| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
24,831 |
22,998 |
$9.07M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
20,494 |
18,503 |
$8.41M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
14,628 |
13,058 |
$5.80M |
| T2034 |
Crisis intervention, waiver; per diem |
5,344 |
5,026 |
$4.55M |
| S9480 |
Intensive outpatient psychiatric services, per diem |
4,383 |
3,964 |
$3.48M |
| G0378 |
Hospital observation service, per hour |
3,400 |
2,609 |
$2.39M |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
7,959 |
7,408 |
$2.13M |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
6,380 |
3,793 |
$1.50M |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
2,946 |
1,750 |
$1.36M |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
2,106 |
900 |
$1.09M |
| OP250 |
|
54,494 |
31,058 |
$1.03M |
| 80053 |
Comprehensive metabolic panel |
34,393 |
28,343 |
$957K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
633 |
592 |
$938K |
| 71046 |
Radiologic examination, chest; 2 views |
9,031 |
8,587 |
$699K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
9,712 |
2,571 |
$696K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
4,162 |
4,076 |
$638K |
| OP710 |
|
5,084 |
4,723 |
$577K |
| 76642 |
|
2,049 |
1,993 |
$558K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
2,852 |
2,687 |
$553K |
| 71045 |
Radiologic examination, chest; single view |
6,301 |
5,764 |
$500K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
10,894 |
9,116 |
$442K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
9,811 |
7,327 |
$421K |
| U0004 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc, making use of high throughput technologies as described by cms-2020-01-r |
2,739 |
2,254 |
$404K |
| 92587 |
|
2,023 |
1,966 |
$391K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
2,399 |
2,253 |
$383K |
| OP370 |
|
3,120 |
2,911 |
$338K |
| OP272 |
|
9,691 |
8,744 |
$321K |
| 96367 |
|
1,255 |
643 |
$304K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
3,822 |
3,739 |
$303K |
| 70450 |
Computed tomography, head or brain; without contrast material |
5,085 |
4,621 |
$291K |
| 93971 |
|
1,093 |
1,055 |
$283K |
| 45378 |
Colonoscopy, flexible; diagnostic, including collection of specimen(s) |
179 |
174 |
$279K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
2,383 |
2,248 |
$276K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
14,080 |
12,563 |
$267K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
8,324 |
6,986 |
$267K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
12,896 |
11,338 |
$247K |
| 36415 |
Collection of venous blood by venipuncture |
43,492 |
33,967 |
$246K |
| 92555 |
|
1,993 |
1,885 |
$238K |
| 92579 |
|
1,037 |
973 |
$233K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
34,766 |
28,070 |
$232K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
1,017 |
986 |
$226K |
| 92567 |
|
2,363 |
2,242 |
$218K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
256 |
235 |
$211K |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
7,961 |
7,333 |
$208K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
1,649 |
1,586 |
$200K |
| 76536 |
|
637 |
606 |
$183K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
4,254 |
3,804 |
$181K |
| 86850 |
|
2,981 |
2,788 |
$175K |
| 50590 |
|
80 |
77 |
$172K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
3,374 |
1,012 |
$159K |
| G0279 |
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) |
1,626 |
1,568 |
$153K |
| J2791 |
