| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
14,271 |
12,367 |
$5.95M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
7,420 |
6,777 |
$1.85M |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
1,892 |
1,729 |
$790K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
4,322 |
4,089 |
$629K |
| G0378 |
Hospital observation service, per hour |
5,618 |
2,598 |
$484K |
| 86832 |
|
3,267 |
2,899 |
$443K |
| 50200 |
|
677 |
616 |
$323K |
| 77301 |
|
43 |
38 |
$302K |
| 87497 |
|
3,715 |
2,402 |
$289K |
| 77523 |
|
781 |
62 |
$268K |
| 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 |
3,599 |
2,975 |
$216K |
| 87522 |
Neg quan hep c or qual rna |
260 |
217 |
$180K |
| 80053 |
Comprehensive metabolic panel |
13,561 |
10,759 |
$112K |
| 85610 |
|
11,912 |
8,869 |
$105K |
| 93505 |
|
24 |
12 |
$79K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
2,501 |
2,266 |
$58K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
824 |
787 |
$52K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
3,046 |
2,795 |
$48K |
| 93308 |
|
201 |
176 |
$40K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
4,494 |
2,834 |
$32K |
| 81370 |
|
12 |
12 |
$32K |
| 86850 |
|
2,969 |
2,021 |
$21K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
189 |
179 |
$20K |
| 86833 |
|
3,244 |
2,883 |
$18K |
| 36430 |
|
109 |
37 |
$18K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
1,390 |
1,261 |
$14K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
8,038 |
6,579 |
$12K |
| 84702 |
|
1,062 |
960 |
$11K |
| 86900 |
|
3,492 |
2,298 |
$10K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
24,596 |
18,071 |
$10K |
| 84484 |
|
5,718 |
4,683 |
$10K |
| 81001 |
|
17,668 |
12,660 |
$10K |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
5,497 |
4,897 |
$9K |
| 74183 |
|
67 |
66 |
$9K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
2,174 |
1,879 |
$8K |
| 77334 |
|
53 |
48 |
$6K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
13 |
12 |
$5K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
6,463 |
5,317 |
$5K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
8,604 |
6,682 |
$5K |
| 70450 |
Computed tomography, head or brain; without contrast material |
2,293 |
2,088 |
$4K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
455 |
401 |
$4K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
823 |
756 |
$4K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
5,361 |
4,665 |
$3K |
| 93971 |
|
231 |
220 |
$3K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
170 |
165 |
$2K |
| 71046 |
Radiologic examination, chest; 2 views |
3,463 |
3,165 |
$2K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
6,775 |
5,808 |
$2K |
| 76776 |
|
1,113 |
968 |
$2K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
8,953 |
7,531 |
$2K |
| 87186 |
|
1,001 |
904 |
$2K |
| 71045 |
Radiologic examination, chest; single view |
4,583 |
4,061 |
$2K |
| 83880 |
|
2,041 |
1,840 |
$2K |
| 87799 |
|
421 |
339 |
$2K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
284 |
262 |
$1K |
| 86830 |
|
25 |
24 |
$1K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
2,341 |
1,855 |
$1K |
| 82728 |
|
479 |
460 |
$1K |
| 87040 |
|
3,456 |
1,549 |
$1K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
738 |
428 |
$1K |
| 80051 |
|
729 |
612 |
$1K |
| 36415 |
Collection of venous blood by venipuncture |
17,495 |
12,466 |
$1K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
2,281 |
1,882 |
$1K |
| 96376 |
|
1,865 |
1,590 |
$937.99 |
| 83690 |
|
7,217 |
6,140 |
$923.65 |
| 80197 |
|
1,601 |
971 |
$915.67 |
| 87103 |
|
1,730 |
1,402 |
$885.01 |
| 84443 |
Thyroid stimulating hormone (TSH) |
1,713 |
1,579 |
$862.40 |
| 93325 |
|
492 |
430 |
$832.01 |
| 82570 |
|
2,168 |
1,831 |
