| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
16,476 |
12,207 |
$3.50M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
22,425 |
16,938 |
$3.36M |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
4,755 |
3,733 |
$2.77M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
16,895 |
13,293 |
$1.79M |
| G0378 |
Hospital observation service, per hour |
7,763 |
5,259 |
$1.20M |
| 70450 |
Computed tomography, head or brain; without contrast material |
6,024 |
4,402 |
$971K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
64,686 |
38,295 |
$621K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
1,173 |
893 |
$556K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
1,374 |
1,081 |
$553K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
12,042 |
7,516 |
$507K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
28,558 |
9,550 |
$481K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
2,318 |
1,828 |
$435K |
| 41899 |
Unlisted procedure, dentoalveolar structures |
482 |
339 |
$422K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
8,686 |
5,967 |
$411K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
2,100 |
1,537 |
$397K |
| 0202U |
Oncology (prostate), multianalyte, gene expression profiling |
1,864 |
1,511 |
$388K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
21,858 |
14,620 |
$387K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
8,516 |
7,366 |
$364K |
| 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 |
5,498 |
4,455 |
$359K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
11,298 |
8,200 |
$328K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
7,757 |
4,280 |
$319K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
9,205 |
7,855 |
$314K |
| 71046 |
Radiologic examination, chest; 2 views |
9,364 |
7,208 |
$302K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
882 |
719 |
$299K |
| 80053 |
Comprehensive metabolic panel |
54,343 |
39,279 |
$289K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
64,379 |
44,119 |
$247K |
| 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 |
8,613 |
5,789 |
$228K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
3,398 |
2,805 |
$228K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
1,927 |
1,569 |
$222K |
| 93971 |
|
1,465 |
1,119 |
$168K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
1,567 |
1,283 |
$159K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
4,026 |
3,423 |
$153K |
| 96376 |
|
4,021 |
2,230 |
$143K |
| 76830 |
Ultrasound, transvaginal |
1,267 |
1,061 |
$142K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
211 |
169 |
$140K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
3,720 |
2,404 |
$134K |
| 84443 |
Thyroid stimulating hormone (TSH) |
15,341 |
12,679 |
$127K |
| 76801 |
|
755 |
612 |
$126K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
10,404 |
3,847 |
$123K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
2,978 |
2,437 |
$120K |
| 90870 |
|
2,039 |
509 |
$114K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
5,064 |
4,077 |
$112K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
13,947 |
9,217 |
$110K |
| U0005 |
Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, cdc or non-cdc, making use of high throughput technologies, completed within 2 calendar days from date of specimen collection (list separately in addition to either hcpcs code u0003 or u0004) as described by cms-2020-01-r2 |
4,892 |
3,991 |
$106K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
3,533 |
2,631 |
$106K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
5,821 |
4,807 |
$105K |
| 71045 |
Radiologic examination, chest; single view |
4,137 |
2,973 |
$104K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
5,831 |
4,822 |
$103K |
| 99215 |
Prolong outpt/office vis |
1,561 |
1,363 |
$101K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
2,412 |
1,473 |
$94K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
