| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
343,159 |
289,761 |
$65.07M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
172,115 |
159,539 |
$31.49M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
132,346 |
126,711 |
$23.63M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
117,884 |
107,210 |
$21.33M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
91,521 |
87,526 |
$15.12M |
| G9005 |
Coordinated care fee, risk adjusted maintenance |
42,846 |
42,266 |
$13.16M |
| 96361 |
Intravenous infusion, hydration; each additional hour |
43,901 |
40,573 |
$12.73M |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
65,594 |
55,404 |
$12.47M |
| T1016 |
Case management, each 15 minutes |
42,778 |
42,778 |
$9.91M |
| J9271 |
Injection, pembrolizumab, 1 mg |
1,121 |
912 |
$8.98M |
| J1745 |
Injection, infliximab, excludes biosimilar, 10 mg |
2,733 |
2,460 |
$7.11M |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
33,934 |
31,615 |
$6.22M |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
43,990 |
35,072 |
$5.41M |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
9,155 |
8,957 |
$5.35M |
| J1561 |
Injection, immune globulin, (gamunex-c/gammaked), non-lyophilized (e.g., liquid), 500 mg |
3,297 |
1,281 |
$5.15M |
| 90834 |
Psychotherapy, 45 minutes with patient |
27,024 |
14,007 |
$5.05M |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
26,451 |
26,334 |
$4.77M |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
7,363 |
7,313 |
$4.76M |
| 87633 |
Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets |
63,491 |
61,477 |
$4.44M |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
31,175 |
19,471 |
$4.14M |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
22,556 |
21,680 |
$4.13M |
| 70450 |
Computed tomography, head or brain; without contrast material |
14,983 |
14,435 |
$4.02M |
| 90832 |
Psychotherapy, 30 minutes with patient |
25,575 |
14,310 |
$3.80M |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
5,633 |
5,363 |
$3.75M |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
23,183 |
15,744 |
$3.65M |
| 96415 |
|
6,461 |
5,055 |
$3.62M |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
4,505 |
4,469 |
$3.53M |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
37,495 |
16,686 |
$3.45M |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
17,787 |
17,718 |
$3.21M |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
12,165 |
11,901 |
$3.16M |
| 80048 |
Basic metabolic panel (calcium, ionized) |
216,040 |
187,282 |
$3.06M |
| 80076 |
|
138,727 |
123,637 |
$2.79M |
| J2505 |
Injection, pegfilgrastim, 6 mg |
1,000 |
781 |
$2.72M |
| 99215 |
Prolong outpt/office vis |
14,021 |
12,716 |
$2.59M |
| 93505 |
|
1,407 |
1,252 |
$2.55M |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
86,745 |
78,470 |
$2.43M |
| 87486 |
|
65,655 |
63,481 |
$2.43M |
| J0485 |
Injection, belatacept, 1 mg |
3,468 |
2,950 |
$2.19M |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
87,273 |
78,453 |
$2.14M |
| J9312 |
Injection, rituximab, 10 mg |
470 |
357 |
$2.13M |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
15,467 |
15,021 |
$2.09M |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
11,426 |
11,374 |
$1.99M |
| 90791 |
Psychiatric diagnostic evaluation |
4,428 |
3,776 |
$1.86M |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
6,959 |
5,338 |
$1.73M |
| 86850 |
|
37,859 |
34,846 |
$1.72M |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
4,221 |
4,121 |
$1.69M |
| 76770 |
|
4,354 |
4,270 |
$1.68M |
| 42820 |
Tonsillectomy and adenoidectomy; younger than age 12 |
916 |
911 |
$1.67M |
| Q5117 |
Injection, trastuzumab-anns, biosimilar, (kanjinti), 10 mg |
1,007 |
685 |
$1.59M |
| 36415 |
Collection of venous blood by venipuncture |
310,693 |
219,674 |
$1.54M |
| 69436 |
Tympanostomy (requiring insertion of ventilating tube), general anesthesia |
930 |
928 |
$1.52M |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
68,021 |
65,495 |
$1.32M |
| 77336 |
|
3,004 |
1,471 |
$1.30M |
| 86901 |
|
45,151 |
35,744 |
$1.30M |
| 59025 |
Fetal non-stress test |
4,911 |
4,396 |
$1.30M |
| Q5107 |
Injection, bevacizumab-awwb, biosimilar, (mvasi), 10 mg |
1,468 |
950 |
$1.28M |
| 87581 |
|
65,601 |
63,486 |
$1.26M |
| 93970 |
|
2,219 |
2,189 |
$1.25M |
| D0999 |
Unspecified diagnostic procedure, by report |
11,374 |
10,494 |
$1.24M |
| 87637 |
Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV |
14,521 |
14,378 |
$1.24M |
| 86480 |
|
18,027 |
17,851 |
$1.23M |
| 47562 |
|
424 |
422 |
$1.21M |
| 77412 |
|
4,006 |
512 |
$1.16M |
| 86900 |
|
45,614 |
36,069 |
$1.13M |
| 80061 |
Lipid panel |
50,865 |
49,905 |
$1.11M |
| 90846 |
Family psychotherapy without the patient present, 50 minutes |
7,394 |
5,244 |
$1.10M |
| J2506 |
Injection, pegfilgrastim, excludes biosimilar, 0.5 mg |
1,092 |
830 |
$1.09M |
| Q5104 |
Injection, infliximab-abda, biosimilar, (renflexis), 10 mg |
766 |
627 |
$1.04M |
| 36430 |
|
2,920 |
2,045 |
$1.04M |
| 12001 |
|
2,040 |
2,022 |
$1.04M |
| J1439 |
Injection, ferric carboxymaltose, 1 mg |
2,438 |
1,774 |
$1.03M |
| 12011 |
|
1,919 |
1,908 |
$1.01M |
| 80053 |
Comprehensive metabolic panel |
52,561 |
44,162 |
$1.00M |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
39,369 |
37,571 |
$988K |
| 90651 |
|
11,114 |
11,045 |
$978K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
3,499 |
3,427 |
$953K |
| J7307 |
Etonogestrel (contraceptive) implant system, including implant and supplies |
1,161 |
1,155 |
$946K |
| 72197 |
|
1,968 |
1,936 |
$944K |
| 90686 |
|
50,400 |
50,184 |
$944K |
| 96416 |
|
1,452 |
916 |
$929K |
| G0121 |
Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk |
1,051 |
1,050 |
$896K |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
12,472 |
12,212 |
$893K |
| J2350 |
Injection, ocrelizumab, 1 mg |
50 |
38 |
$873K |
| 90847 |
Family psychotherapy with the patient present, 50 minutes |
3,418 |
2,275 |
$868K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
4,085 |
3,986 |
$858K |
| 66984 |
Extracapsular cataract removal with insertion of intraocular lens prosthesis |
612 |
584 |
$835K |
