| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
68,438 |
63,054 |
$7.82M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
53,602 |
48,055 |
$6.52M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
42,576 |
37,115 |
$5.87M |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
20,874 |
16,636 |
$1.89M |
| 96361 |
Intravenous infusion, hydration; each additional hour |
7,227 |
5,240 |
$1.76M |
| 70450 |
Computed tomography, head or brain; without contrast material |
7,710 |
6,569 |
$1.71M |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
5,183 |
4,227 |
$1.27M |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
8,720 |
8,235 |
$884K |
| 80053 |
Comprehensive metabolic panel |
96,932 |
80,582 |
$840K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
13,994 |
4,710 |
$714K |
| G0378 |
Hospital observation service, per hour |
11,545 |
4,180 |
$712K |
| J9271 |
Injection, pembrolizumab, 1 mg |
187 |
105 |
$694K |
| 92507 |
Treatment of speech, language, voice, communication, and/or auditory processing disorder |
9,647 |
3,333 |
$680K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
6,652 |
2,838 |
$630K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
10,027 |
2,979 |
$585K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
2,705 |
1,510 |
$573K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
2,290 |
1,789 |
$517K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
4,733 |
2,769 |
$481K |
| 95810 |
Polysomnography; sleep staging with 4 or more additional parameters |
750 |
695 |
$459K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
4,348 |
3,058 |
$458K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
4,481 |
2,136 |
$387K |
| 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 |
2,026 |
1,930 |
$374K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
1,047 |
848 |
$349K |
| 11045 |
|
932 |
410 |
$327K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
1,460 |
1,134 |
$305K |
| G0382 |
Level 3 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room or emergency department; (2) it is held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment; or (3) during the calendar year immediately preceding the calendar year in which a determination under 42 cfr 489.24 is being made, based on a representative sample of patient visits that occurred during that calendar year, it provides at least one-third of all of its outpatient visits for the treatment of emergency medical conditions on an urgent basis without requiring a previously scheduled appointment) |
2,409 |
2,378 |
$215K |
| 0202U |
Oncology (prostate), multianalyte, gene expression profiling |
1,637 |
1,343 |
$209K |
| 95811 |
|
331 |
301 |
$190K |
| 45385 |
Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) |
480 |
385 |
$185K |
| 93458 |
|
241 |
168 |
$183K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
101,171 |
82,565 |
$181K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
4,457 |
1,641 |
$163K |
| 93975 |
|
1,497 |
1,166 |
$163K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
852 |
663 |
$161K |
| 71046 |
Radiologic examination, chest; 2 views |
10,230 |
9,228 |
$160K |
| 70496 |
|
769 |
618 |
$149K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
406 |
320 |
$149K |
| 78815 |
Positron emission tomography (PET) for limited area imaging |
366 |
299 |
