| Code | Description | Claims | Beneficiaries | Total Paid |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
12,237 |
11,114 |
$1.75M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
7,884 |
7,246 |
$1.20M |
| 96361 |
Intravenous infusion, hydration; each additional hour |
2,998 |
2,742 |
$1.01M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
5,896 |
5,512 |
$814K |
| 95810 |
Polysomnography; sleep staging with 4 or more additional parameters |
1,054 |
1,036 |
$797K |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
5,851 |
5,494 |
$770K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
4,933 |
4,591 |
$716K |
| 95811 |
|
873 |
840 |
$592K |
| G0378 |
Hospital observation service, per hour |
2,211 |
1,984 |
$369K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
15,566 |
13,392 |
$362K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
2,881 |
2,718 |
$259K |
| S9485 |
Crisis intervention mental health services, per diem |
820 |
567 |
$240K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
2,481 |
2,463 |
$199K |
| 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 |
3,785 |
3,532 |
$198K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
195 |
192 |
$193K |
| 70450 |
Computed tomography, head or brain; without contrast material |
2,583 |
2,382 |
$163K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
4,635 |
4,190 |
$146K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
1,590 |
1,499 |
$119K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
1,772 |
596 |
$119K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
6,434 |
6,325 |
$105K |
| 80053 |
Comprehensive metabolic panel |
23,985 |
22,058 |
$101K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
26,496 |
23,633 |
$97K |
| 84443 |
Thyroid stimulating hormone (TSH) |
11,950 |
11,710 |
$95K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
13,742 |
13,491 |
$84K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
2,205 |
2,189 |
$72K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
2,498 |
2,482 |
$72K |
| 71046 |
Radiologic examination, chest; 2 views |
4,868 |
4,603 |
$69K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
2,209 |
2,193 |
$68K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
15,855 |
14,318 |
$68K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
753 |
338 |
$68K |
| 99215 |
Prolong outpt/office vis |
358 |
355 |
$66K |
| 80061 |
Lipid panel |
18,312 |
17,932 |
$63K |
| 80050 |
General health panel |
3,448 |
3,416 |
$60K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
338 |
326 |
$50K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
4,753 |
4,320 |
$47K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
2,077 |
1,898 |
$46K |
| 20610 |
|
270 |
248 |
$44K |
| 86803 |
|
2,635 |
2,624 |
$42K |
| 82607 |
|
5,770 |
5,668 |
$41K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
486 |
454 |
$38K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
49 |
49 |
$37K |
| 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 |
1,890 |
1,737 |
$34K |
| 84153 |
|
2,278 |
2,250 |
$33K |
| 84484 |
|
4,696 |
4,088 |
$31K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
423 |
398 |
$31K |
| 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 |
2,016 |
1,876 |
$30K |
| 85027 |
|
9,447 |
8,924 |
$30K |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
965 |
965 |
$29K |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
1,172 |
1,171 |
$27K |
| 82728 |
|
3,190 |
3,109 |
$27K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
6,975 |
6,430 |
$26K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
1,165 |
1,164 |
$26K |