| 93458 |
|
549 |
544 |
$826K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
20,139 |
19,840 |
$817K |
| 97161 |
|
5,118 |
5,070 |
$803K |
| J9144 |
Injection, daratumumab, 10 mg and hyaluronidase-fihj |
267 |
167 |
$797K |
| P9040 |
Red blood cells, leukocytes reduced, irradiated, each unit |
1,721 |
1,332 |
$782K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
22,064 |
9,950 |
$777K |
| 44970 |
|
246 |
243 |
$728K |
| 49650 |
|
283 |
278 |
$728K |
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
7,708 |
3,506 |
$715K |
| 10060 |
|
1,939 |
1,888 |
$710K |
| 0002A |
|
18,733 |
18,701 |
$703K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
8,969 |
8,907 |
$697K |
| 0001A |
|
20,472 |
20,418 |
$650K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
22,209 |
21,331 |
$644K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
3,661 |
3,623 |
$642K |
| 45385 |
Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) |
1,376 |
1,362 |
$642K |
| 87536 |
|
11,427 |
11,101 |
$623K |
| 90837 |
Psychotherapy, 53 minutes with patient |
3,215 |
1,888 |
$609K |
| 90715 |
|
24,131 |
24,047 |
$608K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
22,273 |
21,612 |
$608K |
| 97802 |
|
13,064 |
12,853 |
$605K |
| J9306 |
Injection, pertuzumab, 1 mg |
119 |
91 |
$586K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
4,642 |
2,755 |
$577K |
| Q5103 |
Injection, infliximab-dyyb, biosimilar, (inflectra), 10 mg |
683 |
577 |
$575K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
18,751 |
17,606 |
$564K |
| 19083 |
|
353 |
350 |
$563K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
1,648 |
1,615 |
$558K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
3,320 |
3,270 |
$536K |
| 96367 |
|
4,703 |
3,812 |
$519K |
| 99243 |
|
2,498 |
2,194 |
$517K |
| 77334 |
|
1,391 |
1,066 |
$496K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
43,661 |
38,453 |
$496K |
| 97803 |
|
11,339 |
10,357 |
$495K |
| 83880 |
|
18,218 |
17,344 |
$483K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
9,004 |
4,841 |
$478K |
| 54161 |
|
470 |
467 |
$476K |
| 43235 |
|
593 |
590 |
$473K |
| 99205 |
Prolong outpt/office vis |
2,695 |
2,675 |
$473K |
| 88342 |
|
8,306 |
7,637 |
$473K |
| 11982 |
|
1,188 |
1,187 |
$467K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
11,713 |
11,446 |
$455K |
| 11981 |
|
1,088 |
1,087 |
$435K |
| 74183 |
|
2,450 |
2,408 |
$430K |
| J1726 |
Injection, hydroxyprogesterone caproate, (makena), 10 mg |
1,056 |
459 |
$421K |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
13,579 |
13,504 |
$406K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
1,364 |
1,344 |
$405K |
| Q5115 |
Injection, rituximab-abbs, biosimilar, (truxima), 10 mg |
235 |
140 |
$404K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
9,469 |
9,209 |
$402K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
32,094 |
25,197 |
$398K |
| 58100 |
|
662 |
651 |
$396K |
| 87799 |
|
13,402 |
8,257 |
$388K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
59,012 |
55,622 |
$388K |
| C1713 |
Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) |
5,106 |
4,994 |
$382K |
| 83655 |
|
25,953 |
25,861 |
$378K |
| 52356 |
|
169 |
161 |
$373K |
| 12002 |
|
714 |
708 |
$372K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
836 |
659 |
$371K |
| 85610 |
|
73,543 |
49,618 |
$364K |
| 94375 |
|
3,315 |
3,257 |
$363K |
| 90677 |
|
5,835 |
5,831 |
$356K |
| 70496 |
|
1,258 |
1,231 |
$353K |
| 96910 |
|
4,121 |
1,023 |
$345K |
| 93454 |
|
219 |
211 |
$343K |
| 58300 |
|
2,008 |
1,993 |
$333K |
| J9035 |
Injection, bevacizumab, 10 mg |
97 |
62 |
$331K |
| 82803 |
|
16,972 |
14,977 |
$330K |
| J0585 |
Injection, onabotulinumtoxina, 1 unit |
899 |
867 |
$326K |
| 11900 |
|
990 |
970 |
$324K |
| 71250 |
|
2,657 |
2,589 |
$314K |
| P9016 |
Red blood cells, leukocytes reduced, each unit |
649 |
513 |
$312K |
| 93451 |
|
156 |
154 |
$311K |
| 88307 |
|
4,388 |
4,146 |
$307K |
| J9355 |
Injection, trastuzumab, excludes biosimilar, 10 mg |
101 |
64 |
$299K |
| 88184 |
|
3,889 |
3,720 |
$292K |
| 77386 |
|
1,736 |
177 |
$290K |
| 93460 |
|
154 |
151 |
$286K |
| J0185 |
Injection, aprepitant, 1 mg |
3,363 |
2,276 |
$285K |
| J3490 |
Unclassified drugs |
2,892 |
1,981 |
$285K |
| OP370 |
|
725 |
597 |
$283K |
| 77300 |
|
1,268 |
1,087 |
$280K |
| 97162 |
|
1,599 |
1,593 |
$279K |
| 71046 |
Radiologic examination, chest; 2 views |
49,863 |
48,130 |
$279K |
| OP710 |
|
1,223 |
955 |
$276K |
| 90882 |
|
3,071 |
2,026 |
$270K |
| J0741 |
Injection, cabotegravir and rilpivirine, 2mg/3mg |
202 |
200 |
$264K |
| 90833 |
Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) |
3,840 |
2,884 |
$264K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
6,525 |
6,494 |
$264K |
| J7297 |
Levonorgestrel-releasing intrauterine contraceptive system (liletta), 52 mg |
383 |
382 |
$263K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
765 |
702 |
$262K |
| 85055 |
|
7,304 |
6,008 |
$260K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
4,831 |
4,742 |
$256K |
| 94060 |
|
1,258 |
1,232 |
$254K |
| J0561 |
Injection, penicillin g benzathine, 100,000 units |
2,243 |
2,048 |
$252K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
45,353 |
39,171 |
$247K |
| 85027 |
|
87,621 |
82,897 |
$242K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
1,123 |
1,013 |
$242K |
| J7300 |
Intrauterine copper contraceptive (paragard) |
528 |
523 |
$241K |
| 58301 |
|
1,557 |
1,544 |
$240K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
197,818 |
169,803 |
$236K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
89,861 |
78,276 |
$236K |
| 97166 |
|
1,271 |
1,269 |
$234K |
| 92526 |
|
1,699 |
1,520 |
$232K |
| 97535 |
Self-care/home management training, each 15 minutes |
2,893 |
2,145 |
$231K |
| 80047 |
|
14,090 |
13,084 |
$229K |
| 93971 |
|
3,629 |
3,545 |
$228K |
| 87507 |
|
3,480 |
3,447 |
$227K |
| 93975 |
|
808 |
785 |
$225K |
| J9299 |
Injection, nivolumab, 1 mg |
49 |
27 |
$220K |
| 90750 |
|
2,526 |
2,503 |
$218K |
| 74178 |
|
1,289 |
1,272 |
$217K |
| 92611 |
|
795 |
793 |
$212K |
| J9070 |
Cyclophosphamide, 100 mg |
