| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
13,576 |
10,361 |
$786K |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
34,388 |
23,556 |
$701K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
4,979 |
4,248 |
$607K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
55,374 |
35,417 |
$362K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
96,896 |
55,623 |
$327K |
| 70450 |
Computed tomography, head or brain; without contrast material |
4,521 |
3,920 |
$281K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
1,068 |
925 |
$196K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
1,861 |
1,190 |
$194K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
1,551 |
1,425 |
$182K |
| 71046 |
Radiologic examination, chest; 2 views |
10,842 |
8,434 |
$146K |
| 71045 |
Radiologic examination, chest; single view |
6,525 |
5,155 |
$140K |
| G0378 |
Hospital observation service, per hour |
881 |
835 |
$135K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
16,095 |
13,410 |
$133K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
29,290 |
25,836 |
$131K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
1,591 |
1,373 |
$122K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
18,640 |
6,158 |
$98K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
1,690 |
1,515 |
$95K |
| A0427 |
Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) |
3,638 |
3,224 |
$91K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
7,122 |
6,665 |
$84K |
| A0428 |
Ambulance service, basic life support, non-emergency transport, (bls) |
3,227 |
1,572 |
$83K |
| A0425 |
Ground mileage, per statute mile |
11,163 |
7,214 |
$82K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
3,411 |
1,263 |
$70K |
| A0429 |
Ambulance service, basic life support, emergency transport (bls-emergency) |
3,194 |
2,760 |
$59K |
| 80053 |
Comprehensive metabolic panel |
28,236 |
23,450 |
$48K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
7,872 |
2,866 |
$34K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
11,186 |
9,763 |
$33K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
2,162 |
2,082 |
$32K |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
1,390 |
684 |
$31K |
| 73502 |
|
740 |
654 |
$28K |
| 97161 |
|
2,093 |
2,034 |
$27K |
| 73030 |
|
1,856 |
1,511 |
$27K |
| 71250 |
|
313 |
280 |
$26K |
| 73564 |
|
1,836 |
1,582 |
$25K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
510 |
262 |
$25K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
1,283 |
1,040 |
$23K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
8,351 |
7,486 |
$21K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
3,715 |
2,924 |
$20K |
| 73630 |
|
2,157 |
1,646 |
$19K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
4,264 |
3,458 |
$16K |
| 73610 |
|
2,081 |
1,600 |
$16K |
| 20610 |
|
888 |
417 |
$15K |
| 97113 |
|
1,286 |
429 |
$15K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
3,997 |
3,504 |
$13K |
| 73130 |
|
1,446 |
1,147 |
$13K |
| 97162 |
|
1,211 |
1,182 |
$13K |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
2,609 |
2,379 |
$13K |
| 99215 |
Prolong outpt/office vis |
1,764 |
1,548 |
$12K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
2,689 |
1,733 |
$11K |
| 93017 |
|
248 |
234 |
$11K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
8,798 |
7,281 |
$10K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
4,086 |
3,594 |
$10K |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
1,709 |
1,428 |
$9K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
3,400 |
2,934 |