403 |
324 |
$94K |
| 87633 |
Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets |
794 |
680 |
$92K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
1,210 |
858 |
$92K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
8,844 |
6,884 |
$90K |
| 80061 |
Lipid panel |
10,371 |
8,898 |
$87K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
4,334 |
3,707 |
$79K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
2,559 |
1,995 |
$77K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
221 |
170 |
$77K |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
9,875 |
5,998 |
$77K |
| G2023 |
Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
3,096 |
2,041 |
$73K |
| 97161 |
|
2,992 |
2,483 |
$71K |
| 93017 |
|
709 |
575 |
$69K |
| 80306 |
|
8,840 |
6,315 |
$67K |
| 97162 |
|
2,904 |
2,301 |
$66K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
16,479 |
11,549 |
$66K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
5,833 |
3,193 |
$65K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
12,319 |
10,338 |
$63K |
| G0108 |
Diabetes outpatient self-management training services, individual, per 30 minutes |
2,421 |
1,858 |
$61K |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
3,044 |
2,589 |
$57K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
2,304 |
2,023 |
$54K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
1,832 |
1,023 |
$52K |
| 84484 |
|
13,723 |
7,638 |
$50K |
| 87660 |
|
4,089 |
3,260 |
$47K |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
2,019 |
1,667 |
$46K |
| 99001 |
|
9,426 |
8,478 |
$45K |
| 87510 |
|
4,089 |
3,260 |
$44K |
| 87480 |
|
4,089 |
3,260 |
$44K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
12,674 |
9,453 |
$41K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
379 |
296 |
$37K |
| A9500 |
Technetium tc-99m sestamibi, diagnostic, per study dose |
372 |
302 |
$37K |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
2,063 |
1,763 |
$36K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
578 |
508 |
$35K |
| J0585 |
Injection, onabotulinumtoxina, 1 unit |
594 |
307 |
$35K |
| 73630 |
|
887 |
680 |
$35K |
| 73610 |
|
764 |
559 |
$33K |
| 73030 |
|
807 |
583 |
$31K |
| 87522 |
Neg quan hep c or qual rna |
994 |
846 |
$29K |
| 73564 |
|
644 |
454 |
$29K |
| 83690 |
|
8,746 |
6,450 |
$29K |
| 84703 |
|
6,456 |
4,899 |
$29K |
| 83880 |
|
2,334 |
1,739 |
$28K |
| 87486 |
|
1,420 |
1,207 |
$28K |
| 87581 |
|
1,419 |
1,206 |
$28K |
| 70498 |
|
76 |
62 |
$27K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
584 |
383 |
$27K |
| 73130 |
|
559 |
418 |
$27K |
| J7050 |
Infusion, normal saline solution, 250 cc |
2,804 |
1,871 |
$27K |
| 85027 |
|
8,407 |
6,132 |
$27K |
| 97535 |
Self-care/home management training, each 15 minutes |
2,534 |
1,277 |
$25K |
| 93225 |
|
364 |
287 |
$25K |
| 97113 |
|
1,576 |
449 |
$24K |
| 87186 |
|
5,126 |
3,868 |
$23K |
| 94726 |
|
428 |
344 |
$23K |
| 86850 |
|
3,557 |
2,798 |
$23K |
| 82728 |
|
2,401 |
1,968 |
$23K |
| 73502 |
|
485 |
331 |
$23K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
59 |
52 |
$23K |
| 87483 |
|
219 |
135 |
$22K |
| 70496 |
|
61 |
50 |
$22K |
| 93325 |
|
404 |
327 |
$21K |
| H0004 |
Behavioral health counseling and therapy, per 15 minutes |
568 |
195 |
$20K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
234 |
147 |
$20K |
| 83605 |
|
4,891 |
3,235 |
$20K |
| 86780 |
|
2,165 |
1,851 |
$20K |
| Q3014 |
Telehealth originating site facility fee |
6,250 |
3,686 |
$19K |
| 97165 |
|
815 |
652 |
$19K |
| 82607 |
|
2,592 |
2,157 |
$19K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
649 |
513 |
$19K |
| G0383 |
Level 4 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room or emergency department; (2) it is held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment; or (3) during the calendar year immediately preceding the calendar year in which a determination under 42 cfr 489.24 is being made, based on a representative sample of patient visits that occurred during that calendar year, it provides at least one-third of all of its outpatient visits for the treatment of emergency medical conditions on an urgent basis without requiring a previously scheduled appointment) |
