| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| G0378 |
Hospital observation service, per hour |
2,439 |
1,573 |
$1.20M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
5,954 |
5,081 |
$664K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
3,094 |
2,685 |
$455K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
23,207 |
18,719 |
$359K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
4,583 |
3,999 |
$260K |
| 84484 |
|
7,918 |
6,078 |
$187K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
9,208 |
6,668 |
$173K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
19,345 |
13,000 |
$165K |
| 71046 |
Radiologic examination, chest; 2 views |
11,047 |
8,309 |
$153K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
675 |
560 |
$136K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
2,516 |
1,910 |
$121K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
513 |
276 |
$115K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
9,455 |
7,842 |
$94K |
| 70450 |
Computed tomography, head or brain; without contrast material |
7,582 |
5,724 |
$92K |
| 71045 |
Radiologic examination, chest; single view |
18,825 |
11,468 |
$71K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
19,266 |
14,521 |
$69K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
938 |
638 |
$59K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
1,450 |
1,263 |
$59K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
2,416 |
1,818 |
$58K |
| 93971 |
|
213 |
173 |
$56K |
| 84100 |
|
9,836 |
6,725 |
$51K |
| 87040 |
|
747 |
605 |
$49K |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
17,195 |
13,422 |
$48K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
1,484 |
1,127 |
$46K |
| 84703 |
|
2,043 |
1,741 |
$41K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
1,356 |
985 |
$38K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
4,792 |
4,218 |
$35K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
146 |
126 |
$28K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
442 |
243 |
$23K |
| 87088 |
|
1,225 |
1,049 |
$22K |
| 71250 |
|
1,042 |
819 |
$22K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
240 |
185 |
$21K |
| 36415 |
Collection of venous blood by venipuncture |
13,917 |
9,448 |
$21K |
| 81001 |
|
5,410 |
4,509 |
$21K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
237 |
195 |
$18K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
163 |
115 |
$17K |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
1,741 |
1,486 |
$17K |
| 80053 |
Comprehensive metabolic panel |
2,619 |
1,684 |
$16K |
| 82805 |
|
3,571 |
2,932 |
$15K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
334 |
274 |
$13K |
| 83605 |
|
3,228 |
2,591 |
$12K |
| 85730 |
|
2,621 |
2,167 |
$12K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
1,381 |
1,156 |
$12K |
| 82962 |
|
2,977 |
1,878 |
$11K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
39 |
35 |
$11K |
| 85610 |
|
4,838 |
3,415 |
$11K |
| 94799 |
|
566 |
317 |
$10K |
| 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 |
1,532 |
1,337 |
$10K |
| 87070 |
|
126 |
110 |
$10K |
| 83690 |
|
3,594 |
3,097 |
$8K |
| 83735 |
|
10,422 |
7,072 |
$8K |
| 83880 |
|
3,136 |
2,627 |
$7K |
| 93970 |
|
16 |
14 |
$7K |
| 73610 |
|
97 |
63 |
$7K |
| 76775 |
|
269 |
226 |
$7K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
597 |
377 |
$7K |
| 73630 |
|
258 |
162 |
$6K |
| 73564 |
|
119 |
73 |
$6K |
| 97162 |
|
46 |
40 |
$6K |
| 73502 |
|
140 |
88 |
$5K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
183 |
51 |
$5K |
| 85379 |
|
1,110 |
918 |
$5K |
| 87186 |
|
115 |
99 |
$4K |
| 74021 |
|
69 |
44 |
$4K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
16 |
12 |
$4K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
65 |
56 |
$4K |
| 87637 |
Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV |
588 |
444 |
$4K |
| 84443 |
Thyroid stimulating hormone (TSH) |
846 |
703 |
$3K |
| 85027 |
