| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
Emergency department visit for the evaluation and management, high severity |
20,347 |
19,312 |
$4.22M |
| G0378 |
Hospital observation service, per hour |
2,063 |
1,191 |
$1.73M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
7,006 |
6,702 |
$1.55M |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
3,433 |
3,403 |
$535K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
2,224 |
2,047 |
$470K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
2,101 |
1,962 |
$318K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
977 |
624 |
$210K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
3,403 |
3,353 |
$139K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
230 |
218 |
$115K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
265 |
254 |
$97K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
1,248 |
716 |
$79K |
| T1015 |
Clinic visit/encounter, all-inclusive |
1,098 |
476 |
$71K |
| 97602 |
|
571 |
354 |
$70K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
426 |
414 |
$57K |
| 77066 |
Tomosynthesis, mammo |
273 |
266 |
$49K |
| 76642 |
|
552 |
505 |
$46K |
| 97597 |
|
756 |
290 |
$46K |
| 76641 |
|
330 |
229 |
$37K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
1,440 |
965 |
$36K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
289 |
282 |
$32K |
| 71250 |
|
299 |
298 |
$32K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
471 |
250 |
$30K |
| 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 |
403 |
394 |
$28K |
| G0279 |
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) |
671 |
646 |
$26K |
| 77065 |
Tomosynthesis, mammo |
199 |
183 |
$26K |
| 76830 |
Ultrasound, transvaginal |
295 |
289 |
$25K |
| 76536 |
|
260 |
253 |
$25K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
1,103 |
1,028 |
$24K |
| 45385 |
Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) |
41 |
37 |
$24K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
357 |
345 |
$23K |
| 71046 |
Radiologic examination, chest; 2 views |
1,200 |
1,169 |
$23K |
| 97598 |
|
221 |
73 |
$22K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
150 |
139 |
$22K |
| 76770 |
|
284 |
280 |
$22K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
7,162 |
5,851 |
$20K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
6,238 |
5,100 |
$19K |
| 77080 |
|
206 |
200 |
$19K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
167 |
160 |
$18K |
| 72110 |
|
351 |
342 |
$15K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
1,467 |
1,244 |
$15K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
3,231 |
2,935 |
$15K |
| 70450 |
Computed tomography, head or brain; without contrast material |
587 |
560 |
$14K |
| 93970 |
|
110 |
108 |
$14K |
| 74183 |
|
15 |
15 |
$13K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
330 |
322 |
$11K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
201 |
192 |
$10K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
16 |
12 |
$8K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
97 |
96 |
$8K |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
1,337 |
1,270 |
$8K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
411 |
265 |
$8K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
95 |
94 |
$8K |
| 10005 |
|
15 |
13 |
$8K |
| 94729 |
|
108 |
108 |
$6K |
| 73630 |
|
405 |
342 |
$6K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
1,255 |
753 |
$6K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
26 |
26 |
$5K |
| 95886 |
|
58 |
55 |
$5K |
| 73030 |
|
215 |
196 |
$5K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
244 |
222 |
$5K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
172 |
167 |
$5K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
105 |
94 |
$5K |
| 84484 |
|
1,994 |
1,587 |
$5K |
| 71045 |
Radiologic examination, chest; single view |
1,637 |
1,503 |
$5K |
| 88342 |
|
132 |
121 |
$5K |
| 73564 |
|
213 |
174 |
$4K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
3,480 |
3,335 |
$4K |
| 72050 |
|
69 |
68 |
$4K |
| 80076 |
|
1,385 |
1,206 |
$4K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
70 |
66 |
$3K |
| 73610 |
|
157 |
144 |
$3K |
| 97161 |
|
114 |
112 |
$3K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
12 |
12 |
$2K |
| 97162 |
|
71 |
68 |
$2K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
107 |
74 |
$2K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
416 |
309 |
$2K |
| 94726 |
|
44 |
44 |
$2K |
| 93971 |
|
27 |
27 |
$2K |
| 73130 |
|
190 |
153 |
$2K |
| 83880 |
|
289 |
273 |
$2K |
| 80053 |
Comprehensive metabolic panel |
418 |
340 |
$2K |
| C1769 |
Guide wire |
87 |
81 |
$2K |
| 82803 |
|
291 |
255 |
$2K |
| A9270 |
Non-covered item or service |
16,960 |
5,063 |
$2K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
260 |
237 |
$2K |
| A9585 |
Injection, gadobutrol, 0.1 ml |
614 |
458 |
$2K |
| 81001 |
|
923 |
845 |
$2K |
| 96417 |
|
17 |
12 |
$2K |