1,349 |
1,011 |
$19K |
| 81001 |
|
12,143 |
9,148 |
$19K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
2,660 |
1,427 |
$18K |
| 95810 |
Polysomnography; sleep staging with 4 or more additional parameters |
28 |
25 |
$18K |
| 86803 |
|
1,719 |
1,494 |
$17K |
| 84702 |
|
1,729 |
1,147 |
$17K |
| 72100 |
|
327 |
280 |
$17K |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
2,295 |
1,689 |
$16K |
| 84439 |
|
2,911 |
2,421 |
$16K |
| 87070 |
|
2,962 |
2,345 |
$15K |
| 80050 |
General health panel |
2,085 |
2,049 |
$15K |
| 83735 |
|
4,147 |
2,947 |
$15K |
| 94729 |
|
430 |
345 |
$15K |
| A9585 |
Injection, gadobutrol, 0.1 ml |
941 |
734 |
$14K |
| 85610 |
|
8,464 |
5,232 |
$14K |
| C1769 |
Guide wire |
579 |
426 |
$14K |
| 83550 |
|
2,357 |
1,912 |
$14K |
| G0390 |
Trauma response team associated with hospital critical care service |
131 |
124 |
$14K |
| 87040 |
|
2,438 |
1,090 |
$13K |
| 87340 |
|
1,877 |
1,618 |
$13K |
| 86140 |
|
4,240 |
3,123 |
$13K |
| 87631 |
|
233 |
204 |
$13K |
| G0382 |
Level 3 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room or emergency department; (2) it is held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment; or (3) during the calendar year immediately preceding the calendar year in which a determination under 42 cfr 489.24 is being made, based on a representative sample of patient visits that occurred during that calendar year, it provides at least one-third of all of its outpatient visits for the treatment of emergency medical conditions on an urgent basis without requiring a previously scheduled appointment) |
1,203 |
948 |
$12K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
245 |
207 |
$12K |
| 87081 |
|
2,811 |
2,397 |
$12K |
| J2785 |
Injection, regadenoson, 0.1 mg |
298 |
241 |
$12K |
| 97166 |
|
541 |
403 |
$12K |
| 97597 |
|
550 |
308 |
$12K |
| 81025 |
|
3,185 |
2,438 |
$12K |
| 93351 |
|
40 |
36 |
$12K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
51 |
41 |
$11K |
| 93296 |
|
1,215 |
879 |
$11K |
| 80076 |
|
2,191 |
1,733 |
$11K |
| 83540 |
|
2,465 |
1,993 |
$11K |
| 86618 |
|
1,055 |
899 |
$10K |
| 88342 |
|
1,145 |
896 |
$10K |
| 74018 |
|
307 |
216 |
$10K |
| 87077 |
|
2,580 |
1,806 |
$10K |
| 81003 |
|
11,713 |
8,597 |
$10K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
374 |
313 |
$10K |
| 73110 |
|
270 |
208 |
$9K |
| 83655 |
|
976 |
843 |
$9K |
| 94010 |
|
342 |
280 |
$9K |
| M0243 |
Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring |
105 |
85 |
$9K |
| 83970 |
|
349 |
281 |
$9K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,241 |
998 |
$9K |
| 93356 |
|
159 |
123 |
$8K |
| 85379 |
|
1,599 |
1,270 |
$8K |
| A9270 |
Non-covered item or service |
53,624 |
5,852 |
$8K |
| 94060 |
|
93 |
68 |
$8K |
| 81420 |
Fetal chromosomal aneuploidy genomic sequence analysis panel |
14 |
14 |
$7K |
| 86762 |
|
696 |
622 |
$7K |
| J3490 |
Unclassified drugs |
7,365 |
3,418 |
$7K |
| 36415 |
Collection of venous blood by venipuncture |
33,546 |
25,599 |
$7K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
137 |
121 |
$7K |
| J2704 |
Injection, propofol, 10 mg |
8,212 |
5,326 |
$7K |
| 85652 |
|
4,476 |
3,350 |
$7K |
| 82570 |
|
2,081 |
1,681 |
$7K |
| 82746 |
|
696 |
592 |
$7K |
| 87205 |
|
2,568 |
1,974 |
$6K |
| 59025 |
Fetal non-stress test |
70 |
60 |
$6K |
| 51705 |
|
220 |
111 |
$6K |
| 86900 |
|
3,756 |
2,939 |
$6K |
| 86038 |
|
730 |
639 |
$6K |
| 88304 |
|
365 |
306 |
$6K |
| 80074 |
|
209 |
187 |
$6K |
| 87653 |
|
318 |
289 |
$6K |
| 86901 |
|
3,756 |
2,938 |
$6K |
| 90834 |
Psychotherapy, 45 minutes with patient |
362 |
148 |
$6K |
| 80164 |
|
1,048 |
704 |
