| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| J9271 |
Injection, pembrolizumab, 1 mg |
3,651 |
2,776 |
$13.00M |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
102,498 |
62,631 |
$6.94M |
| J9299 |
Injection, nivolumab, 1 mg |
2,459 |
1,789 |
$4.44M |
| 96361 |
Intravenous infusion, hydration; each additional hour |
18,258 |
6,542 |
$4.31M |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
33,808 |
18,648 |
$3.08M |
| J2505 |
Injection, pegfilgrastim, 6 mg |
1,906 |
1,376 |
$2.70M |
| J9263 |
Injection, oxaliplatin, 0.5 mg |
4,173 |
1,747 |
$2.33M |
| J9355 |
Injection, trastuzumab, excludes biosimilar, 10 mg |
1,955 |
1,106 |
$2.05M |
| J9035 |
Injection, bevacizumab, 10 mg |
1,724 |
769 |
$1.95M |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
17,697 |
6,687 |
$1.71M |
| 96415 |
|
7,808 |
4,817 |
$1.55M |
| 36430 |
|
10,804 |
3,731 |
$1.44M |
| P9040 |
Red blood cells, leukocytes reduced, irradiated, each unit |
6,696 |
3,315 |
$1.27M |
| 77523 |
|
958 |
93 |
$1.24M |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
5,981 |
2,333 |
$1.17M |
| P9037 |
Platelets, pheresis, leukocytes reduced, irradiated, each unit |
4,283 |
1,409 |
$1.16M |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
8,616 |
8,287 |
$1.07M |
| 77412 |
|
2,902 |
370 |
$1.07M |
| J2506 |
Injection, pegfilgrastim, excludes biosimilar, 0.5 mg |
1,070 |
720 |
$900K |
| 78815 |
Positron emission tomography (PET) for limited area imaging |
1,418 |
1,361 |
$723K |
| J9217 |
Leuprolide acetate (for depot suspension), 7.5 mg |
2,656 |
2,523 |
$589K |
| J9144 |
Injection, daratumumab, 10 mg and hyaluronidase-fihj |
487 |
295 |
$581K |
| 36592 |
|
43,249 |
15,514 |
$580K |
| 38222 |
|
1,315 |
1,206 |
$546K |
| J9022 |
Injection, atezolizumab, 10 mg |
57 |
40 |
$510K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
7,892 |
3,008 |
$505K |
| 88185 |
|
4,661 |
3,721 |
$492K |
| J2469 |
Injection, palonosetron hcl, 25 mcg |
10,032 |
5,901 |
$487K |
| 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 |
6,570 |
3,683 |
$418K |
| 36415 |
Collection of venous blood by venipuncture |
46,916 |
34,756 |
$411K |
| J1442 |
Injection, filgrastim (g-csf), excludes biosimilars, 1 microgram |
2,142 |
472 |
$407K |
| J9306 |
Injection, pertuzumab, 1 mg |
250 |
180 |
$407K |
| 81382 |
|
3,815 |
1,161 |
$380K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
48,141 |
22,462 |
$371K |
| J0897 |
Injection, denosumab, 1 mg |
1,278 |
1,160 |
$371K |
| Q5117 |
Injection, trastuzumab-anns, biosimilar, (kanjinti), 10 mg |
233 |
148 |
$333K |
| 77336 |
|
3,740 |
1,769 |
$323K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
14,832 |
7,692 |
$311K |
| 76642 |
|
4,435 |
3,765 |
$290K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
116,031 |
57,461 |
$288K |
| 77387 |
|
6,348 |
685 |
$287K |
| 80053 |
Comprehensive metabolic panel |
49,163 |
33,765 |
$287K |
| 87497 |
|
8,365 |
3,395 |
$282K |
| J0185 |
Injection, aprepitant, 1 mg |
4,461 |
2,735 |
$275K |
| J9395 |
Injection, fulvestrant, 25 mg |
1,417 |
1,193 |
$273K |
| 36591 |
|
35,678 |
18,524 |
$262K |
| 96367 |
|
5,293 |
3,225 |
$250K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
8,143 |
8,025 |
$247K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
1,363 |
1,292 |
$244K |
| 96416 |
|
3,220 |
1,865 |
$225K |
| 71250 |
|
2,718 |
2,619 |
$217K |
