| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
56,260 |
50,087 |
$12.30M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
24,462 |
20,370 |
$8.03M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
11,896 |
8,253 |
$4.58M |
| 41899 |
Unlisted procedure, dentoalveolar structures |
1,596 |
1,505 |
$3.83M |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
20,706 |
19,388 |
$2.88M |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
24,541 |
17,450 |
$2.13M |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
8,713 |
8,077 |
$1.72M |
| G0378 |
Hospital observation service, per hour |
9,017 |
3,687 |
$1.68M |
| 64493 |
|
1,796 |
1,425 |
$1.61M |
| 95810 |
Polysomnography; sleep staging with 4 or more additional parameters |
2,577 |
2,444 |
$1.53M |
| 64635 |
|
925 |
654 |
$1.35M |
| 47562 |
|
475 |
337 |
$1.06M |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
2,195 |
1,543 |
$950K |
| 62323 |
|
2,018 |
1,691 |
$890K |
| J3490 |
Unclassified drugs |
58,968 |
17,371 |
$870K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
19,798 |
12,019 |
$789K |
| 95811 |
|
1,384 |
1,331 |
$789K |
| 71046 |
Radiologic examination, chest; 2 views |
15,013 |
13,505 |
$623K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
2,392 |
2,200 |
$613K |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
5,496 |
5,069 |
$558K |
| 70450 |
Computed tomography, head or brain; without contrast material |
7,807 |
6,450 |
$536K |
| 64494 |
|
1,847 |
1,295 |
$531K |
| 45385 |
Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) |
882 |
649 |
$494K |
| 36415 |
Collection of venous blood by venipuncture |
118,431 |
73,064 |
$474K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
730 |
584 |
$447K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
5,757 |
3,802 |
$429K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
20,802 |
18,649 |
$428K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
2,930 |
2,694 |
$400K |
| 71045 |
Radiologic examination, chest; single view |
9,122 |
7,823 |
$385K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
11,297 |
9,585 |
$350K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
12,668 |
4,603 |
$336K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
5,893 |
2,808 |
$330K |
| 64636 |
|
882 |
547 |
$320K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
14,011 |
9,303 |
$309K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
9,364 |
8,450 |
$300K |
| 76830 |
Ultrasound, transvaginal |
3,393 |
3,180 |
$289K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
3,806 |
3,655 |
$282K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
3,923 |
3,811 |
$266K |
| 80053 |
Comprehensive metabolic panel |
34,399 |
30,924 |
$261K |
| C1713 |
Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) |
232 |
209 |
$249K |
| 96376 |
|
6,387 |
3,887 |
$231K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
496 |
349 |
$215K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
44,087 |
39,367 |
$209K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
6,272 |
5,595 |
$208K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
3,543 |
3,246 |
$208K |
| 72100 |
|
4,309 |
3,828 |
$203K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
1,813 |
1,676 |
$203K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
2,012 |
1,914 |
$198K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
3,089 |
1,633 |
$197K |
| 84443 |
Thyroid stimulating hormone (TSH) |
12,011 |
11,625 |
$174K |
| C1776 |
Joint device (implantable) |
45 |
44 |
$168K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
