| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
63,722 |
59,274 |
$6.93M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
54,199 |
48,216 |
$6.22M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
30,394 |
26,292 |
$3.73M |
| 70450 |
Computed tomography, head or brain; without contrast material |
10,282 |
9,093 |
$2.32M |
| 41899 |
Unlisted procedure, dentoalveolar structures |
2,353 |
2,128 |
$2.04M |
| 96361 |
Intravenous infusion, hydration; each additional hour |
5,657 |
4,239 |
$1.72M |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
7,584 |
6,596 |
$1.72M |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
16,603 |
16,005 |
$1.59M |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
9,163 |
7,275 |
$1.52M |
| 92507 |
Treatment of speech, language, voice, communication, and/or auditory processing disorder |
15,704 |
5,476 |
$1.09M |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
5,260 |
4,308 |
$717K |
| 80053 |
Comprehensive metabolic panel |
81,024 |
70,320 |
$696K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
11,395 |
3,230 |
$667K |
| 0202U |
Oncology (prostate), multianalyte, gene expression profiling |
4,400 |
3,837 |
$613K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
1,767 |
1,493 |
$607K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
1,624 |
1,358 |
$395K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
1,446 |
963 |
$339K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
1,290 |
1,029 |
$299K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
704 |
588 |
$276K |
| G0378 |
Hospital observation service, per hour |
3,698 |
1,389 |
$270K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
3,860 |
1,197 |
$260K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
1,229 |
1,065 |
$255K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
1,852 |
1,702 |
$242K |
| 45385 |
Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) |
544 |
470 |
$235K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
18,176 |
15,759 |
$227K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
1,713 |
1,587 |
$223K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
1,443 |
1,279 |
$222K |
| 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 |
1,398 |
1,370 |
$221K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
695 |
575 |
$219K |
| 95810 |
Polysomnography; sleep staging with 4 or more additional parameters |
355 |
326 |
$196K |
| 84443 |
Thyroid stimulating hormone (TSH) |
18,782 |
16,575 |
$179K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
4,894 |
4,517 |
$176K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
3,890 |
2,733 |
$173K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
82,114 |
69,987 |
$148K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
11,840 |
10,762 |
$144K |
| 36415 |
Collection of venous blood by venipuncture |
117,028 |
97,815 |
$132K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
10,142 |
8,274 |
$130K |
| 76801 |
|
1,498 |
1,265 |
$127K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
20,112 |
17,755 |
$123K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
10,560 |
9,471 |
$116K |
| 97162 |
|
1,752 |
1,462 |
$104K |
| 80061 |
Lipid panel |
10,634 |
9,424 |
$103K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
1,144 |
662 |
$103K |
| 93975 |
|
1,660 |
1,386 |
$97K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
4,874 |
4,500 |
$97K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
17,421 |
15,813 |
$93K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
947 |
797 |
$93K |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
2,703 |
2,484 |
$92K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
2,097 |
739 |
$92K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
1,374 |
1,133 |
$89K |
| 87801 |