| P9100 |
Pathogen(s) test for platelets |
2,251 |
736 |
$208K |
| 38220 |
|
592 |
553 |
$208K |
| 80076 |
|
45,434 |
20,879 |
$202K |
| J9041 |
Injection, bortezomib, 0.1 mg |
621 |
157 |
$189K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,311 |
1,040 |
$183K |
| 77295 |
|
329 |
294 |
$165K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
9,179 |
8,858 |
$155K |
| 81268 |
|
1,810 |
829 |
$151K |
| 78816 |
|
230 |
229 |
$147K |
| J1453 |
Injection, fosaprepitant, 1 mg |
1,638 |
977 |
$145K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
8,200 |
8,081 |
$135K |
| 83735 |
|
40,514 |
14,147 |
$134K |
| J9206 |
Injection, irinotecan, 20 mg |
3,101 |
1,295 |
$116K |
| J9201 |
Injection, gemcitabine hydrochloride, not otherwise specified, 200 mg |
2,075 |
731 |
$114K |
| P9073 |
Platelets, pheresis, pathogen-reduced, each unit |
426 |
207 |
$113K |
| 87633 |
Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets |
1,326 |
1,076 |
$108K |
| 83615 |
|
49,149 |
24,320 |
$102K |
| 86923 |
|
5,919 |
2,793 |
$101K |
| 88264 |
|
2,101 |
1,952 |
$99K |
| 88237 |
|
2,433 |
2,253 |
$98K |
| J9264 |
Injection, paclitaxel protein-bound particles, 1 mg |
245 |
62 |
$92K |
| J9070 |
Cyclophosphamide, 100 mg |
1,122 |
628 |
$92K |
| 86900 |
|
15,724 |
6,338 |
$90K |
| 70491 |
|
1,290 |
1,234 |
$89K |
| 88184 |
|
4,586 |
3,720 |
$85K |
| 84100 |
|
37,744 |
14,701 |
$82K |
| 77334 |
|
1,060 |
833 |
$82K |
| J9305 |
Injection, pemetrexed, not otherwise specified, 10 mg |
49 |
24 |
$78K |
| C8908 |
Magnetic resonance imaging without contrast followed by with contrast, breast; bilateral |
356 |
352 |
$75K |
| J9312 |
Injection, rituximab, 10 mg |
33 |
12 |
$75K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
25,318 |
12,878 |
$73K |
| 77300 |
|
902 |
837 |
$70K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
6,684 |
4,435 |
$70K |
| 77065 |
Tomosynthesis, mammo |
2,584 |
2,348 |
$67K |
| 87799 |
|
2,489 |
849 |
$66K |
| J9358 |
Injection, fam-trastuzumab deruxtecan-nxki, 1 mg |
38 |
26 |
$65K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
2,533 |
1,383 |
$64K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
2,360 |
1,509 |
$59K |
| Q3014 |
Telehealth originating site facility fee |
2,922 |
2,650 |
$56K |
| 96523 |
|
1,441 |
947 |
$55K |
| J1447 |
Injection, tbo-filgrastim, 1 microgram |
269 |
63 |
$55K |
| 77066 |
Tomosynthesis, mammo |
1,971 |
1,866 |
$55K |
| C9803 |
Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
5,498 |
3,071 |
$54K |
| 96402 |
|
5,523 |
4,194 |
$54K |
| 86850 |
|
14,107 |
5,772 |
$53K |
| J2997 |
Injection, alteplase recombinant, 1 mg |
1,114 |
936 |
$52K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
12,344 |
10,061 |
$49K |
| 77280 |
|
399 |
299 |
$47K |
| 96409 |
|
3,064 |
1,731 |
$46K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
4,805 |
2,862 |
$45K |
| 88275 |
|
1,676 |
1,215 |
$44K |
| J3489 |
Injection, zoledronic acid, 1 mg |
2,466 |
2,345 |
$44K |
| 36593 |
|
946 |
794 |
$43K |
| J1439 |
Injection, ferric carboxymaltose, 1 mg |
456 |
377 |
$42K |
| J9310 |
Injection, rituximab, 100 mg |
18 |
13 |
$42K |
| 71046 |
Radiologic examination, chest; 2 views |
2,409 |
2,214 |
$41K |
| A9552 |
Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries |
2,576 |
2,491 |
$41K |
| 77080 |
|
809 |
781 |
$40K |
| 82378 |
|
10,859 |
8,288 |
$39K |
