 |
18,419 |
$44.56 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
12,093 |
11,200 |
$43.16 |
| J2704 |
Injection, propofol, 10 mg |
16,696 |
15,961 |
$39.70 |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
1,164 |
990 |
$39.54 |
| 85384 |
|
51 |
44 |
$39.42 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
27,453 |
22,038 |
$37.56 |
| 87046 |
|
26 |
25 |
$37.46 |
| 84436 |
|
192 |
189 |
$32.76 |
| 83010 |
|
13 |
13 |
$30.60 |
| 82248 |
|
41 |
40 |
$29.42 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
6,125 |
4,491 |
$25.80 |
| 97116 |
|
12 |
12 |
$25.18 |
| 84480 |
|
26 |
25 |
$25.18 |
| 81000 |
|
53 |
49 |
$24.48 |
| 83930 |
|
449 |
431 |
$20.50 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
14,466 |
12,687 |
$18.94 |
| 87045 |
|
26 |
25 |
$18.73 |
| 84445 |
|
13 |
13 |
$17.83 |
| A9270 |
Non-covered item or service |
96,310 |
40,369 |
$17.25 |
| 82803 |
|
62 |
55 |
$17.16 |
| 87427 |
|
12 |
12 |
$14.62 |
| 84466 |
|
38 |
38 |
$14.24 |
| 84145 |
|
71 |
66 |
$13.69 |
| 82040 |
|
26 |
26 |
$12.94 |
| 86364 |
|
13 |
13 |
$12.87 |
| 82010 |
|
1,237 |
1,094 |
$12.59 |
| 82140 |
|
154 |
145 |
$10.66 |
| 84153 |
|
15 |
13 |
$10.36 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
14,541 |
11,948 |
$9.44 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
111 |
102 |
$8.39 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
4,743 |
4,070 |
$7.73 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
9,583 |
7,739 |
$6.61 |
| 82800 |
|
461 |
413 |
$6.44 |
| 84460 |
|
24 |
24 |
$5.98 |
| 84132 |
|
194 |
124 |
$4.98 |
| 81015 |
|
26 |
26 |
$4.64 |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
1,099 |
935 |
$3.55 |
| 84450 |
|
12 |
12 |
$2.92 |
| J0137 |
Injection, acetaminophen (hikma), not therapeutically equivalent to j0131, 10 mg |
38 |
38 |
$2.79 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
9,180 |
7,236 |
$1.09 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
3,801 |
3,330 |
$0.56 |
| J1630 |
Injection, haloperidol, up to 5 mg |
2,403 |
2,115 |
$0.53 |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
2,424 |
1,935 |
$0.00 |
| J0171 |
Injection, adrenalin, epinephrine, 0.1 mg |
766 |
673 |
$0.00 |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
1,817 |
1,030 |
$0.00 |
| 94729 |
|
1,133 |
1,107 |
$0.00 |
| 93356 |
|
671 |
670 |
$0.00 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
3,370 |
3,119 |
$0.00 |
| 99152 |
|
904 |
854 |
$0.00 |
| 90461 |
|
2,621 |
2,616 |
$0.00 |
| Q0144 |
Azithromycin dihydrate, oral, capsules/powder, 1 gram |
1,067 |
1,005 |
$0.00 |
| C1894 |
Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser |
1,000 |
948 |
$0.00 |
| C1713 |
Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) |
1,610 |
1,460 |
$0.00 |
| J2710 |
Injection, neostigmine methylsulfate, up to 0.5 mg |
2,002 |
1,936 |
$0.00 |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
2,848 |
2,287 |
$0.00 |
| 90714 |
|
680 |
670 |
$0.00 |
| S5000 |
Prescription drug, generic |
1,899 |
973 |
$0.00 |
| 90715 |
|
1,477 |
1,407 |
$0.00 |
| J3370 |
Injection, vancomycin hcl, 500 mg |
1,011 |
707 |
$0.00 |
| 94799 |
|
247 |
118 |
$0.00 |
| J1596 |
Injection, glycopyrrolate, 0.1 mg |
94 |
94 |
$0.00 |
| J2919 |
Injection, methylprednisolone sodium succinate, 5 mg |
142 |
124 |
$0.00 |
| J1644 |
Injection, heparin sodium, per 1000 units |
2,089 |
954 |
$0.00 |
| C9113 |
Injection, pantoprazole sodium, per vial |
271 |
181 |
$0.00 |
| J1171 |
Injection, hydromorphone, 0.1 mg |
142 |
104 |
$0.00 |
| 76942 |
|
127 |
101 |
$0.00 |
| A9502 |
Technetium tc-99m tetrofosmin, diagnostic, per study dose |
221 |
219 |
$0.00 |
| G1004 |
Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program |
483 |
428 |
$0.00 |
| A9552 |
Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries |
24 |
24 |
$0.00 |
| J2004 |
Injection, lidocaine hcl with epinephrine, 1 mg |
34 |
34 |
$0.00 |
| 82805 |
|
57 |
54 |
$0.00 |
| 12011 |
|
24 |
24 |
$0.00 |
| 36600 |
|
27 |
24 |
$0.00 |
| J0136 |
Injection, acetaminophen (b braun), not therapeutically equivalent to j0131, 10 mg |