$9K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
153 |
74 |
$8K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
5,288 |
4,404 |
$8K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
54 |
51 |
$8K |
| 99070 |
|
626 |
369 |
$8K |
| 97165 |
|
521 |
512 |
$7K |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
15,876 |
13,206 |
$7K |
| 93971 |
|
175 |
170 |
$7K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
364 |
151 |
$7K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
1,960 |
1,906 |
$7K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
6,258 |
2,686 |
$7K |
| 73110 |
|
901 |
732 |
$6K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
43,042 |
34,124 |
$6K |
| 36591 |
|
645 |
401 |
$6K |
| J3490 |
Unclassified drugs |
26,915 |
8,252 |
$6K |
| 94664 |
|
1,576 |
1,285 |
$5K |
| 84443 |
Thyroid stimulating hormone (TSH) |
10,994 |
10,439 |
$5K |
| J1030 |
Injection, methylprednisolone acetate, 40 mg |
942 |
908 |
$5K |
| 36415 |
Collection of venous blood by venipuncture |
62,915 |
49,647 |
$5K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
10,628 |
10,411 |
$4K |
| 94010 |
|
475 |
302 |
$4K |
| 99442 |
|
1,403 |
1,333 |
$4K |
| 72110 |
|
156 |
141 |
$4K |
| 45385 |
Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) |
52 |
41 |
$4K |
| 74018 |
|
386 |
340 |
$4K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
268 |
263 |
$3K |
| Q9957 |
Injection, perflutren lipid microspheres, per ml |
111 |
108 |
$3K |
| 72100 |
|
226 |
206 |
$3K |
| A9500 |
Technetium tc-99m sestamibi, diagnostic, per study dose |
53 |
50 |
$3K |
| 99222 |
Initial hospital care, per day, moderate complexity |
322 |
312 |
$3K |
| 11721 |
|
485 |
273 |
$3K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
79 |
51 |
$3K |
| J3370 |
Injection, vancomycin hcl, 500 mg |
151 |
73 |
$3K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
2,888 |
2,537 |
$2K |
| 90715 |
|
2,431 |
2,387 |
$2K |
| 36600 |
|
382 |
329 |
$2K |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
3,636 |
3,208 |
$2K |
| 99441 |
|
1,037 |
984 |
$2K |
| 92507 |
Treatment of speech, language, voice, communication, and/or auditory processing disorder |
6,183 |
2,053 |
$2K |
| 99495 |
|
60 |
29 |
$2K |
| 99443 |
|
378 |
359 |
$2K |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
2,480 |
2,472 |
$2K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
2,713 |
2,570 |
$2K |
| 84484 |
|
9,332 |
7,694 |
$2K |
| J3372 |
Injection, vancomycin hcl (xellia), not therapeutically equivalent to j3370, 500 mg |
254 |
142 |
$2K |
| 83735 |
|
16,008 |
12,836 |
$2K |
| 97597 |
|
149 |
44 |
$2K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
37 |
27 |
$2K |
| 69209 |
|
227 |
212 |
$2K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
2,423 |
1,785 |
$2K |
| 83880 |
|
3,065 |
2,741 |
$1K |
| J2060 |
Injection, lorazepam, 2 mg |
2,010 |
1,621 |
$1K |
| 82728 |
|
3,222 |
3,059 |
$1K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
6,154 |
5,124 |
$1K |
| 85610 |
|
9,985 |
7,044 |
$1K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
29 |
29 |
$1K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
3,206 |
3,146 |
$1K |
| 82607 |
|
2,705 |
2,634 |
$1K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
5,495 |
5,162 |
$1K |
| 80061 |
Lipid panel |
9,752 |
9,552 |
$1K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
9,011 |
6,551 |
$1K |
| 76642 |
|
67 |
54 |
$1K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
1,030 |
1,015 |
$1K |
| J0134 |
Injection, acetaminophen (fresenius kabi), not therapeutically equivalent to j0131, 10 mg |