$149K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
10,024 |
8,454 |
$123K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
1,146 |
869 |
$122K |
| 84484 |
|
26,973 |
18,034 |
$121K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
1,248 |
1,041 |
$99K |
| 80061 |
Lipid panel |
6,227 |
5,596 |
$97K |
| 96367 |
|
1,817 |
985 |
$92K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
3,265 |
1,182 |
$89K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
1,024 |
838 |
$85K |
| 84443 |
Thyroid stimulating hormone (TSH) |
9,146 |
7,958 |
$85K |
| 36415 |
Collection of venous blood by venipuncture |
62,540 |
48,535 |
$83K |
| 29581 |
|
853 |
431 |
$83K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
9,075 |
6,478 |
$76K |
| 71250 |
|
1,005 |
839 |
$75K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
513 |
416 |
$72K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
38,009 |
31,798 |
$72K |
| 87801 |
Infectious agent detection by nucleic acid; amplified probe, multiple organisms |
1,465 |
1,281 |
$70K |
| 84439 |
|
3,621 |
3,261 |
$69K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
3,248 |
2,635 |
$68K |
| 71045 |
Radiologic examination, chest; single view |
24,550 |
21,380 |
$67K |
| 94060 |
|
626 |
575 |
$65K |
| 12001 |
|
439 |
378 |
$64K |
| 76642 |
|
570 |
488 |
$64K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
5,446 |
4,850 |
$61K |
| 93971 |
|
965 |
815 |
$60K |
| 80320 |
|
6,015 |
4,729 |
$59K |
| 71271 |
|
429 |
375 |
$58K |
| 74174 |
|
247 |
185 |
$57K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
1,337 |
1,211 |
$56K |
| 96415 |
|
570 |
248 |
$53K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
270 |
240 |
$51K |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
1,608 |
1,358 |
$50K |
| 88142 |
|
2,552 |
2,351 |
$49K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
156 |
112 |
$48K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
3,317 |
3,051 |
$45K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
1,907 |
1,850 |
$45K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
359 |
319 |
$43K |
| 82728 |
|
4,366 |
3,930 |
$42K |
| 97116 |
|
1,985 |
782 |
$41K |
| 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 |
1,926 |
1,831 |
$40K |
| 83735 |
|
10,733 |
7,977 |
$40K |
| 97161 |
|
937 |
804 |
$39K |
| 81001 |
|
44,414 |
39,667 |
$39K |
| 72100 |
|
1,112 |
993 |
$36K |
| 82607 |
|
2,902 |
2,587 |
$34K |
| 59025 |
Fetal non-stress test |
214 |
137 |
$33K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
9,423 |
8,018 |
$33K |
| 82805 |
|
1,357 |
931 |
$32K |
| 70491 |
|
117 |
95 |
$31K |
| 97166 |
|
704 |
550 |
$31K |
| 85027 |
|
6,772 |
5,131 |
$30K |
| 97597 |
|
509 |
327 |
$30K |
| 83540 |
|
4,447 |
4,003 |
$28K |
| 77386 |
|
207 |
15 |
$27K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
23,385 |
17,188 |
$27K |
| 83550 |
|
4,297 |
3,874 |
$27K |
| 86900 |
|
1,774 |
1,346 |
$27K |
| 83880 |
|
5,790 |
4,617 |
$27K |
| 94729 |
|
612 |
565 |
$27K |
| A9609 |
Fludeoxyglucose f18 up to 15 millicuries |
129 |
116 |
$27K |
| 93970 |
|
228 |
188 |
$26K |
| 73130 |
|
1,557 |
1,346 |
$24K |
| 97113 |
|
266 |
94 |
$24K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
2,147 |
1,767 |
$24K |
| 97162 |
|
1,078 |
843 |
$24K |
| 88341 |
|
423 |
275 |
$23K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
26,864 |
22,815 |
$22K |
| 72131 |
|
546 |
439 |