933 |
638 |
$211K |
| J3380 |
Injection, vedolizumab, intravenous, 1 mg |
69 |
67 |
$211K |
| 92551 |
|
2,730 |
2,694 |
$210K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
896 |
888 |
$207K |
| J0897 |
Injection, denosumab, 1 mg |
259 |
247 |
$203K |
| 90670 |
|
18,614 |
18,517 |
$203K |
| 76000 |
|
2,508 |
2,433 |
$200K |
| 86356 |
|
6,275 |
6,062 |
$199K |
| 70486 |
|
2,177 |
2,140 |
$195K |
| 96409 |
|
2,775 |
1,372 |
$192K |
| 42830 |
|
98 |
98 |
$190K |
| 87517 |
|
5,074 |
3,809 |
$189K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
13,552 |
13,254 |
$189K |
| 72192 |
|
766 |
761 |
$188K |
| 58661 |
|
72 |
72 |
$186K |
| 99382 |
|
945 |
931 |
$185K |
| 70491 |
|
692 |
671 |
$182K |
| J9217 |
Leuprolide acetate (for depot suspension), 7.5 mg |
727 |
715 |
$182K |
| 76999 |
|
2,120 |
2,082 |
$181K |
| 99443 |
|
2,536 |
2,081 |
$180K |
| 81003 |
|
154,261 |
113,877 |
$179K |
| Q0138 |
Injection, ferumoxytol, for treatment of iron deficiency anemia, 1 mg (non-esrd use) |
875 |
740 |
$179K |
| 45378 |
Colonoscopy, flexible; diagnostic, including collection of specimen(s) |
237 |
236 |
$178K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
1,265 |
1,241 |
$178K |
| 36416 |
|
9,588 |
9,283 |
$177K |
| 94726 |
|
1,201 |
1,190 |
$176K |
| 90674 |
|
4,969 |
4,968 |
$175K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,119 |
1,052 |
$174K |
| 86703 |
|
11,847 |
11,319 |
$171K |
| 99381 |
|
1,037 |
1,007 |
$169K |
| 90378 |
|
57 |
54 |
$162K |
| 92610 |
|
1,085 |
1,081 |
$161K |
| 72141 |
|
644 |
634 |
$161K |
| 58558 |
|
118 |
117 |
$160K |
| 97165 |
|
1,144 |
1,140 |
$159K |
| 83970 |
|
5,444 |
5,112 |
$157K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
610 |
602 |
$156K |
| 90697 |
|
5,940 |
5,934 |
$155K |
| 84703 |
|
90,907 |
84,632 |
$154K |
| 31624 |
|
166 |
155 |
$149K |
| 36591 |
|
2,322 |
1,572 |
$146K |
| 86360 |
|
9,755 |
9,445 |
$145K |
| 76870 |
|
2,184 |
2,108 |
$145K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
49,516 |
48,511 |
$143K |
| C1776 |
Joint device (implantable) |
136 |
132 |
$141K |
| C9600 |
Percutaneous transcatheter placement of drug eluting intracoronary stent(s), with coronary angioplasty when performed; single major coronary artery or branch |
60 |
57 |
$140K |
| 99188 |
|
2,323 |
2,321 |
$140K |
| 96417 |
|
4,944 |
3,254 |
$140K |
| 91322 |
|
1,938 |
1,934 |
$139K |
| 77065 |
Tomosynthesis, mammo |
1,781 |
1,692 |
$139K |
| 76937 |
|
807 |
750 |
$138K |
| 76801 |
|
953 |
899 |
$137K |
| 83021 |
|
9,939 |
9,615 |
$136K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
4,543 |
4,525 |
$136K |
| 84443 |
Thyroid stimulating hormone (TSH) |
48,263 |
46,680 |
$136K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
790 |
778 |
$133K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
1,995 |
1,891 |
$133K |
| 90681 |
|
12,379 |
12,343 |
$132K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
66,532 |
64,458 |
$131K |
| 88304 |
|
4,576 |
4,484 |
$129K |
| 99442 |
|
3,295 |
2,878 |
$126K |
| 90647 |
|
13,783 |
13,728 |
$126K |
| 88341 |
|
3,825 |
3,352 |
$126K |
| 97116 |
|
2,642 |
1,672 |
$125K |
| 76830 |
Ultrasound, transvaginal |
5,541 |
5,231 |
$124K |
| 92557 |
|
1,993 |
1,954 |
$119K |
| 86832 |
|
1,658 |
1,498 |
$119K |
| J0178 |
Injection, aflibercept, 1 mg |
228 |
213 |
$117K |
| 0003A |
|
3,113 |
3,105 |
$116K |
| 86359 |
|
9,733 |
9,420 |
$116K |
| 77280 |
|
263 |
239 |
$116K |
| 93017 |
|
765 |
761 |
$116K |
| J0490 |
Injection, belimumab, 10 mg |
70 |
38 |
$116K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
1,555 |
1,162 |
$115K |
| 86355 |
|
9,730 |
9,420 |
$114K |
| 86357 |
|
9,730 |
9,420 |
$114K |
| 77290 |
|
306 |
280 |
$112K |
| 71045 |
Radiologic examination, chest; single view |
12,770 |
12,247 |
$112K |
| 92550 |
|
2,221 |
2,170 |
$110K |
| 90723 |
|
12,661 |
12,602 |
$108K |
| 86833 |
|
1,848 |
1,656 |
$108K |
| 94618 |
|
588 |
580 |
$106K |
| 0124A |
|
2,901 |
2,899 |
$106K |
| 90836 |
|
965 |
603 |
$105K |
| 99383 |
|
529 |
529 |
$105K |
| 93304 |
|
361 |
349 |
$102K |
| 74230 |
|
428 |
421 |
$102K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
3,354 |
3,281 |
$101K |
| 17110 |
|
283 |
280 |
$101K |
| 73221 |
|
317 |
302 |
$100K |
| 76642 |
|
1,434 |
1,410 |
$98K |
| 92978 |
|
378 |
361 |
$98K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
5,230 |
4,892 |
$98K |
| 87653 |
|
4,475 |
4,456 |
$97K |
| Q5123 |
Injection, rituximab-arrx, biosimilar, (riabni), 10 mg |
46 |
28 |
$96K |
| 83735 |
|
49,475 |
37,990 |
$95K |
| 96402 |
|
1,598 |
1,476 |
$95K |
| 90716 |
|
6,346 |
6,311 |
$91K |
| 96401 |
|
1,904 |
908 |
$91K |
| 87529 |
|
4,438 |
2,417 |
$90K |
| 93320 |
|
338 |
335 |
$90K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
46,681 |
46,118 |
$90K |
| 92579 |
|
1,053 |
1,000 |
$90K |
| 90707 |
|
6,743 |
6,710 |
$89K |
| J1750 |
Injection, iron dextran, 50 mg |
571 |
527 |
$88K |
| 96377 |
|
1,786 |
1,372 |
$87K |
| 99244 |
Office or other outpatient consultation, moderate to high complexity |
430 |
424 |
$85K |
| 96450 |
|
110 |
83 |
$83K |
| 92567 |
|
1,186 |
1,159 |
$83K |
| J9202 |
Goserelin acetate implant, per 3.6 mg |
113 |
109 |
$83K |
| 99173 |
|
2,817 |
2,772 |
$82K |
| 94621 |
|
420 |
415 |
$82K |
| J2790 |
Injection, rho d immune globulin, human, full dose, 300 micrograms (1500 i.u.) |
793 |
712 |
$79K |
| 90633 |
|
9,554 |
9,516 |
$78K |
| 96411 |
|
2,589 |
1,802 |
$77K |
| C1769 |
Guide wire |
7,246 |
6,835 |
$76K |
| 76942 |
|
609 |
588 |
$76K |
| 86352 |
|
1,204 |
1,063 |
$76K |
| 99384 |
|
392 |
384 |
$74K |
| 82728 |
|
22,680 |
21,360 |
$74K |
| 86803 |
|
31,950 |
31,597 |
$74K |
| 64615 |
|
184 |
184 |
$71K |
| G0108 |
Diabetes outpatient self-management training services, individual, per 30 minutes |
2,504 |
1,882 |
$70K |
| 94010 |
|
878 |
707 |
$70K |
| 0072A |
|
1,687 |
1,686 |
$68K |
| 86923 |
|
3,360 |
2,152 |
$67K |
| 85045 |
|
12,385 |
10,800 |
$66K |
| 90656 |
|
5,746 |
5,744 |
$65K |
| 94729 |
|
2,799 |
2,773 |
$64K |
| 80197 |
|
10,218 |
6,839 |
$64K |
| 90734 |
|
5,685 |
5,665 |
$64K |
| 0071A |
|
1,553 |
1,551 |
$63K |
| 11104 |
|