1,082 |
908 |
$1K |
| 99239 |
Hospital discharge day management, more than 30 minutes |
41 |
41 |
$1K |
| 99219 |
|
232 |
222 |
$1K |
| 74022 |
|
37 |
37 |
$1K |
| 87088 |
|
5,897 |
5,416 |
$1K |
| 76536 |
|
55 |
41 |
$1K |
| 82803 |
|
1,409 |
1,164 |
$1K |
| 87186 |
|
3,288 |
3,050 |
$990.00 |
| 87040 |
|
2,602 |
2,034 |
$987.46 |
| J7050 |
Infusion, normal saline solution, 250 cc |
2,969 |
1,683 |
$957.70 |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
244 |
184 |
$947.49 |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
1,486 |
1,279 |
$912.50 |
| 99217 |
|
281 |
267 |
$905.71 |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
351 |
300 |
$875.19 |
| 80305 |
|
6,529 |
5,126 |
$807.65 |
| 94760 |
|
612 |
504 |
$801.36 |
| G0108 |
Diabetes outpatient self-management training services, individual, per 30 minutes |
484 |
439 |
$799.43 |
| 80050 |
General health panel |
2,751 |
2,626 |
$770.22 |
| 80076 |
|
848 |
760 |
$764.68 |
| 83605 |
|
3,204 |
2,750 |
$762.86 |
| 83690 |
|
8,263 |
7,292 |
$756.89 |
| 86901 |
|
2,124 |
1,872 |
$743.51 |
| A6216 |
Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
122 |
48 |
$734.37 |
| 86140 |
|
6,576 |
5,754 |
$695.63 |
| 84466 |
|
2,073 |
1,971 |
$683.75 |
| 99050 |
|
2,226 |
2,088 |
$676.00 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
450 |
344 |
$660.22 |
| 82565 |
|
13,012 |
10,425 |
$656.62 |
| 83615 |
|
3,496 |
2,446 |
$652.79 |
| 82310 |
|
12,758 |
10,204 |
$640.74 |
| 81001 |
|
7,824 |
7,072 |
$600.42 |
| 73590 |
|
80 |
65 |
$582.16 |
| G2211 |
Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established) |
851 |
791 |
$576.60 |
| 87077 |
|
3,501 |
3,251 |
$564.72 |
| 82374 |
|
12,596 |
10,124 |
$559.81 |
| 82247 |
|
11,120 |
9,296 |
$558.21 |
| 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 |
10,273 |
8,813 |
$543.89 |
| 82435 |
|
12,600 |
10,125 |
$538.54 |
| 86803 |
|
2,355 |
2,280 |
$512.35 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
2,752 |
2,281 |
$497.99 |
| 86920 |
|
20 |
12 |
$492.40 |
| 00731 |
|
26 |
25 |
$478.37 |
| 81003 |
|
7,965 |
7,248 |
$478.25 |
| 83540 |
|
2,486 |
2,367 |
$472.82 |
| 84460 |
|
11,222 |
9,390 |
$472.72 |
| 73560 |
|
27 |
26 |
$472.38 |
| 84450 |
|
11,203 |
9,375 |
$458.39 |
| 99490 |
Ccm add 20min |
72 |
36 |
$449.07 |
| 84075 |
|
11,134 |
9,296 |
$441.60 |
| 84520 |
|
12,757 |
10,208 |
$438.77 |
| 84295 |
|
12,615 |
10,138 |
$432.48 |
| 82962 |
|
3,919 |
2,696 |
$422.14 |
| 86900 |
|
2,078 |
1,832 |
$422.04 |
| 84132 |
|
12,666 |
10,161 |
$413.44 |
| A6250 |
Skin sealants, protectants, moisturizers, ointments, any type, any size |
308 |
135 |
$397.71 |
| 85730 |
|
3,871 |
3,553 |
$397.54 |
| 73140 |
|
126 |
74 |
$361.55 |
| 93016 |
|
218 |
205 |
$345.96 |
| 84155 |
|
11,222 |
9,375 |
$337.38 |
| 97035 |
|
131 |
50 |
$336.84 |
| 82040 |
|
11,206 |
9,339 |
$332.46 |
| 73080 |
|
27 |
25 |
$327.39 |
| 82043 |
|
1,425 |
1,406 |
$326.18 |
| 82550 |
|
1,810 |
1,534 |
$323.03 |
| 84100 |
|
4,044 |
3,333 |
$311.63 |
| 80306 |
|
3,106 |
2,769 |
$302.98 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
5,483 |
5,344 |
$302.52 |
| 93976 |
|
12 |
12 |
$300.63 |
| 85379 |
|
2,324 |
2,207 |
$296.97 |
| 94060 |
|
22 |
12 |
$296.57 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
2,126 |
1,974 |
$292.18 |
| 84439 |
|
2,565 |
2,470 |
$290.88 |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
1,543 |
1,481 |
$287.48 |
| 85652 |
|
5,096 |
4,486 |
$285.98 |
| A4565 |
Slings |
121 |
116 |
$278.07 |
| 82746 |
|
1,016 |
987 |
$267.51 |
| J1940 |