$22K |
| 80076 |
|
1,072 |
937 |
$22K |
| 85652 |
|
4,923 |
4,336 |
$22K |
| 86480 |
|
465 |
414 |
$20K |
| 76775 |
|
295 |
242 |
$19K |
| 82248 |
|
3,158 |
2,757 |
$19K |
| 73030 |
|
1,287 |
1,051 |
$19K |
| 86140 |
|
1,661 |
1,301 |
$18K |
| J1756 |
Injection, iron sucrose, 1 mg |
348 |
139 |
$18K |
| 77336 |
|
240 |
95 |
$18K |
| 84550 |
|
2,408 |
2,131 |
$17K |
| J0500 |
Injection, dicyclomine hcl, up to 20 mg |
789 |
609 |
$17K |
| 73630 |
|
1,554 |
1,351 |
$17K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
3,879 |
2,517 |
$17K |
| 96523 |
|
446 |
285 |
$17K |
| 76536 |
|
176 |
157 |
$16K |
| 80074 |
|
761 |
637 |
$16K |
| 82746 |
|
2,794 |
2,491 |
$16K |
| 73502 |
|
810 |
670 |
$15K |
| 90715 |
|
1,064 |
849 |
$15K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
70 |
65 |
$14K |
| 83615 |
|
2,791 |
2,447 |
$14K |
| 93017 |
|
217 |
163 |
$14K |
| 94726 |
|
264 |
247 |
$14K |
| 83690 |
|
23,450 |
20,366 |
$13K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
5,625 |
4,771 |
$13K |
| 82570 |
|
1,997 |
1,648 |
$13K |
| 73562 |
|
783 |
681 |
$13K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
911 |
800 |
$13K |
| 99152 |
|
286 |
231 |
$13K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
20,556 |
15,399 |
$12K |
| 86850 |
|
1,529 |
1,164 |
$12K |
| 70498 |
|
787 |
635 |
$12K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
1,301 |
1,177 |
$12K |
| 95819 |
|
98 |
78 |
$12K |
| 85610 |
|
5,913 |
3,854 |
$12K |
| J1750 |
Injection, iron dextran, 50 mg |
100 |
52 |
$12K |
| 87340 |
|
732 |
637 |
$12K |
| 12002 |
|
87 |
77 |
$11K |
| 86803 |
|
756 |
677 |
$11K |
| 86200 |
|
348 |
302 |
$11K |
| 84100 |
|
2,562 |
1,862 |
$11K |
| 88307 |
|
125 |
83 |
$11K |
| 70486 |
|
502 |
429 |
$11K |
| 83605 |
|
5,218 |
3,617 |
$11K |
| 77080 |
|
151 |
138 |
$10K |
| 74018 |
|
585 |
477 |
$10K |
| 83721 |
|
850 |
829 |
$10K |
| 84702 |
|
4,057 |
3,388 |
$9K |
| 76937 |
|
515 |
348 |
$9K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
115 |
91 |
$9K |
| 10060 |
|
66 |
57 |
$8K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
513 |
385 |
$8K |
| 82962 |
|
7,479 |
3,638 |
$8K |
| 96376 |
|
3,634 |
1,883 |
$8K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
1,393 |
1,182 |
$8K |
| 97535 |
Self-care/home management training, each 15 minutes |
568 |
319 |
$8K |
| 80329 |
|
3,094 |
2,548 |
$8K |
| 81003 |
|
6,448 |
5,253 |
$8K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
6,737 |
3,212 |
$8K |
| 73560 |
|
388 |
313 |
$8K |
| 86430 |
|
520 |
445 |
$7K |
| 94727 |
|
148 |
138 |
$7K |
| 92523 |
|
104 |
83 |
$7K |
| 41899 |
Unlisted procedure, dentoalveolar structures |
15 |
15 |
$7K |
| 83516 |
|
347 |
264 |
$7K |
| 73610 |
|
1,223 |
1,061 |
$7K |
| 86038 |
|
459 |
397 |
$7K |
| 73110 |
|
806 |
692 |
$7K |
| 86160 |
|
392 |
166 |
$7K |
| 12011 |
|
43 |
41 |
$6K |
| 73564 |
|
609 |
520 |
$6K |
| 84156 |
|
1,519 |
1,229 |
$6K |
| 88342 |
|
1,351 |
1,015 |
$6K |
| 88184 |
|
89 |
82 |
$6K |
| 72040 |
|
173 |
141 |
$6K |
| P9016 |
Red blood cells, leukocytes reduced, each unit |
44 |
28 |
$6K |
| 86708 |
|
237 |
209 |
$6K |
| 77066 |
Tomosynthesis, mammo |
232 |
202 |
$6K |
| 72050 |
|
76 |
68 |
$6K |
| 85730 |
|
2,373 |
1,768 |
$6K |
| 96417 |
|
818 |
371 |
$6K |
| 94150 |
|
260 |
111 |
$6K |
| 82565 |
|
822 |
676 |
$6K |
| 36430 |
|
76 |
52 |
$5K |
| 72141 |
|
58 |
53 |
$5K |
| 97016 |
|
