| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
14,165 |
11,601 |
$2.62M |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
16,973 |
14,252 |
$2.36M |
| 96361 |
Intravenous infusion, hydration; each additional hour |
4,196 |
3,209 |
$1.76M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
9,795 |
7,677 |
$1.49M |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
7,971 |
6,743 |
$1.42M |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
4,129 |
2,304 |
$930K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
4,238 |
3,389 |
$644K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,916 |
3,861 |
$588K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
2,085 |
1,527 |
$449K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
1,280 |
725 |
$444K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
2,909 |
2,554 |
$367K |
| 70450 |
Computed tomography, head or brain; without contrast material |
2,152 |
1,447 |
$363K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
10,219 |
3,529 |
$349K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
1,414 |
1,085 |
$334K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
1,841 |
1,425 |
$206K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
5,468 |
4,748 |
$168K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
835 |
750 |
$131K |
| 87631 |
|
991 |
881 |
$98K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
953 |
481 |
$93K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
2,864 |
2,560 |
$85K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
1,773 |
1,612 |
$74K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
3,602 |
1,290 |
$72K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
607 |
517 |
$67K |
| 80053 |
Comprehensive metabolic panel |
7,780 |
6,081 |
$63K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
12,491 |
9,565 |
$62K |
| 92507 |
Treatment of speech, language, voice, communication, and/or auditory processing disorder |
1,282 |
280 |
$48K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
2,243 |
1,476 |
$43K |
| G0378 |
Hospital observation service, per hour |
874 |
343 |
$42K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
210 |
151 |
$42K |
| 97162 |
|
1,010 |
888 |
$39K |
| 87430 |
|
1,913 |
1,735 |
$35K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
5,681 |
4,435 |
$35K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
183 |
80 |
$34K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
809 |
263 |
$30K |
| 96367 |
|
160 |
100 |
$29K |
| 85027 |
|
2,541 |
1,815 |
$27K |
| 81025 |
|
3,169 |
2,681 |
$26K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
1,054 |
492 |
$21K |
| 81001 |
|
4,852 |
4,133 |
$19K |
| 71046 |
Radiologic examination, chest; 2 views |
5,616 |
4,151 |
$19K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
182 |
170 |
$17K |
| 84484 |
|
2,631 |
1,850 |
$17K |
| 83690 |
|
3,426 |
2,834 |
$16K |
| 87081 |
|
1,678 |
1,514 |
$14K |
| 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 |
189 |
172 |
$14K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
2,310 |
2,014 |
$13K |
| 97535 |
Self-care/home management training, each 15 minutes |
754 |
313 |
$12K |
| 83605 |
|
2,097 |
1,573 |
$11K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
4,301 |
3,547 |
$11K |
| 81003 |
|
4,286 |
3,654 |
$10K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
5,214 |
4,142 |
$9K |
| 84443 |
Thyroid stimulating hormone (TSH) |
875 |
755 |
$9K |
| 76830 |
Ultrasound, transvaginal |
48 |
40 |
$9K |
| 83735 |
|
2,813 |
1,811 |
$9K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
5,475 |
4,368 |
$9K |
| 87186 |
|
1,379 |
1,153 |
$8K |
| 84145 |
|
702 |
542 |
$7K |
| 87077 |
|
1,426 |
1,100 |
$7K |
| 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 |
204 |
157 |
$7K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
172 |
137 |
$7K |
| 82077 |
|
680 |
517 |
$6K |
| 87040 |
|
1,314 |
636 |
$6K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
31 |
26 |
$5K |
| 85379 |
|
782 |
696 |
$5K |
| 80305 |
|
583 |
483 |
$5K |
| 71045 |
Radiologic examination, chest; single view |
2,094 |
1,407 |
$5K |
| 82962 |
|
2,339 |
1,148 |
$4K |
| 85610 |
|
1,633 |
1,300 |
$4K |
| 80306 |
|
332 |
248 |
$4K |
| 12001 |
|
16 |
12 |
$4K |
| 85007 |
|
1,396 |
1,067 |
$3K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
43 |
39 |
$3K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
87 |
80 |