| 81378 |
|
1,107 |
645 |
$39K |
| 82533 |
|
6,094 |
4,986 |
$38K |
| 74183 |
|
230 |
223 |
$38K |
| J1756 |
Injection, iron sucrose, 1 mg |
2,405 |
1,336 |
$38K |
| 78306 |
|
251 |
244 |
$37K |
| 82784 |
|
5,520 |
3,383 |
$36K |
| 99215 |
Prolong outpt/office vis |
214 |
121 |
$35K |
| 86830 |
|
670 |
588 |
$35K |
| 86901 |
|
15,582 |
6,259 |
$34K |
| 80069 |
|
3,293 |
1,313 |
$34K |
| 19083 |
|
57 |
53 |
$34K |
| 94010 |
|
1,908 |
1,839 |
$31K |
| 96368 |
|
4,823 |
2,407 |
$31K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
1,114 |
902 |
$30K |
| 94726 |
|
1,527 |
1,468 |
$29K |
| 96401 |
|
4,011 |
1,738 |
$29K |
| 36561 |
|
26 |
25 |
$29K |
| 86300 |
|
4,485 |
3,765 |
$29K |
| 88271 |
|
1,682 |
1,214 |
$29K |
| 88341 |
|
1,101 |
841 |
$27K |
| 94729 |
|
1,760 |
1,695 |
$27K |
| 86644 |
|
2,225 |
1,421 |
$26K |
| 81206 |
|
301 |
284 |
$26K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
3,419 |
3,265 |
$25K |
| 97535 |
Self-care/home management training, each 15 minutes |
1,515 |
1,138 |
$25K |
| J7050 |
Infusion, normal saline solution, 250 cc |
24,088 |
11,904 |
$24K |
| 86301 |
|
3,812 |
2,579 |
$23K |
| 80197 |
|
1,947 |
527 |
$22K |
| 77290 |
|
109 |
98 |
$22K |
| G0498 |
Chemotherapy administration, intravenous infusion technique; initiation of infusion in the office/clinic setting using office/clinic pump/supplies, with continuation of the infusion in the community setting (e.g., home, domiciliary, rest home or assisted living) using a portable pump provided by the office/clinic, includes follow up office/clinic visit at the conclusion of the infusion |
1,007 |
599 |
$22K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
2,536 |
2,098 |
$22K |
| 72197 |
|
110 |
105 |
$21K |
| 88342 |
|
1,897 |
1,711 |
$21K |
| 86831 |
|
733 |
641 |
$21K |
| 87040 |
|
1,377 |
1,033 |
$20K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
16,846 |
7,033 |
$20K |
| 82728 |
|
8,066 |
6,930 |
$20K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
382 |
178 |
$20K |
| 78812 |
|
39 |
38 |
$20K |
| 96417 |
|
9,957 |
5,997 |
$19K |
| Q5107 |
Injection, bevacizumab-awwb, biosimilar, (mvasi), 10 mg |
59 |
24 |
$19K |
| 77001 |
|
273 |
257 |
$19K |
| 84443 |
Thyroid stimulating hormone (TSH) |
10,789 |
9,347 |
$18K |
| 80158 |
|
1,625 |
302 |
$18K |
| 90686 |
|
1,571 |
1,531 |
$17K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
336 |
268 |
$16K |
| 81455 |
|
69 |
64 |
$16K |
| G0279 |
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) |
3,705 |
3,492 |
$16K |
| 85730 |
|
6,755 |
4,876 |
$16K |
| 83001 |
|
1,505 |
1,428 |
$15K |
| 86920 |
|
2,009 |
949 |
$15K |
| J9171 |
Injection, docetaxel, 1 mg |
72 |
54 |
$15K |
| 96411 |
|
4,708 |
2,949 |
$14K |
| 76937 |
|
255 |
242 |
$14K |
| 85610 |
|
8,043 |
5,591 |
$14K |
| 85049 |
|
5,427 |
2,327 |
$14K |
| 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 |
657 |
538 |
$13K |
| 86704 |
|
3,347 |
2,534 |
$12K |
| 86803 |
|
3,028 |
2,217 |
$12K |
| 76536 |
|
188 |
186 |
$12K |
| 87340 |
|
3,392 |
2,575 |
$12K |
| 77301 |
|
29 |
28 |
$11K |
| 83520 |
|
3,633 |
1,714 |
$11K |
| 80061 |
Lipid panel |
1,755 |
1,651 |
$11K |
| 81267 |
|
167 |
158 |
$11K |
| 86703 |
|
2,224 |
1,501 |
$11K |
| 86999 |
|
792 |
742 |
$10K |
| 87536 |
|
290 |
264 |
$10K |
| 84439 |
|
7,749 |
6,590 |
$10K |
| 81001 |
|
4,643 |
3,799 |
$10K |
| 86334 |
|
1,716 |
1,537 |