Injection, rho(d) immune globulin (human), (rhophylac), intramuscular or intravenous, 100 iu |
1,295 |
1,252 |
$153K |
| 93975 |
|
394 |
372 |
$148K |
| 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 |
5,512 |
4,389 |
$143K |
| 92582 |
|
598 |
578 |
$143K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
1,017 |
993 |
$139K |
| 76641 |
|
233 |
227 |
$137K |
| 76830 |
Ultrasound, transvaginal |
1,186 |
1,162 |
$132K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
434 |
398 |
$129K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
1,912 |
1,734 |
$119K |
| 77065 |
Tomosynthesis, mammo |
853 |
808 |
$119K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
5,839 |
5,188 |
$117K |
| 73630 |
|
1,611 |
1,551 |
$112K |
| 73130 |
|
1,471 |
1,406 |
$101K |
| 77066 |
Tomosynthesis, mammo |
493 |
472 |
$100K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
2,730 |
1,844 |
$97K |
| 92557 |
|
465 |
431 |
$97K |
| 45385 |
Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) |
77 |
71 |
$94K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,265 |
1,165 |
$93K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,014 |
914 |
$87K |
| 86900 |
|
3,109 |
2,916 |
$86K |
| 92550 |
|
730 |
696 |
$86K |
| OP258 |
|
25,854 |
19,041 |
$83K |
| 73030 |
|
1,143 |
1,074 |
$83K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
1,425 |
1,293 |
$78K |
| 82962 |
|
7,137 |
4,610 |
$78K |
| 76770 |
|
466 |
453 |
$72K |
| 93970 |
|
192 |
174 |
$67K |
| 87081 |
|
2,163 |
2,133 |
$67K |
| 97162 |
|
1,057 |
979 |
$62K |
| 73562 |
|
803 |
754 |
$61K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
1,206 |
1,154 |
$60K |
| 82247 |
|
1,749 |
1,116 |
$57K |
| A9270 |
Non-covered item or service |
9,425 |
4,486 |
$56K |
| 73610 |
|
1,170 |
1,130 |
$54K |
| 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 |
2,749 |
2,334 |
$52K |
| 72110 |
|
566 |
536 |
$49K |
| 84443 |
Thyroid stimulating hormone (TSH) |
2,984 |
2,660 |
$49K |
| OP278 |
|
171 |
159 |
$45K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
3,064 |
2,380 |
$41K |
| 86901 |
|
3,112 |
2,918 |
$40K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
1,657 |
1,639 |
$40K |
| 78815 |
Positron emission tomography (PET) for limited area imaging |
29 |
28 |
$38K |
| 87040 |
|
2,410 |
2,225 |
$37K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
37 |
36 |
$36K |
| 84484 |
|
7,967 |
6,738 |
$35K |
| 81001 |
|
7,015 |
6,412 |
$35K |
| 96376 |
|
2,149 |
1,485 |
$34K |
| 93976 |
|
428 |
412 |
$33K |
| 74018 |
|
946 |
860 |
$32K |
| 82248 |
|
3,226 |
2,320 |
$32K |
| 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 |
388 |
364 |
$32K |
| 80061 |
Lipid panel |
1,778 |
1,662 |
$30K |
| 85610 |
|
6,958 |
6,271 |
$29K |
| 88312 |
|
560 |
522 |
$28K |
| J1756 |
Injection, iron sucrose, 1 mg |
1,219 |
401 |
$27K |
| J1439 |
Injection, ferric carboxymaltose, 1 mg |
39 |
26 |
$27K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
3,858 |
3,513 |
$26K |
| 85027 |
|
3,889 |
3,232 |
$25K |
| 85730 |
|
6,435 |
5,902 |
$24K |
| 73110 |
|
462 |
439 |
$24K |
| 96415 |
|
94 |
62 |
$24K |
| 87807 |
|
819 |
809 |
$23K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
887 |
737 |
$22K |
| 81003 |
|
4,916 |
4,560 |
$22K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
103 |
97 |
$22K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
146 |
104 |
$22K |
| 12001 |
|
690 |
647 |
$21K |
| 85007 |
|
3,036 |
2,552 |
$20K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
167 |
147 |
$19K |
| 74021 |
|
