| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
Emergency department visit for the evaluation and management, high severity |
32,663 |
26,859 |
$5.37M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
40,342 |
34,819 |
$3.74M |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
8,571 |
7,473 |
$3.63M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
10,626 |
7,189 |
$2.68M |
| 87633 |
Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets |
8,736 |
7,991 |
$1.89M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
76,359 |
61,200 |
$1.42M |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
34,905 |
8,258 |
$1.40M |
| 70450 |
Computed tomography, head or brain; without contrast material |
8,591 |
6,922 |
$1.22M |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
4,148 |
3,120 |
$1.18M |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
4,049 |
3,380 |
$1.10M |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
24,349 |
15,979 |
$1.04M |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
27,951 |
20,776 |
$1.03M |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
11,378 |
10,228 |
$885K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
17,742 |
11,602 |
$823K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
3,812 |
3,210 |
$762K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
23,829 |
15,014 |
$705K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
10,751 |
6,678 |
$659K |
| 80053 |
Comprehensive metabolic panel |
71,569 |
50,608 |
$658K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
2,711 |
1,245 |
$586K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
15,391 |
12,960 |
$531K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
16,579 |
12,507 |
$509K |
| 36415 |
Collection of venous blood by venipuncture |
101,281 |
58,737 |
$507K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
4,637 |
4,158 |
$504K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
20,855 |
17,504 |
$482K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
2,792 |
2,632 |
$468K |
| 87428 |
|
21,235 |
16,447 |
$446K |
| 95810 |
Polysomnography; sleep staging with 4 or more additional parameters |
894 |
801 |
$440K |
| G0378 |
Hospital observation service, per hour |
3,690 |
3,212 |
$439K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
1,537 |
1,433 |
$438K |
| 71046 |
Radiologic examination, chest; 2 views |
12,427 |
10,627 |
$428K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
69,681 |
53,684 |
$402K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
1,265 |
1,174 |
$399K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
4,362 |
4,236 |
$316K |
| 71045 |
Radiologic examination, chest; single view |
13,001 |
10,239 |
$315K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
3,719 |
3,275 |
$314K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
3,404 |
3,133 |
$282K |
| 76830 |
Ultrasound, transvaginal |
3,841 |
3,608 |
$274K |
| 97597 |
|
5,822 |
2,592 |
$271K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
1,792 |
1,623 |
$261K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
19,556 |
16,183 |
$260K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
4,587 |
3,461 |
$248K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
9,146 |
7,244 |
$248K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
735 |
553 |
$229K |
| 80050 |
General health panel |
6,184 |
5,592 |