Injection, furosemide, up to 20 mg |
145 |
130 |
$263.85 |
| 87070 |
|
3,090 |
2,945 |
$250.74 |
| 85027 |
|
2,300 |
2,023 |
$239.54 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
4,808 |
2,418 |
$237.51 |
| J2919 |
Injection, methylprednisolone sodium succinate, 5 mg |
133 |
83 |
$234.91 |
| 93018 |
|
218 |
205 |
$231.61 |
| 87634 |
|
841 |
792 |
$228.76 |
| 76775 |
|
13 |
13 |
$225.60 |
| 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 |
5,620 |
5,203 |
$225.17 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
1,383 |
1,180 |
$223.10 |
| 82150 |
|
581 |
550 |
$221.63 |
| 86886 |
|
172 |
139 |
$213.96 |
| J1010 |
Injection, methylprednisolone acetate, 1 mg |
60 |
59 |
$206.07 |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
2,398 |
2,140 |
$199.54 |
| 00812 |
|
31 |
30 |
$190.42 |
| 99238 |
Hospital discharge day management, 30 minutes or less |
13 |
13 |
$188.80 |
| 72050 |
|
12 |
12 |
$186.67 |
| 82248 |
|
1,960 |
1,632 |
$181.83 |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
3,125 |
2,590 |
$172.59 |
| J3480 |
Injection, potassium chloride, per 2 meq |
96 |
74 |
$169.45 |
| C9113 |
Injection, pantoprazole sodium, per vial |
143 |
111 |
$168.47 |
| J8499 |
Prescription drug, oral, non chemotherapeutic, nos |
769 |
335 |
$166.65 |
| 90662 |
|
1,004 |
992 |
$161.65 |
| 90670 |
|
2,012 |
1,967 |
$159.65 |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
33 |
32 |
$150.20 |
| 86850 |
|
1,775 |
1,591 |
$145.26 |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
74 |
67 |
$144.44 |
| 87205 |
|
1,921 |
1,812 |
$143.83 |
| 76830 |
Ultrasound, transvaginal |
118 |
82 |
$132.74 |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
2,585 |
2,466 |
$131.20 |
| 77065 |
Tomosynthesis, mammo |
13 |
13 |
$130.49 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
105 |
88 |
$127.89 |
| 88142 |
|
882 |
827 |
$124.47 |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
2,681 |
2,598 |
$120.25 |
| 93242 |
|
28 |
28 |
$117.10 |
| J2543 |
Injection, piperacillin sodium/tazobactam sodium, 1 gram/0.125 grams (1.125 grams) |
56 |
39 |
$115.12 |
| 86317 |
|
923 |
892 |
$115.06 |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
2,591 |
2,471 |
$112.10 |
| 99225 |
|
56 |
38 |
$109.69 |
| 0064A |
|
452 |
442 |
$103.80 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
165 |
103 |
$102.23 |
| 82570 |
|
651 |
602 |
$99.84 |
| 51798 |
|
17 |
16 |
$99.23 |
| G0279 |
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) |
38 |
37 |
$98.27 |
| J0595 |
Injection, butorphanol tartrate, 1 mg |
47 |
46 |
$96.15 |
| 95251 |
|
36 |
36 |
$95.54 |
| 87340 |
|
1,801 |
1,737 |
$91.39 |
| 87503 |
|
529 |
488 |
$89.58 |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
205 |
198 |
$86.56 |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
74 |
63 |
$85.05 |
| 86618 |
|
1,020 |
976 |
$81.39 |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
735 |
715 |
$78.53 |
| A0426 |
Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) |
17 |
15 |
$73.60 |
| J3411 |
Injection, thiamine hcl, 100 mg |
53 |
50 |
$72.21 |
| 87522 |
Neg quan hep c or qual rna |
268 |
256 |
$70.90 |
| 93793 |
|
59 |
25 |
$69.00 |
| 90686 |
|
4,578 |
4,528 |
$67.80 |
| 81025 |
|
7,049 |
6,455 |
$65.11 |
| 12001 |
|
66 |
65 |
$64.01 |
| 86704 |
|
856 |
827 |
$60.26 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
5,923 |
2,973 |
$58.37 |
| 83516 |
|
70 |
67 |
$55.61 |
| 82140 |
|
58 |
56 |
$54.94 |
| 80164 |
|
365 |
334 |
$54.90 |
| G0008 |
Administration of influenza virus vaccine |
1,953 |
1,934 |