353 |
348 |
$18K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
2,395 |
2,356 |
$17K |
| 81025 |
|
1,954 |
1,809 |
$16K |
| 77080 |
|
82 |
79 |
$14K |
| 83690 |
|
7,423 |
6,734 |
$14K |
| OP270 |
|
2,307 |
2,084 |
$14K |
| 83735 |
|
3,859 |
3,296 |
$13K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
1,256 |
1,168 |
$13K |
| J2060 |
Injection, lorazepam, 2 mg |
1,108 |
884 |
$12K |
| A9579 |
Injection, gadolinium-based magnetic resonance contrast agent, not otherwise specified (nos), per ml |
366 |
333 |
$12K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
2,749 |
2,079 |
$12K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
263 |
237 |
$12K |
| 90791 |
Psychiatric diagnostic evaluation |
515 |
357 |
$12K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
6,437 |
5,402 |
$12K |
| 84439 |
|
661 |
588 |
$11K |
| J1644 |
Injection, heparin sodium, per 1000 units |
463 |
194 |
$11K |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
2,269 |
2,065 |
$11K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,216 |
1,036 |
$10K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
2,448 |
2,276 |
$10K |
| 88313 |
|
151 |
137 |
$9K |
| 97597 |
|
16 |
12 |
$9K |
| 87186 |
|
637 |
544 |
$8K |
| 73590 |
|
99 |
91 |
$8K |
| 82542 |
|
459 |
449 |
$7K |
| 72100 |
|
228 |
226 |
$7K |
| J2704 |
Injection, propofol, 10 mg |
3,867 |
3,588 |
$7K |
| 84702 |
|
965 |
888 |
$7K |
| 86140 |
|
1,125 |
1,058 |
$7K |
| 76882 |
|
26 |
24 |
$7K |
| 80320 |
|
1,178 |
1,058 |
$7K |
| 87633 |
Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets |
63 |
60 |
$7K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
2,402 |
2,110 |
$7K |
| 80164 |
|
364 |
313 |
$6K |
| 84703 |
|
1,709 |
1,604 |
$6K |
| OP255 |
|
1,066 |
788 |
$6K |
| 80179 |
|
2,089 |
1,745 |
$6K |
| 83605 |
|
828 |
734 |
$5K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
167 |
53 |
$5K |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
2,255 |
1,721 |
$5K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
135 |
57 |
$5K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
181 |
179 |
$5K |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
1,616 |
1,260 |
$5K |
| 97802 |
|
39 |
30 |
$5K |
| 92586 |
|
27 |
27 |
$5K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
4,759 |
4,342 |
$5K |
| 97014 |
|
86 |
26 |
$4K |
| 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) |
111 |
107 |
$4K |
| 85651 |
|
727 |
682 |
$4K |
| 73502 |
|
115 |
107 |
$4K |
| 95886 |
|
14 |
12 |
$4K |
| 97161 |
|
88 |
87 |
$4K |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
943 |
833 |
$4K |
| A9575 |
Injection, gadoterate meglumine, 0.1 ml |
421 |
396 |
$4K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
563 |
417 |
$4K |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
1,687 |
1,476 |
$4K |
| C1781 |
Mesh (implantable) |
13 |
13 |
$4K |
| M0244 |
Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring in the home or residence; this includes a beneficiary's home that has been made provider-based to the hospital during the covid-19 public health emergency |
66 |
66 |
$4K |
| 80329 |
|
465 |
377 |
$4K |
| 92611 |
|
35 |
26 |
$3K |
| J0690 |
Injection, cefazolin sodium, 500 mg |
1,208 |
1,026 |
$3K |
| 90715 |
|
715 |
662 |
$3K |
| 80143 |
|
892 |
742 |
$3K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
52 |
46 |
$3K |
| 74022 |
|
42 |
40 |
$3K |
| 76870 |
|
14 |
13 |
$3K |
| 83880 |
|
328 |
297 |
$2K |
| 73090 |
|
69 |
63 |
$2K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