$10K |
| 84466 |
|
4,865 |
4,568 |
$9K |
| C1751 |
Catheter, infusion, inserted peripherally, centrally or midline (other than hemodialysis) |
8,017 |
5,768 |
$9K |
| 86688 |
|
2,221 |
1,501 |
$9K |
| 84403 |
|
1,130 |
1,059 |
$9K |
| 87631 |
|
435 |
219 |
$9K |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
5,570 |
2,501 |
$9K |
| 86592 |
|
2,243 |
1,516 |
$9K |
| P9033 |
Platelets, leukocytes reduced, irradiated, each unit |
84 |
44 |
$8K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
133 |
70 |
$8K |
| A9579 |
Injection, gadolinium-based magnetic resonance contrast agent, not otherwise specified (nos), per ml |
4,729 |
4,357 |
$8K |
| 77338 |
|
42 |
40 |
$8K |
| A6209 |
Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
15,948 |
8,274 |
$8K |
| 82105 |
|
1,555 |
1,281 |
$7K |
| 85046 |
|
6,737 |
5,239 |
$7K |
| 88240 |
|
2,136 |
1,198 |
$7K |
| 86687 |
|
2,214 |
1,504 |
$7K |
| 84550 |
|
6,021 |
3,642 |
$7K |
| 83521 |
|
3,603 |
1,546 |
$7K |
| 88311 |
|
1,417 |
1,242 |
$7K |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
9,194 |
1,576 |
$7K |
| 84165 |
|
3,863 |
3,381 |
$7K |
| 84153 |
|
2,404 |
2,155 |
$7K |
| J9145 |
Injection, daratumumab, 10 mg |
16 |
12 |
$7K |
| 83540 |
|
4,938 |
4,637 |
$7K |
| 82670 |
|
597 |
570 |
$6K |
| 82248 |
|
3,261 |
2,771 |
$6K |
| 99195 |
|
260 |
218 |
$6K |
| 88313 |
|
481 |
408 |
$6K |
| 85027 |
|
2,955 |
2,203 |
$5K |
| J1950 |
Injection, leuprolide acetate (for depot suspension), per 3.75 mg |
13 |
13 |
$5K |
| J9370 |
Vincristine sulfate, 1 mg |
1,052 |
792 |
$5K |
| 82977 |
|
2,363 |
1,932 |
$5K |
| Q5101 |
Injection, filgrastim-sndz, biosimilar, (zarxio), 1 microgram |
35 |
15 |
$5K |
| G0008 |
Administration of influenza virus vaccine |
2,092 |
2,027 |
$5K |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
2,603 |
2,296 |
$5K |
| 86304 |
|
1,626 |
1,346 |
$5K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
1,669 |
1,470 |
$4K |
| 82607 |
|
1,658 |
1,595 |
$4K |
| 84270 |
|
611 |
568 |
$4K |
| 86360 |
|
251 |
238 |
$4K |
| J3480 |
Injection, potassium chloride, per 2 meq |
3,678 |
898 |
$4K |
| 82570 |
|
1,732 |
1,456 |
$4K |
| 86922 |
|
164 |
65 |
$4K |
| 87081 |
|
38 |
36 |
$3K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
10,757 |
5,365 |
$3K |
| 96376 |
|
1,816 |
1,057 |
$3K |
| 86695 |
|
374 |
346 |
$3K |
| 86355 |
|
193 |
187 |
$3K |
| 86359 |
|
242 |
228 |
$3K |
| 78472 |
|
16 |
13 |
$3K |
| 82465 |
|
1,503 |
1,324 |
$3K |
| J9267 |
Injection, paclitaxel, 1 mg |
3,393 |
1,333 |
$3K |
| 91320 |
|
203 |
197 |
$3K |
| 84432 |
|
311 |
297 |
$3K |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
2,547 |
1,521 |
$3K |
| 99001 |
|
263 |
171 |
$2K |
| 84703 |
|
899 |
802 |
$2K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
1,347 |
1,199 |
$2K |
| 87517 |
|
168 |
157 |
$2K |
| 84478 |
|
1,850 |
1,540 |
$2K |
| 82746 |
|
1,220 |
1,181 |
$2K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
181 |
147 |
$2K |
| 73720 |
|
14 |
12 |
$2K |
| 97162 |
|
45 |
43 |
$2K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
93 |
66 |
$2K |
| J9000 |
Injection, doxorubicin hydrochloride, 10 mg |
1,109 |
688 |
$2K |
| J0640 |
Injection, leucovorin calcium, per 50 mg |
5,238 |
2,243 |
$2K |
| 86140 |
|
1,378 |
929 |
$2K |
| 82043 |
|
460 |
424 |
$2K |
| 86800 |
|
328 |
314 |
$2K |
| J9190 |
Injection, fluorouracil, 500 mg |
