| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
23,151 |
21,215 |
$3.63M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
17,890 |
16,986 |
$2.64M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
14,405 |
13,535 |
$2.05M |
| 96361 |
Intravenous infusion, hydration; each additional hour |
5,292 |
4,851 |
$1.79M |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
658 |
652 |
$722K |
| G0378 |
Hospital observation service, per hour |
6,387 |
3,683 |
$702K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
4,988 |
4,729 |
$612K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,244 |
3,086 |
$559K |
| 70450 |
Computed tomography, head or brain; without contrast material |
5,417 |
5,121 |
$478K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
3,030 |
2,929 |
$458K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,160 |
2,107 |
$427K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
4,928 |
4,878 |
$369K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
6,786 |
6,272 |
$352K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
4,754 |
1,464 |
$344K |
| 45385 |
Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) |
361 |
359 |
$338K |
| 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 |
6,822 |
6,343 |
$338K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
385 |
383 |
$306K |
| S9485 |
Crisis intervention mental health services, per diem |
694 |
521 |
$300K |
| 71046 |
Radiologic examination, chest; 2 views |
12,027 |
11,461 |
$288K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
2,220 |
2,060 |
$218K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
1,352 |
1,345 |
$217K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
1,560 |
1,442 |
$217K |
| 80053 |
Comprehensive metabolic panel |
42,766 |
39,031 |
$215K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
6,720 |
6,334 |
$189K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
40,448 |
35,893 |
$172K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
914 |
907 |
$148K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
9,113 |
8,921 |
$139K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
4,990 |
4,937 |
$121K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
3,718 |
3,236 |
$109K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
3,849 |
3,717 |
$102K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
3,314 |
3,196 |
$88K |
| 84484 |
|
11,541 |
10,058 |
$85K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
10,090 |
9,319 |
$84K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
16,418 |
16,021 |
$84K |
| 76830 |
Ultrasound, transvaginal |
862 |
859 |
$84K |
| 84443 |
Thyroid stimulating hormone (TSH) |
12,652 |
12,327 |
$83K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
766 |
734 |
$82K |
| 80061 |
Lipid panel |
21,605 |
21,137 |
$78K |
| 80050 |
General health panel |
4,535 |
4,500 |
$74K |
| 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 |
2,771 |
2,549 |
$71K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
18,623 |
16,636 |
$70K |
| 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 |
4,185 |
3,989 |
$67K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
377 |
368 |
$67K |
| 73630 |
|
2,196 |
2,031 |
$65K |
| 93971 |
|
656 |
639 |
$61K |
| 62323 |
|
156 |
156 |
$60K |
| 73030 |
|
1,973 |
1,812 |
$56K |
| 83735 |
|
13,208 |
11,633 |
$51K |
| 85027 |
|
15,152 |
14,016 |
$49K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
275 |
265 |
$48K |
| 73564 |
|
1,616 |
1,421 |
$48K |
| 82607 |
|
5,587 |
5,472 |
$44K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
406 |
384 |
$43K |
| ATP14 |
|
6,502 |
6,003 |
$43K |
| 83690 |
|
9,126 |
8,417 |
$40K |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
931 |
897 |
$40K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
903 |
688 |
$39K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
3,516 |
3,439 |
$38K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
8,730 |
8,111 |
$37K |
| 87631 |
|
416 |
407 |
$36K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
17,845 |
16,292 |
$36K |
| 77080 |
|
459 |
457 |
$36K |
| 73610 |
|