3,467 |
3,190 |
$149K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
340 |
248 |
$144K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
6,221 |
6,070 |
$141K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
29,077 |
24,623 |
$135K |
| 80061 |
Lipid panel |
11,806 |
10,445 |
$131K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
3,324 |
3,224 |
$131K |
| M0243 |
Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring |
435 |
421 |
$129K |
| 64483 |
|
156 |
138 |
$125K |
| 73630 |
|
3,632 |
3,393 |
$123K |
| 84702 |
|
14,740 |
13,148 |
$122K |
| 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 |
2,084 |
1,940 |
$121K |
| 12001 |
|
1,245 |
1,190 |
$119K |
| 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 |
1,557 |
1,418 |
$111K |
| 87631 |
|
1,006 |
992 |
$109K |
| 95886 |
|
1,136 |
987 |
$107K |
| 97162 |
|
2,632 |
1,710 |
$104K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
3,471 |
2,040 |
$103K |
| 73564 |
|
2,647 |
2,330 |
$103K |
| 10060 |
|
672 |
623 |
$102K |
| 73130 |
|
2,963 |
2,676 |
$101K |
| 84484 |
|
15,907 |
10,515 |
$97K |
| 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 |
819 |
760 |
$97K |
| 94726 |
|
698 |
643 |
$92K |
| 73610 |
|
3,108 |
2,847 |
$90K |
| 45378 |
Colonoscopy, flexible; diagnostic, including collection of specimen(s) |
172 |
148 |
$88K |
| 74018 |
|
2,240 |
2,071 |
$85K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
3,636 |
3,466 |
$84K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
3,595 |
3,458 |
$82K |
| 29125 |
|
919 |
875 |
$82K |
| 85027 |
|
18,989 |
17,497 |
$81K |
| 76770 |
|
1,149 |
1,040 |
$80K |
| 93971 |
|
1,079 |
1,037 |
$77K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
8,833 |
8,522 |
$76K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
3,338 |
2,990 |
$76K |
| 73030 |
|
2,572 |
2,213 |
$76K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
1,745 |
1,642 |
$72K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
1,093 |
530 |
$67K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
3,099 |
1,459 |
$66K |
| J0689 |
Injection, cefazolin sodium (baxter), not therapeutically equivalent to j0690, 500 mg |
2,246 |
1,014 |
$64K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
508 |
420 |
$63K |
| 86900 |
|
3,424 |
3,222 |
$63K |
| 62321 |
|
148 |
119 |
$62K |
| C1889 |
Implantable/insertable device, not otherwise classified |
30 |
29 |
$61K |
| 97161 |
|
1,370 |
904 |
$61K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
2,697 |
2,634 |
$60K |
| 73110 |
|
2,112 |
1,861 |
$60K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
447 |
405 |
$57K |
| 82607 |
|
3,310 |
3,222 |
$55K |
| 76536 |
|
706 |
679 |
$55K |
| 83690 |
|
14,936 |
13,695 |
$52K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
14,303 |
12,403 |
$51K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
2,957 |
1,824 |
$49K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
2,700 |
2,611 |
$48K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
4,575 |
3,067 |
$46K |
| J1745 |
Injection, infliximab, excludes biosimilar, 10 mg |
12 |
12 |
$46K |
| 86481 |
|
521 |
506 |
$45K |
| 80074 |
|
1,071 |
1,035 |
$44K |
| 72050 |
|
803 |
726 |
$43K |
| 72072 |
|
976 |
850 |
$41K |
| 12011 |
|
403 |
389 |
$40K |
| 73502 |
|
1,312 |
1,120 |
$40K |
| 88304 |
|
1,384 |
1,312 |
$39K |
| 70498 |
|
462 |
445 |
$38K |
| 85610 |
|
10,579 |
6,508 |
$38K |
| 80076 |
|
6,295 |
5,869 |
$37K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
9,947 |
8,700 |
$37K |
| 70496 |
|
334 |
307 |
$37K |
| 93017 |
|
361 |
345 |
$35K |
| 82962 |
|
11,207 |
5,792 |