$6K |
| 93880 |
|
41 |
37 |
$6K |
| 97163 |
|
218 |
159 |
$6K |
| 84153 |
|
583 |
484 |
$6K |
| 97803 |
|
290 |
179 |
$6K |
| 96367 |
|
232 |
148 |
$5K |
| 86480 |
|
134 |
107 |
$5K |
| 97116 |
|
857 |
416 |
$5K |
| 90715 |
|
840 |
646 |
$5K |
| J0690 |
Injection, cefazolin sodium, 500 mg |
2,582 |
1,674 |
$5K |
| 70486 |
|
14 |
12 |
$5K |
| 77336 |
|
45 |
14 |
$4K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
164 |
138 |
$4K |
| 87476 |
|
247 |
232 |
$4K |
| 86706 |
|
597 |
507 |
$4K |
| 74019 |
|
96 |
65 |
$4K |
| 82565 |
|
1,600 |
1,222 |
$4K |
| J0330 |
Injection, succinylcholine chloride, up to 20 mg |
3,604 |
1,317 |
$4K |
| 93970 |
|
16 |
13 |
$4K |
| 82962 |
|
5,271 |
2,509 |
$4K |
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
381 |
39 |
$4K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
285 |
162 |
$4K |
| J1170 |
Injection, hydromorphone, up to 4 mg |
3,565 |
2,038 |
$4K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
120 |
108 |
$4K |
| 97802 |
|
104 |
80 |
$4K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
10,773 |
6,909 |
$4K |
| 82784 |
|
269 |
214 |
$4K |
| 82950 |
|
976 |
856 |
$4K |
| C1713 |
Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) |
15 |
12 |
$3K |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
767 |
467 |
$3K |
| 82550 |
|
1,013 |
698 |
$3K |
| 88112 |
|
148 |
104 |
$3K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
19 |
14 |
$3K |
| 74230 |
|
35 |
26 |
$3K |
| J0171 |
Injection, adrenalin, epinephrine, 0.1 mg |
730 |
584 |
$3K |
| 83516 |
|
360 |
280 |
$3K |
| 12001 |
|
41 |
37 |
$3K |
| 88307 |
|
38 |
36 |
$3K |
| 85730 |
|
1,020 |
743 |
$3K |
| 51798 |
|
1,572 |
1,041 |
$3K |
| 84403 |
|
141 |
115 |
$3K |
| 10060 |
|
27 |
25 |
$3K |
| 82043 |
|
796 |
664 |
$3K |
| 76000 |
|
30 |
24 |
$2K |
| 52287 |
|
22 |
13 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,396 |
1,024 |
$2K |
| 84100 |
|
835 |
581 |
$2K |
| 95806 |
|
27 |
27 |
$2K |
| C9399 |
Unclassified drugs or biologicals |
544 |
365 |
$2K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
7,447 |
5,185 |
$2K |
| 76775 |
|
17 |
12 |
$2K |
| 74022 |
|
35 |
25 |
$2K |
| M0245 |
Intravenous infusion, bamlanivimab and etesevimab, includes infusion and post administration monitoring |
21 |
16 |
$2K |
| 80178 |
|
531 |
376 |
$2K |
| 90686 |
|
1,673 |
1,235 |
$2K |
| 85018 |
|
1,313 |
979 |
$2K |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
2,162 |
1,410 |
$2K |
| 73590 |
|
50 |
39 |
$2K |
| 92650 |
|
24 |
21 |
$2K |
| H0001 |
Alcohol and/or drug assessment |
18 |
12 |
$2K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
11,174 |
7,394 |
$2K |
| 87902 |
|
33 |
25 |
$2K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
5,113 |
3,898 |
$2K |
| 92611 |
|
34 |
25 |
$2K |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
914 |
646 |
$2K |
| 84156 |
|
624 |
493 |
$2K |
| 72110 |
|
36 |
27 |
$2K |
| C1887 |
Catheter, guiding (may include infusion/perfusion capability) |
52 |
39 |
$1K |
| 87493 |
|
118 |
97 |
$1K |
| 51702 |
|
133 |
74 |
$1K |
| 80320 |
|
167 |
88 |
$1K |
| 80143 |
|
137 |
96 |
$1K |
| 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 |
25 |
16 |
$1K |
| 82805 |
|
64 |
55 |
$1K |
| 85014 |
|
1,014 |
753 |
$1K |
| J2795 |
Injection, ropivacaine hydrochloride, 1 mg |
735 |
552 |
$1K |
| 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 |
1,861 |
1,108 |
$1K |
| A9502 |
Technetium tc-99m tetrofosmin, diagnostic, per study dose |
59 |
49 |
$1K |
| 82947 |
|
514 |
413 |
$1K |
| 86617 |
|
55 |
44 |
$1K |
| 80179 |
|
115 |
81 |
$1K |
| C9803 |
Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
2,309 |
1,389 |
$1K |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
5,631 |
4,187 |
$962.41 |
| J1644 |
Injection, heparin sodium, per 1000 units |
1,862 |
711 |
$961.09 |
| 88312 |
|
50 |
42 |
$944.25 |
| J2370 |
Injection, phenylephrine hcl, up to 1 ml |
1,143 |
864 |
$922.45 |