| 93975 |
|
25 |
25 |
$2K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
260 |
237 |
$1K |
| 73562 |
|
50 |
40 |
$1K |
| 83690 |
|
890 |
794 |
$1K |
| 76376 |
|
44 |
44 |
$1K |
| J2704 |
Injection, propofol, 10 mg |
3,313 |
3,209 |
$1K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
605 |
551 |
$1K |
| 85730 |
|
494 |
434 |
$1K |
| 84443 |
Thyroid stimulating hormone (TSH) |
240 |
227 |
$1K |
| 73502 |
|
44 |
43 |
$1K |
| 83605 |
|
571 |
487 |
$1K |
| 85027 |
|
225 |
188 |
$1K |
| 93922 |
|
14 |
14 |
$970.37 |
| 90715 |
|
106 |
99 |
$840.94 |
| 73110 |
|
68 |
57 |
$837.03 |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
63 |
25 |
$808.46 |
| 83735 |
|
667 |
514 |
$775.05 |
| 85610 |
|
582 |
502 |
$745.69 |
| 0001A |
|
15 |
15 |
$679.02 |
| 87077 |
|
204 |
193 |
$652.43 |
| 80320 |
|
121 |
111 |
$646.82 |
| 85379 |
|
258 |
239 |
$637.18 |
| 87040 |
|
147 |
128 |
$560.20 |
| J2469 |
Injection, palonosetron hcl, 25 mcg |
552 |
321 |
$555.81 |
| G0433 |
Infectious agent antibody detection by enzyme-linked immunosorbent assay (elisa) technique, hiv-1 and/or hiv-2, screening |
140 |
132 |
$546.81 |
| 86900 |
|
226 |
212 |
$482.59 |
| 36415 |
Collection of venous blood by venipuncture |
964 |
626 |
$433.90 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
152 |
146 |
$404.67 |
| 99215 |
Prolong outpt/office vis |
30 |
25 |
$385.30 |
| 86850 |
|
149 |
144 |
$334.07 |
| 96376 |
|
241 |
134 |
$303.30 |
| 94060 |
|
14 |
14 |
$299.80 |
| 72100 |
|
38 |
37 |
$299.45 |
| 81003 |
|
359 |
338 |
$299.37 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
2,247 |
1,776 |
$276.13 |
| 84702 |
|
56 |
53 |
$262.72 |
| 86901 |
|
192 |
182 |
$230.40 |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
21 |
12 |
$193.18 |
| 87186 |
|
89 |
84 |
$168.36 |
| 82550 |
|
82 |
72 |
$153.62 |
| 73080 |
|
14 |
13 |
$150.20 |
| 80329 |
|
15 |
15 |
$86.58 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
3,061 |
2,699 |
$84.60 |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
22 |
19 |
$79.18 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
3,118 |
2,754 |
$75.90 |
| J3490 |
Unclassified drugs |
3,570 |
2,532 |
$74.13 |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
1,435 |
754 |
$67.06 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
2,531 |
2,034 |
$66.95 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
647 |
548 |
$65.10 |
| 87205 |
|
30 |
29 |
$61.19 |
| 87070 |
|
12 |
12 |
$47.94 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
4,058 |
3,541 |
$47.36 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
700 |
599 |
$44.42 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
15 |
15 |
$39.41 |
| 86140 |
|
36 |
28 |
$30.87 |
| 84100 |
|
70 |
63 |
$27.19 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
2,307 |
2,207 |
$24.69 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
577 |
438 |
$16.97 |
| 85652 |
|
12 |
12 |
$15.05 |
| 83540 |
|
15 |
13 |
$12.05 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
949 |
556 |
$10.75 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
570 |
510 |
$10.33 |
| J1642 |
Injection, heparin sodium, (heparin lock flush), per 10 units |
398 |
225 |
$7.14 |
| 83550 |
|
13 |
12 |
$7.13 |
| J1815 |
Injection, insulin, per 5 units |
743 |
287 |
$5.62 |
| J2060 |
Injection, lorazepam, 2 mg |
15 |
12 |
$4.70 |
| 88300 |
|
15 |
12 |
$0.00 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
323 |
294 |
$0.00 |
| J2003 |
Injection, lidocaine hydrochloride, 1 mg |
214 |
193 |
$0.00 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
508 |
332 |
$0.00 |
| 00000 |
|
169 |
91 |
$0.00 |
| J2370 |
Injection, phenylephrine hcl, up to 1 ml |
13 |
12 |
$0.00 |
| J1439 |
Injection, ferric carboxymaltose, 1 mg |
30 |
17 |
$0.00 |
| J7999 |
Compounded drug, not otherwise classified |
54 |
36 |
$0.00 |
| J1790 |
Injection, droperidol, up to 5 mg |
39 |
36 |
$0.00 |
| C1713 |
Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) |
24 |
24 |
$0.00 |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
128 |
111 |
$0.00 |
| J1644 |
Injection, heparin sodium, per 1000 units |
108 |
57 |
$0.00 |
| J1596 |
Injection, glycopyrrolate, 0.1 mg |
352 |
340 |
$0.00 |
| G1004 |
Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program |
194 |
151 |
$0.00 |
| J1756 |
Injection, iron sucrose, 1 mg |
767 |
314 |
$0.00 |
| J2916 |
Injection, sodium ferric gluconate complex in sucrose injection, 12.5 mg |
274 |
104 |
$0.00 |
| J2004 |
Injection, lidocaine hcl with epinephrine, 1 mg |
15 |
15 |
$0.00 |
| J2919 |
Injection, methylprednisolone sodium succinate, 5 mg |
45 |
42 |
$0.00 |
| J0702 |
Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg |
52 |
52 |
$0.00 |
| Q9966 |
Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml |
66 |
65 |
$0.00 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
30 |
29 |
$0.00 |
| J1171 |
Injection, hydromorphone, 0.1 mg |
61 |
40 |
$0.00 |