$793.28 |
| 82077 |
|
445 |
417 |
$765.12 |
| 87633 |
Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets |
114 |
81 |
$735.92 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
7,952 |
5,136 |
$705.18 |
| 86923 |
|
12 |
12 |
$681.73 |
| 86901 |
|
3,553 |
2,353 |
$677.76 |
| 83735 |
|
4,858 |
3,504 |
$677.22 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
384 |
282 |
$657.00 |
| 85027 |
|
2,947 |
2,050 |
$656.89 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
89 |
83 |
$650.75 |
| 85730 |
|
2,181 |
1,956 |
$595.79 |
| 83970 |
|
92 |
82 |
$587.12 |
| 84156 |
|
2,021 |
1,718 |
$570.34 |
| 93321 |
|
322 |
277 |
$566.25 |
| A9270 |
Non-covered item or service |
3,972 |
2,089 |
$541.50 |
| 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 |
631 |
576 |
$536.50 |
| 82248 |
|
8,466 |
7,179 |
$502.41 |
| 83605 |
|
3,604 |
3,090 |
$412.43 |
| 87077 |
|
946 |
860 |
$354.40 |
| 80076 |
|
899 |
815 |
$347.73 |
| 84100 |
|
2,281 |
1,550 |
$338.31 |
| 82947 |
|
3,199 |
1,921 |
$291.68 |
| 87070 |
|
1,022 |
769 |
$290.35 |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
12 |
12 |
$271.43 |
| J1644 |
Injection, heparin sodium, per 1000 units |
3,661 |
1,430 |
$253.38 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
1,904 |
1,343 |
$253.00 |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
1,670 |
1,439 |
$216.83 |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
75 |
67 |
$216.44 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
2,143 |
1,800 |
$213.90 |
| 80320 |
|
26 |
25 |
$183.08 |
| 80047 |
|
2,070 |
1,874 |
$182.18 |
| J2704 |
Injection, propofol, 10 mg |
9,867 |
2,636 |
$169.63 |
| 86140 |
|
1,302 |
1,160 |
$161.57 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
2,789 |
1,937 |
$160.67 |
| C1769 |
Guide wire |
490 |
439 |
$160.65 |
| A9552 |
Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries |
45 |
36 |
$157.67 |
| 81025 |
|
3,480 |
3,189 |
$147.83 |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
313 |
303 |
$145.77 |
| 84450 |
|
847 |
677 |
$136.66 |
| 85379 |
|
1,819 |
1,661 |
$132.63 |
| 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 |
1,878 |
1,574 |
$122.87 |
| 87507 |
|
12 |
12 |
$119.58 |
| C9803 |
Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
5,033 |
4,393 |
$116.95 |
| 82565 |
|
1,571 |
1,172 |
$104.50 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
1,201 |
940 |
$98.78 |
| J7050 |
Infusion, normal saline solution, 250 cc |
1,317 |
584 |
$97.12 |
| 87075 |
|
251 |
165 |
$95.09 |
| 82948 |
|
3,579 |
1,445 |
$94.18 |
| 87205 |
|
1,157 |
914 |
$89.67 |
| 88307 |
|
80 |
56 |
$87.69 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
4,700 |
3,428 |
$87.18 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
487 |
430 |
$86.75 |
| J7030 |
Infusion, normal saline solution , 1000 cc |
1,841 |
1,300 |
$84.43 |
| A9585 |
Injection, gadobutrol, 0.1 ml |
2,276 |
1,353 |
$83.69 |
| 84520 |
|
1,135 |
837 |
$82.40 |
| 0353U |
|
49 |
46 |
$79.37 |
| 84460 |
|
837 |
668 |
$78.28 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
2,638 |
2,054 |
$77.62 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
9,345 |
5,457 |
$66.87 |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
473 |
336 |
$64.65 |
| 87631 |
|
69 |
62 |
$64.34 |
| 99001 |
|
27 |
26 |
$54.93 |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
15 |
14 |
$50.73 |
| 86635 |
|
259 |
115 |
$50.70 |
| 84132 |
|
507 |
327 |
$50.12 |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
106 |
86 |
$44.40 |
| 88313 |
|
1,168 |
833 |
$40.20 |
| 85652 |
|
179 |
172 |
$39.53 |
| 82247 |
|
767 |
613 |
$39.20 |
| 82374 |
|
411 |
246 |
$36.82 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
1,405 |
1,027 |
$36.75 |
