| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
Emergency department visit for the evaluation and management, high severity |
30,063 |
28,381 |
$6.46M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
42,320 |
40,578 |
$5.98M |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
26,906 |
22,779 |
$2.15M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
4,619 |
4,259 |
$1.41M |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
10,776 |
10,000 |
$1.17M |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
2,486 |
1,467 |
$419K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
8,031 |
7,406 |
$344K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
3,567 |
3,429 |
$316K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
7,167 |
6,522 |
$302K |
| 42820 |
Tonsillectomy and adenoidectomy; younger than age 12 |
58 |
58 |
$287K |
| 69436 |
Tympanostomy (requiring insertion of ventilating tube), general anesthesia |
328 |
323 |
$284K |
| 71046 |
Radiologic examination, chest; 2 views |
3,461 |
3,299 |
$194K |
| 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 |
2,774 |
2,680 |
$151K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
3,371 |
3,230 |
$131K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
3,890 |
3,778 |
$122K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
3,891 |
3,779 |
$120K |
| 86900 |
|
1,439 |
1,355 |
$116K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
1,562 |
1,516 |
$115K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
406 |
392 |
$83K |
| 71045 |
Radiologic examination, chest; single view |
1,583 |
1,483 |
$80K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
2,375 |
712 |
$79K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
587 |
521 |
$72K |
| 92507 |
Treatment of speech, language, voice, communication, and/or auditory processing disorder |
991 |
305 |
$64K |
| 80053 |
Comprehensive metabolic panel |
42,457 |
39,492 |
$54K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
46,159 |
42,108 |
$45K |
| 94060 |
|
300 |
282 |
$45K |
| 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 |
2,360 |
2,280 |
$45K |
| 70450 |
Computed tomography, head or brain; without contrast material |
452 |
423 |
$43K |
| 59025 |
Fetal non-stress test |
338 |
285 |
$41K |
| 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 |
472 |
447 |
$33K |
| 84443 |
Thyroid stimulating hormone (TSH) |
3,176 |
3,052 |
$28K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
1,298 |
1,237 |
$25K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
112 |
63 |
$23K |
| 80061 |
Lipid panel |
2,105 |
2,031 |
$22K |
| 90837 |
Psychotherapy, 53 minutes with patient |
147 |
120 |
$22K |
| 36415 |
Collection of venous blood by venipuncture |
50,554 |
45,009 |
$21K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
225 |
215 |
$21K |
| 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 |
283 |
279 |
$20K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
1,407 |
1,315 |
$18K |
| 86780 |
|
1,669 |
1,581 |
$18K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
58 |
56 |
$16K |
| C9803 |
Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
7,444 |
7,086 |
$15K |
| 0353U |
|
218 |
208 |
$13K |
| 41899 |
Unlisted procedure, dentoalveolar structures |
56 |
53 |
$12K |
| 86762 |
|
1,026 |
976 |
$12K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
469 |
347 |
$12K |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
445 |
435 |
$9K |
| 87340 |
|
1,072 |
1,022 |