$229K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
471 |
423 |
$217K |
| 97161 |
|
5,938 |
4,079 |
$202K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
4,066 |
2,378 |
$198K |
| 84703 |
|
17,560 |
15,395 |
$187K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
729 |
656 |
$176K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
15,457 |
12,386 |
$171K |
| 93971 |
|
1,866 |
1,651 |
$163K |
| 95811 |
|
257 |
236 |
$160K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
24,159 |
20,920 |
$140K |
| C1713 |
Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) |
609 |
565 |
$136K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
3,456 |
2,780 |
$134K |
| 73221 |
|
444 |
412 |
$132K |
| 70486 |
|
809 |
735 |
$131K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
5,345 |
4,597 |
$131K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
19,140 |
14,546 |
$131K |
| 45378 |
Colonoscopy, flexible; diagnostic, including collection of specimen(s) |
372 |
316 |
$130K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
4,936 |
4,526 |
$130K |
| 96376 |
|
5,431 |
3,281 |
$129K |
| 84443 |
Thyroid stimulating hormone (TSH) |
8,837 |
8,199 |
$128K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
2,967 |
2,689 |
$125K |
| 80061 |
Lipid panel |
11,056 |
10,131 |
$124K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
6,048 |
5,684 |
$122K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
4,887 |
4,506 |
$119K |
| 72110 |
|
2,238 |
1,920 |
$118K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
4,115 |
3,664 |
$115K |
| 87430 |
|
6,240 |
5,757 |
$112K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
6,684 |
1,879 |
$111K |
| 84484 |
|
13,226 |
10,237 |
$103K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
5,385 |
4,709 |
$102K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
9,415 |
6,144 |
$101K |
| 73560 |
|
4,820 |
3,673 |
$100K |
| J2795 |
Injection, ropivacaine hydrochloride, 1 mg |
1,951 |
1,310 |
$98K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
986 |
507 |
$97K |
| 82607 |
|
7,663 |
6,977 |
$95K |
| 20610 |
|
2,880 |
2,167 |
$94K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
1,968 |
1,758 |
$90K |
| 87070 |
|
9,048 |
7,224 |
$89K |
| 76536 |
|
1,063 |
999 |
$89K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
4,789 |
4,262 |
$89K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
214 |
205 |
$87K |
| 81003 |
|
26,565 |
22,763 |
$87K |
| 73630 |
|
3,166 |
2,676 |
$84K |
| 73030 |
|
3,537 |
2,867 |
$83K |
| J7620 |
Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme |
839 |
461 |
$79K |
| 96367 |
|
2,044 |
1,245 |
$78K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
8,945 |
8,469 |
$78K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
10,824 |
7,145 |
$77K |
| 83735 |
|
15,151 |
11,837 |
$76K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
3,817 |
1,197 |
$75K |
| J1750 |
Injection, iron dextran, 50 mg |
286 |
159 |
$74K |
| 87077 |
|
11,400 |
9,195 |
$72K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
15,000 |
12,703 |
$72K |
| 80074 |
|
1,990 |
1,816 |
$71K |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
11,367 |
9,650 |
$71K |
| 71250 |
|
442 |
384 |
$71K |
| 73130 |
|
2,610 |
2,211 |
$70K |
| 73610 |
|
2,609 |
2,286 |
$70K |
| 80055 |
|
1,520 |
1,462 |
$70K |
| 74018 |
|
2,745 |
2,353 |
$70K |
| 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 |