$54.42 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
340 |
288 |
$51.10 |
| 86708 |
|
814 |
785 |
$49.91 |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
1,595 |
1,554 |
$49.15 |
| 82947 |
|
2,197 |
1,833 |
$45.98 |
| 80051 |
|
97 |
76 |
$44.27 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
193 |
182 |
$41.11 |
| 84165 |
|
55 |
53 |
$40.41 |
| 93246 |
|
13 |
12 |
$40.00 |
| 0352U |
|
179 |
174 |
$38.67 |
| 85018 |
|
838 |
755 |
$38.02 |
| 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 |
1,357 |
1,247 |
$37.93 |
| 80299 |
|
25 |
24 |
$35.79 |
| 90656 |
|
473 |
472 |
$34.74 |
| J7042 |
5% dextrose/normal saline (500 ml = 1 unit) |
96 |
86 |
$30.23 |
| 83970 |
|
67 |
65 |
$27.81 |
| 90632 |
|
15 |
15 |
$22.85 |
| 86038 |
|
192 |
184 |
$18.74 |
| 87493 |
|
14 |
12 |
$17.75 |
| 82077 |
|
159 |
147 |
$17.27 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
17 |
16 |
$15.81 |
| 87045 |
|
39 |
36 |
$15.32 |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
12 |
12 |
$13.42 |
| 87046 |
|
39 |
36 |
$13.04 |
| J2470 |
Injection, pantoprazole sodium, 40 mg |
17 |
15 |
$12.36 |
| 93244 |
|
27 |
27 |
$10.97 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
4,625 |
2,312 |
$10.00 |
| 84153 |
|
86 |
82 |
$9.98 |
| 85007 |
|
374 |
269 |
$9.64 |
| 0124A |
|
63 |
63 |
$9.63 |
| 80177 |
|
120 |
114 |
$9.43 |
| 85014 |
|
161 |
130 |
$9.22 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
3,987 |
3,916 |
$8.55 |
| 86592 |
|
1,046 |
1,019 |
$7.93 |
| 87478 |
|
378 |
369 |
$6.53 |
| 87468 |
|
379 |
370 |
$6.53 |
| 87484 |
|
378 |
369 |
$6.53 |
| 87469 |
|
379 |
370 |
$6.53 |
| 87427 |
|
13 |
12 |
$5.77 |
| 93248 |
|
13 |
12 |
$4.98 |
| 99406 |
|
72 |
65 |
$4.88 |
| A4627 |
Spacer, bag or reservoir, with or without mask, for use with metered dose inhaler |
493 |
464 |
$4.86 |
| 82784 |
|
67 |
60 |
$4.44 |
| 87210 |
|
204 |
192 |
$3.60 |
| 82105 |
|
118 |
108 |
$2.59 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
250 |
234 |
$2.54 |
| 86255 |
|
26 |
25 |
$2.35 |
| 80175 |
|
71 |
68 |
$1.87 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
902 |
834 |
$1.85 |
| 87185 |
|
27 |
25 |
$0.64 |
| 85651 |
|
74 |
67 |
$0.49 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
690 |
671 |
$0.22 |
| J7620 |
Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme |
1,455 |
1,134 |
$0.09 |
| G0009 |
Administration of pneumococcal vaccine |
149 |
148 |
$0.06 |
| G8979 |
Mobility: walking & moving around functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting |
429 |
388 |
$0.04 |
| G8985 |
Carrying, moving and handling objects, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting |
179 |
154 |
$0.04 |
| G8980 |
Mobility: walking & moving around functional limitation, discharge status, at discharge from therapy or to end reporting |
24 |
24 |
$0.03 |
| G8978 |
Mobility: walking & moving around functional limitation, current status, at therapy episode outset and at reporting intervals |
381 |
349 |
$0.03 |
| G8984 |
Carrying, moving & handling objects functional limitation, current status, at therapy episode outset and at reporting intervals |
144 |
132 |
$0.03 |
| J0571 |
Buprenorphine, oral, 1 mg |
19 |
13 |
$0.00 |
| 90723 |
|
397 |
396 |
$0.00 |
| 90651 |
|
251 |
248 |
$0.00 |
| 90680 |
|
287 |
287 |
$0.00 |
| 90697 |
|
221 |
217 |
$0.00 |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
218 |
179 |
$0.00 |
| 70496 |
|
15 |
12 |
$0.00 |
| 90480 |
|
341 |
339 |
$0.00 |
| 86762 |
|
67 |
66 |
$0.00 |
| 0134A |
|
133 |
132 |
$0.00 |
| 90647 |
|
628 |
625 |