$34K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
6,756 |
6,290 |
$34K |
| 87522 |
Neg quan hep c or qual rna |
939 |
908 |
$33K |
| 83880 |
|
1,681 |
1,583 |
$33K |
| 84439 |
|
3,741 |
3,624 |
$32K |
| 82746 |
|
2,213 |
2,146 |
$31K |
| 94729 |
|
625 |
596 |
$30K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,434 |
1,372 |
$30K |
| 86780 |
|
2,413 |
2,307 |
$28K |
| 81001 |
|
15,322 |
14,083 |
$28K |
| 82077 |
|
3,129 |
2,858 |
$27K |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
10,616 |
7,319 |
$26K |
| 71250 |
|
419 |
321 |
$26K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
681 |
296 |
$26K |
| 82728 |
|
1,849 |
1,732 |
$25K |
| 73140 |
|
757 |
722 |
$24K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
20,896 |
16,875 |
$24K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
521 |
502 |
$24K |
| 73080 |
|
914 |
837 |
$23K |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
3,662 |
2,878 |
$22K |
| G0472 |
Hepatitis c antibody screening, for individual at high risk and other covered indication(s) |
551 |
529 |
$22K |
| 97010 |
|
2,906 |
1,213 |
$22K |
| 71101 |
|
608 |
500 |
$21K |
| 94060 |
|
135 |
102 |
$21K |
| 73562 |
|
362 |
332 |
$20K |
| 83970 |
|
583 |
556 |
$20K |
| 85379 |
|
3,776 |
3,613 |
$19K |
| 83605 |
|
3,126 |
2,561 |
$19K |
| 86803 |
|
1,502 |
1,457 |
$18K |
| 86850 |
|
2,624 |
2,516 |
$18K |
| 95806 |
|
170 |
159 |
$18K |
| 87430 |
|
2,859 |
2,756 |
$18K |
| 71271 |
|
229 |
220 |
$17K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
162 |
139 |
$17K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
4,566 |
2,369 |
$17K |
| 83735 |
|
3,593 |
3,059 |
$17K |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
1,321 |
1,032 |
$16K |
| 87340 |
|
1,898 |
1,851 |
$16K |
| J0690 |
Injection, cefazolin sodium, 500 mg |
2,483 |
2,052 |
$15K |
| 83550 |
|
1,952 |
1,899 |
$15K |
| 97014 |
|
1,017 |
445 |
$15K |
| 87077 |
|
2,282 |
2,039 |
$15K |
| 90715 |
|
1,300 |
1,102 |
$15K |
| 82570 |
|
2,803 |
2,543 |
$14K |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
2,680 |
640 |
$14K |
| 83540 |
|
2,411 |
2,322 |
$14K |
| 82803 |
|
961 |
883 |
$14K |
| 84145 |
|
880 |
803 |
$14K |
| 84703 |
|
4,151 |
3,897 |
$14K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
9,917 |
8,560 |
$14K |
| 86762 |
|
1,078 |
1,052 |
$14K |
| 82565 |
|
1,509 |
962 |
$13K |
| C9290 |
Injection, bupivacaine liposome, 1 mg |
210 |
125 |
$13K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
49 |
41 |
$13K |
| 70486 |
|
266 |
248 |
$12K |
| 84403 |
|
501 |
486 |
$12K |
| 86140 |
|
2,748 |
2,607 |
$12K |
| 12002 |
|
117 |
116 |
$12K |
| 81003 |
|
7,606 |
7,201 |
$11K |
| 99219 |
|
294 |
110 |
$11K |
| 87186 |
|
2,091 |
1,958 |
$11K |
| 94010 |
|
131 |
105 |
$10K |
| 77080 |
|
189 |
179 |
$10K |
| 77066 |
Tomosynthesis, mammo |
121 |
110 |
$10K |
| A9502 |
Technetium tc-99m tetrofosmin, diagnostic, per study dose |
259 |
230 |
$10K |
| C9113 |
Injection, pantoprazole sodium, per vial |
2,160 |
1,203 |
$10K |
| 93970 |
|
68 |
64 |
$10K |
| 76870 |
|
151 |
146 |
$10K |
| 80143 |
|
1,167 |
1,093 |
$10K |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
2,097 |
1,607 |
$10K |
| J1815 |
Injection, insulin, per 5 units |
3,580 |
1,085 |
$10K |
| 29515 |
|
75 |
67 |
$9K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
8,782 |
6,039 |
$9K |
| 80179 |
|
1,081 |
1,015 |
$9K |
| 73590 |
|
348 |
299 |
$9K |
| 76642 |
|
176 |
143 |
$9K |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
5,454 |
4,829 |
$9K |
| 81025 |
|
2,077 |
1,930 |
$8K |
| 96367 |
|
230 |
186 |
$8K |
| 80069 |
|