Infectious agent detection by nucleic acid; amplified probe, multiple organisms |
2,119 |
1,747 |
$88K |
| 59025 |
Fetal non-stress test |
535 |
346 |
$85K |
| 95886 |
|
533 |
452 |
$80K |
| 87210 |
|
5,323 |
4,697 |
$80K |
| 84439 |
|
4,996 |
4,514 |
$79K |
| 93017 |
|
1,122 |
962 |
$78K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
568 |
493 |
$77K |
| 95811 |
|
149 |
140 |
$76K |
| 94060 |
|
682 |
615 |
$76K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
1,833 |
1,660 |
$69K |
| 95806 |
|
178 |
164 |
$67K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
841 |
718 |
$67K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
3,327 |
1,335 |
$67K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
4,471 |
3,909 |
$65K |
| 71046 |
Radiologic examination, chest; 2 views |
12,036 |
11,156 |
$64K |
| 84484 |
|
20,331 |
14,944 |
$63K |
| 12001 |
|
440 |
385 |
$61K |
| 83605 |
|
14,892 |
11,826 |
$54K |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
3,153 |
2,943 |
$53K |
| 84702 |
|
3,226 |
2,396 |
$51K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
27,726 |
23,676 |
$50K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
267 |
238 |
$50K |
| 64488 |
|
330 |
232 |
$50K |
| 86900 |
|
3,048 |
2,428 |
$46K |
| 71250 |
|
654 |
579 |
$46K |
| 76642 |
|
437 |
382 |
$46K |
| 97161 |
|
728 |
631 |
$46K |
| 71045 |
Radiologic examination, chest; single view |
18,308 |
16,017 |
$46K |
| 94729 |
|
809 |
735 |
$44K |
| 70496 |
|
218 |
161 |
$43K |
| 94726 |
|
760 |
687 |
$42K |
| 80320 |
|
3,523 |
3,022 |
$42K |
| 76830 |
Ultrasound, transvaginal |
1,305 |
1,153 |
$41K |
| 87070 |
|
2,580 |
2,255 |
$39K |
| 85027 |
|
6,307 |
5,295 |
$39K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
247 |
222 |
$38K |
| 93971 |
|
648 |
549 |
$37K |
| 76536 |
|
361 |
327 |
$37K |
| 97166 |
|
659 |
520 |
$36K |
| 97014 |
|
1,272 |
463 |
$32K |
| 74150 |
|
235 |
176 |
$32K |
| 93458 |
|
34 |
30 |
$31K |
| 86850 |
|
2,384 |
2,022 |
$31K |
| 71271 |
|
245 |
212 |
$30K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
36,513 |
32,073 |
$30K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
1,762 |
1,447 |
$29K |
| 86803 |
|
1,546 |
1,261 |
$29K |
| 72131 |
|
726 |
601 |
$28K |
| 74018 |
|
1,547 |
1,278 |
$28K |
| 87808 |
|
4,579 |
3,999 |
$28K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
590 |
493 |
$27K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
1,107 |
952 |
$27K |
| 82607 |
|
1,832 |
1,513 |
$25K |
| 86592 |
|
2,131 |
1,864 |
$24K |
| 87040 |
|
4,500 |
2,316 |
$24K |
| 72110 |
|
768 |
674 |
$24K |
| 70491 |
|
94 |
70 |
$24K |
| 93880 |
|
342 |
300 |
$23K |
| 45378 |
Colonoscopy, flexible; diagnostic, including collection of specimen(s) |
47 |
37 |
$22K |
| 87420 |
|
791 |
766 |
$22K |
| 12011 |
|
140 |
127 |
$21K |
| 86787 |
|
898 |
744 |
$20K |
| 43248 |
|
53 |
47 |
$20K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
6,998 |
4,350 |
$20K |
| 97116 |
|
1,078 |
504 |
$18K |
| 70498 |
|
358 |
274 |
$18K |
| 73630 |
|
1,767 |
1,550 |
$18K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
1,976 |
1,678 |
$18K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
1,790 |
1,617 |
$17K |
| 83655 |
|
506 |
500 |
$17K |
| 81003 |
|
20,191 |
17,919 |
$17K |
| 86403 |
|
4,976 |
2,778 |
$16K |
| 43235 |
|
36 |
28 |
$16K |
| 82570 |
|
1,769 |
1,645 |
$16K |
| 91200 |
|
136 |
121 |
$15K |
| 81001 |
|
26,089 |
22,932 |
$15K |
| 86901 |
|
3,050 |
2,444 |
$15K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
21,142 |
17,674 |
$14K |
| 72141 |
|
129 |
108 |
$14K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
29,282 |
24,836 |
$14K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
8,114 |
7,398 |
$14K |
| 87081 |
|
2,508 |
2,366 |
$14K |
| 80081 |
|
467 |
359 |
$13K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
68 |
57 |
$13K |
| 73030 |