$3K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
87 |
80 |
$3K |
| 80143 |
|
236 |
165 |
$2K |
| 80179 |
|
243 |
165 |
$2K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
19 |
13 |
$2K |
| 93971 |
|
17 |
12 |
$2K |
| 73610 |
|
683 |
521 |
$2K |
| 82803 |
|
177 |
122 |
$2K |
| 83880 |
|
142 |
115 |
$2K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
21 |
16 |
$2K |
| 86140 |
|
569 |
458 |
$2K |
| 99215 |
Prolong outpt/office vis |
12 |
12 |
$1K |
| 87070 |
|
184 |
146 |
$1K |
| 82565 |
|
500 |
333 |
$1K |
| 73630 |
|
426 |
323 |
$1K |
| J0561 |
Injection, penicillin g benzathine, 100,000 units |
21 |
14 |
$1K |
| 82948 |
|
252 |
170 |
$1K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
4,050 |
2,937 |
$1K |
| 82247 |
|
647 |
383 |
$1K |
| 84460 |
|
540 |
351 |
$1K |
| 85730 |
|
305 |
265 |
$1K |
| 87147 |
|
170 |
141 |
$1K |
| 86617 |
|
49 |
42 |
$1K |
| 36415 |
Collection of venous blood by venipuncture |
3,643 |
2,762 |
$914.73 |
| 87905 |
|
95 |
80 |
$867.08 |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
30 |
26 |
$833.98 |
| 84450 |
|
373 |
219 |
$669.89 |
| 97163 |
|
17 |
13 |
$623.60 |
| 87220 |
|
155 |
134 |
$598.85 |
| 97166 |
|
15 |
14 |
$542.17 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
32 |
27 |
$505.61 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
3,110 |
2,604 |
$454.59 |
| 73110 |
|
68 |
53 |
$409.38 |
| 73030 |
|
104 |
62 |
$391.88 |
| J7030 |
Infusion, normal saline solution , 1000 cc |
5,259 |
3,544 |
$376.18 |
| 94762 |
|
146 |
135 |
$321.03 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
5,288 |
4,090 |
$299.04 |
| 73130 |
|
47 |
40 |
$294.41 |
| 84075 |
|
143 |
78 |
$294.25 |
| 80050 |
General health panel |
176 |
149 |
$231.54 |
| 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 |
1,343 |
1,138 |
$185.56 |
| 87808 |
|
16 |
13 |
$173.80 |
| 84703 |
|
28 |
26 |
$173.55 |
| 90715 |
|
13 |
12 |
$169.37 |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
3,518 |
2,638 |
$165.83 |
| 96376 |
|
716 |
485 |
$153.22 |
| J1642 |
Injection, heparin sodium, (heparin lock flush), per 10 units |
1,545 |
493 |
$146.27 |
| 87205 |
|
66 |
40 |
$127.75 |
| 86900 |
|
43 |
40 |
$125.25 |
| 86901 |
|
60 |
53 |
$113.49 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
3,728 |
2,704 |
$113.33 |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
769 |
602 |
$110.65 |
| J2704 |
Injection, propofol, 10 mg |
1,536 |
1,203 |
$101.24 |
| A9270 |
Non-covered item or service |
2,875 |
890 |
$87.88 |
| 87088 |
|
16 |
14 |
$77.59 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
1,799 |
1,414 |
$69.66 |
| 86850 |
|
29 |
27 |
$64.56 |
| 82040 |
|
16 |
12 |
$61.99 |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
85 |
62 |
$52.85 |
| J7050 |
Infusion, normal saline solution, 250 cc |
3,736 |
1,305 |
$52.13 |
| 73562 |
|
13 |
12 |
$40.92 |
| 80320 |
|
99 |
90 |
$37.64 |
| 80051 |
|
18 |
14 |
$36.20 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
1,259 |
1,044 |
$35.07 |
| 85652 |
|
13 |
13 |
$27.90 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
551 |
436 |
$25.59 |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
260 |
190 |
$19.51 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
2,222 |
1,673 |
$18.94 |
| 82272 |
|
14 |
12 |
$17.04 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
643 |
440 |
$15.38 |
| J7060 |
5% dextrose/water (500 ml = 1 unit) |
675 |
423 |
$14.79 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
614 |
400 |
$13.99 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
13 |
12 |
$5.22 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
240 |
171 |
$2.71 |
| 73564 |
|
54 |
43 |
$2.13 |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
101 |
76 |
$0.60 |
| S0119 |
Ondansetron, oral, 4 mg (for circumstances falling under the medicare statute, use hcpcs q code) |
107 |
97 |
$0.00 |
| L3908 |
Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf |
15 |
14 |
$0.00 |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
29 |
12 |
$0.00 |
| 74018 |
|
15 |
12 |
$0.00 |
| J1756 |
Injection, iron sucrose, 1 mg |
21 |
13 |
$0.00 |
| J3490 |
Unclassified drugs |
187 |
145 |
$0.00 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
88 |
74 |
$0.00 |
| 36000 |
|
21 |
17 |
$0.00 |
| J8540 |
Dexamethasone, oral, 0.25 mg |
14 |
12 |
$0.00 |
| J1790 |
Injection, droperidol, up to 5 mg |
84 |
70 |
$0.00 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
71 |
42 |
$0.00 |