$9K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
314 |
110 |
$8K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
63 |
57 |
$7K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
78 |
72 |
$7K |
| 20610 |
|
25 |
24 |
$6K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
3,322 |
3,068 |
$6K |
| 85027 |
|
1,492 |
1,387 |
$6K |
| 11721 |
|
694 |
641 |
$6K |
| A0425 |
Ground mileage, per statute mile |
73 |
65 |
$5K |
| 88142 |
|
248 |
242 |
$5K |
| 84439 |
|
729 |
707 |
$4K |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
168 |
164 |
$4K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
38 |
37 |
$4K |
| 95813 |
|
16 |
16 |
$4K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
598 |
572 |
$3K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
30 |
30 |
$3K |
| 86803 |
|
287 |
262 |
$3K |
| 76830 |
Ultrasound, transvaginal |
29 |
29 |
$3K |
| 90834 |
Psychotherapy, 45 minutes with patient |
17 |
12 |
$3K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
9,798 |
8,780 |
$3K |
| 81001 |
|
24,734 |
23,280 |
$2K |
| 86140 |
|
2,758 |
2,606 |
$2K |
| 29581 |
|
27 |
12 |
$2K |
| 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 |
595 |
546 |
$2K |
| 90791 |
Psychiatric diagnostic evaluation |
13 |
13 |
$2K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
119 |
114 |
$2K |
| 87150 |
|
87 |
80 |
$2K |
| 87210 |
|
378 |
354 |
$2K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
3,037 |
2,849 |
$2K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
12 |
12 |
$1K |
| 87660 |
|
118 |
116 |
$1K |
| 97597 |
|
17 |
12 |
$1K |
| 85652 |
|
785 |
736 |
$1K |
| 87480 |
|
118 |
116 |
$1K |
| 87510 |
|
118 |
116 |
$1K |
| 97162 |
|
12 |
12 |
$830.83 |
| 93017 |
|
12 |
12 |
$801.27 |
| 71250 |
|
12 |
12 |
$790.75 |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
513 |
476 |
$656.79 |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
12 |
12 |
$618.96 |
| 84460 |
|
175 |
167 |
$583.01 |
| 84450 |
|
175 |
167 |
$576.14 |
| 82565 |
|
146 |
141 |
$517.93 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
1,338 |
1,262 |
$500.25 |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
392 |
386 |
$467.23 |
| 80069 |
|
89 |
87 |
$465.23 |
| 82105 |
|
25 |
25 |
$442.82 |
| 86850 |
|
1,363 |
1,289 |
$442.24 |
| J0134 |
Injection, acetaminophen (fresenius kabi), not therapeutically equivalent to j0131, 10 mg |
132 |
127 |
$367.43 |
| 82950 |
|
77 |
76 |
$350.48 |
| 73630 |
|
16 |
16 |
$341.36 |
| 80048 |
Basic metabolic panel (calcium, ionized) |
903 |
837 |
$296.64 |
| 84484 |
|
3,781 |
3,095 |
$289.18 |
| 82728 |
|
25 |
24 |
$287.24 |
| 82040 |
|
75 |
74 |
$284.71 |
| 83540 |
|
53 |
51 |
$266.61 |
| 90656 |
|
240 |
189 |
$262.26 |
| 87070 |
|
41 |
38 |
$257.99 |
| 73562 |
|
17 |
17 |
$256.02 |
| 73610 |
|
16 |
15 |
$256.02 |
| 86200 |
|
26 |
25 |
$247.68 |
| 84145 |
|
2,307 |
2,168 |
$244.94 |
| 83605 |
|
3,685 |
3,259 |
$242.70 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,596 |
1,539 |
$222.85 |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
1,944 |
1,888 |
$211.15 |
| 87186 |
|
55 |
48 |
$210.81 |
| 87077 |
|
53 |
46 |
$196.92 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
169 |
158 |
$189.92 |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
2,114 |
2,024 |
$172.44 |
| 94726 |
|
122 |
115 |
$167.16 |
| 96127 |
|
869 |
831 |
$166.57 |
| 83690 |
|
4,698 |
4,450 |
$127.65 |
| 85730 |
|
1,684 |
1,539 |
$123.47 |
| 83516 |
|
12 |
12 |
$122.48 |
| 82570 |
|
27 |