1,331 |
1,155 |
$68K |
| 72100 |
|
2,318 |
2,031 |
$68K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
4,574 |
4,041 |
$68K |
| 83880 |
|
4,136 |
3,504 |
$66K |
| 92507 |
Treatment of speech, language, voice, communication, and/or auditory processing disorder |
1,288 |
310 |
$66K |
| 47563 |
|
57 |
54 |
$66K |
| 87800 |
|
2,248 |
2,073 |
$65K |
| 82728 |
|
5,472 |
4,986 |
$60K |
| 93970 |
|
372 |
350 |
$59K |
| 84702 |
|
5,169 |
3,592 |
$59K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
1,441 |
1,220 |
$58K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
3,452 |
2,557 |
$57K |
| 12001 |
|
535 |
467 |
$57K |
| 82962 |
|
9,256 |
5,420 |
$56K |
| 71271 |
|
500 |
461 |
$55K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
1,477 |
506 |
$54K |
| 76775 |
|
881 |
777 |
$54K |
| 77080 |
|
1,213 |
867 |
$53K |
| 83690 |
|
13,216 |
11,445 |
$53K |
| 72050 |
|
854 |
709 |
$52K |
| 86900 |
|
5,462 |
4,608 |
$51K |
| 59025 |
Fetal non-stress test |
742 |
546 |
$49K |
| 86003 |
|
824 |
657 |
$49K |
| J3490 |
Unclassified drugs |
2,523 |
2,108 |
$49K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
8,760 |
7,336 |
$48K |
| 36600 |
|
2,682 |
1,968 |
$48K |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
15,335 |
11,242 |
$47K |
| 11102 |
|
1,066 |
936 |
$46K |
| 87186 |
|
6,868 |
6,277 |
$46K |
| 73110 |
|
1,750 |
1,471 |
$45K |
| 85610 |
|
14,414 |
11,050 |
$43K |
| 73502 |
|
1,686 |
1,419 |
$42K |
| 81001 |
|
15,881 |
14,002 |
$42K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
115 |
93 |
$42K |
| 99220 |
|
196 |
158 |
$42K |
| 85027 |
|
6,136 |
5,216 |
$41K |
| 86703 |
|
3,332 |
3,141 |
$39K |
| 85379 |
|
5,486 |
4,997 |
$37K |
| 72131 |
|
245 |
210 |
$37K |
| 86803 |
|
3,086 |
2,920 |
$36K |
| 87653 |
|
1,388 |
1,339 |
$35K |
| 83605 |
|
6,748 |
5,602 |
$35K |
| 83550 |
|
4,759 |
4,528 |
$34K |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
2,158 |
1,630 |
$33K |
| 84439 |
|
4,682 |
4,414 |
$33K |
| 69436 |
Tympanostomy (requiring insertion of ventilating tube), general anesthesia |
116 |
88 |
$33K |
| 82077 |
|
2,600 |
2,064 |
$33K |
| 87040 |
|
3,804 |
2,610 |
$31K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
7,624 |
6,663 |
$31K |
| 82565 |
|
5,918 |
5,375 |
$31K |
| 17110 |
|
719 |
642 |
$30K |
| 72040 |
|
1,033 |
789 |
$30K |
| 76641 |
|
441 |
343 |
$29K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
2,707 |
2,409 |
$29K |
| 83540 |
|
4,990 |
4,720 |
$29K |
| A9585 |
Injection, gadobutrol, 0.1 ml |
1,287 |
913 |
$28K |
| 42820 |
Tonsillectomy and adenoidectomy; younger than age 12 |
13 |
13 |
$28K |
| 85730 |
|
8,021 |
7,073 |
$27K |
| 86850 |
|
3,714 |
3,399 |
$27K |
| 80143 |
|
1,555 |
1,035 |
$27K |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
4,306 |
2,604 |
$26K |
| 73562 |
|
1,055 |
842 |
$25K |
| 97032 |
|
2,009 |
642 |
$25K |
| J1170 |
Injection, hydromorphone, up to 4 mg |
6,301 |
3,851 |
$25K |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
6,308 |
5,495 |
$25K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
283 |
248 |
$24K |
| 72141 |
|
103 |
95 |
$24K |
| 82803 |
|
2,212 |
1,865 |
$24K |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
617 |
462 |
$23K |
| 64721 |
|
28 |
27 |
$23K |
| 82746 |
|
2,069 |
1,953 |
$23K |
| 76642 |
|
481 |
425 |
$22K |
| 97165 |
|
527 |
452 |
$21K |
| 87081 |
|
2,525 |
2,380 |
$21K |