$0.00 |
| 90698 |
|
218 |
216 |
$0.00 |
| 90696 |
|
102 |
102 |
$0.00 |
| 0011A |
|
265 |
263 |
$0.00 |
| 80178 |
|
18 |
12 |
$0.00 |
| 87147 |
|
184 |
175 |
$0.00 |
| 90716 |
|
54 |
53 |
$0.00 |
| 90732 |
|
61 |
61 |
$0.00 |
| 85008 |
|
45 |
33 |
$0.00 |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
13 |
12 |
$0.00 |
| 90744 |
|
67 |
66 |
$0.00 |
| 87428 |
|
50 |
49 |
$0.00 |
| 86706 |
|
157 |
153 |
$0.00 |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
42 |
24 |
$0.00 |
| 74019 |
|
14 |
14 |
$0.00 |
| 76801 |
|
12 |
12 |
$0.00 |
| 0031A |
|
142 |
138 |
$0.00 |
| 0012A |
|
82 |
82 |
$0.00 |
| 87430 |
|
75 |
71 |
$0.00 |
| G0103 |
Prostate cancer screening; prostate specific antigen test (psa) |
14 |
14 |
$0.00 |
| 90677 |
|
280 |
279 |
$0.00 |
| E0112 |
Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips |
15 |
15 |
$0.00 |
| 87081 |
|
38 |
36 |
$0.00 |
| 87807 |
|
83 |
78 |
$0.00 |
| 82390 |
|
15 |
14 |
$0.00 |
| J0574 |
Buprenorphine/naloxone, oral, greater than 6 mg, but less than or equal to 10 mg buprenorphine |
24 |
12 |
$0.00 |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
49 |
24 |
$0.00 |
| 86364 |
|
14 |
14 |
$0.00 |
| 84702 |
|
1,646 |
1,308 |
$0.00 |
| 99188 |
|
297 |
289 |
$0.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
4,147 |
2,080 |
$0.00 |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
410 |
399 |
$0.00 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
6,535 |
3,064 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
3,326 |
3,238 |
$0.00 |
| G2023 |
Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
17 |
17 |
$0.00 |
| C9803 |
Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
442 |
429 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
3,142 |
1,576 |
$0.00 |
| 83655 |
|
1,018 |
978 |
$0.00 |
| 91322 |
|
240 |
239 |
$0.00 |
| 90700 |
|
108 |
104 |
$0.00 |
| 90461 |
|
1,935 |
1,908 |
$0.00 |
| 90734 |
|
282 |
277 |
$0.00 |
| G2250 |
Remote assessment of recorded video and/or images submitted by an established patient (e.g., store and forward), including interpretation with follow-up with the patient within 24 business hours, not originating from a related service provided within the previous 7 days nor leading to a service or procedure within the next 24 hours or soonest available appointment |
13 |
13 |
$0.00 |
| 71271 |
|
409 |
260 |
$0.00 |
| 90685 |
|
120 |
118 |
$0.00 |
| S0119 |
Ondansetron, oral, 4 mg (for circumstances falling under the medicare statute, use hcpcs q code) |
691 |
607 |
$0.00 |
| 86787 |
|
67 |
65 |
$0.00 |
| 90710 |
|
229 |
229 |
$0.00 |
| 90633 |
|
1,154 |
1,142 |
$0.00 |
| 82009 |
|
60 |
56 |
$0.00 |
| 84145 |
|
30 |
26 |
$0.00 |
| 86709 |
|
67 |
64 |
$0.00 |
| 84146 |
|
13 |
13 |
$0.00 |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
98 |
92 |
$0.00 |
| 87631 |
|
52 |
49 |
$0.00 |
| 84403 |
|
27 |
27 |
$0.00 |
| 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 |
183 |
179 |
$0.00 |
| 84550 |
|
28 |
27 |
$0.00 |
| G0438 |
Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit |
29 |
28 |
$0.00 |
| 80143 |
|
17 |
17 |
$0.00 |
| 84156 |
|
16 |
12 |
$0.00 |
| 90681 |
|
47 |
47 |
$0.00 |
| S0164 |
Injection, pantoprazole sodium, 40 mg |
28 |
26 |
$0.00 |
| S0028 |
Injection, famotidine, 20 mg |
79 |
69 |
$0.00 |
| 99382 |
|
26 |
13 |
$0.00 |
| 90707 |
|
41 |
41 |
$0.00 |
| 99001 |
|
94 |
89 |
$0.00 |
| J1171 |
Injection, hydromorphone, 0.1 mg |
21 |
13 |
$0.00 |
| 91320 |
|
21 |
21 |
$0.00 |
| 0034A |
|
16 |
16 |
$0.00 |
| 0013A |
|
13 |
13 |
$0.00 |
| 80179 |
|
14 |
14 |
$0.00 |