| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
Emergency department visit for the evaluation and management, high severity |
47,672 |
37,695 |
$7.24M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
53,421 |
41,794 |
$6.05M |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
89,552 |
78,402 |
$5.71M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
14,835 |
12,107 |
$2.83M |
| 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 |
12,367 |
9,887 |
$941K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
5,798 |
5,191 |
$329K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
5,638 |
5,105 |
$273K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
1,159 |
1,058 |
$203K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
387 |
363 |
$198K |
| 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 |
8,395 |
6,692 |
$138K |
| G0483 |
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; 22 or more drug class(es), including metabolite(s) if performed |
846 |
667 |
$121K |
| 36591 |
|
18,845 |
17,385 |
$94K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,250 |
1,217 |
$89K |
| J0585 |
Injection, onabotulinumtoxina, 1 unit |
188 |
90 |
$88K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
527 |
501 |
$67K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
1,085 |
886 |
$66K |
| 67028 |
Intravitreal injection of a pharmacologic agent |
348 |
301 |
$62K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
2,392 |
1,911 |
$60K |
| 80053 |
Comprehensive metabolic panel |
10,967 |
10,029 |
$51K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
1,976 |
1,761 |
$49K |
| 36415 |
Collection of venous blood by venipuncture |
14,426 |
12,753 |
$45K |
| C9803 |
Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
1,622 |
1,384 |
$45K |
| 69436 |
Tympanostomy (requiring insertion of ventilating tube), general anesthesia |
56 |
38 |
$41K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
323 |
310 |
$34K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
18,181 |
16,619 |
$29K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
459 |
278 |
$29K |
| 93296 |
|
1,163 |
1,125 |
$26K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
2,194 |
1,318 |
$26K |
| 0202U |
Oncology (prostate), multianalyte, gene expression profiling |
92 |
82 |
$25K |
| 98941 |
Chiropractic manipulative treatment; spinal, 3-4 regions |
1,388 |
797 |
$25K |
| 64615 |
|
92 |
90 |
$21K |
| 87631 |
|
228 |
216 |
$20K |
| 95810 |
Polysomnography; sleep staging with 4 or more additional parameters |
26 |
25 |
$20K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
855 |
807 |
$18K |
| 71046 |
Radiologic examination, chest; 2 views |
747 |
662 |
$17K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
81 |
72 |
$17K |
| 0002A |
|
631 |
623 |
$17K |
| 93303 |
Transthoracic echocardiography for congenital cardiac anomalies, follow-up or limited study |
39 |
38 |
$16K |
| 0001A |
|
669 |
655 |
$15K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
201 |
106 |
$15K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
75 |
71 |
$15K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
739 |
615 |
$14K |
| G0481 |
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; 8-14 drug class(es), including metabolite(s) if performed |
163 |
142 |
$12K |
| 71045 |
Radiologic examination, chest; single view |
708 |
602 |
$12K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
579 |
191 |
$10K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
15 |
12 |
$10K |
| 82728 |
|
848 |
805 |
$9K |
| 84425 |
|
577 |
561 |
$8K |
| 82607 |
|
844 |
791 |
$8K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
215 |
188 |
$8K |
| 84443 |
Thyroid stimulating hormone (TSH) |
1,036 |
934 |
$7K |
| 93299 |
|
236 |
206 |
$7K |