| J2360 |
Injection, orphenadrine citrate, up to 60 mg |
454 |
418 |
$20K |
| J2710 |
Injection, neostigmine methylsulfate, up to 0.5 mg |
1,502 |
1,328 |
$20K |
| 36591 |
|
662 |
369 |
$20K |
| 84146 |
|
1,781 |
1,608 |
$20K |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
6,328 |
4,775 |
$20K |
| J0690 |
Injection, cefazolin sodium, 500 mg |
3,197 |
2,681 |
$20K |
| 17000 |
|
668 |
587 |
$19K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
139 |
130 |
$19K |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
1,041 |
946 |
$18K |
| 90715 |
|
1,502 |
1,363 |
$18K |
| 83655 |
|
1,608 |
1,531 |
$18K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
978 |
923 |
$17K |
| 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 |
276 |
265 |
$17K |
| 72070 |
|
552 |
492 |
$17K |
| J2704 |
Injection, propofol, 10 mg |
2,036 |
1,811 |
$16K |
| 87507 |
|
78 |
73 |
$16K |
| 96417 |
|
251 |
143 |
$15K |
| C9113 |
Injection, pantoprazole sodium, per vial |
2,245 |
1,421 |
$15K |
| 73590 |
|
621 |
516 |
$14K |
| J0561 |
Injection, penicillin g benzathine, 100,000 units |
197 |
187 |
$14K |
| 86592 |
|
3,538 |
3,228 |
$14K |
| 97162 |
|
314 |
296 |
$14K |
| 85007 |
|
5,140 |
4,282 |
$14K |
| 86038 |
|
1,538 |
1,452 |
$14K |
| G0297 |
Low dose ct scan (ldct) for lung cancer screening |
153 |
138 |
$14K |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
2,335 |
2,027 |
$13K |
| 82950 |
|
2,594 |
2,476 |
$13K |
| 73090 |
|
540 |
453 |
$13K |
| 86901 |
|
5,400 |
4,601 |
$13K |
| 73080 |
|
567 |
491 |
$13K |
| 88304 |
|
368 |
325 |
$13K |
| L3908 |
Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf |
331 |
284 |
$12K |
| J1642 |
Injection, heparin sodium, (heparin lock flush), per 10 units |
3,043 |
1,702 |
$12K |
| 82150 |
|
2,949 |
2,522 |
$12K |
| 83521 |
|
1,025 |
406 |
$12K |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
4,122 |
3,206 |
$12K |
| 74019 |
|
407 |
371 |
$12K |
| 95886 |
|
699 |
486 |
$11K |
| J0171 |
Injection, adrenalin, epinephrine, 0.1 mg |
955 |
816 |
$11K |
| 85652 |
|
2,924 |
2,673 |
$11K |
| 87420 |
|
558 |
514 |
$11K |
| L4350 |
Ankle control orthosis, stirrup style, rigid, includes any type interface (e.g., pneumatic, gel), prefabricated, off-the-shelf |
205 |
174 |
$11K |
| C1776 |
Joint device (implantable) |
12 |
12 |
$10K |
| 81025 |
|
2,282 |
1,834 |
$10K |
| J2469 |
Injection, palonosetron hcl, 25 mcg |
140 |
76 |
$10K |
| 87807 |
|
1,381 |
1,164 |
$10K |
| 99215 |
Prolong outpt/office vis |
446 |
400 |
$10K |
| 76870 |
|
108 |
102 |
$10K |
| 36592 |
|
427 |
334 |
$10K |
| 80179 |
|
1,108 |
951 |
$10K |
| J3370 |
Injection, vancomycin hcl, 500 mg |
800 |
497 |
$9K |
| 73120 |
|
559 |
443 |
$9K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
446 |
400 |
$9K |
| 82550 |
|
2,160 |
1,897 |
$9K |
| 74178 |
|
14 |
12 |
$9K |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
4,504 |
3,726 |
$9K |
| 86140 |
|
2,805 |
2,504 |
$9K |
| 73100 |
|
533 |
395 |
$9K |
| 96368 |
|
276 |
186 |
$8K |
| 86403 |
|
1,093 |
865 |
$8K |
| 73140 |
|
309 |
261 |
$8K |
| J2060 |
Injection, lorazepam, 2 mg |
1,068 |
801 |
$8K |
| 20605 |
|
289 |
214 |
$8K |
| 70496 |
|
47 |
44 |
$8K |
| 78226 |
|
47 |
40 |
$7K |
| 59410 |
|
15 |
12 |
$7K |
| J0330 |
Injection, succinylcholine chloride, up to 20 mg |
1,525 |
1,331 |
$7K |
| C1758 |
Catheter, ureteral |
944 |
697 |
$7K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