1,306 |
1,199 |
$35K |
| 83970 |
|
2,174 |
2,101 |
$35K |
| 82728 |
|
4,565 |
4,427 |
$34K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
93 |
93 |
$33K |
| 71045 |
Radiologic examination, chest; single view |
6,922 |
6,452 |
$32K |
| 72100 |
|
1,086 |
1,063 |
$32K |
| 73562 |
|
1,272 |
1,216 |
$31K |
| 86803 |
|
1,872 |
1,864 |
$30K |
| 58558 |
|
14 |
14 |
$29K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
1,286 |
1,281 |
$28K |
| 0002A |
|
847 |
836 |
$26K |
| 73130 |
|
1,056 |
989 |
$26K |
| 81025 |
|
5,971 |
5,672 |
$26K |
| 84466 |
|
3,929 |
3,795 |
$25K |
| 73560 |
|
730 |
699 |
$25K |
| 85610 |
|
6,185 |
4,734 |
$24K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
8,777 |
7,093 |
$23K |
| 84702 |
|
2,125 |
1,945 |
$23K |
| 82948 |
|
5,075 |
3,645 |
$22K |
| 84153 |
|
1,464 |
1,457 |
$22K |
| 82746 |
|
1,929 |
1,907 |
$21K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
4,479 |
4,095 |
$20K |
| 0011A |
|
983 |
919 |
$20K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
266 |
252 |
$19K |
| 45378 |
Colonoscopy, flexible; diagnostic, including collection of specimen(s) |
12 |
12 |
$19K |
| 86850 |
|
2,777 |
2,627 |
$18K |
| 0001A |
|
802 |
784 |
$18K |
| 81001 |
|
10,118 |
9,415 |
$18K |
| 83880 |
|
1,313 |
1,222 |
$18K |
| 83540 |
|
5,179 |
5,025 |
$18K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
412 |
150 |
$17K |
| 76536 |
|
160 |
160 |
$16K |
| 84439 |
|
3,352 |
3,271 |
$16K |
| 0012A |
|
563 |
559 |
$16K |
| 82570 |
|
6,800 |
6,589 |
$15K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
7,155 |
5,888 |
$15K |
| 87430 |
|
1,287 |
1,233 |
$15K |
| 86901 |
|
2,958 |
2,794 |
$14K |
| 73502 |
|
609 |
560 |
$14K |
| ATP15 |
|
1,774 |
1,652 |
$14K |
| 87637 |
Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV |
126 |
125 |
$14K |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
595 |
595 |
$14K |
| 80074 |
|
439 |
435 |
$14K |
| 81003 |
|
10,334 |
9,748 |
$14K |
| 83605 |
|
2,338 |
2,125 |
$14K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
6,836 |
6,187 |
$13K |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
2,576 |
2,311 |
$13K |
| 82043 |
|
5,677 |
5,546 |
$13K |
| 87186 |
|
2,805 |
2,637 |
$13K |
| 84100 |
|
9,235 |
8,346 |
$12K |
| ATP08 |
|
2,783 |
2,519 |
$12K |
| 36415 |
Collection of venous blood by venipuncture |
29,725 |
26,865 |
$12K |
| J2704 |
Injection, propofol, 10 mg |
6,281 |
4,996 |
$11K |
| 84703 |
|
1,943 |
1,784 |
$11K |
| 87801 |
Infectious agent detection by nucleic acid; amplified probe, multiple organisms |
257 |
229 |
$10K |
| 86140 |
|
3,105 |
2,919 |
$10K |
| 80143 |
|
1,732 |
1,567 |
$10K |
| 87070 |
|
1,498 |
1,450 |
$10K |
| 73110 |
|
353 |
324 |
$9K |
| 95810 |
Polysomnography; sleep staging with 4 or more additional parameters |
12 |
12 |
$9K |
| 97162 |
|
168 |
158 |
$9K |
| 87480 |
|
520 |
512 |
$9K |
| 87510 |
|
520 |
512 |
$9K |
| 87660 |
|
521 |
512 |
$9K |
| 86480 |
|
194 |
192 |
$8K |
| 86900 |
|
2,662 |
2,506 |
$8K |
| 86592 |
|
1,330 |
1,320 |
$8K |
| 99215 |
Prolong outpt/office vis |
39 |
39 |
$8K |
| 71250 |
|
153 |
151 |
$7K |
| 80076 |
|
3,916 |
3,738 |
$7K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
156 |
147 |
$7K |
| 87400 |
|
393 |
375 |
$7K |
| 85730 |
|
2,055 |
1,915 |
$6K |
| 85379 |
|
863 |
831 |
$6K |
| 76642 |
|
54 |
54 |
$6K |
| J1170 |
Injection, hydromorphone, up to 4 mg |
1,963 |
1,183 |
$5K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
99 |
94 |
$5K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
999 |
938 |
$5K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
7,017 |
6,558 |
$4K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
2,848 |
2,284 |
$4K |
| 85007 |
|
2,109 |
1,923 |
$4K |
| J0137 |
Injection, acetaminophen (hikma), not therapeutically equivalent to j0131, 10 mg |
684 |
575 |
$4K |
| 87040 |
|
453 |
414 |
$4K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
1,070 |
1,016 |
$4K |
| 85652 |
|
2,451 |
2,360 |
$4K |
| 82550 |
|
3,013 |
2,871 |
$4K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
826 |
655 |
$3K |
| 82565 |
|
1,183 |
1,103 |
$3K |
| 97803 |
|
42 |
40 |
$3K |