96 |
95 |
$63K |
| 72082 |
|
3,303 |
3,256 |
$61K |
| 88112 |
|
1,243 |
1,164 |
$61K |
| 82784 |
|
11,101 |
5,991 |
$60K |
| J1453 |
Injection, fosaprepitant, 1 mg |
386 |
270 |
$60K |
| 99408 |
|
542 |
536 |
$58K |
| C1753 |
Catheter, intravascular ultrasound |
494 |
478 |
$57K |
| 93270 |
|
280 |
270 |
$57K |
| 93325 |
|
924 |
896 |
$56K |
| 84100 |
|
36,998 |
28,026 |
$56K |
| 86828 |
|
3,047 |
1,568 |
$55K |
| 99407 |
|
519 |
335 |
$55K |
| J2469 |
Injection, palonosetron hcl, 25 mcg |
5,339 |
3,343 |
$55K |
| J0881 |
Injection, darbepoetin alfa, 1 microgram (non-esrd use) |
359 |
237 |
$54K |
| 77338 |
|
186 |
131 |
$54K |
| 76857 |
|
1,854 |
1,811 |
$54K |
| 86592 |
|
51,316 |
50,569 |
$54K |
| A9585 |
Injection, gadobutrol, 0.1 ml |
7,544 |
7,437 |
$53K |
| 87497 |
|
3,165 |
2,217 |
$53K |
| 90700 |
|
5,197 |
5,179 |
$53K |
| 90732 |
|
1,579 |
1,577 |
$52K |
| 90620 |
|
1,954 |
1,932 |
$52K |
| 76536 |
|
1,014 |
992 |
$52K |
| OP272 |
|
1,006 |
771 |
$52K |
| 99385 |
|
315 |
315 |
$52K |
| 86141 |
|
21,521 |
20,515 |
$51K |
| 84702 |
|
24,207 |
20,469 |
$49K |
| J0640 |
Injection, leucovorin calcium, per 50 mg |
1,254 |
758 |
$49K |
| 97542 |
|
450 |
446 |
$49K |
| C1874 |
Stent, coated/covered, with delivery system |
202 |
197 |
$48K |
| 90461 |
|
5,143 |
5,115 |
$47K |
| 86317 |
|
7,841 |
7,492 |
$47K |
| OP270 |
|
828 |
646 |
$46K |
| 72158 |
|
163 |
160 |
$46K |
| 90696 |
|
4,111 |
4,092 |
$46K |
| 90746 |
|
1,550 |
1,529 |
$46K |
| 76881 |
|
323 |
300 |
$46K |
| 84439 |
|
11,668 |
11,023 |
$45K |
| 85730 |
|
33,176 |
31,093 |
$45K |
| 90710 |
|
4,155 |
4,136 |
$44K |
| 81025 |
|
8,039 |
7,577 |
$43K |
| 77295 |
|
288 |
275 |
$43K |
| 93308 |
|
189 |
184 |
$42K |
| 93456 |
|
26 |
26 |
$42K |
| 0054A |
|
1,188 |
1,187 |
$42K |
| 82607 |
|
12,200 |
12,057 |
$41K |
| 77332 |
|
98 |
86 |
$41K |
| J3262 |
Injection, tocilizumab, 1 mg |
65 |
38 |
$41K |
| 92002 |
|
327 |
300 |
$40K |
| 87522 |
Neg quan hep c or qual rna |
1,249 |
1,203 |
$40K |
| 70543 |
|
87 |
84 |
$40K |
| 87496 |
|
2,097 |
1,568 |
$40K |
| 77072 |
|
2,020 |
1,991 |
$39K |
| G9001 |
Coordinated care fee, initial rate |
523 |
523 |
$39K |
| 70544 |
|
283 |
279 |
$39K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
48,634 |
45,393 |
$38K |
| 77066 |
Tomosynthesis, mammo |
586 |
578 |
$38K |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
39,552 |
36,102 |
$38K |
| 83615 |
|
17,861 |
12,442 |
$38K |
| 84484 |
|
52,103 |
36,047 |
$38K |
| C1887 |
Catheter, guiding (may include infusion/perfusion capability) |
3,821 |
3,611 |
$38K |
| 99245 |
|
169 |
169 |
$38K |
| D1110 |
Prophylaxis - adult |
1,805 |
1,703 |
$36K |
| 27447 |
|
12 |
12 |
$36K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
22,650 |
19,762 |
$35K |
| 81001 |
|
53,086 |
50,333 |
$35K |
| C1725 |
Catheter, transluminal angioplasty, non-laser (may include guidance, infusion/perfusion capability) |
1,001 |
937 |
$35K |
| 88346 |
|
809 |
701 |
$34K |
| 73564 |
|
3,016 |
2,832 |
$34K |
| 86807 |
|
2,043 |
1,174 |
$33K |
| 87340 |
|
22,429 |
22,006 |
$33K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
666 |
630 |
$33K |
| 90480 |
|
1,976 |
1,971 |
$33K |
| 96376 |
|
7,978 |
7,335 |
$33K |
| 77049 |
|
82 |
82 |
$32K |
| 73700 |
|
174 |
168 |
$32K |
| 54150 |
|
30 |
30 |
$32K |
| 99441 |
|
1,181 |
984 |
$32K |
| 74240 |
|
129 |
128 |
$32K |
| 83516 |
|
3,608 |
2,455 |
$32K |
| 96900 |
|
329 |
97 |
$31K |
| C1894 |
Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser |
4,216 |
3,896 |
$31K |
| C1781 |
Mesh (implantable) |
542 |
532 |
$31K |
| 71555 |
|
93 |
93 |
$31K |
| 11976 |
|
50 |
50 |
$30K |
| 86821 |
|
651 |
595 |
$30K |
| 76098 |
|
201 |
193 |
$30K |
| 88185 |
|
344 |
280 |
$30K |
| 67028 |
Intravitreal injection of a pharmacologic agent |
442 |
395 |
$29K |
| 47563 |
|
12 |
12 |
$29K |
| 90381 |
|
443 |
442 |
$29K |
| 85018 |
|
13,017 |
10,642 |
$29K |
| 91320 |
|
543 |
543 |
$28K |
| 88360 |
|
346 |
326 |
$28K |
| 76825 |
|
303 |
297 |
$28K |
| 84550 |
|
14,213 |
9,814 |
$28K |
| 3E033GC |
|
118 |
25 |
$28K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
17,222 |
15,785 |
$28K |
| 92507 |
Treatment of speech, language, voice, communication, and/or auditory processing disorder |
173 |
87 |
$28K |
| 73630 |
|
7,716 |
7,176 |
$28K |
| 92555 |
|
288 |
279 |
$27K |
| 82670 |
|
2,006 |
1,956 |
$27K |
| 75561 |
|
66 |
65 |
$27K |
| 84403 |
|
3,195 |
2,972 |
$27K |
| 73030 |
|
7,327 |
6,736 |
$27K |
| 83540 |
|
18,590 |
17,858 |
$26K |
| 83550 |
|
17,256 |
16,728 |
$26K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
210 |
208 |
$26K |
| J2997 |
Injection, alteplase recombinant, 1 mg |
140 |
116 |
$26K |
| 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 |
1,277 |
1,002 |
$26K |
| 84165 |
|
2,737 |
2,226 |
$26K |
| 82805 |
|
1,078 |
1,032 |
$26K |
| 90619 |
|
851 |
851 |
$25K |
| J9045 |
Injection, carboplatin, 50 mg |
1,367 |
931 |
$25K |
| Q3014 |
Telehealth originating site facility fee |
5,749 |
5,054 |
$25K |
| 25605 |
|
50 |
50 |
$25K |
| 86769 |
|
1,607 |
1,558 |
$25K |
| 70498 |
|
1,122 |
1,109 |
$24K |
| J9201 |
Injection, gemcitabine hydrochloride, not otherwise specified, 200 mg |
670 |
324 |
$24K |
| 92015 |
Determination of refractive state |
491 |
488 |
$24K |
| 90634 |
|
1,863 |
1,846 |
$24K |
| C1819 |
Surgical tissue localization and excision device (implantable) |
421 |
403 |
$24K |
| J9267 |
Injection, paclitaxel, 1 mg |
1,530 |
719 |
$24K |
| 92650 |
|
256 |
253 |
$23K |
| 88312 |
|
1,387 |
1,100 |
$23K |
| 82570 |
|
11,597 |
10,176 |
$23K |
| OP250 |
|
3,754 |
2,451 |
$22K |
| 86765 |
|
12,535 |
12,347 |
$22K |
| 83001 |
|
3,801 |
3,732 |
$22K |
| 86762 |
|
12,694 |
12,481 |
$22K |
| J7298 |
Levonorgestrel-releasing intrauterine contraceptive system (mirena), 52 mg |
27 |
27 |
$22K |
| 88262 |
|
199 |
187 |
$22K |
| 92582 |
|
285 |
278 |
$22K |
| V2632 |
Posterior chamber intraocular lens |
421 |
103 |
$22K |
| 88142 |
|
719 |
717 |
$21K |
| 72110 |
|
2,709 |
2,691 |
$21K |
| J7050 |
Infusion, normal saline solution, 250 cc |
31,274 |
23,904 |
$21K |
| 91318 |
|
624 |
617 |
$21K |
| 84145 |
|
3,856 |