97 |
85 |
$7K |
| J1956 |
Injection, levofloxacin, 250 mg |
256 |
175 |
$7K |
| 87522 |
Neg quan hep c or qual rna |
167 |
157 |
$7K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
20 |
12 |
$7K |
| 99205 |
Prolong outpt/office vis |
339 |
309 |
$7K |
| 82043 |
|
1,363 |
1,256 |
$6K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
894 |
803 |
$6K |
| 87205 |
|
1,864 |
1,584 |
$6K |
| 82248 |
|
1,079 |
747 |
$5K |
| 70498 |
|
47 |
44 |
$5K |
| L1830 |
Knee orthosis, immobilizer, canvas longitudinal, prefabricated, off-the-shelf |
123 |
109 |
$5K |
| 85018 |
|
2,827 |
2,523 |
$5K |
| 85014 |
|
2,901 |
2,544 |
$5K |
| J2550 |
Injection, promethazine hcl, up to 50 mg |
1,526 |
1,170 |
$5K |
| 83020 |
|
370 |
351 |
$5K |
| G0399 |
Home sleep test (hst) with type iii portable monitor, unattended; minimum of 4 channels: 2 respiratory movement/airflow, 1 ecg/heart rate and 1 oxygen saturation |
64 |
59 |
$5K |
| 93017 |
|
43 |
38 |
$5K |
| 82247 |
|
957 |
664 |
$5K |
| 80320 |
|
607 |
500 |
$5K |
| 92567 |
|
1,138 |
852 |
$5K |
| 86696 |
|
271 |
252 |
$4K |
| Q9969 |
Tc-99m from non-highly enriched uranium source, full cost recovery add-on, per study dose |
1,250 |
1,174 |
$4K |
| 10060 |
|
29 |
25 |
$4K |
| 74246 |
|
37 |
37 |
$4K |
| J2543 |
Injection, piperacillin sodium/tazobactam sodium, 1 gram/0.125 grams (1.125 grams) |
201 |
130 |
$4K |
| C1819 |
Surgical tissue localization and excision device (implantable) |
26 |
26 |
$4K |
| M0243 |
Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring |
21 |
20 |
$4K |
| J0500 |
Injection, dicyclomine hcl, up to 20 mg |
188 |
171 |
$4K |
| 29125 |
|
94 |
87 |
$4K |
| 99244 |
Office or other outpatient consultation, moderate to high complexity |
105 |
84 |
$4K |
| 84112 |
|
61 |
53 |
$4K |
| 82570 |
|
926 |
765 |
$4K |
| 76801 |
|
33 |
27 |
$4K |
| 84550 |
|
820 |
759 |
$3K |
| 83516 |
|
300 |
275 |
$3K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
408 |
388 |
$3K |
| 74300 |
|
55 |
52 |
$3K |
| 82977 |
|
582 |
539 |
$3K |
| 83970 |
|
101 |
96 |
$3K |
| 96127 |
|
770 |
585 |
$3K |
| G8978 |
Mobility: walking & moving around functional limitation, current status, at therapy episode outset and at reporting intervals |
710 |
446 |
$3K |
| 82784 |
|
181 |
172 |
$3K |
| 96415 |
|
45 |
38 |
$3K |
| 70491 |
|
19 |
12 |
$3K |
| 86695 |
|
258 |
239 |
$3K |
| 80069 |
|
262 |
204 |
$3K |
| 85045 |
|
1,047 |
885 |
$3K |
| 96523 |
|
191 |
154 |
$3K |
| 64450 |
|
13 |
12 |
$3K |
| 73600 |
|
209 |
169 |
$3K |
| J0360 |
Injection, hydralazine hcl, up to 20 mg |
174 |
111 |
$3K |
| 84100 |
|
870 |
590 |
$3K |
| 86480 |
|
53 |
50 |
$3K |
| 84156 |
|
850 |
736 |
$3K |
| 97535 |
Self-care/home management training, each 15 minutes |
144 |
84 |
$3K |
| 86334 |
|
145 |
142 |
$3K |
| 95816 |
|
51 |
40 |
$3K |
| 31575 |
|
68 |
51 |
$3K |
| 82009 |
|
1,152 |
940 |
$3K |
| 71101 |
|
48 |
42 |
$2K |
| 81420 |
Fetal chromosomal aneuploidy genomic sequence analysis panel |
13 |
13 |
$2K |
| 95911 |
|
35 |
25 |
$2K |
| 12011 |
|
12 |
12 |
$2K |
| C2626 |
Infusion pump, non-programmable, temporary (implantable) |
58 |
52 |
$2K |
| 82652 |
|
64 |
63 |
$2K |
| J2919 |
Injection, methylprednisolone sodium succinate, 5 mg |
179 |
147 |
$2K |
| 36430 |
|
18 |
13 |
$2K |
| 12002 |
|
12 |
12 |
$2K |
| 84132 |
|
629 |
527 |
$2K |
| 82553 |
|
281 |
250 |
$2K |
| P9016 |