| 84146 |
|
65 |
63 |
$887.11 |
| 86431 |
|
200 |
172 |
$875.12 |
| 82105 |
|
69 |
61 |
$858.00 |
| C1760 |
Closure device, vascular (implantable/insertable) |
20 |
14 |
$819.27 |
| 96415 |
|
25 |
24 |
$803.60 |
| 83789 |
|
278 |
255 |
$757.29 |
| 51701 |
|
38 |
26 |
$726.26 |
| 90832 |
Psychotherapy, 30 minutes with patient |
47 |
15 |
$716.13 |
| 99495 |
|
64 |
56 |
$714.13 |
| 97035 |
|
71 |
34 |
$692.08 |
| G0384 |
Level 5 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room or emergency department; (2) it is held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment; or (3) during the calendar year immediately preceding the calendar year in which a determination under 42 cfr 489.24 is being made, based on a representative sample of patient visits that occurred during that calendar year, it provides at least one-third of all of its outpatient visits for the treatment of emergency medical conditions on an urgent basis without requiring a previously scheduled appointment) |
68 |
57 |
$678.76 |
| 76376 |
|
14 |
13 |
$670.08 |
| H0005 |
Alcohol and/or drug services; group counseling by a clinician |
30 |
12 |
$664.75 |
| 90662 |
|
168 |
116 |
$601.57 |
| 82140 |
|
99 |
57 |
$597.32 |
| G0008 |
Administration of influenza virus vaccine |
1,982 |
1,482 |
$597.24 |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
285 |
219 |
$542.44 |
| G0379 |
Direct admission of patient for hospital observation care |
64 |
51 |
$512.56 |
| 84481 |
|
48 |
37 |
$499.34 |
| 91320 |
|
92 |
90 |
$493.21 |
| 82330 |
|
75 |
64 |
$491.01 |
| 52000 |
|
14 |
12 |
$468.25 |
| 83721 |
|
103 |
90 |
$459.42 |
| 82248 |
|
151 |
95 |
$452.42 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
1,905 |
1,247 |
$448.90 |
| 87899 |
|
49 |
40 |
$427.52 |
| 88313 |
|
30 |
25 |
$415.50 |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
332 |
149 |
$408.94 |
| C1894 |
Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser |
34 |
27 |
$408.90 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
1,137 |
878 |
$402.19 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
14 |
12 |
$400.50 |
| J2060 |
Injection, lorazepam, 2 mg |
2,344 |
1,474 |
$374.19 |
| 85007 |
|
313 |
229 |
$367.27 |
| 80159 |
|
32 |
25 |
$366.85 |
| 29581 |
|
23 |
13 |
$350.81 |
| 87075 |
|
59 |
39 |
$324.68 |
| J3480 |
Injection, potassium chloride, per 2 meq |
271 |
163 |
$322.33 |
| 87045 |
|
59 |
52 |
$321.97 |
| J3411 |
Injection, thiamine hcl, 100 mg |
119 |
54 |
$313.89 |
| 84165 |
|
39 |
38 |
$308.23 |
| J3370 |
Injection, vancomycin hcl, 500 mg |
90 |
53 |
$294.60 |
| P9604 |
Travel allowance one way in connection with medically necessary laboratory specimen collection drawn from home bound or nursing home bound patient; prorated trip charge |
184 |
105 |
$287.00 |
| J2543 |
Injection, piperacillin sodium/tazobactam sodium, 1 gram/0.125 grams (1.125 grams) |
45 |
26 |
$280.57 |
| 82010 |
|
48 |
40 |
$266.43 |
| 84520 |
|
101 |
93 |
$259.20 |
| 84550 |
|
76 |
52 |
$229.99 |
| 86704 |
|
33 |
28 |
$225.38 |
| G0103 |
Prostate cancer screening; prostate specific antigen test (psa) |
13 |
12 |
$219.99 |
| 99243 |
|
12 |
12 |
$216.24 |
| G0381 |
Level 2 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room or emergency department; (2) it is held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment; or (3) during the calendar year immediately preceding the calendar year in which a determination under 42 cfr 489.24 is being made, based on a representative sample of patient visits that occurred during that calendar year, it provides at least one-third of all of its outpatient visits for the treatment of emergency medical conditions on an urgent basis without requiring a previously scheduled appointment) |
49 |
45 |
$213.43 |
| 87046 |
|
59 |
52 |
$207.13 |
| 83615 |
|
70 |
54 |
$195.84 |
| 90677 |
|
12 |
12 |
$176.02 |
| 83001 |
|
12 |
12 |
$169.97 |
| 84132 |
|
136 |
91 |
$158.87 |