3,712 |
$21K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
374 |
357 |
$20K |
| 73610 |
|
8,047 |
7,344 |
$20K |
| 77301 |
|
145 |
102 |
$20K |
| 52332 |
|
13 |
13 |
$20K |
| J3489 |
Injection, zoledronic acid, 1 mg |
473 |
462 |
$20K |
| 92568 |
|
194 |
190 |
$19K |
| G0105 |
Colorectal cancer screening; colonoscopy on individual at high risk |
25 |
25 |
$19K |
| 90672 |
|
1,273 |
1,270 |
$19K |
| J9190 |
Injection, fluorouracil, 500 mg |
1,464 |
872 |
$18K |
| 83002 |
|
2,534 |
2,473 |
$18K |
| J8540 |
Dexamethasone, oral, 0.25 mg |
9,400 |
5,320 |
$18K |
| 73080 |
|
3,543 |
3,023 |
$18K |
| 73200 |
|
80 |
78 |
$18K |
| 90662 |
|
1,981 |
1,068 |
$18K |
| 58662 |
|
12 |
12 |
$18K |
| 20680 |
|
12 |
12 |
$18K |
| 86160 |
|
3,995 |
2,033 |
$18K |
| 72156 |
|
69 |
69 |
$17K |
| 91319 |
|
537 |
537 |
$17K |
| 57455 |
|
26 |
26 |
$17K |
| 76641 |
|
230 |
228 |
$17K |
| 88365 |
|
268 |
259 |
$17K |
| J1756 |
Injection, iron sucrose, 1 mg |
366 |
226 |
$17K |
| 73521 |
|
2,156 |
2,136 |
$17K |
| Q5108 |
Injection, pegfilgrastim-jmdb (fulphila), biosimilar, 0.5 mg |
17 |
12 |
$17K |
| 87040 |
|
10,932 |
7,818 |
$17K |
| 86787 |
|
9,628 |
9,337 |
$17K |
| 85652 |
|
16,973 |
16,241 |
$17K |
| 76982 |
|
61 |
61 |
$17K |
| 84146 |
|
3,675 |
3,618 |
$16K |
| 86335 |
|
1,050 |
601 |
$16K |
| 77073 |
|
1,182 |
1,132 |
$16K |
| 0081A |
|
407 |
407 |
$16K |
| 99242 |
|
78 |
78 |
$16K |
| 31575 |
|
70 |
69 |
$16K |
| 24640 |
|
35 |
30 |
$16K |
| 86735 |
|
5,767 |
5,671 |
$16K |
| 0154A |
|
446 |
446 |
$16K |
| 84153 |
|
3,389 |
3,212 |
$16K |
| 91010 |
|
27 |
27 |
$16K |
| 82962 |
|
49,724 |
39,487 |
$16K |
| 83605 |
|
19,314 |
16,520 |
$16K |
| 90849 |
|
217 |
115 |
$15K |
| 70487 |
|
50 |
50 |
$15K |
| 0052A |
|
383 |
382 |
$15K |
| 94150 |
|
361 |
343 |
$15K |
| 82977 |
|
5,396 |
4,550 |
$15K |
| 73110 |
|
5,801 |
4,853 |
$14K |
| 57454 |
|
29 |
29 |
$14K |
| 90694 |
|
1,838 |
1,833 |
$14K |
| 82746 |
|
4,553 |
4,497 |
$14K |
| 84207 |
|
777 |
765 |
$14K |
| 83690 |
|
38,870 |
36,660 |
$14K |
| 72131 |
|
111 |
110 |
$14K |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
12,106 |
9,897 |
$14K |
| 12013 |
|
24 |
24 |
$13K |
| 82950 |
|
10,000 |
9,947 |
$13K |
| 73560 |
|
5,270 |
4,846 |
$13K |
| 97760 |
|
121 |
106 |
$13K |
| 84480 |
|
4,172 |
3,774 |
$13K |
| 72157 |
|
44 |
44 |
$13K |
| 78306 |
|
278 |
274 |
$13K |
| 73562 |
|
4,260 |
3,935 |
$13K |
| 76818 |
|
342 |
276 |
$12K |
| 84156 |
|
9,902 |
8,797 |
$12K |
| 45331 |
|
13 |
13 |
$12K |
| 86870 |
|
296 |
276 |
$12K |
| 82043 |
|
10,028 |
9,747 |
$12K |
| 86704 |
|
6,388 |
6,221 |
$12K |
| 64643 |
|
24 |
24 |
$12K |
| 82820 |
|
480 |
344 |
$12K |
| 82378 |
|
3,107 |
2,557 |
$12K |
| 87102 |
|
12,821 |
12,504 |
$12K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
88 |
83 |
$12K |
| 0082A |
|
290 |
290 |
$11K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
7,379 |
7,306 |
$11K |
| J9206 |
Injection, irinotecan, 20 mg |
494 |
267 |
$11K |
| 86235 |
|
1,781 |
926 |
$11K |
| 86665 |
|
2,211 |
1,295 |
$11K |
| 88271 |
|
324 |
307 |
$11K |
| 99429 |
|
2,143 |
1,885 |
$11K |
| 76813 |
|
163 |
139 |
$11K |
| 86147 |
|
752 |
386 |
$11K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
17,263 |
16,383 |
$11K |
| 72100 |
|
3,273 |
3,221 |
$11K |
| 92134 |
|
116 |
102 |
$11K |
| 0064A |
|
329 |
324 |
$11K |
| 82105 |
|
2,910 |
2,746 |
$11K |
| 85379 |
|
7,243 |
7,044 |
$11K |
| 0051A |
|
276 |
276 |
$11K |
| 73620 |
|
719 |
700 |
$10K |
| 82533 |
|
1,414 |
1,267 |
$10K |
| J2704 |
Injection, propofol, 10 mg |
41,887 |
31,372 |
$10K |
| 72170 |
|
2,881 |
2,821 |
$10K |
| 31628 |
|
54 |
52 |
$10K |
| 90649 |
|
220 |
219 |
$10K |
| J0690 |
Injection, cefazolin sodium, 500 mg |
11,365 |
10,047 |
$10K |
| 47000 |
|
14 |
14 |
$10K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
9,065 |
8,318 |
$10K |
| J9000 |
Injection, doxorubicin hydrochloride, 10 mg |
596 |
365 |
$10K |
| 83020 |
|
1,203 |
1,053 |
$10K |
| 83883 |
|
3,458 |
1,676 |
$10K |
| 93303 |
Transthoracic echocardiography for congenital cardiac anomalies, follow-up or limited study |
341 |
339 |
$10K |
| 82610 |
|
1,889 |
1,135 |
$10K |
| 87205 |
|
22,088 |
20,842 |
$10K |
| C2617 |
Stent, non-coronary, temporary, without delivery system |
373 |
350 |
$10K |
| 73130 |
|
5,976 |
5,269 |
$10K |
| 82330 |
|
8,136 |
7,287 |
$9K |
| 74221 |
|
40 |
40 |
$9K |
| 73502 |
|
3,046 |
2,846 |
$9K |
| 87088 |
|
9,665 |
9,130 |
$9K |
| 96368 |
|
1,091 |
729 |
$9K |
| 76885 |
|
77 |
76 |
$9K |
| 80329 |
|
2,160 |
2,033 |
$9K |
| J9370 |
Vincristine sulfate, 1 mg |
1,204 |
821 |
$9K |
| 73120 |
|
1,246 |
1,196 |
$9K |
| U0001 |
Cdc 2019 novel coronavirus (2019-ncov) real-time rt-pcr diagnostic panel |
3,364 |
2,941 |
$9K |
| 87070 |
|
9,430 |
8,775 |
$9K |
| 82810 |
|
2,930 |
1,706 |
$9K |
| 70480 |
|
42 |
41 |
$9K |
| 88300 |
|
2,199 |
2,126 |
$9K |
| 86300 |
|
1,760 |
946 |
$9K |
| 87186 |
|
11,938 |
11,066 |
$9K |
| G0424 |
Pulmonary rehabilitation, including exercise (includes monitoring), one hour, per session, up to two sessions per day |
80 |
26 |
$8K |
| 73590 |
|
3,731 |
3,399 |
$8K |
| 84402 |
|
1,311 |
1,306 |
$8K |
| 73090 |
|
3,032 |
2,655 |
$8K |
| J7042 |
5% dextrose/normal saline (500 ml = 1 unit) |
7,871 |
7,308 |
$8K |
| 88344 |
|
124 |
112 |
$8K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
24,856 |
23,697 |
$8K |
| 0173A |
|
230 |
230 |
$8K |
| 90714 |
|
389 |
372 |
$8K |
| 93225 |
|
42 |
42 |
$8K |
| 82550 |
|
6,390 |
5,785 |
$7K |
| 84305 |
|
406 |
399 |
$7K |
| C1760 |
Closure device, vascular (implantable/insertable) |
380 |
368 |
$7K |
| Q9966 |
Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml |
2,730 |
2,674 |
$7K |
| 0074A |
|
183 |
183 |
$7K |
| D0120 |
Periodic oral evaluation - established patient |
5,070 |
5,039 |
$7K |
| 88364 |
|
107 |
102 |
$7K |
| J9171 |
Injection, docetaxel, 1 mg |
167 |
125 |
$7K |
| 82248 |
|
4,862 |
3,574 |
$7K |
| 72146 |
|
47 |
47 |
$7K |
| 83520 |
|
1,014 |
867 |
$7K |
| 96136 |
|
37 |
27 |
$7K |
| 86003 |
|
488 |
258 |
$7K |
| 86225 |
|
1,681 |
1,637 |
$7K |
| 36593 |
|
45 |
36 |
$7K |
| 82652 |
|
252 |
247 |
$7K |