223 |
69 |
$5K |
| 72128 |
|
244 |
195 |
$5K |
| 86901 |
|
1,772 |
1,346 |
$5K |
| 76830 |
Ultrasound, transvaginal |
382 |
313 |
$5K |
| J2469 |
Injection, palonosetron hcl, 25 mcg |
1,037 |
442 |
$4K |
| 82550 |
|
2,608 |
2,204 |
$4K |
| 82043 |
|
577 |
523 |
$4K |
| 86592 |
|
183 |
162 |
$4K |
| J3490 |
Unclassified drugs |
402 |
163 |
$4K |
| 36591 |
|
301 |
167 |
$4K |
| 73080 |
|
362 |
311 |
$4K |
| 77065 |
Tomosynthesis, mammo |
160 |
119 |
$4K |
| G0279 |
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) |
527 |
465 |
$4K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
1,384 |
1,181 |
$4K |
| 83970 |
|
119 |
103 |
$4K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
36 |
29 |
$4K |
| 82784 |
|
404 |
267 |
$4K |
| 87186 |
|
1,538 |
1,197 |
$4K |
| 85045 |
|
999 |
864 |
$4K |
| 84153 |
|
356 |
302 |
$4K |
| 76882 |
|
33 |
24 |
$4K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
78 |
62 |
$3K |
| 84703 |
|
5,723 |
5,061 |
$3K |
| 86706 |
|
225 |
178 |
$3K |
| 86780 |
|
256 |
216 |
$3K |
| G0123 |
Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, screening by cytotechnologist under physician supervision |
242 |
231 |
$3K |
| 71101 |
|
313 |
271 |
$3K |
| 82040 |
|
620 |
548 |
$3K |
| 87070 |
|
887 |
673 |
$3K |
| 84145 |
|
873 |
619 |
$3K |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
4,532 |
1,716 |
$2K |
| 94664 |
|
743 |
510 |
$2K |
| 84460 |
|
238 |
200 |
$2K |
| 84165 |
|
400 |
326 |
$2K |
| 81025 |
|
6,068 |
4,977 |
$2K |
| 72170 |
|
413 |
318 |
$2K |
| 87077 |
|
1,956 |
1,489 |
$2K |
| 84630 |
|
123 |
108 |
$2K |
| 76000 |
|
20 |
14 |
$2K |
| 73221 |
|
12 |
12 |
$2K |
| 99153 |
Mod sedat endo service >5yrs |
61 |
43 |
$2K |
| 97605 |
|
132 |
52 |
$2K |
| 87081 |
|
3,092 |
2,665 |
$2K |
| 00731 |
|
788 |
623 |
$2K |
| 88304 |
|
374 |
260 |
$2K |
| C9803 |
Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
45 |
43 |
$2K |
| 94618 |
|
29 |
26 |
$2K |
| 11719 |
|
183 |
158 |
$2K |
| 87075 |
|
592 |
445 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,152 |
900 |
$2K |
| 85379 |
|
1,535 |
1,199 |
$2K |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
4,265 |
2,744 |
$2K |
| 86922 |
|
108 |
55 |
$1K |
| 85007 |
|
1,076 |
718 |
$1K |
| 84481 |
|
77 |
65 |
$1K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
12,518 |
10,295 |
$1K |
| 84155 |
|
447 |
365 |
$1K |
| 86704 |
|
160 |
134 |
$1K |
| 85018 |
|
505 |
290 |
$1K |
| 73590 |
|
370 |
312 |
$1K |
| 73090 |
|
266 |
240 |
$1K |
| 84450 |
|
154 |
129 |
$1K |
| 87430 |
|
2,984 |
2,524 |
$997.89 |
| 80069 |
|
99 |
92 |
$978.47 |
| 94761 |
|
10,090 |
5,039 |
$975.61 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
2,628 |
1,263 |
$956.73 |
| 87040 |
|
1,915 |
958 |
$939.87 |
| 86141 |
|
56 |
40 |
$917.57 |
| 84112 |
|
26 |
25 |
$914.64 |
| 72072 |
|
27 |
24 |
$905.11 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
15,920 |
13,066 |
$898.70 |
| J1453 |
Injection, fosaprepitant, 1 mg |
94 |
53 |
$890.24 |
| J1642 |
Injection, heparin sodium, (heparin lock flush), per 10 units |
4,439 |
2,092 |
$887.02 |
| 82140 |
|
125 |
79 |
$869.50 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
306 |
289 |
$849.50 |
| 92610 |
|
21 |
15 |
$838.24 |
| 96368 |
|
581 |
301 |
$815.69 |
| J3420 |
Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg |
466 |
304 |
$758.52 |
| 84520 |
|
111 |
89 |
$723.15 |
| A9552 |
Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries |
209 |
158 |
$712.00 |
| J0702 |
Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg |
58 |
27 |
$709.52 |
| 80164 |
|
61 |
49 |
$685.14 |
| 76801 |
|
91 |
81 |
$681.07 |
| 83883 |
|
93 |
42 |
$649.56 |
| 72110 |
|
18 |
14 |
$531.14 |
| 85014 |
|
341 |
184 |
$512.40 |
| 87210 |
|
544 |
455 |
$512.05 |
| 83655 |
|
15 |
14 |
$495.30 |
| 87088 |
|
295 |
247 |
$474.55 |
| 73060 |
|
60 |
52 |
$463.69 |
| 72070 |
|
19 |
14 |
$416.63 |
| 85613 |
|
54 |
43 |
$405.18 |
| 82785 |
|
25 |
24 |
$405.12 |
| J7030 |
Infusion, normal saline solution , 1000 cc |
2,537 |
1,955 |
$383.85 |
| 86431 |
|
49 |
49 |
$365.94 |
| 84154 |
|
18 |
12 |
$336.46 |
| J9045 |
Injection, carboplatin, 50 mg |
43 |
14 |
$333.04 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
13,997 |
10,138 |
$319.39 |
| 76870 |
|
77 |
51 |
$315.69 |
| 84425 |
|
13 |
13 |
$309.28 |
| J7050 |
Infusion, normal saline solution, 250 cc |
777 |
369 |
$304.72 |
| 73552 |
|
17 |
13 |
$302.05 |
| 00840 |
|
292 |
189 |
$301.56 |
| C1713 |
Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) |
208 |
134 |
$294.40 |
| 82010 |
|
444 |
311 |
$276.90 |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
1,337 |
705 |
$258.26 |
| J2543 |
Injection, piperacillin sodium/tazobactam sodium, 1 gram/0.125 grams (1.125 grams) |
107 |
27 |
$245.39 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
5,230 |
3,226 |
$235.32 |
| C1769 |
Guide wire |
1,053 |
744 |
$235.25 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
2,714 |
1,385 |
$234.78 |
| J1953 |
Injection, levetiracetam, 10 mg |
79 |
54 |
$232.73 |
| J2704 |
Injection, propofol, 10 mg |
7,809 |
4,527 |
$232.16 |
| J8540 |
Dexamethasone, oral, 0.25 mg |
850 |
650 |
$221.67 |
| J1644 |
Injection, heparin sodium, per 1000 units |
1,937 |
782 |
$197.23 |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
717 |
530 |
$183.73 |
| J2785 |
Injection, regadenoson, 0.1 mg |
118 |
80 |
$183.45 |
| C1894 |
Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser |
1,011 |
715 |
$182.86 |
| 86300 |
|
14 |
14 |
$177.43 |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
12 |
12 |
$170.72 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
3,341 |
2,084 |
$168.82 |
| 86593 |
|
42 |
40 |
$158.84 |
| C9399 |
Unclassified drugs or biologicals |
74 |
58 |
$156.06 |
| J1456 |
Injection, fosaprepitant (teva), not therapeutically equivalent to j1453, 1 mg |
32 |
12 |
$152.02 |
| J2360 |
Injection, orphenadrine citrate, up to 60 mg |
256 |
204 |
$151.46 |
| 86039 |
|
26 |
25 |
$143.48 |
| J2550 |
Injection, promethazine hcl, up to 50 mg |
769 |
505 |
$142.73 |
| 86812 |
|
17 |
15 |
$139.04 |
| 82947 |
|
67 |
41 |
$137.27 |
| J2060 |
Injection, lorazepam, 2 mg |
946 |
655 |
$127.81 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
6,744 |
4,156 |
$123.80 |
| 87205 |
|
96 |
80 |
$121.77 |
| 80143 |
|
212 |
193 |
$119.80 |
| J3480 |
Injection, potassium chloride, per 2 meq |
455 |
173 |
$118.62 |
| 83521 |
|
19 |
12 |
$109.99 |
| 82105 |
|
12 |
12 |
$109.01 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
1,732 |
1,153 |
$92.88 |
| 82525 |
|
21 |
13 |
$90.56 |
| J3370 |
Injection, vancomycin hcl, 500 mg |
414 |
203 |
$84.60 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
600 |
377 |
$81.75 |
| 80179 |
|
212 |
193 |
$79.30 |
| 51798 |
|
78 |
52 |
$76.56 |