| 80061 |
Lipid panel |
859 |
839 |
$7K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
215 |
188 |
$7K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
93 |
66 |
$7K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
1,287 |
1,263 |
$7K |
| 82746 |
|
709 |
674 |
$7K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
4,810 |
4,437 |
$6K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
2,582 |
2,335 |
$6K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
123 |
26 |
$5K |
| 82525 |
|
560 |
542 |
$5K |
| J3490 |
Unclassified drugs |
3,672 |
2,388 |
$5K |
| 84590 |
|
566 |
550 |
$4K |
| 73630 |
|
187 |
170 |
$4K |
| 84630 |
|
580 |
562 |
$4K |
| G0108 |
Diabetes outpatient self-management training services, individual, per 30 minutes |
113 |
111 |
$4K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
49 |
49 |
$4K |
| 70450 |
Computed tomography, head or brain; without contrast material |
119 |
101 |
$4K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
282 |
267 |
$4K |
| 95886 |
|
27 |
26 |
$4K |
| J2704 |
Injection, propofol, 10 mg |
2,602 |
2,352 |
$3K |
| 93325 |
|
52 |
51 |
$3K |
| T1016 |
Case management, each 15 minutes |
67 |
38 |
$3K |
| 93298 |
|
111 |
105 |
$3K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
35 |
35 |
$3K |
| 81513 |
|
51 |
49 |
$3K |
| 90686 |
|
310 |
296 |
$3K |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
5,380 |
3,881 |
$3K |
| 92134 |
|
605 |
537 |
$3K |
| 93320 |
|
39 |
38 |
$3K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
1,274 |
1,142 |
$3K |
| 0031A |
|
95 |
91 |
$2K |
| 94010 |
|
95 |
89 |
$2K |
| 0240U |
|
12 |
12 |
$2K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
3,120 |
2,877 |
$2K |
| 0072A |
|
85 |
71 |
$2K |
| 98940 |
|
125 |
76 |
$2K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
110 |
99 |
$2K |
| 0124A |
|
59 |
53 |
$2K |
| 20610 |
|
30 |
26 |
$2K |
| 86140 |
|
549 |
492 |
$1K |
| 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 |
88 |
82 |
$1K |
| 0004A |
|
73 |
58 |
$1K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
17 |
14 |
$1K |
| 76830 |
Ultrasound, transvaginal |
16 |
14 |
$1K |
| 86780 |
|
88 |
80 |
$1K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
1,818 |
1,401 |
$1K |
| 85027 |
|
1,137 |
1,033 |
$1K |
| 83735 |
|
1,253 |
1,147 |
$1K |
| 94729 |
|
170 |
162 |
$1K |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
1,811 |
1,658 |
$1K |
| 0071A |
|
33 |
33 |
$987.40 |
| 84484 |
|
509 |
399 |
$968.88 |
| 96367 |
|
16 |
12 |
$952.90 |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
51 |
49 |
$880.10 |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
511 |
441 |
$778.65 |
| 81001 |
|
1,845 |
1,685 |
$730.65 |
| C9257 |
Injection, bevacizumab, 0.25 mg |
87 |
83 |
$717.19 |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
115 |
103 |
$664.72 |
| 73610 |
|
50 |
40 |
$664.24 |
| 87481 |
|
51 |
49 |
$658.61 |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
43 |
12 |
$648.16 |
| J1756 |
Injection, iron sucrose, 1 mg |
32 |
12 |
$630.00 |
| 0012A |
|
23 |
21 |
$599.17 |
| 0011A |
|
22 |
21 |
$530.08 |
| 84703 |
|
861 |
791 |
$479.47 |
| 73120 |
|
15 |
12 |
$475.35 |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
656 |
490 |
$474.90 |
| 11721 |
|
56 |
54 |
$466.62 |
| 83690 |
|
577 |
516 |
$466.55 |
| 90480 |
|
26 |
26 |
$451.00 |
| 86803 |
|
105 |
97 |
$446.51 |
| 92567 |
|
26 |
26 |
$443.58 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
389 |
335 |
$438.65 |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
58 |
58 |
$426.55 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
1,420 |
1,205 |
$426.18 |
| Q3014 |
Telehealth originating site facility fee |
53 |
47 |
$425.14 |
| 84466 |
|
104 |
90 |
$380.85 |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