| 64644 |
|
25 |
25 |
$7K |
| 93321 |
|
488 |
467 |
$7K |
| 83498 |
|
482 |
473 |
$7K |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
11,918 |
11,340 |
$7K |
| H2011 |
Crisis intervention service, per 15 minutes |
46 |
36 |
$6K |
| 88311 |
|
1,090 |
1,055 |
$6K |
| 86708 |
|
2,324 |
2,250 |
$6K |
| 84446 |
|
844 |
825 |
$6K |
| 29125 |
|
24 |
24 |
$6K |
| J7060 |
5% dextrose/water (500 ml = 1 unit) |
9,864 |
7,390 |
$6K |
| 88720 |
|
1,469 |
1,333 |
$6K |
| 82024 |
|
183 |
169 |
$6K |
| 90380 |
|
183 |
183 |
$6K |
| 86780 |
|
2,826 |
2,763 |
$6K |
| 87641 |
|
252 |
244 |
$6K |
| 86580 |
|
1,377 |
969 |
$6K |
| 90744 |
|
558 |
557 |
$6K |
| 86038 |
|
3,218 |
3,167 |
$6K |
| 82627 |
|
894 |
885 |
$6K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
28 |
28 |
$6K |
| 88274 |
|
62 |
61 |
$6K |
| 86334 |
|
1,617 |
1,511 |
$6K |
| 96523 |
|
80 |
77 |
$6K |
| 87535 |
|
1,088 |
1,057 |
$6K |
| A9500 |
Technetium tc-99m sestamibi, diagnostic, per study dose |
687 |
670 |
$6K |
| 84590 |
|
1,016 |
997 |
$6K |
| D1351 |
Sealant - per tooth |
202 |
187 |
$6K |
| 51702 |
|
12 |
12 |
$6K |
| J9263 |
Injection, oxaliplatin, 0.5 mg |
209 |
129 |
$6K |
| 0134A |
|
140 |
137 |
$6K |
| 84704 |
|
823 |
819 |
$6K |
| 84163 |
|
823 |
819 |
$5K |
| 74018 |
|
1,966 |
1,909 |
$5K |
| 84425 |
|
1,264 |
1,254 |
$5K |
| 86812 |
|
55 |
55 |
$5K |
| 75557 |
|
12 |
12 |
$5K |
| 80195 |
|
811 |
537 |
$5K |
| 84436 |
|
2,793 |
2,418 |
$5K |
| 57456 |
|
13 |
13 |
$5K |
| 90691 |
|
151 |
151 |
$5K |
| 88302 |
|
539 |
515 |
$5K |
| J1437 |
Injection, ferric derisomaltose, 10 mg |
12 |
12 |
$5K |
| 86644 |
|
1,156 |
1,078 |
$5K |
| 86376 |
|
944 |
928 |
$5K |
| 73000 |
|
716 |
629 |
$5K |
| 85245 |
|
166 |
156 |
$5K |
| 73140 |
|
2,924 |
2,655 |
$5K |
| J1610 |
Injection, glucagon hydrochloride, per 1 mg |
39 |
37 |
$5K |
| 85384 |
|
1,855 |
1,594 |
$5K |
| 72040 |
|
1,171 |
1,156 |
$5K |
| 87081 |
|
5,105 |
4,976 |
$5K |
| 80158 |
|
567 |
402 |
$5K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
239 |
197 |
$5K |
| 73552 |
|
1,741 |
1,609 |
$5K |
| 90476 |
|
285 |
247 |
$5K |
| 86694 |
|
1,070 |
564 |
$5K |
| 73060 |
|
1,693 |
1,583 |
$5K |
| 57452 |
|
14 |
14 |
$5K |
| 82947 |
|
7,746 |
7,394 |
$5K |
| 87181 |
|
6,354 |
6,054 |
$5K |
| 0296T |
|
78 |
77 |
$4K |
| 82088 |
|
134 |
133 |
$4K |
| 88313 |
|
631 |
600 |
$4K |
| 80320 |
|
6,857 |
6,408 |
$4K |
| 86593 |
|
2,881 |
2,814 |
$4K |
| 99241 |
|
26 |
26 |
$4K |
| 17000 |
|
26 |
26 |
$4K |
| 88237 |
|
42 |
36 |
$4K |
| 90611 |
|
256 |
252 |
$4K |
| 82525 |
|
516 |
506 |
$4K |
| D7140 |
Extraction, erupted tooth or exposed root |
56 |
54 |
$4K |
| 0053A |
|
107 |
106 |
$4K |
| 84460 |
|
6,744 |
6,668 |
$4K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
40,943 |
36,608 |
$4K |
| 90685 |
|
226 |
226 |
$4K |
| 87631 |
|
60 |
60 |
$4K |
| 80069 |
|
401 |
277 |
$4K |
| 84481 |
|
1,235 |
1,035 |
$4K |
| 84630 |
|
1,044 |
1,031 |
$4K |
| 86200 |
|
863 |
853 |
$4K |
| 84450 |
|
2,047 |
1,473 |
$4K |
| 86800 |
|
719 |
680 |
$4K |
| 80180 |
|
421 |
361 |
$4K |
| 72050 |
|
261 |
257 |
$4K |
| 74455 |
|
12 |
12 |
$4K |
| 86696 |
|
1,153 |
1,115 |
$4K |
| 86431 |
|
1,764 |
1,742 |
$4K |
| 74246 |
|
12 |
12 |
$3K |
| 88235 |
|
26 |
26 |
$3K |
| 82951 |
|
415 |
410 |
$3K |
| 73600 |
|
683 |
658 |
$3K |
| 72070 |
|
893 |
881 |
$3K |
| 72052 |
|
278 |
274 |
$3K |
| 74019 |
|
1,553 |
1,515 |
$3K |
| 0012A |
|
116 |
116 |
$3K |
| 85347 |
|
2,472 |
1,621 |
$3K |
| 88275 |
|
26 |
24 |
$3K |
| 82565 |
|
4,501 |
4,249 |
$3K |
| 90660 |
|
212 |
212 |
$3K |
| 82657 |
|
566 |
541 |
$3K |
| 86645 |
|
648 |
607 |
$3K |
| 77062 |
|
45 |
45 |
$3K |
| 86695 |
|
932 |
903 |
$3K |
| 85014 |
|
16,435 |
15,345 |
$3K |
| 82150 |
|
2,077 |
1,795 |
$3K |
| 86945 |
|
69 |
49 |
$3K |
| Q0139 |
Injection, ferumoxytol, for treatment of iron deficiency anemia, 1 mg (for esrd on dialysis) |
16 |
12 |
$3K |
| 76506 |
|
12 |
12 |
$3K |
| 51798 |
|
12 |
12 |
$3K |
| 76827 |
|
118 |
118 |
$3K |
| 89051 |
|
1,463 |
1,223 |
$3K |
| 87077 |
|
6,375 |
5,728 |
$3K |
| 82785 |
|
495 |
480 |
$3K |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
3,781 |
3,349 |
$2K |
| 81002 |
|
10,236 |
8,349 |
$2K |
| 90653 |
|
593 |
592 |
$2K |
| 81220 |
CFTR (cystic fibrosis transmembrane conductance regulator) gene analysis; common variants |
15 |
15 |
$2K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
34,812 |
30,599 |
$2K |
| J1642 |
Injection, heparin sodium, (heparin lock flush), per 10 units |
10,166 |
4,293 |
$2K |
| 83010 |
|
980 |
766 |
$2K |
| 75574 |
|
12 |
12 |
$2K |
| 80162 |
|
309 |
289 |
$2K |
| G0008 |
Administration of influenza virus vaccine |
2,909 |
2,902 |
$2K |
| 83921 |
|
250 |
247 |
$2K |
| 88280 |
|
134 |
125 |
$2K |
| J0171 |
Injection, adrenalin, epinephrine, 0.1 mg |
1,997 |
1,922 |
$2K |
| 87593 |
|
125 |
68 |
$2K |
| 0011A |
|
109 |
109 |
$2K |
| 36592 |
|
27 |
17 |
$2K |
| 92585 |
|
13 |
12 |
$2K |
| 87338 |
|
902 |
899 |
$2K |
| 92588 |
|
24 |
24 |
$2K |
| 83525 |
|
173 |
128 |
$2K |
| 86304 |
|
932 |
805 |
$2K |
| 90682 |
|
69 |
69 |
$2K |
| 86880 |
|
67 |
49 |
$2K |
| 86777 |
|
395 |
383 |
$2K |
| 84681 |
|
229 |
204 |
$2K |
| 71101 |
|
1,124 |
1,099 |
$2K |
| 85246 |
|
73 |
71 |
$2K |
| 80299 |
|
306 |
285 |
$2K |
| 86146 |
|
423 |
217 |
$2K |
| C1726 |
Catheter, balloon dilatation, non-vascular |
39 |
39 |
$2K |
| 72114 |
|
81 |
81 |
$2K |
| 82157 |
|
113 |
112 |
$2K |
| 92626 |
|
92 |
84 |
$2K |
| 84445 |
|
42 |
41 |
$2K |
| 73100 |
|
414 |
381 |
$2K |
| 86709 |
|
424 |
415 |
$2K |
| C1730 |
Catheter, electrophysiology, diagnostic, other than 3d mapping (19 or fewer electrodes) |
108 |
101 |
$2K |
| 87116 |
|
1,024 |
900 |
$2K |
| 96137 |
|
20 |
14 |
$2K |
| 82085 |
|
131 |
123 |
$2K |
| 80177 |
|
616 |
591 |
$2K |
| 90739 |
|
41 |
41 |
$2K |
| 85660 |
|
1,236 |
952 |
$2K |
| 90713 |
|
142 |
142 |
$2K |
| J2785 |
Injection, regadenoson, 0.1 mg |
297 |
297 |
$1K |
| 80164 |
|
897 |
829 |
$1K |
| 83090 |
|
122 |
117 |
$1K |
| 92587 |
|
12 |
12 |
$1K |
| C1751 |
Catheter, infusion, inserted peripherally, centrally or midline (other than hemodialysis) |
176 |
164 |
$1K |