1,046 |
786 |
$8K |
| 82043 |
|
1,299 |
1,236 |
$8K |
| 84425 |
|
404 |
391 |
$8K |
| 87040 |
|
1,343 |
724 |
$8K |
| 83013 |
|
98 |
97 |
$7K |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
1,456 |
952 |
$7K |
| 86901 |
|
3,388 |
3,255 |
$6K |
| 86706 |
|
580 |
563 |
$6K |
| 88342 |
|
158 |
153 |
$6K |
| 85652 |
|
2,768 |
2,652 |
$6K |
| J0330 |
Injection, succinylcholine chloride, up to 20 mg |
1,984 |
1,858 |
$6K |
| 85730 |
|
1,559 |
1,422 |
$6K |
| 84550 |
|
1,297 |
1,259 |
$5K |
| 73090 |
|
260 |
224 |
$5K |
| 84481 |
|
388 |
386 |
$5K |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
4,482 |
3,487 |
$5K |
| G0475 |
Hiv antigen/antibody, combination assay, screening |
291 |
284 |
$5K |
| 82950 |
|
1,048 |
1,027 |
$5K |
| A9575 |
Injection, gadoterate meglumine, 0.1 ml |
290 |
260 |
$5K |
| J1980 |
Injection, hyoscyamine sulfate, up to 0.25 mg |
431 |
346 |
$5K |
| 93225 |
|
69 |
54 |
$5K |
| 87801 |
Infectious agent detection by nucleic acid; amplified probe, multiple organisms |
92 |
91 |
$5K |
| 84156 |
|
1,354 |
1,280 |
$5K |
| 87637 |
Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV |
34 |
32 |
$4K |
| 84100 |
|
1,251 |
1,065 |
$4K |
| J0561 |
Injection, penicillin g benzathine, 100,000 units |
44 |
40 |
$4K |
| 82977 |
|
618 |
563 |
$4K |
| 83516 |
|
344 |
299 |
$4K |
| 97116 |
|
212 |
149 |
$4K |
| 87210 |
|
1,885 |
1,810 |
$4K |
| 84146 |
|
224 |
217 |
$4K |
| 86038 |
|
392 |
385 |
$4K |
| 86480 |
|
75 |
73 |
$4K |
| 83001 |
|
201 |
197 |
$4K |
| Q9969 |
Tc-99m from non-highly enriched uranium source, full cost recovery add-on, per study dose |
396 |
366 |
$4K |
| 78264 |
|
22 |
12 |
$3K |
| J1030 |
Injection, methylprednisolone acetate, 40 mg |
1,074 |
1,049 |
$3K |
| 70491 |
|
43 |
37 |
$3K |
| 94761 |
|
304 |
161 |
$3K |
| J1170 |
Injection, hydromorphone, up to 4 mg |
3,295 |
2,611 |
$3K |
| 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 |
3,123 |
2,777 |
$3K |
| 75574 |
|
34 |
24 |
$3K |
| 84450 |
|
750 |
669 |
$3K |
| 87070 |
|
687 |
562 |
$3K |
| Q9966 |
Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml |
3,345 |
3,214 |
$3K |
| 84460 |
|
709 |
647 |
$3K |
| 87088 |
|
616 |
585 |
$3K |
| 82550 |
|
598 |
532 |
$3K |
| 87205 |
|
1,109 |
985 |
$3K |
| 87808 |
|
246 |
240 |
$3K |
| A9577 |
Injection, gadobenate dimeglumine (multihance), per ml |
254 |
210 |
$3K |
| J2919 |
Injection, methylprednisolone sodium succinate, 5 mg |
330 |
152 |
$3K |
| 96415 |
|
43 |
39 |
$3K |
| 84153 |
|
163 |
159 |
$2K |
| J1040 |
Injection, methylprednisolone acetate, 80 mg |
645 |
597 |
$2K |
| 87807 |
|
554 |
522 |
$2K |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
1,884 |
1,473 |
$2K |
| J1790 |
Injection, droperidol, up to 5 mg |
1,593 |
1,276 |
$2K |
| G0297 |
Low dose ct scan (ldct) for lung cancer screening |
54 |
48 |
$2K |
| 72040 |
|
70 |
60 |
$2K |
| P9612 |
Catheterization for collection of specimen, single patient, all places of service |
119 |
58 |
$2K |
| 82784 |
|
203 |
188 |
$2K |
| J0171 |
Injection, adrenalin, epinephrine, 0.1 mg |
110 |
15 |
$2K |
| J2060 |
Injection, lorazepam, 2 mg |
2,475 |
1,925 |
$2K |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
889 |
766 |
$2K |
| 87046 |
|
68 |
66 |
$2K |
| 29130 |
|
18 |
15 |
$2K |
| 76942 |
|
31 |
27 |
$1K |
| 83002 |
|
89 |
87 |
$1K |
| 82947 |
|
353 |
302 |
$1K |
| J0134 |
Injection, acetaminophen (fresenius kabi), not therapeutically equivalent to j0131, 10 mg |
355 |
330 |
$1K |
| 72141 |
|
17 |
12 |
$1K |
| 83525 |
|
100 |
98 |
$1K |
| J1010 |
Injection, methylprednisolone acetate, 1 mg |
133 |
83 |
$1K |