Red blood cells, leukocytes reduced, each unit |
18 |
13 |
$2K |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
782 |
662 |
$2K |
| 73700 |
|
12 |
12 |
$2K |
| 97012 |
|
126 |
38 |
$2K |
| G0010 |
Administration of hepatitis b vaccine |
111 |
106 |
$2K |
| 86039 |
|
197 |
184 |
$2K |
| 93225 |
|
27 |
26 |
$2K |
| 01967 |
Neuraxial labor analgesia/anesthesia for planned vaginal delivery |
19 |
13 |
$2K |
| 87340 |
|
212 |
206 |
$2K |
| 31231 |
|
30 |
30 |
$2K |
| J9045 |
Injection, carboplatin, 50 mg |
24 |
12 |
$1K |
| 76882 |
|
30 |
28 |
$1K |
| 83001 |
|
107 |
102 |
$1K |
| J3480 |
Injection, potassium chloride, per 2 meq |
173 |
108 |
$1K |
| 17003 |
|
265 |
244 |
$1K |
| 77066 |
Tomosynthesis, mammo |
13 |
12 |
$1K |
| 84436 |
|
217 |
202 |
$1K |
| 86141 |
|
140 |
125 |
$1K |
| 17311 |
|
26 |
12 |
$1K |
| 97116 |
|
89 |
66 |
$1K |
| 92557 |
|
118 |
90 |
$1K |
| 83615 |
|
256 |
232 |
$1K |
| J1030 |
Injection, methylprednisolone acetate, 40 mg |
350 |
247 |
$1K |
| 74022 |
|
32 |
29 |
$1K |
| J1953 |
Injection, levetiracetam, 10 mg |
43 |
40 |
$1K |
| J3411 |
Injection, thiamine hcl, 100 mg |
133 |
84 |
$1K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
79 |
61 |
$1K |
| 73620 |
|
116 |
94 |
$1K |
| G8984 |
Carrying, moving & handling objects functional limitation, current status, at therapy episode outset and at reporting intervals |
318 |
220 |
$1K |
| 93226 |
|
27 |
26 |
$1K |
| 92570 |
|
192 |
139 |
$1K |
| 00170 |
Anesthesia for intraoral procedures, including biopsy |
13 |
12 |
$1K |
| 92587 |
|
549 |
368 |
$1K |
| 86431 |
|
224 |
215 |
$993.66 |
| 36416 |
|
2,066 |
1,358 |
$952.27 |
| 86317 |
|
86 |
84 |
$941.04 |
| 83520 |
|
76 |
67 |
$913.54 |
| A9537 |
Technetium tc-99m mebrofenin, diagnostic, per study dose, up to 15 millicuries |
15 |
15 |
$911.82 |
| 73552 |
|
49 |
40 |
$877.27 |
| 84165 |
|
108 |
106 |
$860.36 |
| 87075 |
|
153 |
121 |
$847.24 |
| G0279 |
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) |
34 |
26 |
$779.56 |
| J0694 |
Injection, cefoxitin sodium, 1 gm |
48 |
37 |
$774.19 |
| 80299 |
|
139 |
80 |
$769.23 |
| 87899 |
|
72 |
67 |
$768.83 |
| 83013 |
|
15 |
14 |
$768.38 |
| 86923 |
|
16 |
12 |
$750.13 |
| 99385 |
|
132 |
86 |
$746.87 |
| 82627 |
|
29 |
24 |
$730.19 |
| 87400 |
|
42 |
40 |
$718.74 |
| G8979 |
Mobility: walking & moving around functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting |
586 |
496 |
$695.92 |
| 86787 |
|
62 |
58 |
$647.34 |
| 74220 |
|
12 |
12 |
$636.85 |
| 52000 |
|
17 |
12 |
$602.08 |
| 82140 |
|
64 |
56 |
$600.86 |
| 80177 |
|
48 |
42 |
$591.18 |
| 83883 |
|
26 |
24 |
$564.57 |
| 99195 |
|
17 |
12 |
$508.45 |
| J2274 |
Injection, morphine sulfate, preservative-free for epidural or intrathecal use, 10 mg |
262 |
223 |
$499.87 |
| 99243 |
|
22 |
22 |
$497.76 |
| J1940 |
Injection, furosemide, up to 20 mg |
153 |
77 |
$490.69 |
| 84481 |
|
41 |
40 |
$489.67 |
| 84460 |
|
109 |
102 |
$488.83 |
| C1729 |
Catheter, drainage |
58 |
55 |
$478.79 |
| 90686 |
|
111 |
101 |
$468.15 |
| J0688 |
Injection, cefazolin sodium (hikma), not therapeutically equivalent to j0690, 500 mg |
116 |
105 |
$458.01 |
| J3420 |
Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg |
415 |
246 |
$453.41 |
| 73565 |
|
12 |
12 |
$437.94 |
| 00731 |
|
15 |
13 |
$429.19 |
| 82378 |
|
28 |
26 |
$386.54 |
| 82105 |
|
29 |
26 |
$381.88 |
| 82670 |
|
14 |
12 |
$332.87 |
| 86762 |
|
44 |
42 |
$331.29 |