| 70498 |
|
41 |
39 |
$36.56 |
| 84295 |
|
444 |
275 |
$35.02 |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
16 |
14 |
$34.14 |
| 82435 |
|
438 |
271 |
$34.12 |
| 82310 |
|
393 |
264 |
$33.30 |
| 84075 |
|
798 |
640 |
$30.60 |
| 84703 |
|
473 |
424 |
$22.90 |
| 80061 |
Lipid panel |
274 |
257 |
$19.92 |
| 88342 |
|
1,331 |
1,179 |
$16.70 |
| 83615 |
|
147 |
73 |
$12.02 |
| J3490 |
Unclassified drugs |
1,191 |
823 |
$11.47 |
| 85651 |
|
45 |
43 |
$9.59 |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
496 |
426 |
$8.99 |
| 82550 |
|
61 |
53 |
$6.44 |
| J1940 |
Injection, furosemide, up to 20 mg |
36 |
26 |
$5.84 |
| 97161 |
|
52 |
50 |
$4.88 |
| 85014 |
|
1,654 |
1,475 |
$3.63 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
1,769 |
1,320 |
$2.19 |
| 83550 |
|
29 |
26 |
$0.80 |
| 83540 |
|
29 |
26 |
$0.60 |
| J2370 |
Injection, phenylephrine hcl, up to 1 ml |
33 |
29 |
$0.46 |
| 87046 |
|
12 |
12 |
$0.18 |
| G1004 |
Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program |
1,489 |
1,160 |
$0.02 |
| 76376 |
|
125 |
115 |
$0.00 |
| 77336 |
|
810 |
310 |
$0.00 |
| 72125 |
Computed tomography, cervical spine; without contrast material |
103 |
100 |
$0.00 |
| 84155 |
|
451 |
357 |
$0.00 |
| 76942 |
|
78 |
71 |
$0.00 |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
278 |
171 |
$0.00 |
| 77387 |
|
3,062 |
248 |
$0.00 |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
109 |
97 |
$0.00 |
| 0757T |
|
14 |
13 |
$0.00 |
| J2550 |
Injection, promethazine hcl, up to 50 mg |
64 |
49 |
$0.00 |
| J0134 |
Injection, acetaminophen (fresenius kabi), not therapeutically equivalent to j0131, 10 mg |
175 |
163 |
$0.00 |
| S0028 |
Injection, famotidine, 20 mg |
68 |
66 |
$0.00 |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
151 |
108 |
$0.00 |
| C9113 |
Injection, pantoprazole sodium, per vial |
122 |
79 |
$0.00 |
| 0760T |
|
25 |
24 |
$0.00 |
| 0753T |
|
50 |
49 |
$0.00 |
| Q9957 |
Injection, perflutren lipid microspheres, per ml |
38 |
38 |
$0.00 |
| 73030 |
|
13 |
12 |
$0.00 |
| 89051 |
|
44 |
36 |
$0.00 |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
17 |
12 |
$0.00 |
| 73630 |
|
32 |
28 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
32 |
32 |
$0.00 |
| J1171 |
Injection, hydromorphone, 0.1 mg |
69 |
33 |
$0.00 |
| 93976 |
|
30 |
26 |
$0.00 |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
14 |
13 |
$0.00 |
| 77338 |
|
46 |
38 |
$0.00 |
| 76937 |
|
17 |
13 |
$0.00 |
| C1894 |
Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser |
14 |
13 |
$0.00 |
| 93970 |
|
14 |
14 |
$0.00 |
| 71250 |
|
12 |
12 |
$0.00 |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
22 |
13 |
$0.00 |
| 81376 |
|
13 |
13 |
$0.00 |
| 88341 |
|
577 |
502 |
$0.00 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
727 |
602 |
$0.00 |
| 87581 |
|
114 |
81 |
$0.00 |
| 86831 |
|
25 |
24 |
$0.00 |
| 82040 |
|
551 |
430 |
$0.00 |
| J2060 |
Injection, lorazepam, 2 mg |
647 |
474 |
$0.00 |
| 94761 |
|
25 |
25 |
$0.00 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
78 |
71 |
$0.00 |
| 77300 |
|
62 |
54 |
$0.00 |
| Q9965 |
Low osmolar contrast material, 100-199 mg/ml iodine concentration, per ml |
178 |
111 |
$0.00 |
| 87081 |
|
34 |
34 |
$0.00 |
| 84560 |
|
85 |
73 |
$0.00 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
15 |
12 |
$0.00 |
| 87486 |
|
114 |
81 |
$0.00 |
| 87015 |
|
16 |
12 |
$0.00 |
| 76830 |
Ultrasound, transvaginal |
88 |
81 |
$0.00 |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
15 |
14 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
26 |
26 |
$0.00 |
| 82330 |
|
35 |
30 |
$0.00 |
| 0099U |
|
21 |
19 |
$0.00 |
| 70496 |
|
54 |
52 |
$0.00 |
| J7507 |
Tacrolimus, immediate release, oral, 1 mg |
23 |
14 |
$0.00 |