14 |
13 |
$0.00 |
| J0134 |
Injection, acetaminophen (fresenius kabi), not therapeutically equivalent to j0131, 10 mg |
54 |
52 |
$0.00 |
| 82365 |
|
40 |
40 |
$0.00 |
| 87102 |
|
13 |
12 |
$0.00 |
| 86200 |
|
14 |
14 |
$0.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
16 |
16 |
$0.00 |
| Q9950 |
Injection, sulfur hexafluoride lipid microspheres, per ml |
12 |
12 |
$0.00 |
| 59426 |
|
15 |
15 |
$0.00 |
| 90681 |
|
30 |
30 |
$0.00 |
| 29125 |
|
29 |
25 |
$0.00 |
| C1751 |
Catheter, infusion, inserted peripherally, centrally or midline (other than hemodialysis) |
18 |
13 |
$0.00 |
| 94664 |
|
15 |
12 |
$0.00 |
| 76001 |
|
15 |
14 |
$0.00 |
| J1953 |
Injection, levetiracetam, 10 mg |
14 |
12 |
$0.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
48 |
48 |
$0.00 |
| J2060 |
Injection, lorazepam, 2 mg |
3,043 |
2,484 |
$0.00 |
| J1642 |
Injection, heparin sodium, (heparin lock flush), per 10 units |
2,233 |
1,266 |
$0.00 |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
2,953 |
2,818 |
$0.00 |
| J0330 |
Injection, succinylcholine chloride, up to 20 mg |
2,642 |
2,514 |
$0.00 |
| J1040 |
Injection, methylprednisolone acetate, 80 mg |
1,076 |
1,000 |
$0.00 |
| J8597 |
Antiemetic drug, oral, not otherwise specified |
461 |
407 |
$0.00 |
| J7050 |
Infusion, normal saline solution, 250 cc |
5,405 |
3,226 |
$0.00 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
988 |
834 |
$0.00 |
| C1769 |
Guide wire |
1,955 |
1,823 |
$0.00 |
| J1010 |
Injection, methylprednisolone acetate, 1 mg |
87 |
86 |
$0.00 |
| J2360 |
Injection, orphenadrine citrate, up to 60 mg |
2,471 |
2,371 |
$0.00 |
| J3490 |
Unclassified drugs |
20,292 |
11,916 |
$0.00 |
| A9500 |
Technetium tc-99m sestamibi, diagnostic, per study dose |
595 |
578 |
$0.00 |
| 94760 |
|
754 |
561 |
$0.00 |
| J1741 |
Injection, ibuprofen, 100 mg |
1,403 |
1,356 |
$0.00 |
| J1030 |
Injection, methylprednisolone acetate, 40 mg |
131 |
107 |
$0.00 |
| 95886 |
|
663 |
652 |
$0.00 |
| J0500 |
Injection, dicyclomine hcl, up to 20 mg |
27 |
25 |
$0.00 |
| 97010 |
|
1,777 |
591 |
$0.00 |
| V2632 |
Posterior chamber intraocular lens |
57 |
51 |
$0.00 |
| A9585 |
Injection, gadobutrol, 0.1 ml |
2,151 |
2,066 |
$0.00 |
| J2795 |
Injection, ropivacaine hydrochloride, 1 mg |
1,308 |
1,230 |
$0.00 |
| J3420 |
Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg |
232 |
207 |
$0.00 |
| J3480 |
Injection, potassium chloride, per 2 meq |
581 |
387 |
$0.00 |
| 86308 |
|
59 |
58 |
$0.00 |
| J3535 |
Drug administered through a metered dose inhaler |
80 |
61 |
$0.00 |
| J2785 |
Injection, regadenoson, 0.1 mg |
471 |
463 |
$0.00 |
| 72170 |
|
42 |
40 |
$0.00 |
| 80329 |
|
263 |
137 |
$0.00 |
| 90647 |
|
101 |
101 |
$0.00 |
| 80320 |
|
229 |
211 |
$0.00 |
| 90723 |
|
99 |
99 |
$0.00 |
| J2370 |
Injection, phenylephrine hcl, up to 1 ml |
439 |
428 |
$0.00 |
| 99153 |
Mod sedat endo service >5yrs |
69 |
26 |
$0.00 |
| J2371 |
Injection, phenylephrine hydrochloride, 20 micrograms |
134 |
133 |
$0.00 |
| J7620 |
Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme |
264 |
236 |
$0.00 |
| J1940 |
Injection, furosemide, up to 20 mg |
15 |
12 |
$0.00 |
| 12001 |
|
201 |
198 |
$0.00 |
| C2617 |
Stent, non-coronary, temporary, without delivery system |
158 |
143 |
$0.00 |
| 96368 |
|
135 |
123 |
$0.00 |
| C1781 |
Mesh (implantable) |
37 |
36 |
$0.00 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
43 |
42 |
$0.00 |
| 99024 |
|
16 |
16 |
$0.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
19 |
18 |
$0.00 |
| C1889 |
Implantable/insertable device, not otherwise classified |
63 |
56 |
$0.00 |
| J1815 |
Injection, insulin, per 5 units |
77 |
54 |
$0.00 |
| 87801 |
Infectious agent detection by nucleic acid; amplified probe, multiple organisms |
76 |
75 |
$0.00 |
| 88108 |
|
13 |
12 |
$0.00 |
| 64494 |
|
12 |
12 |
$0.00 |
| 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 |
$0.00 |
| 88300 |
|
26 |
26 |
$0.00 |
| J1836 |
Injection, metronidazole, 10 mg |
21 |
12 |
$0.00 |
| J3411 |
Injection, thiamine hcl, 100 mg |
20 |
13 |
$0.00 |
| 64415 |
|
13 |
12 |
$0.00 |