|
3,414 |
2,160 |
$3K |
| 86850 |
|
1,301 |
1,047 |
$3K |
| 87430 |
|
36 |
29 |
$2K |
| 97163 |
|
39 |
27 |
$2K |
| 80076 |
|
4,927 |
4,212 |
$2K |
| 73030 |
|
35 |
27 |
$2K |
| 70544 |
|
25 |
14 |
$2K |
| 86900 |
|
1,395 |
1,122 |
$2K |
| 73130 |
|
21 |
12 |
$1K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
2,793 |
1,921 |
$1K |
| 74018 |
|
146 |
88 |
$1K |
| 86140 |
|
76 |
64 |
$1K |
| 82947 |
|
1,669 |
834 |
$1K |
| J1644 |
Injection, heparin sodium, per 1000 units |
1,594 |
617 |
$1K |
| 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 |
310 |
297 |
$1K |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
1,116 |
891 |
$997.69 |
| 36591 |
|
58 |
40 |
$982.97 |
| 70486 |
|
48 |
25 |
$957.03 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
1,682 |
972 |
$950.19 |
| 72100 |
|
23 |
15 |
$901.31 |
| 87807 |
|
12 |
12 |
$867.19 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
219 |
182 |
$859.98 |
| 82010 |
|
106 |
81 |
$839.89 |
| 86901 |
|
1,353 |
1,091 |
$837.27 |
| 81025 |
|
26 |
25 |
$775.96 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
1,482 |
1,081 |
$770.31 |
| Q0162 |
Ondansetron 1 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 |
413 |
283 |
$635.12 |
| 87077 |
|
73 |
64 |
$620.01 |
| 83550 |
|
28 |
25 |
$619.70 |
| 74174 |
|
17 |
13 |
$603.69 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
358 |
295 |
$584.15 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
675 |
471 |
$535.41 |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
588 |
292 |
$521.42 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
618 |
312 |
$508.31 |
| 93017 |
|
14 |
12 |
$508.25 |
| 82150 |
|
2,454 |
2,116 |
$480.71 |
| J2704 |
Injection, propofol, 10 mg |
782 |
620 |
$451.19 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
1,301 |
881 |
$443.35 |
| 97116 |
|
40 |
26 |
$331.27 |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
43 |
12 |
$331.23 |
| 78582 |
|
13 |
12 |
$209.55 |
| 82330 |
|
102 |
95 |
$115.55 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
14 |
13 |
$89.07 |
| 80051 |
|
76 |
66 |
$86.54 |
| J7644 |
Ipratropium bromide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per milligram |
15 |
14 |
$80.28 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
21 |
13 |
$44.25 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
31 |
24 |
$40.24 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
317 |
163 |
$25.16 |
| 82803 |
|
30 |
24 |
$15.92 |
| G8979 |
Mobility: walking & moving around functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting |
77 |
62 |
$0.02 |
| G8978 |
Mobility: walking & moving around functional limitation, current status, at therapy episode outset and at reporting intervals |
66 |
57 |
$0.02 |
| G1004 |
Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program |
18 |
18 |
$0.00 |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
102 |
51 |
$0.00 |
| 85014 |
|
31 |
25 |
$0.00 |
| 80061 |
Lipid panel |
110 |
83 |
$0.00 |
| 82565 |
|
46 |
36 |
$0.00 |
| 84295 |
|
30 |
24 |
$0.00 |
| 83540 |
|
27 |
24 |
$0.00 |
| A9270 |
Non-covered item or service |
3,403 |
1,058 |
$0.00 |
| J1815 |
Injection, insulin, per 5 units |
574 |
225 |
$0.00 |
| 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 |
99 |
92 |
$0.00 |
| 82550 |
|
49 |
33 |
$0.00 |
| 82607 |
|
12 |
12 |
$0.00 |
| 84132 |
|
46 |
37 |
$0.00 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
126 |
89 |
$0.00 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
17 |
14 |
$0.00 |
| 78580 |
|
12 |
12 |
$0.00 |
| 97535 |
Self-care/home management training, each 15 minutes |
33 |
15 |
$0.00 |
| 82435 |
|
30 |
24 |
$0.00 |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
12 |
12 |
$0.00 |
| 85652 |
|
13 |
13 |
$0.00 |
| 82728 |
|
13 |
12 |
$0.00 |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
17 |
13 |
$0.00 |
| J7050 |
Infusion, normal saline solution, 250 cc |
22 |
13 |
$0.00 |