6,511 |
2,720 |
$2K |
| 86696 |
|
383 |
353 |
$2K |
| J0881 |
Injection, darbepoetin alfa, 1 microgram (non-esrd use) |
28 |
13 |
$2K |
| 77332 |
|
25 |
24 |
$2K |
| 86317 |
|
150 |
98 |
$2K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
1,358 |
1,296 |
$2K |
| 85525 |
|
267 |
216 |
$2K |
| 72156 |
|
13 |
12 |
$2K |
| 70355 |
|
65 |
64 |
$2K |
| 84156 |
|
799 |
642 |
$2K |
| J7060 |
5% dextrose/water (500 ml = 1 unit) |
7,465 |
2,897 |
$1K |
| 86787 |
|
425 |
393 |
$1K |
| 83002 |
|
173 |
166 |
$1K |
| J3490 |
Unclassified drugs |
1,230 |
763 |
$1K |
| 86141 |
|
819 |
640 |
$1K |
| 83690 |
|
1,910 |
1,526 |
$1K |
| A4648 |
Tissue marker, implantable, any type, each |
855 |
774 |
$1K |
| J1642 |
Injection, heparin sodium, (heparin lock flush), per 10 units |
980 |
300 |
$1K |
| 80195 |
|
182 |
41 |
$1K |
| 86965 |
|
88 |
44 |
$1K |
| 76942 |
|
19 |
19 |
$1K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
318 |
296 |
$1K |
| 84702 |
|
307 |
272 |
$1K |
| 90480 |
|
203 |
197 |
$1K |
| 82150 |
|
1,657 |
1,322 |
$1K |
| 86382 |
|
116 |
107 |
$1K |
| 82565 |
|
678 |
552 |
$1K |
| 87522 |
Neg quan hep c or qual rna |
63 |
63 |
$999.62 |
| 90662 |
|
452 |
425 |
$973.08 |
| 83010 |
|
229 |
186 |
$956.94 |
| 82232 |
|
98 |
94 |
$955.48 |
| 86706 |
|
766 |
742 |
$907.38 |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
262 |
233 |
$888.13 |
| 83021 |
|
101 |
80 |
$863.43 |
| 90656 |
|
94 |
94 |
$774.06 |
| 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 |
59 |
53 |
$739.98 |
| 87390 |
|
116 |
107 |
$714.37 |
| 87205 |
|
549 |
511 |
$705.24 |
| 85651 |
|
726 |
677 |
$598.16 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
8,575 |
4,785 |
$563.05 |
| 83721 |
|
474 |
455 |
$560.90 |
| J9045 |
Injection, carboplatin, 50 mg |
1,753 |
1,073 |
$543.14 |
| 83880 |
|
81 |
68 |
$503.55 |
| C1894 |
Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser |
241 |
228 |
$488.30 |
| 86778 |
|
41 |
37 |
$378.66 |
| 90670 |
|
26 |
25 |
$355.34 |
| M0220 |
Injection, tixagevimab and cilgavimab, for the pre-exposure prophylaxis only, for certain adults and pediatric individuals (12 years of age and older weighing at least 40kg) with no known sars-cov-2 exposure, who either have moderate to severely compromised immune systems or for whom vaccination with any available covid-19 vaccine is not recommended due to a history of severe adverse reaction to a covid-19 vaccine(s) and/or covid-19 vaccine component(s), includes injection and post administration monitoring |
77 |
67 |
$306.02 |
| 85384 |
|
343 |
169 |
$279.84 |
| 90739 |
|
14 |
13 |
$276.69 |
| J0461 |
Injection, atropine sulfate, 0.01 mg |
2,406 |
1,331 |
$275.93 |
| 82550 |
|
196 |
109 |
$269.22 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
108 |
97 |
$268.39 |
| 86902 |
|
65 |
39 |
$263.51 |
| 86480 |
|
28 |
24 |
$262.28 |
| 83718 |
|
269 |
261 |
$240.91 |
| 96377 |
|
90 |
66 |
$236.22 |
| 84484 |
|
100 |
79 |
$224.80 |
| 86481 |
|
16 |
15 |
$223.18 |
| 94760 |
|
139 |
133 |
$219.10 |
| A9560 |
Technetium tc-99m labeled red blood cells, diagnostic, per study dose, up to 30 millicuries |
16 |
13 |
$213.18 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
728 |
420 |
$212.49 |
| 81479 |
Unlisted molecular pathology procedure |
15 |
12 |
$177.72 |
| 80299 |
|
21 |
13 |
$171.56 |
| 85379 |
|
32 |
13 |
$160.67 |
| 86777 |
|