| 87634 |
|
81 |
69 |
$72.14 |
| 83010 |
|
29 |
25 |
$70.34 |
| 86317 |
|
14 |
12 |
$67.26 |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
749 |
512 |
$63.80 |
| 29125 |
|
61 |
52 |
$61.91 |
| J2919 |
Injection, methylprednisolone sodium succinate, 5 mg |
302 |
209 |
$61.37 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
1,179 |
821 |
$54.86 |
| 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 |
90 |
61 |
$53.62 |
| C9113 |
Injection, pantoprazole sodium, per vial |
126 |
75 |
$44.64 |
| J1790 |
Injection, droperidol, up to 5 mg |
484 |
388 |
$44.08 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
2,474 |
1,730 |
$41.32 |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
927 |
672 |
$36.51 |
| J2920 |
Injection, methylprednisolone sodium succinate, up to 40 mg |
131 |
67 |
$34.56 |
| 00813 |
|
226 |
183 |
$34.39 |
| J1630 |
Injection, haloperidol, up to 5 mg |
386 |
270 |
$31.96 |
| J2371 |
Injection, phenylephrine hydrochloride, 20 micrograms |
502 |
311 |
$21.28 |
| J2470 |
Injection, pantoprazole sodium, 40 mg |
236 |
179 |
$17.83 |
| J2272 |
Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg |
54 |
46 |
$12.35 |
| J0360 |
Injection, hydralazine hcl, up to 20 mg |
40 |
27 |
$12.01 |
| 82378 |
|
13 |
12 |
$11.28 |
| J1940 |
Injection, furosemide, up to 20 mg |
222 |
99 |
$10.60 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
2,145 |
1,598 |
$8.87 |
| J1596 |
Injection, glycopyrrolate, 0.1 mg |
16 |
13 |
$6.42 |
| 36416 |
|
799 |
430 |
$5.69 |
| Q0162 |
Ondansetron 1 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen |
184 |
159 |
$5.25 |
| J1171 |
Injection, hydromorphone, 0.1 mg |
257 |
123 |
$4.29 |
| J2370 |
Injection, phenylephrine hcl, up to 1 ml |
138 |
66 |
$3.34 |
| J0330 |
Injection, succinylcholine chloride, up to 20 mg |
79 |
61 |
$1.95 |
| A9577 |
Injection, gadobenate dimeglumine (multihance), per ml |
90 |
73 |
$1.84 |
| J2305 |
Injection, nitroglycerin, 5 mg |
12 |
12 |
$1.44 |
| J7620 |
Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme |
29 |
27 |
$0.31 |
| 76376 |
|
315 |
154 |
$0.00 |
| 00812 |
|
120 |
87 |
$0.00 |
| 01810 |
|
21 |
12 |
$0.00 |
| C1729 |
Catheter, drainage |
42 |
25 |
$0.00 |
| 00811 |
|
57 |
39 |
$0.00 |
| J0171 |
Injection, adrenalin, epinephrine, 0.1 mg |
21 |
13 |
$0.00 |
| C1887 |
Catheter, guiding (may include infusion/perfusion capability) |
18 |
13 |
$0.00 |
| 43249 |
|
14 |
14 |
$0.00 |
| C1776 |
Joint device (implantable) |
45 |
27 |
$0.00 |
| 00170 |
Anesthesia for intraoral procedures, including biopsy |
24 |
24 |
$0.00 |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
16 |
14 |
$0.00 |
| C1889 |
Implantable/insertable device, not otherwise classified |
65 |
43 |
$0.00 |
| A9579 |
Injection, gadolinium-based magnetic resonance contrast agent, not otherwise specified (nos), per ml |
532 |
459 |
$0.00 |
| 00790 |
|
59 |
39 |
$0.00 |
| A9500 |
Technetium tc-99m sestamibi, diagnostic, per study dose |
178 |
131 |
$0.00 |
| J2003 |
Injection, lidocaine hydrochloride, 1 mg |
128 |
120 |
$0.00 |
| J2795 |
Injection, ropivacaine hydrochloride, 1 mg |
65 |
41 |
$0.00 |
| G0379 |
Direct admission of patient for hospital observation care |
14 |
12 |
$0.00 |
| C1725 |
Catheter, transluminal angioplasty, non-laser (may include guidance, infusion/perfusion capability) |
19 |
15 |
$0.00 |
| 00952 |
|
18 |
12 |
$0.00 |