26 |
$102.27 |
| 83655 |
|
35 |
26 |
$93.50 |
| 87040 |
|
1,311 |
795 |
$74.32 |
| 83880 |
|
129 |
117 |
$73.75 |
| 85610 |
|
1,983 |
1,815 |
$67.46 |
| 90461 |
|
172 |
118 |
$60.95 |
| 82043 |
|
13 |
12 |
$51.88 |
| 82248 |
|
12 |
12 |
$34.62 |
| 86430 |
|
12 |
12 |
$33.95 |
| 86901 |
|
1,426 |
1,343 |
$31.86 |
| 86431 |
|
16 |
13 |
$26.95 |
| 85018 |
|
12 |
12 |
$25.47 |
| 85014 |
|
12 |
12 |
$22.54 |
| 83615 |
|
36 |
29 |
$17.22 |
| 83735 |
|
191 |
166 |
$14.43 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
4,250 |
4,052 |
$13.28 |
| 81025 |
|
947 |
915 |
$11.79 |
| 84703 |
|
379 |
363 |
$7.35 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
2,781 |
2,522 |
$6.36 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
3,329 |
3,107 |
$5.75 |
| J0689 |
Injection, cefazolin sodium (baxter), not therapeutically equivalent to j0690, 500 mg |
14 |
14 |
$5.02 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
1,284 |
1,123 |
$3.61 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
1,582 |
1,409 |
$1.72 |
| 90677 |
|
43 |
28 |
$0.12 |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
28 |
24 |
$0.01 |
| 72114 |
|
12 |
12 |
$0.00 |
| J2550 |
Injection, promethazine hcl, up to 50 mg |
146 |
135 |
$0.00 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
315 |
278 |
$0.00 |
| 80076 |
|
297 |
281 |
$0.00 |
| 94729 |
|
135 |
130 |
$0.00 |
| 90833 |
Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) |
42 |
39 |
$0.00 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
252 |
237 |
$0.00 |
| 87339 |
|
45 |
44 |
$0.00 |
| 73110 |
|
16 |
12 |
$0.00 |
| 87633 |
Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets |
16 |
16 |
$0.00 |
| 81003 |
|
29 |
27 |
$0.00 |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
17 |
12 |
$0.00 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
26 |
25 |
$0.00 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
12 |
12 |
$0.00 |
| C1758 |
Catheter, ureteral |
13 |
12 |
$0.00 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
66 |
57 |
$0.00 |
| 92134 |
|
13 |
12 |
$0.00 |
| 88312 |
|
13 |
12 |
$0.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
40 |
18 |
$0.00 |
| 82550 |
|
179 |
160 |
$0.00 |
| 83874 |
|
250 |
217 |
$0.00 |
| C1889 |
Implantable/insertable device, not otherwise classified |
181 |
179 |
$0.00 |
| 86308 |
|
269 |
254 |
$0.00 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
87 |
82 |
$0.00 |
| J1642 |
Injection, heparin sodium, (heparin lock flush), per 10 units |
212 |
125 |
$0.00 |
| J2704 |
Injection, propofol, 10 mg |
247 |
231 |
$0.00 |
| J2060 |
Injection, lorazepam, 2 mg |
277 |
253 |
$0.00 |
| 85379 |
|
226 |
220 |
$0.00 |
| J3490 |
Unclassified drugs |
53 |
50 |
$0.00 |
| J1790 |
Injection, droperidol, up to 5 mg |
14 |
12 |
$0.00 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
70 |
66 |
$0.00 |
| A9579 |
Injection, gadolinium-based magnetic resonance contrast agent, not otherwise specified (nos), per ml |
13 |
12 |
$0.00 |
| J2795 |
Injection, ropivacaine hydrochloride, 1 mg |
97 |
76 |
$0.00 |
| 74019 |
|
107 |
97 |
$0.00 |
| 74420 |
|
30 |
24 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
14 |
14 |
$0.00 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
26 |
24 |
$0.00 |
| S0020 |
Injection, bupivicaine hydrochloride, 30 ml |
53 |
52 |
$0.00 |
| 82803 |
|
35 |
31 |
$0.00 |
| 0352U |
|
19 |
19 |
$0.00 |
| G0378 |
Hospital observation service, per hour |
14 |
12 |
$0.00 |
| 12001 |
|
12 |
12 |
$0.00 |