| 83735 |
|
7,510 |
6,477 |
$25K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
9,573 |
8,702 |
$23K |
| ATP14 |
|
5,143 |
4,593 |
$22K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
151 |
146 |
$22K |
| 76642 |
|
176 |
173 |
$21K |
| 84439 |
|
3,495 |
3,386 |
$18K |
| 84403 |
|
870 |
841 |
$18K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
112 |
102 |
$17K |
| 83690 |
|
4,203 |
3,878 |
$17K |
| 71045 |
Radiologic examination, chest; single view |
2,468 |
2,301 |
$16K |
| 81025 |
|
2,967 |
2,816 |
$16K |
| 82948 |
|
6,284 |
5,211 |
$15K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
83 |
81 |
$15K |
| 45385 |
Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) |
12 |
12 |
$13K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
68 |
65 |
$13K |
| 83540 |
|
3,296 |
3,208 |
$12K |
| 77080 |
|
179 |
177 |
$12K |
| 87186 |
|
1,866 |
1,769 |
$12K |
| 82570 |
|
4,228 |
4,118 |
$11K |
| 81001 |
|
7,743 |
7,160 |
$11K |
| 83880 |
|
1,328 |
1,204 |
$11K |
| 86618 |
|
350 |
337 |
$10K |
| 82043 |
|
3,695 |
3,625 |
$9K |
| ATP08 |
|
2,884 |
2,454 |
$8K |
| 82746 |
|
906 |
895 |
$8K |
| 87070 |
|
1,208 |
1,182 |
$8K |
| 83605 |
|
1,507 |
1,377 |
$8K |
| 85610 |
|
5,478 |
3,740 |
$8K |
| 80305 |
|
1,785 |
1,631 |
$8K |
| 86140 |
|
1,737 |
1,653 |
$8K |
| 84450 |
|
4,228 |
4,116 |
$7K |
| 84702 |
|
688 |
645 |
$7K |
| ATP15 |
|
1,006 |
911 |
$7K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
3,696 |
2,995 |
$7K |
| 83721 |
|
2,675 |
2,620 |
$7K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
3,148 |
2,821 |
$6K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
834 |
705 |
$6K |
| 84460 |
|
4,909 |
4,786 |
$6K |
| 87631 |
|
78 |
77 |
$6K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
1,879 |
1,823 |
$6K |
| 36415 |
Collection of venous blood by venipuncture |
23,932 |
21,421 |
$6K |
| 82565 |
|
4,585 |
4,334 |
$6K |
| 87340 |
|
457 |
455 |
$6K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
67 |
64 |
$6K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
4,967 |
4,136 |
$5K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
24 |
24 |
$5K |
| 81003 |
|
4,385 |
4,186 |
$5K |
| 86592 |
|
184 |
184 |
$5K |
| 80076 |
|
1,770 |
1,686 |
$4K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
16 |
16 |
$4K |
| 87637 |
Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV |
35 |
33 |
$4K |
| 86706 |
|
230 |
228 |
$4K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
118 |
114 |
$4K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
26 |
24 |
$4K |
| 84100 |
|
4,220 |
3,781 |
$4K |
| 83970 |
|
278 |
263 |
$4K |
| 88142 |
|
119 |
119 |
$4K |
| ATP17 |
|
2,009 |
1,805 |
$3K |
| 85730 |
|
1,270 |
1,172 |
$3K |
| 82330 |
|
718 |
662 |
$3K |
| J2704 |
Injection, propofol, 10 mg |
5,342 |
4,073 |
$3K |
| 77062 |
|
27 |
27 |
$3K |
| A9585 |
Injection, gadobutrol, 0.1 ml |
887 |
841 |
$3K |
| 85652 |
|
1,200 |
1,174 |
$2K |
| 86038 |
|
249 |
248 |
$2K |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
2,623 |
2,345 |
$2K |
| 76775 |
|
20 |
20 |
$2K |
| 82550 |
|
1,899 |
1,761 |
$2K |
| 80143 |
|
1,306 |
1,173 |
$2K |
| 73562 |
|
146 |
144 |
$2K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
2,468 |
2,113 |
$2K |
| 70496 |
|
15 |
14 |
$2K |
| 87205 |
|
395 |
389 |
$2K |
| 71250 |
|
38 |
37 |
$2K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
30 |
12 |
$2K |
| 73130 |
|
72 |
65 |
$2K |
| 81513 |
|
13 |
12 |
$2K |
| 77066 |
Tomosynthesis, mammo |
44 |
43 |
$2K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
699 |
642 |
$1K |
| 84520 |
|
2,874 |
2,728 |
$1K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
49 |