| 74220 |
|
107 |
104 |
$1K |
| D0140 |
Limited oral evaluation - problem focused |
361 |
344 |
$1K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
45,291 |
41,614 |
$1K |
| 71271 |
|
13 |
13 |
$1K |
| 83519 |
|
69 |
56 |
$1K |
| 73070 |
|
764 |
705 |
$1K |
| 90678 |
|
74 |
74 |
$1K |
| 74174 |
|
26 |
25 |
$1K |
| 87206 |
|
1,616 |
978 |
$1K |
| 81268 |
|
51 |
26 |
$1K |
| 94727 |
|
76 |
76 |
$1K |
| 85651 |
|
1,722 |
1,671 |
$1K |
| 87210 |
|
873 |
856 |
$1K |
| J1815 |
Injection, insulin, per 5 units |
1,161 |
865 |
$1K |
| 82677 |
|
331 |
324 |
$1K |
| J1170 |
Injection, hydromorphone, up to 4 mg |
6,225 |
4,467 |
$1K |
| 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 |
12 |
12 |
$1K |
| 92652 |
|
14 |
13 |
$1K |
| 95117 |
|
35 |
25 |
$1K |
| 71270 |
|
37 |
36 |
$1K |
| 0083A |
|
29 |
29 |
$1K |
| 99493 |
|
12 |
12 |
$1K |
| G0009 |
Administration of pneumococcal vaccine |
674 |
674 |
$1K |
| J1720 |
Injection, hydrocortisone sodium succinate, up to 100 mg |
1,431 |
1,289 |
$1K |
| 84270 |
|
80 |
78 |
$1K |
| A9541 |
Technetium tc-99m sulfur colloid, diagnostic, per study dose, up to 20 millicuries |
71 |
70 |
$1K |
| 80179 |
|
1,506 |
1,468 |
$1K |
| 91312 |
|
165 |
165 |
$1K |
| 85613 |
|
165 |
149 |
$1K |
| 73660 |
|
524 |
493 |
$1K |
| 86140 |
|
1,774 |
1,715 |
$1K |
| 90661 |
|
83 |
83 |
$991.96 |
| 74021 |
|
1,218 |
1,201 |
$979.80 |
| J1729 |
Injection, hydroxyprogesterone caproate, not otherwise specified, 10 mg |
14 |
14 |
$953.50 |
| 82239 |
|
534 |
473 |
$947.80 |
| 87184 |
|
980 |
833 |
$931.02 |
| Q0163 |
Diphenhydramine hydrochloride, 50 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at time of chemotherapy treatment not to exceed a 48 hour dosage regimen |
12,621 |
9,624 |
$927.02 |
| C1758 |
Catheter, ureteral |
244 |
236 |
$921.62 |
| J3420 |
Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg |
3,483 |
2,628 |
$889.83 |
| J2310 |
Injection, naloxone hydrochloride, per 1 mg |
87 |
74 |
$869.54 |
| 84132 |
|
3,421 |
2,813 |
$865.14 |
| 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 |
20,189 |
18,218 |
$852.68 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
7,325 |
6,197 |
$849.33 |
| 86039 |
|
290 |
280 |
$847.65 |
| 82523 |
|
67 |
65 |
$819.51 |
| D1206 |
Topical application of fluoride varnish |
3,505 |
3,500 |
$813.78 |
| 85240 |
|
84 |
81 |
$788.29 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
13,074 |
11,861 |
$775.62 |
| 82948 |
|
1,117 |
960 |
$770.51 |
| 82435 |
|
2,754 |
2,551 |
$769.12 |
| 86255 |
|
134 |
131 |
$752.29 |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
43 |
43 |
$740.00 |
| 87493 |
|
25 |
25 |
$731.16 |
| 84166 |
|
223 |
220 |
$697.07 |
| 90384 |
|
14 |
13 |
$695.78 |
| 0031A |
|
15 |
15 |
$659.48 |
| 82952 |
|
350 |
347 |
$650.90 |
| 87015 |
|
1,037 |
899 |
$649.99 |
| G0279 |
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) |
81 |
81 |
$648.80 |
| 85460 |
|
27 |
25 |
$648.41 |
| 94761 |
|
89 |
89 |
$644.44 |
| 82397 |
|
117 |
113 |
$644.37 |
| J1644 |
Injection, heparin sodium, per 1000 units |
4,595 |
3,424 |
$635.00 |
| G0101 |
Cervical or vaginal cancer screening; pelvic and clinical breast examination |
41 |
41 |
$629.23 |
| 90630 |
|
16 |
16 |
$623.52 |
| 83993 |
|
16 |
16 |
$610.96 |
| 82247 |
|
1,472 |
1,080 |
$605.83 |
| 84134 |
|
120 |
117 |
$601.55 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
22,634 |
21,346 |
$597.25 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,702 |
1,681 |
$582.69 |
| 84295 |
|
2,745 |
2,570 |
$570.76 |
| 90658 |
|
79 |
79 |
$563.78 |
| J2795 |
Injection, ropivacaine hydrochloride, 1 mg |
1,344 |
1,178 |
$544.69 |
| J9060 |
Injection, cisplatin, powder or solution, 10 mg |
73 |
36 |
$538.24 |
| 0202U |
Oncology (prostate), multianalyte, gene expression profiling |
24 |
24 |
$531.32 |
| 84155 |
|
1,163 |
1,129 |
$530.10 |
| 87101 |
|
49 |
49 |
$517.87 |
| 76882 |
|
134 |
128 |
$516.09 |
| 86336 |
|
350 |
343 |
$511.15 |
| 84154 |
|
52 |
51 |
$505.88 |
| J2370 |
Injection, phenylephrine hcl, up to 1 ml |
938 |
910 |
$504.56 |
| 94200 |
|
138 |
138 |
$486.76 |
| 99417 |
Prolong home eval add 15m |
50 |
50 |
$467.20 |
| 94626 |
|
49 |
12 |
$465.38 |
| J0136 |
Injection, acetaminophen (b braun), not therapeutically equivalent to j0131, 10 mg |
439 |
427 |
$459.18 |
| 86617 |
|
90 |
47 |
$458.59 |
| 0013A |
|
12 |
12 |
$440.00 |
| 86316 |
|
126 |
123 |
$422.74 |
| 81267 |
|
15 |
14 |
$414.92 |
| 82040 |
|
271 |
258 |
$412.75 |
| 82310 |
|
552 |
538 |
$399.13 |
| 86922 |
|
15 |
13 |
$397.70 |
| 76826 |
|
15 |
13 |
$388.08 |
| 86618 |
|
119 |
118 |
$381.22 |
| 87640 |
|
208 |
202 |
$362.51 |
| 70360 |
|
374 |
368 |
$356.18 |
| J0461 |
Injection, atropine sulfate, 0.01 mg |
462 |
309 |
$338.66 |
| 82542 |
|
58 |
56 |
$332.83 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
6,791 |
5,798 |
$322.93 |
| 88173 |
|
92 |
76 |
$318.04 |
| G1003 |
Clinical decision support mechanism medicalis, as defined by the medicare appropriate use criteria program |
8,171 |
7,115 |
$314.95 |
| 82103 |
|
53 |
50 |
$307.45 |
| 82340 |
|
85 |
84 |
$299.87 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
11,806 |
11,155 |
$288.55 |
| J3370 |
Injection, vancomycin hcl, 500 mg |
1,120 |
1,014 |
$280.70 |
| 73565 |
|
30 |
30 |
$277.35 |
| 72202 |
|
13 |
13 |
$271.21 |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
2,859 |
2,177 |
$265.06 |
| 86364 |
|
306 |
293 |
$260.73 |
| 80178 |
|
241 |
222 |
$257.60 |
| 76828 |
|
15 |
13 |
$254.05 |
| 82787 |
|
52 |
25 |
$252.08 |
| J7644 |
Ipratropium bromide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per milligram |
9,294 |
7,956 |
$251.42 |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
2,399 |
2,089 |
$248.25 |
| J9250 |
Methotrexate sodium, 5 mg |
121 |
65 |
$239.24 |
| 84244 |
|
38 |
38 |
$219.55 |
| 82010 |
|
1,718 |
1,523 |
$208.67 |
| 90698 |
|
27 |
27 |
$206.11 |
| J2274 |
Injection, morphine sulfate, preservative-free for epidural or intrathecal use, 10 mg |
148 |
139 |
$202.38 |
| 90648 |
|
23 |
22 |
$200.07 |
| 87075 |
|
178 |
150 |
$191.31 |
| J2272 |
Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg |
2,688 |
2,396 |
$190.57 |
| 86682 |
|
75 |
73 |
$186.69 |
| 82164 |
|
12 |
12 |
$181.48 |
| 80050 |
General health panel |
16 |
16 |
$180.74 |
| J0184 |
Injection, amisulpride, 1 mg |
57 |
57 |
$179.21 |
| 90632 |
|
12 |
12 |
$177.54 |
| 86021 |
|
45 |
42 |
$176.06 |
| 82379 |
|
30 |
29 |
$174.47 |
| 82390 |
|
49 |
44 |
$173.65 |
| 83937 |
|
12 |
12 |
$169.26 |
| J0702 |
Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg |
29 |
17 |
$165.44 |
| 86778 |
|
96 |
96 |
$164.67 |
| 94760 |
|
199 |
189 |
$160.22 |
| A9503 |
Technetium tc-99m medronate, diagnostic, per study dose, up to 30 millicuries |
174 |
168 |
$157.03 |
| J1630 |
Injection, haloperidol, up to 5 mg |
2,625 |
2,171 |
$155.36 |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
2,746 |
2,704 |
$142.47 |
| 84157 |
|
117 |
115 |
$141.12 |
| 84520 |
|
295 |
255 |
$140.06 |
| J2060 |
Injection, lorazepam, 2 mg |
2,635 |
2,183 |
$137.10 |
| Q9963 |
High osmolar contrast material, 350-399 mg/ml iodine concentration, per ml |
269 |
266 |
$131.30 |
| 81000 |
|
106 |
106 |
$130.40 |
| 84255 |
|
15 |
14 |
$128.81 |
| 82270 |
|
12 |
12 |
$117.26 |
| J7070 |
Infusion, d5w, 1000 cc |
394 |
314 |
$116.10 |
| 71100 |
|
83 |
80 |
$113.53 |
| 82945 |
|
130 |
127 |
$112.21 |
| S4993 |
Contraceptive pills for birth control |
165 |
165 |
$111.10 |
| J2919 |
Injection, methylprednisolone sodium succinate, 5 mg |
737 |
569 |
$109.48 |
| J1940 |
Injection, furosemide, up to 20 mg |
1,558 |
1,408 |
$104.15 |
| 15853 |
|
66 |
66 |
$100.00 |
| 80175 |
|
13 |
12 |
$95.26 |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
13,953 |
10,456 |
$92.91 |
| J2305 |
Injection, nitroglycerin, 5 mg |
607 |
541 |
$87.84 |
| 82465 |
|
123 |
122 |
$81.15 |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
1,141 |
1,097 |
$79.11 |
| 80187 |
|
37 |
27 |
$73.84 |
| 84478 |
|
34 |
28 |
$63.27 |
| 86702 |
|
15 |
14 |
$58.58 |
| J2543 |
Injection, piperacillin sodium/tazobactam sodium, 1 gram/0.125 grams (1.125 grams) |
394 |
328 |
$56.39 |
| J1953 |
Injection, levetiracetam, 10 mg |
196 |
178 |
$55.90 |
| 87106 |
|
75 |
73 |
$53.78 |
| 86301 |
|
12 |
12 |
$51.75 |
| J7510 |
Prednisolone oral, per 5 mg |
1,784 |
1,743 |
$48.32 |
| 86701 |
|
15 |
14 |
$45.06 |
| 85300 |
|
12 |
12 |
$44.85 |
| J2371 |
Injection, phenylephrine hydrochloride, 20 micrograms |
412 |
398 |
$43.95 |
| J2920 |
Injection, methylprednisolone sodium succinate, up to 40 mg |
128 |
103 |
$38.52 |
| J7642 |
Glycopyrrolate, inhalation solution, compounded product, administered through dme, concentrated form, per milligram |
237 |
236 |
$37.60 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
3,666 |
2,978 |
$34.21 |
| 72074 |
|
25 |
25 |
$31.50 |
| J0134 |
Injection, acetaminophen (fresenius kabi), not therapeutically equivalent to j0131, 10 mg |
506 |
497 |
$30.28 |
| J2710 |
Injection, neostigmine methylsulfate, up to 0.5 mg |
136 |
135 |
$28.31 |
| 96373 |
|
16 |
16 |
$27.20 |
| 82365 |
|
39 |
38 |
$26.53 |
| J3360 |
Injection, diazepam, up to 5 mg |
225 |
199 |
$23.21 |
| J0295 |
Injection, ampicillin sodium/sulbactam sodium, per 1.5 gm |
176 |
149 |
$21.45 |
| 72083 |
|
26 |
26 |
$20.43 |
| J1596 |
Injection, glycopyrrolate, 0.1 mg |
490 |
486 |
$15.24 |
| 86308 |
|
153 |
147 |
$14.60 |
| Q0144 |
Azithromycin dihydrate, oral, capsules/powder, 1 gram |
622 |
588 |
$10.68 |
| J3411 |
Injection, thiamine hcl, 100 mg |
364 |
314 |
$10.19 |
| J1956 |
Injection, levofloxacin, 250 mg |
270 |
260 |
$10.17 |
| J2004 |
Injection, lidocaine hcl with epinephrine, 1 mg |
77 |
77 |
$9.30 |
| D0220 |
Intraoral - periapical first radiographic image |
1,111 |
1,109 |
$9.10 |
| J2003 |
Injection, lidocaine hydrochloride, 1 mg |
718 |
676 |
$8.57 |
| J1643 |
Injection, heparin sodium (pfizer), not therapeutically equivalent to j1644, per 1000 units |
60 |
56 |
$7.11 |
| J0360 |
Injection, hydralazine hcl, up to 20 mg |
28 |
27 |
$6.79 |
| J1580 |
Injection, garamycin, gentamicin, up to 80 mg |
30 |
29 |
$6.66 |
| 87176 |
|
29 |
26 |
$4.88 |
| J1790 |
Injection, droperidol, up to 5 mg |
93 |
82 |
$4.69 |
| J3480 |
Injection, potassium chloride, per 2 meq |
68 |
49 |
$3.33 |
| 84300 |
|
54 |
51 |
$3.10 |
| 84133 |
|
12 |
12 |
$2.64 |
| S0028 |
Injection, famotidine, 20 mg |
124 |
116 |
$1.07 |
| J1171 |
Injection, hydromorphone, 0.1 mg |
130 |
107 |
$0.38 |
| 91300 |
|
316 |
286 |
$0.34 |
| J2470 |
Injection, pantoprazole sodium, 40 mg |
44 |
41 |
$0.01 |
| 99080 |
|
33,364 |
8,121 |
$0.00 |
| D1120 |
Prophylaxis - child |
4,666 |
4,660 |
$0.00 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
16 |
15 |
$0.00 |
| D0330 |
Panoramic radiographic image |
76 |
75 |
$0.00 |
| D0274 |
Bitewings - four radiographic images |
331 |
331 |
$0.00 |
| J0153 |
Injection, adenosine, 1 mg (not to be used to report any adenosine phosphate compounds) |
15 |
14 |
$0.00 |
| D9430 |
|
79 |
74 |
$0.00 |
| D0145 |
Oral evaluation for a patient under three years of age |
12 |
12 |
$0.00 |
| 69210 |
|
28 |
26 |
$0.00 |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
19 |
14 |
$0.00 |
| J0670 |
Injection, mepivacaine hydrochloride, per 10 ml |
12 |
12 |
$0.00 |
| A9562 |
Technetium tc-99m mertiatide, diagnostic, per study dose, up to 15 millicuries |
12 |
12 |
$0.00 |
| J0137 |
Injection, acetaminophen (hikma), not therapeutically equivalent to j0131, 10 mg |
17 |
17 |
$0.00 |
| D0272 |
Bitewings - two radiographic images |
854 |
853 |
$0.00 |
| J1817 |
Insulin for administration through dme (i.e., insulin pump) per 50 units |
69 |
58 |
$0.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
887 |
885 |
$0.00 |
| 76604 |
|
39 |
39 |
$0.00 |
| 76010 |
|
104 |
98 |
$0.00 |
| D1208 |
Topical application of fluoride, excluding varnish |
1,186 |
1,185 |
$0.00 |
| D1330 |
|
38 |
38 |
$0.00 |
| 3E03329 |
|
67 |
12 |
$0.00 |
| D1310 |
|
13 |
13 |
$0.00 |
| 77417 |
|
31 |
12 |
$0.00 |
| A4648 |
Tissue marker, implantable, any type, each |
13 |
13 |
$0.00 |
| 87147 |
|
14 |
13 |
$0.00 |
| J1805 |
Injection, esmolol hydrochloride, 10 mg |
14 |
14 |
$0.00 |
| 88331 |
|
13 |
13 |
$0.00 |
| D9310 |
|
16 |
16 |
$0.00 |