| G2211 |
Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established) |
264 |
233 |
$327.89 |
| 20550 |
|
15 |
15 |
$322.11 |
| 84450 |
|
68 |
66 |
$307.32 |
| 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 |
10,516 |
1,592 |
$292.92 |
| J2470 |
Injection, pantoprazole sodium, 40 mg |
47 |
28 |
$288.80 |
| 87493 |
|
12 |
12 |
$287.48 |
| J2920 |
Injection, methylprednisolone sodium succinate, up to 40 mg |
42 |
25 |
$284.27 |
| 83010 |
|
25 |
25 |
$268.95 |
| 87046 |
|
12 |
12 |
$253.61 |
| 93227 |
|
15 |
12 |
$253.28 |
| 84145 |
|
22 |
14 |
$249.90 |
| 73070 |
|
16 |
14 |
$239.92 |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
28 |
25 |
$234.02 |
| 99406 |
|
16 |
12 |
$233.76 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
12 |
12 |
$221.04 |
| 87324 |
|
27 |
24 |
$210.37 |
| 82785 |
|
15 |
14 |
$202.24 |
| G0103 |
Prostate cancer screening; prostate specific antigen test (psa) |
14 |
12 |
$200.84 |
| Q3014 |
Telehealth originating site facility fee |
37 |
32 |
$199.73 |
| 86308 |
|
62 |
54 |
$195.38 |
| G0008 |
Administration of influenza virus vaccine |
49 |
44 |
$195.16 |
| 86880 |
|
12 |
12 |
$177.38 |
| J1171 |
Injection, hydromorphone, 0.1 mg |
62 |
43 |
$168.85 |
| C1769 |
Guide wire |
13 |
12 |
$163.16 |
| 84153 |
|
18 |
14 |
$159.24 |
| 84155 |
|
108 |
106 |
$158.44 |
| 84478 |
|
31 |
25 |
$150.84 |
| J1815 |
Injection, insulin, per 5 units |
34 |
15 |
$139.13 |
| 83002 |
|
12 |
12 |
$135.64 |
| 11103 |
|
27 |
25 |
$135.54 |
| 87045 |
|
17 |
13 |
$125.49 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
244 |
203 |
$117.50 |
| 72170 |
|
13 |
12 |
$102.04 |
| G8985 |
Carrying, moving and handling objects, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting |
289 |
245 |
$98.30 |
| 86704 |
|
12 |
12 |
$90.85 |
| 85660 |
|
13 |
12 |
$79.50 |
| 69210 |
|
17 |
15 |
$78.36 |
| J2175 |
Injection, meperidine hydrochloride, per 100 mg |
13 |
13 |
$74.42 |
| 87427 |
|
12 |
12 |
$73.70 |
| J1040 |
Injection, methylprednisolone acetate, 80 mg |
26 |
25 |
$69.63 |
| S0020 |
Injection, bupivicaine hydrochloride, 30 ml |
18 |
18 |
$62.14 |
| 95115 |
|
37 |
26 |
$60.22 |
| J1630 |
Injection, haloperidol, up to 5 mg |
14 |
13 |
$44.00 |
| 92552 |
|
16 |
13 |
$36.72 |
| 99386 |
|
13 |
12 |
$27.00 |
| 97803 |
|
209 |
201 |
$8.79 |
| 99024 |
|
2,085 |
1,636 |
$7.82 |
| J7609 |
Albuterol, inhalation solution, compounded product, administered through dme, unit dose, 1 mg |
57 |
54 |
$4.84 |
| Q9966 |
Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml |
51 |
45 |
$4.29 |
| 3074F |
|
201 |
165 |
$0.22 |
| 1160F |
|
1,638 |
1,169 |
$0.18 |
| 1159F |
|
1,606 |
1,144 |
$0.18 |
| G8986 |
Carrying, moving & handling objects functional limitation, discharge status, at discharge from therapy or to end reporting |
12 |
12 |
$0.12 |
| G8980 |
Mobility: walking & moving around functional limitation, discharge status, at discharge from therapy or to end reporting |
12 |
12 |
$0.08 |
| 3078F |
|
63 |
62 |
$0.07 |
| 3008F |
|
523 |
418 |
$0.04 |
| 1126F |
|
85 |
75 |
$0.03 |
| 1036F |
|
203 |
146 |
$0.03 |
| 3725F |
|
220 |
193 |
$0.00 |
| G8483 |
Influenza immunization was not administered for reasons documented by clinician (e.g., patient allergy or other medical reasons, patient declined or other patient reasons, vaccine not available or other system reasons) |
12 |
12 |
$0.00 |
| 0509F |
|
30 |
28 |
$0.00 |