| 69210 |
|
35 |
15 |
$154.16 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
1,614 |
898 |
$153.96 |
| G0472 |
Hepatitis c antibody screening, for individual at high risk and other covered indication(s) |
150 |
125 |
$147.54 |
| 86376 |
|
14 |
12 |
$133.03 |
| Q0177 |
Hydroxyzine pamoate, 25 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 |
1,429 |
568 |
$116.98 |
| Q9966 |
Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml |
118 |
89 |
$114.84 |
| 82977 |
|
35 |
28 |
$108.29 |
| 99152 |
|
17 |
13 |
$101.67 |
| 90653 |
|
17 |
17 |
$97.39 |
| 86708 |
|
13 |
12 |
$96.64 |
| 97010 |
|
36 |
13 |
$81.42 |
| 81015 |
|
47 |
39 |
$72.30 |
| 82150 |
|
15 |
13 |
$65.65 |
| 86308 |
|
16 |
14 |
$57.85 |
| C9113 |
Injection, pantoprazole sodium, per vial |
173 |
81 |
$53.91 |
| 85046 |
|
16 |
14 |
$46.58 |
| 84155 |
|
26 |
25 |
$43.63 |
| J2710 |
Injection, neostigmine methylsulfate, up to 0.5 mg |
103 |
67 |
$42.14 |
| 86592 |
|
13 |
12 |
$40.89 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
27 |
13 |
$24.01 |
| J0689 |
Injection, cefazolin sodium (baxter), not therapeutically equivalent to j0690, 500 mg |
133 |
109 |
$22.21 |
| J1630 |
Injection, haloperidol, up to 5 mg |
110 |
80 |
$13.62 |
| J8597 |
Antiemetic drug, oral, not otherwise specified |
132 |
87 |
$12.33 |
| G0433 |
Infectious agent antibody detection by enzyme-linked immunosorbent assay (elisa) technique, hiv-1 and/or hiv-2, screening |
306 |
269 |
$10.14 |
| G0009 |
Administration of pneumococcal vaccine |
40 |
25 |
$3.84 |
| J0744 |
Injection, ciprofloxacin for intravenous infusion, 200 mg |
22 |
12 |
$2.86 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
17 |
13 |
$0.84 |
| G8979 |
Mobility: walking & moving around functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting |
746 |
424 |
$0.00 |
| Q0244 |
Injection, casirivimab and imdevimab, 1200 mg |
35 |
32 |
$0.00 |
| G8985 |
Carrying, moving and handling objects, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting |
67 |
45 |
$0.00 |
| G8978 |
Mobility: walking & moving around functional limitation, current status, at therapy episode outset and at reporting intervals |
604 |
370 |
$0.00 |
| G0380 |
Level 1 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room or emergency department; (2) it is held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment; or (3) during the calendar year immediately preceding the calendar year in which a determination under 42 cfr 489.24 is being made, based on a representative sample of patient visits that occurred during that calendar year, it provides at least one-third of all of its outpatient visits for the treatment of emergency medical conditions on an urgent basis without requiring a previously scheduled appointment) |
17 |
17 |
$0.00 |
| 91312 |
|
58 |
58 |
$0.00 |
| G8984 |
Carrying, moving & handling objects functional limitation, current status, at therapy episode outset and at reporting intervals |
39 |
28 |
$0.00 |
| 0124A |
|
58 |
58 |
$0.00 |
| Q0245 |
Injection, bamlanivimab and etesevimab, 2100 mg |
22 |
12 |
$0.00 |
| G8980 |
Mobility: walking & moving around functional limitation, discharge status, at discharge from therapy or to end reporting |
219 |
137 |
$0.00 |
| 90480 |
|
92 |
90 |
$0.00 |
| 36416 |
|
958 |
772 |
$0.00 |
| G8988 |
Self care functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting |
190 |
117 |
$0.00 |
| G8987 |
Self care functional limitation, current status, at therapy episode outset and at reporting intervals |
145 |
98 |
$0.00 |
| 90656 |
|
44 |
44 |
$0.00 |
| 91305 |
|
21 |
15 |
$0.00 |
| G8982 |
Changing & maintaining body position functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting |
21 |
14 |
$0.00 |
| 80329 |
|
39 |
12 |
$0.00 |
| G8981 |
Changing & maintaining body position functional limitation, current status, at therapy episode outset and at reporting intervals |
20 |
13 |
$0.00 |