28 |
24 |
$154.33 |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
12 |
12 |
$135.42 |
| 86880 |
|
61 |
50 |
$123.79 |
| 87103 |
|
24 |
14 |
$123.11 |
| 88142 |
|
12 |
12 |
$111.19 |
| 86316 |
|
43 |
39 |
$102.96 |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
463 |
324 |
$93.45 |
| J2704 |
Injection, propofol, 10 mg |
110 |
51 |
$92.02 |
| 82330 |
|
32 |
25 |
$91.21 |
| 88108 |
|
13 |
12 |
$85.26 |
| 82310 |
|
72 |
68 |
$66.84 |
| A9503 |
Technetium tc-99m medronate, diagnostic, per study dose, up to 30 millicuries |
307 |
293 |
$61.38 |
| A9698 |
Non-radioactive contrast imaging material, not otherwise classified, per study |
2,274 |
2,176 |
$59.68 |
| G0009 |
Administration of pneumococcal vaccine |
65 |
63 |
$58.26 |
| G0010 |
Administration of hepatitis b vaccine |
15 |
14 |
$57.48 |
| 90834 |
Psychotherapy, 45 minutes with patient |
13 |
12 |
$52.33 |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
25 |
12 |
$42.82 |
| 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 |
946 |
447 |
$40.74 |
| A9270 |
Non-covered item or service |
4,554 |
1,729 |
$40.01 |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
12 |
12 |
$34.91 |
| 87806 |
|
13 |
12 |
$31.38 |
| 84630 |
|
15 |
15 |
$30.93 |
| J3420 |
Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg |
471 |
371 |
$21.82 |
| J8540 |
Dexamethasone, oral, 0.25 mg |
2,016 |
657 |
$20.92 |
| 83605 |
|
16 |
15 |
$15.63 |
| 89051 |
|
13 |
12 |
$10.08 |
| 84157 |
|
13 |
12 |
$7.20 |
| 82945 |
|
13 |
12 |
$7.08 |
| 86870 |
|
22 |
13 |
$6.72 |
| 85014 |
|
29 |
25 |
$4.93 |
| 87186 |
|
27 |
25 |
$3.89 |
| Q0221 |
Injection, tixagevimab and cilgavimab, for the pre-exposure prophylaxis only, for certain adults and pediatric individuals (12 years of age and older weighing at least 40kg) with no known sars-cov-2 exposure, who either have moderate to severely compromised immune systems or for whom vaccination with any available covid-19 vaccine is not recommended due to a history of severe adverse reaction to a covid-19 vaccine(s) and/or covid-19 vaccine component(s), 600 mg |
30 |
25 |
$0.11 |
| Q0220 |
Injection, tixagevimab and cilgavimab, for the pre-exposure prophylaxis only, for certain adults and pediatric individuals (12 years of age and older weighing at least 40kg) with no known sars-cov-2 exposure, who either have moderate to severely compromised immune systems or for whom vaccination with any available covid-19 vaccine is not recommended due to a history of severe adverse reaction to a covid-19 vaccine(s) and/or covid-19 vaccine component(s), 300 mg |
15 |
12 |
$0.09 |
| G1004 |
Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program |
6,290 |
3,564 |
$0.07 |
| C8937 |
Computer-aided detection, including computer algorithm analysis of breast mri image data for lesion detection/characterization, pharmacokinetic analysis, with further physician review for interpretation (list separately in addition to code for primary procedure) |
412 |
404 |
$0.00 |
| J1171 |
Injection, hydromorphone, 0.1 mg |
48 |
32 |
$0.00 |
| C1788 |
Port, indwelling (implantable) |
50 |
49 |
$0.00 |
| J9060 |
Injection, cisplatin, powder or solution, 10 mg |
23 |
12 |
$0.00 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
18 |
13 |
$0.00 |
| 87077 |
|
15 |
14 |
$0.00 |
| J2003 |
Injection, lidocaine hydrochloride, 1 mg |
271 |
179 |
$0.00 |