141 |
125 |
$355.69 |
| 84439 |
|
136 |
117 |
$316.73 |
| 84481 |
|
25 |
25 |
$309.51 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
315 |
234 |
$300.13 |
| 73030 |
|
33 |
24 |
$296.10 |
| 87070 |
|
46 |
41 |
$291.48 |
| G2023 |
Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
21 |
19 |
$285.80 |
| 73562 |
|
15 |
13 |
$265.60 |
| J1040 |
Injection, methylprednisolone acetate, 80 mg |
26 |
24 |
$264.88 |
| 0064A |
|
19 |
13 |
$251.88 |
| 87340 |
|
100 |
89 |
$248.57 |
| 83540 |
|
135 |
116 |
$220.48 |
| 90834 |
Psychotherapy, 45 minutes with patient |
15 |
13 |
$214.49 |
| 84255 |
|
15 |
14 |
$205.19 |
| 90656 |
|
13 |
12 |
$188.43 |
| S0119 |
Ondansetron, oral, 4 mg (for circumstances falling under the medicare statute, use hcpcs q code) |
31 |
30 |
$149.77 |
| 87205 |
|
45 |
40 |
$145.40 |
| 85652 |
|
84 |
82 |
$142.64 |
| 91320 |
|
14 |
14 |
$124.87 |
| 87480 |
|
222 |
195 |
$123.16 |
| 89190 |
|
12 |
12 |
$120.81 |
| 86705 |
|
15 |
15 |
$117.38 |
| 90691 |
|
12 |
12 |
$109.37 |
| 73100 |
|
15 |
12 |
$103.25 |
| 81003 |
|
674 |
607 |
$89.69 |
| 86431 |
|
28 |
25 |
$81.35 |
| G0008 |
Administration of influenza virus vaccine |
27 |
27 |
$80.00 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
32 |
27 |
$77.60 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
456 |
367 |
$69.75 |
| 86704 |
|
14 |
14 |
$54.79 |
| 87081 |
|
520 |
400 |
$47.70 |
| 86706 |
|
14 |
14 |
$46.75 |
| 83605 |
|
51 |
41 |
$34.71 |
| 82248 |
|
55 |
49 |
$16.72 |
| 87660 |
|
222 |
195 |
$6.10 |
| 87510 |
|
222 |
195 |
$6.10 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
27 |
24 |
$4.32 |
| G8978 |
Mobility: walking & moving around functional limitation, current status, at therapy episode outset and at reporting intervals |
15 |
12 |
$0.00 |
| 91300 |
|
246 |
204 |
$0.00 |
| 87186 |
|
165 |
137 |
$0.00 |
| 87653 |
|
44 |
42 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
188 |
185 |
$0.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
174 |
127 |
$0.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
454 |
220 |
$0.00 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
207 |
156 |
$0.00 |
| 85610 |
|
314 |
215 |
$0.00 |
| 84702 |
|
149 |
98 |
$0.00 |
| 74018 |
|
14 |
13 |
$0.00 |
| 87420 |
|
51 |
50 |
$0.00 |
| A9575 |
Injection, gadoterate meglumine, 0.1 ml |
18 |
13 |
$0.00 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
42 |
32 |
$0.00 |
| 80347 |
|
30 |
24 |
$0.00 |
| 86900 |
|
14 |
13 |
$0.00 |
| 84156 |
|
12 |
12 |
$0.00 |
| 82570 |
|
12 |
12 |
$0.00 |
| G8979 |
Mobility: walking & moving around functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting |
15 |
12 |
$0.00 |
| J2710 |
Injection, neostigmine methylsulfate, up to 0.5 mg |
17 |
13 |
$0.00 |
| 82962 |
|
307 |
146 |
$0.00 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
201 |
168 |
$0.00 |
| 82550 |
|
69 |
59 |
$0.00 |
| 87077 |
|
184 |
151 |
$0.00 |
| 88142 |
|
144 |
125 |
$0.00 |
| A9270 |
Non-covered item or service |
1,235 |
408 |
$0.00 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
97 |
75 |
$0.00 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
124 |
96 |
$0.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
165 |
135 |
$0.00 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
17 |
16 |
$0.00 |
| 96376 |
|
74 |
56 |
$0.00 |
| 86762 |
|
29 |
28 |
$0.00 |
| 86901 |
|
14 |
13 |
$0.00 |
| 91303 |
|
13 |
13 |
$0.00 |
| 82043 |
|
49 |
49 |
$0.00 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
63 |
31 |
$0.00 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
21 |
13 |
$0.00 |
| 85379 |
|
32 |
29 |
$0.00 |
| 82950 |
|
32 |
31 |
$0.00 |
| 83880 |
|
25 |
24 |
$0.00 |
| 82553 |
|
14 |
12 |
$0.00 |
| 73502 |
|
15 |
12 |
$0.00 |
| 85730 |
|
14 |
14 |
$0.00 |