15 |
13 |
$2K |
| 87070 |
|
160 |
154 |
$2K |
| 85378 |
|
737 |
706 |
$2K |
| 73564 |
|
52 |
51 |
$2K |
| 80076 |
|
272 |
214 |
$2K |
| 76775 |
|
13 |
13 |
$2K |
| J1170 |
Injection, hydromorphone, up to 4 mg |
504 |
364 |
$2K |
| 85380 |
|
365 |
343 |
$2K |
| 87088 |
|
483 |
436 |
$2K |
| A9552 |
Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries |
68 |
57 |
$2K |
| 82550 |
|
979 |
860 |
$1K |
| 77072 |
|
14 |
13 |
$1K |
| 70486 |
|
13 |
12 |
$1K |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
1,287 |
1,149 |
$1K |
| M0239 |
Intravenous infusion, bamlanivimab-xxxx, includes infusion and post administration monitoring |
44 |
44 |
$1K |
| 76801 |
|
14 |
12 |
$1K |
| 74230 |
|
38 |
27 |
$1K |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
276 |
247 |
$1K |
| 94760 |
|
213 |
126 |
$1K |
| 84100 |
|
306 |
277 |
$1K |
| 87205 |
|
163 |
157 |
$1K |
| OP637 |
|
690 |
356 |
$925.97 |
| 12002 |
|
17 |
16 |
$916.20 |
| 71101 |
|
12 |
12 |
$850.97 |
| 88304 |
|
94 |
93 |
$830.49 |
| 73080 |
|
26 |
25 |
$783.46 |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
23 |
22 |
$745.40 |
| M0222 |
Intravenous injection, bebtelovimab, includes injection and post administration monitoring |
16 |
15 |
$733.32 |
| 0002A |
|
22 |
22 |
$718.18 |
| 0001A |
|
21 |
21 |
$688.36 |
| 87077 |
|
121 |
119 |
$630.56 |
| 90674 |
|
15 |
15 |
$559.17 |
| J0134 |
Injection, acetaminophen (fresenius kabi), not therapeutically equivalent to j0131, 10 mg |
646 |
584 |
$548.89 |
| 85652 |
|
181 |
172 |
$533.97 |
| C1769 |
Guide wire |
157 |
135 |
$438.34 |
| 77002 |
|
12 |
12 |
$422.90 |
| 86617 |
|
12 |
12 |
$370.43 |
| 87400 |
|
20 |
20 |
$325.78 |
| 74019 |
|
13 |
13 |
$314.12 |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
263 |
250 |
$283.89 |
| G0008 |
Administration of influenza virus vaccine |
17 |
17 |
$234.32 |
| 82607 |
|
30 |
24 |
$226.75 |
| 88300 |
|
43 |
39 |
$200.24 |
| 29515 |
|
12 |
12 |
$158.25 |
| J0136 |
Injection, acetaminophen (b braun), not therapeutically equivalent to j0131, 10 mg |
176 |
157 |
$129.88 |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
488 |
424 |
$129.19 |
| J1815 |
Injection, insulin, per 5 units |
21 |
15 |
$127.44 |
| J2272 |
Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg |
324 |
238 |
$94.90 |
| 82150 |
|
63 |
60 |
$89.50 |
| 87581 |
|
23 |
22 |
$81.70 |
| 87486 |
|
23 |
22 |
$81.70 |
| 75571 |
|
20 |
19 |
$70.63 |
| J3360 |
Injection, diazepam, up to 5 mg |
39 |
30 |
$69.76 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
64 |
56 |
$64.89 |
| 83550 |
|
14 |
12 |
$42.26 |
| J2919 |
Injection, methylprednisolone sodium succinate, 5 mg |
99 |
87 |
$35.57 |
| J1630 |
Injection, haloperidol, up to 5 mg |
185 |
133 |
$32.89 |
| 83540 |
|
14 |
12 |
$30.93 |
| J2003 |
Injection, lidocaine hydrochloride, 1 mg |
64 |
57 |
$23.17 |
| Q0244 |
Injection, casirivimab and imdevimab, 1200 mg |
59 |
57 |
$20.00 |
| J7510 |
Prednisolone oral, per 5 mg |
215 |
212 |
$17.77 |
| 82553 |
|
18 |
12 |
$16.00 |
| Q0222 |
Injection, bebtelovimab, 175 mg |
16 |
14 |
$2.00 |
| J1580 |
Injection, garamycin, gentamicin, up to 80 mg |
13 |
12 |
$0.00 |
| J0702 |
Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg |
14 |
14 |
$0.00 |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
12 |
12 |
$0.00 |
| 29125 |
|
12 |
12 |
$0.00 |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
12 |
12 |
$0.00 |
| J3535 |
Drug administered through a metered dose inhaler |
22 |
12 |
$0.00 |