|
1,064 |
883 |
$13K |
| 87660 |
|
535 |
515 |
$12K |
| 84403 |
|
610 |
524 |
$12K |
| 70486 |
|
492 |
412 |
$12K |
| 73130 |
|
1,300 |
1,149 |
$12K |
| 92523 |
|
208 |
175 |
$11K |
| 87634 |
|
1,507 |
1,377 |
$11K |
| 87340 |
|
720 |
632 |
$11K |
| 73610 |
|
1,196 |
1,046 |
$11K |
| 83540 |
|
1,170 |
1,004 |
$11K |
| 96367 |
|
436 |
315 |
$11K |
| 83735 |
|
15,760 |
13,191 |
$11K |
| 82043 |
|
1,757 |
1,641 |
$11K |
| 88307 |
|
112 |
69 |
$10K |
| 85610 |
|
9,275 |
7,520 |
$10K |
| 73221 |
|
50 |
45 |
$10K |
| 73560 |
|
1,270 |
1,073 |
$10K |
| 82728 |
|
661 |
568 |
$9K |
| 83550 |
|
1,144 |
985 |
$9K |
| 95911 |
|
25 |
25 |
$9K |
| 73502 |
|
578 |
500 |
$9K |
| 72100 |
|
388 |
328 |
$9K |
| 97535 |
Self-care/home management training, each 15 minutes |
522 |
231 |
$9K |
| 86140 |
|
1,883 |
1,460 |
$9K |
| 87077 |
|
1,831 |
1,493 |
$8K |
| 90715 |
|
678 |
562 |
$8K |
| 83525 |
|
367 |
313 |
$8K |
| 84270 |
|
537 |
466 |
$8K |
| 81420 |
Fetal chromosomal aneuploidy genomic sequence analysis panel |
310 |
246 |
$8K |
| J0500 |
Injection, dicyclomine hcl, up to 20 mg |
529 |
380 |
$8K |
| 87186 |
|
2,175 |
1,721 |
$8K |
| 84153 |
|
525 |
451 |
$8K |
| 85014 |
|
1,762 |
1,460 |
$8K |
| 82746 |
|
1,243 |
1,049 |
$8K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
1,217 |
1,178 |
$8K |
| 87536 |
|
206 |
182 |
$7K |
| 82950 |
|
599 |
558 |
$7K |
| 82077 |
|
7,143 |
5,802 |
$7K |
| 77066 |
Tomosynthesis, mammo |
229 |
198 |
$7K |
| 82550 |
|
11,235 |
9,587 |
$7K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
69 |
25 |
$7K |
| 83690 |
|
14,994 |
13,012 |
$6K |
| 80074 |
|
427 |
337 |
$6K |
| 88342 |
|
2,108 |
1,559 |
$6K |
| 80076 |
|
573 |
481 |
$6K |
| 86580 |
|
418 |
283 |
$6K |
| 83970 |
|
238 |
207 |
$6K |
| 00731 |
|
1,726 |
1,421 |
$6K |
| 83880 |
|
2,446 |
1,964 |
$5K |
| 73110 |
|
611 |
527 |
$5K |
| 85018 |
|
1,078 |
957 |
$5K |
| 12002 |
|
44 |
41 |
$5K |
| 80069 |
|
354 |
277 |
$5K |
| 72050 |
|
154 |
141 |
$5K |
| 82553 |
|
633 |
555 |
$5K |
| 84146 |
|
512 |
443 |
$5K |
| 93296 |
|
353 |
337 |
$5K |
| 86762 |
|
302 |
257 |
$5K |
| 10060 |
|
32 |
31 |
$5K |
| 83516 |
|
159 |
127 |
$5K |
| 96376 |
|
2,693 |
1,859 |
$4K |
| 64447 |
|
73 |
41 |
$4K |
| G0279 |
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) |
518 |
449 |
$4K |
| 80329 |
|
729 |
363 |
$4K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
33 |
29 |
$4K |
| 99152 |
|
281 |
227 |
$4K |
| 82105 |
|
174 |
159 |
$4K |
| 00170 |
Anesthesia for intraoral procedures, including biopsy |
2,697 |
2,423 |
$4K |
| 95816 |
|
31 |
28 |
$4K |
| 83001 |
|
178 |
158 |
$4K |
| 87088 |
|
746 |
627 |
$4K |
| 77065 |
Tomosynthesis, mammo |
137 |
103 |
$4K |
| 87641 |
|
73 |
68 |
$3K |
| 85652 |
|
1,250 |
987 |
$3K |
| 87522 |
Neg quan hep c or qual rna |
93 |
71 |
$3K |
| 86038 |
|
124 |
112 |
$3K |
| J3490 |
Unclassified drugs |
124 |
76 |
$3K |
| 84425 |
|
211 |
162 |
$3K |
| 73590 |
|
367 |
314 |
$3K |
| 95910 |
|
138 |
110 |
$3K |
| 73080 |
|
301 |
260 |
$3K |
| 85730 |
|
5,420 |
4,686 |
$3K |
| 80143 |
|
2,389 |
1,938 |
$2K |
| 84703 |
|
1,415 |
1,140 |
$2K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
5,206 |
2,533 |
$2K |
| 87507 |
|
37 |
24 |
$2K |
| 84112 |
|
68 |
52 |
$2K |
| 82330 |
|
742 |
524 |
$2K |
| 80164 |
|
452 |
342 |
$2K |
| C1713 |
Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) |
274 |
188 |
$2K |
| 86376 |
|
97 |
87 |
$2K |
| 97150 |
Therapeutic procedure(s), group (2 or more individuals) |
22 |
15 |
$2K |
| 88304 |
|
558 |
418 |
$2K |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
7,607 |
6,050 |
$2K |
| 84156 |
|
248 |
187 |
$2K |
| 97597 |
|
19 |
12 |
$2K |
| 93298 |
|
123 |
121 |
$2K |
| 84550 |
|
357 |
292 |
$2K |
| 86431 |
|
95 |
89 |
$2K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
30,038 |
25,980 |
$2K |
| 84145 |
|
2,745 |