| 82533 |
|
70 |
62 |
$1K |
| J2710 |
Injection, neostigmine methylsulfate, up to 0.5 mg |
458 |
432 |
$1K |
| J2795 |
Injection, ropivacaine hydrochloride, 1 mg |
197 |
174 |
$1K |
| 82248 |
|
217 |
207 |
$1K |
| 84590 |
|
101 |
99 |
$1K |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
1,452 |
1,242 |
$939.58 |
| 84630 |
|
94 |
91 |
$891.57 |
| 93226 |
|
27 |
26 |
$881.02 |
| 86430 |
|
151 |
149 |
$855.50 |
| 84446 |
|
69 |
67 |
$852.17 |
| C1769 |
Guide wire |
405 |
228 |
$835.79 |
| 86704 |
|
80 |
79 |
$817.51 |
| J2550 |
Injection, promethazine hcl, up to 50 mg |
1,167 |
882 |
$802.63 |
| 87650 |
|
49 |
47 |
$732.66 |
| 87427 |
|
67 |
65 |
$709.39 |
| 87045 |
|
94 |
79 |
$669.24 |
| 97163 |
|
14 |
13 |
$627.44 |
| 90686 |
|
37 |
33 |
$607.23 |
| Q0177 |
Hydroxyzine pamoate, 25 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 |
538 |
257 |
$556.72 |
| G0279 |
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) |
46 |
41 |
$523.14 |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
213 |
135 |
$505.77 |
| 82010 |
|
113 |
104 |
$479.62 |
| J0702 |
Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg |
127 |
103 |
$467.57 |
| 82652 |
|
14 |
13 |
$435.83 |
| 82670 |
|
13 |
13 |
$415.48 |
| J3480 |
Injection, potassium chloride, per 2 meq |
70 |
38 |
$397.25 |
| 88738 |
|
40 |
29 |
$368.46 |
| G8978 |
Mobility: walking & moving around functional limitation, current status, at therapy episode outset and at reporting intervals |
334 |
216 |
$357.69 |
| 87493 |
|
12 |
12 |
$351.41 |
| 82525 |
|
25 |
25 |
$343.47 |
| 88307 |
|
17 |
16 |
$331.73 |
| 97016 |
|
31 |
12 |
$320.22 |
| 86364 |
|
32 |
31 |
$302.91 |
| J1171 |
Injection, hydromorphone, 0.1 mg |
81 |
65 |
$295.75 |
| 86769 |
|
14 |
14 |
$294.25 |
| G0283 |
Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care |
42 |
12 |
$290.41 |
| G8979 |
Mobility: walking & moving around functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting |
218 |
194 |
$272.35 |
| J1596 |
Injection, glycopyrrolate, 0.1 mg |
327 |
311 |
$267.72 |
| J2370 |
Injection, phenylephrine hcl, up to 1 ml |
433 |
380 |
$264.79 |
| 99152 |
|
98 |
82 |
$259.65 |
| 87641 |
|
12 |
12 |
$182.94 |
| 82951 |
|
12 |
12 |
$180.35 |
| 86200 |
|
14 |
13 |
$178.48 |
| 82785 |
|
12 |
12 |
$166.38 |
| 73552 |
|
13 |
12 |
$147.96 |
| 84134 |
|
12 |
12 |
$142.08 |
| J3486 |
Injection, ziprasidone mesylate, 10 mg |
12 |
12 |
$111.62 |
| J3371 |
Injection, vancomycin hcl (mylan), not therapeutically equivalent to j3370, 500 mg |
61 |
55 |
$102.93 |
| J8501 |
Aprepitant, oral, 5 mg |
25 |
14 |
$90.36 |
| J0735 |
Injection, clonidine hydrochloride, 1 mg |
42 |
41 |
$89.59 |
| J2470 |
Injection, pantoprazole sodium, 40 mg |
94 |
51 |
$77.47 |
| J1630 |
Injection, haloperidol, up to 5 mg |
15 |
12 |
$72.60 |
| 99153 |
Mod sedat endo service >5yrs |
14 |
12 |
$70.62 |
| J2371 |
Injection, phenylephrine hydrochloride, 20 micrograms |
439 |
367 |
$64.66 |
| 86308 |
|
24 |
24 |
$60.97 |
| 85018 |
|
22 |
12 |
$57.98 |
| J2272 |
Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg |
41 |
38 |
$47.13 |
| 87015 |
|
16 |
14 |
$41.20 |
| J3411 |
Injection, thiamine hcl, 100 mg |
19 |
15 |
$26.99 |
| J1644 |
Injection, heparin sodium, per 1000 units |
60 |
26 |
$25.40 |
| S2900 |
Surgical techniques requiring use of robotic surgical system (list separately in addition to code for primary procedure) |
44 |
38 |
$3.74 |
| J7510 |
Prednisolone oral, per 5 mg |
14 |
13 |
$1.30 |
| Q0244 |
Injection, casirivimab and imdevimab, 1200 mg |
148 |
121 |
$0.06 |
| A9270 |
Non-covered item or service |
218 |
52 |
$0.03 |