| 87340 |
|
327 |
325 |
$3K |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
1,683 |
1,150 |
$3K |
| 80305 |
|
556 |
521 |
$3K |
| 76000 |
|
93 |
91 |
$3K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
297 |
286 |
$3K |
| J9035 |
Injection, bevacizumab, 10 mg |
12 |
12 |
$3K |
| 84550 |
|
3,065 |
2,967 |
$3K |
| 86706 |
|
247 |
245 |
$3K |
| 87081 |
|
538 |
513 |
$3K |
| 93017 |
|
26 |
26 |
$2K |
| 86765 |
|
59 |
57 |
$2K |
| 86618 |
|
154 |
146 |
$2K |
| 72170 |
|
222 |
214 |
$2K |
| 20553 |
|
12 |
12 |
$2K |
| 70496 |
|
13 |
13 |
$2K |
| J0690 |
Injection, cefazolin sodium, 500 mg |
556 |
465 |
$2K |
| 88142 |
|
85 |
85 |
$2K |
| ATP17 |
|
2,822 |
2,536 |
$2K |
| 73140 |
|
39 |
39 |
$2K |
| 84300 |
|
913 |
884 |
$2K |
| 84156 |
|
1,046 |
998 |
$2K |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
411 |
372 |
$1K |
| 86038 |
|
149 |
147 |
$1K |
| 86708 |
|
119 |
117 |
$1K |
| J1644 |
Injection, heparin sodium, per 1000 units |
612 |
328 |
$1K |
| 86703 |
|
126 |
125 |
$1K |
| 84460 |
|
746 |
711 |
$1K |
| 84133 |
|
805 |
778 |
$1K |
| 87077 |
|
311 |
301 |
$1K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
111 |
96 |
$1K |
| 82436 |
|
661 |
639 |
$1K |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
241 |
227 |
$1K |
| 85651 |
|
460 |
442 |
$1K |
| 84450 |
|
485 |
461 |
$1K |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
44 |
44 |
$1K |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
428 |
362 |
$982.21 |
| J2060 |
Injection, lorazepam, 2 mg |
555 |
415 |
$978.89 |
| 71271 |
|
14 |
14 |
$943.37 |
| 88312 |
|
126 |
124 |
$925.46 |
| 84480 |
|
91 |
89 |
$778.83 |
| 86762 |
|
14 |
14 |
$769.67 |
| ATP21 |
|
307 |
271 |
$755.68 |
| 91301 |
|
682 |
636 |
$729.55 |
| J1040 |
Injection, methylprednisolone acetate, 80 mg |
198 |
182 |
$621.87 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
274 |
267 |
$603.36 |
| 84481 |
|
45 |
43 |
$596.27 |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
13 |
13 |
$543.61 |
| 84403 |
|
27 |
25 |
$527.23 |
| Q9966 |
Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml |
284 |
270 |
$497.18 |
| 84145 |
|
63 |
55 |
$475.43 |
| 99218 |
|
43 |
40 |
$448.43 |
| 82947 |
|
127 |
124 |
$399.49 |
| 84520 |
|
307 |
282 |
$382.06 |
| 86735 |
|
14 |
14 |
$371.53 |
| G0103 |
Prostate cancer screening; prostate specific antigen test (psa) |
427 |
420 |
$351.25 |
| ATP11 |
|
259 |
234 |
$331.08 |
| J7030 |
Infusion, normal saline solution , 1000 cc |
16 |
12 |
$305.44 |
| 82803 |
|
26 |
25 |
$288.90 |
| 88304 |
|
38 |
37 |
$268.19 |
| ATP03 |
|
157 |
154 |
$207.60 |
| 80051 |
|
44 |
40 |
$202.15 |
| 82248 |
|
129 |
121 |
$190.30 |
| 87088 |
|
28 |
27 |
$145.48 |
| 86431 |
|
25 |
25 |
$141.10 |
| Q3014 |
Telehealth originating site facility fee |
75 |
74 |
$137.46 |
| 83935 |
|
25 |
25 |
$120.03 |
| 90715 |
|
17 |
17 |
$107.36 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
78 |
73 |
$92.90 |
| 87205 |
|
12 |
12 |
$69.47 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
241 |
215 |
$65.95 |
| 96376 |
|
152 |
146 |
$55.22 |
| 82962 |
|
283 |
222 |
$51.02 |
| 90686 |
|
15 |
14 |
$33.48 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
229 |
217 |
$33.42 |
| 94762 |
|
60 |
53 |
$32.25 |
| J2274 |
Injection, morphine sulfate, preservative-free for epidural or intrathecal use, 10 mg |
15 |
12 |
$27.78 |
| 84075 |
|
25 |
25 |
$26.81 |
| 82040 |
|
13 |
12 |
$26.19 |
| 77003 |
|
12 |
12 |
$24.63 |
| 81005 |
|
12 |
12 |
$24.10 |
| 81015 |
|
366 |
351 |
$21.98 |
| 84155 |
|
12 |
12 |
$13.48 |
| ATP18 |
|
112 |
110 |
$10.97 |
| 83721 |
|
14 |
13 |
$8.70 |
| J1790 |
Injection, droperidol, up to 5 mg |
51 |
43 |
$7.74 |
| 82310 |
|
61 |
58 |
$2.41 |
| 83550 |
|
109 |
107 |
$0.00 |
| 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 |
118 |
111 |
$0.00 |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
14 |
14 |
$0.00 |
| 80320 |
|
62 |
54 |
$0.00 |
| 84132 |
|
14 |
13 |
$0.00 |
| 80329 |
|
41 |
37 |
$0.00 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
15 |
13 |
$0.00 |
| 83615 |
|
16 |
13 |
$0.00 |
| 91300 |
|
1,034 |
914 |
$0.00 |
| 94664 |
|
14 |
13 |
$0.00 |