47 |
$1K |
| 76830 |
Ultrasound, transvaginal |
27 |
27 |
$1K |
| 85014 |
|
1,462 |
1,364 |
$1K |
| J2060 |
Injection, lorazepam, 2 mg |
173 |
105 |
$1K |
| 99218 |
|
58 |
52 |
$1K |
| 86703 |
|
85 |
85 |
$1K |
| 71271 |
|
13 |
13 |
$1K |
| 76536 |
|
14 |
13 |
$1K |
| 97803 |
|
12 |
12 |
$1K |
| 86850 |
|
331 |
298 |
$1K |
| ATP03 |
|
560 |
487 |
$1K |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
429 |
378 |
$967.53 |
| 82784 |
|
82 |
80 |
$943.10 |
| 82803 |
|
139 |
121 |
$932.80 |
| 84302 |
|
591 |
544 |
$908.11 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
237 |
193 |
$902.27 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
836 |
574 |
$889.25 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
362 |
258 |
$879.43 |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
43 |
38 |
$846.67 |
| 83516 |
|
25 |
25 |
$797.12 |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
15 |
15 |
$769.65 |
| 82040 |
|
555 |
525 |
$750.43 |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
110 |
93 |
$731.75 |
| 85379 |
|
135 |
125 |
$681.53 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
1,048 |
951 |
$654.02 |
| Q3014 |
Telehealth originating site facility fee |
387 |
369 |
$606.79 |
| 85651 |
|
151 |
149 |
$579.23 |
| 86900 |
|
363 |
327 |
$575.20 |
| 86901 |
|
358 |
324 |
$552.99 |
| 87503 |
|
89 |
86 |
$540.08 |
| ATP18 |
|
307 |
258 |
$537.53 |
| G0279 |
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) |
12 |
12 |
$513.24 |
| 94010 |
|
37 |
37 |
$503.49 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
336 |
307 |
$496.09 |
| 83718 |
|
177 |
176 |
$450.99 |
| 85018 |
|
569 |
528 |
$407.29 |
| 73030 |
|
26 |
25 |
$398.71 |
| 87481 |
|
13 |
12 |
$371.38 |
| 97162 |
|
13 |
12 |
$360.84 |
| 82670 |
|
12 |
12 |
$256.86 |
| 87102 |
|
17 |
16 |
$222.72 |
| 73110 |
|
30 |
26 |
$219.70 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
665 |
574 |
$218.15 |
| 87147 |
|
13 |
13 |
$215.57 |
| 84075 |
|
224 |
220 |
$203.66 |
| 84146 |
|
12 |
12 |
$198.21 |
| 87430 |
|
14 |
14 |
$177.96 |
| 82947 |
|
24 |
24 |
$161.49 |
| J0136 |
Injection, acetaminophen (b braun), not therapeutically equivalent to j0131, 10 mg |
91 |
81 |
$158.89 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
104 |
97 |
$158.89 |
| 88304 |
|
27 |
27 |
$154.04 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
4,759 |
4,451 |
$150.35 |
| 84480 |
|
13 |
13 |
$142.34 |
| 84550 |
|
95 |
92 |
$140.79 |
| 80051 |
|
93 |
89 |
$135.62 |
| ATP11 |
|
42 |
41 |
$118.43 |
| 84132 |
|
395 |
359 |
$117.61 |
| 86431 |
|
24 |
24 |
$107.66 |
| 86141 |
|
14 |
14 |
$107.43 |
| 87088 |
|
52 |
51 |
$72.30 |
| 87077 |
|
62 |
55 |
$66.33 |
| 82247 |
|
12 |
12 |
$64.20 |
| 87081 |
|
12 |
12 |
$58.50 |
| 87040 |
|
13 |
12 |
$54.60 |
| 82310 |
|
165 |
159 |
$51.28 |
| J1030 |
Injection, methylprednisolone acetate, 40 mg |
39 |
37 |
$48.65 |
| G0103 |
Prostate cancer screening; prostate specific antigen test (psa) |
399 |
390 |
$36.48 |
| 82465 |
|
177 |
176 |
$31.96 |
| 82374 |
|
127 |
116 |
$29.06 |
| 82435 |
|
143 |
131 |
$27.57 |
| 84478 |
|
177 |
176 |
$14.04 |
| ATP13 |
|
23 |
14 |
$11.04 |
| 83550 |
|
27 |
25 |
$9.02 |
| 82962 |
|
86 |
81 |
$0.00 |
| 96376 |
|
62 |
55 |
$0.00 |
| 70498 |
|
15 |
14 |
$0.00 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
12 |
12 |
$0.00 |
| J3490 |
Unclassified drugs |
16 |
13 |
$0.00 |
| 73560 |
|
12 |
12 |
$0.00 |
| 82248 |
|
162 |
152 |
$0.00 |
| 73610 |
|
14 |
14 |
$0.00 |
| 73630 |
|
13 |
12 |
$0.00 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
15 |
12 |
$0.00 |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
14 |
13 |
$0.00 |