2,176 |
$2K |
| 97035 |
|
87 |
42 |
$2K |
| 86003 |
|
49 |
42 |
$1K |
| 86706 |
|
67 |
54 |
$1K |
| 85379 |
|
1,471 |
1,180 |
$1K |
| 73090 |
|
252 |
218 |
$1K |
| 97165 |
|
29 |
24 |
$1K |
| J2704 |
Injection, propofol, 10 mg |
13,732 |
9,495 |
$1K |
| 83021 |
|
65 |
62 |
$1K |
| 88341 |
|
24 |
13 |
$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 |
67 |
50 |
$1K |
| 83002 |
|
74 |
67 |
$1K |
| 74022 |
|
371 |
305 |
$1K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
13,336 |
11,519 |
$1K |
| 80179 |
|
2,313 |
1,891 |
$1K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
743 |
608 |
$1K |
| 77080 |
|
27 |
24 |
$1K |
| 77336 |
|
32 |
12 |
$1K |
| 00812 |
|
582 |
459 |
$961.44 |
| 77076 |
|
298 |
249 |
$945.04 |
| 86039 |
|
36 |
30 |
$924.20 |
| C1894 |
Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser |
445 |
360 |
$905.32 |
| 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 |
293 |
289 |
$884.32 |
| 36600 |
|
554 |
392 |
$874.41 |
| 83527 |
|
69 |
58 |
$847.03 |
| 73564 |
|
18 |
18 |
$818.15 |
| 64999 |
|
52 |
27 |
$752.59 |
| 73140 |
|
32 |
26 |
$734.52 |
| 87075 |
|
333 |
221 |
$705.21 |
| 87324 |
|
53 |
39 |
$680.97 |
| 81220 |
CFTR (cystic fibrosis transmembrane conductance regulator) gene analysis; common variants |
47 |
37 |
$679.80 |
| 82785 |
|
30 |
26 |
$665.76 |
| 73552 |
|
88 |
77 |
$653.10 |
| 86696 |
|
52 |
37 |
$601.91 |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
1,541 |
609 |
$598.14 |
| 84132 |
|
733 |
541 |
$583.72 |
| J1756 |
Injection, iron sucrose, 1 mg |
27 |
12 |
$583.17 |
| 82248 |
|
61 |
51 |
$581.94 |
| 72072 |
|
32 |
29 |
$568.36 |
| 71101 |
|
106 |
93 |
$563.11 |
| 81223 |
|
13 |
12 |
$525.00 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
2,808 |
2,074 |
$512.63 |
| 87449 |
|
70 |
52 |
$511.19 |
| 00811 |
|
428 |
376 |
$499.91 |
| 81400 |
|
13 |
12 |
$484.15 |
| 81243 |
|
13 |
12 |
$484.15 |
| 81408 |
|
13 |
12 |
$484.15 |
| 81404 |
|
13 |
12 |
$484.15 |
| 72128 |
|
506 |
406 |
$478.55 |
| 82565 |
|
658 |
480 |
$474.59 |
| 86703 |
|
30 |
27 |
$441.88 |
| 82533 |
|
16 |
13 |
$425.28 |
| J2543 |
Injection, piperacillin sodium/tazobactam sodium, 1 gram/0.125 grams (1.125 grams) |
237 |
91 |
$417.46 |
| 82803 |
|
599 |
415 |
$405.06 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
27,050 |
22,299 |
$395.06 |
| C1769 |
Guide wire |
764 |
600 |
$364.45 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
2,235 |
1,793 |
$355.64 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
4,297 |
3,375 |
$334.44 |
| 82150 |
|
335 |
268 |
$332.55 |
| J7030 |
Infusion, normal saline solution , 1000 cc |
603 |
471 |
$299.39 |
| 94664 |
|
129 |
89 |
$298.41 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
2,068 |
1,973 |
$292.41 |
| J2060 |
Injection, lorazepam, 2 mg |
2,502 |
1,882 |
$281.72 |
| 86361 |
|
12 |
12 |
$268.06 |
| A9502 |
Technetium tc-99m tetrofosmin, diagnostic, per study dose |
747 |
573 |
$258.70 |
| 84436 |
|
15 |
15 |
$234.01 |
| 72170 |
|
35 |
27 |
$199.95 |
| 86480 |
|
12 |
12 |
$188.14 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
6,494 |
5,322 |
$185.17 |
| 82010 |
|
281 |
225 |
$174.02 |
| J2360 |
Injection, orphenadrine citrate, up to 60 mg |
886 |
754 |
$163.59 |
| J1953 |
Injection, levetiracetam, 10 mg |
54 |
41 |
$160.78 |
| 84295 |
|
599 |
432 |
$154.06 |
| J0360 |
Injection, hydralazine hcl, up to 20 mg |
398 |
274 |
$145.39 |
| 84479 |
|
13 |
13 |
$145.01 |
| 90714 |
|
20 |
20 |
$140.03 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
2,126 |
1,290 |
$138.18 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
7,061 |
5,027 |
$133.92 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
2,029 |
1,467 |
$132.43 |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
2,278 |
1,687 |
$127.44 |
| J1630 |
Injection, haloperidol, up to 5 mg |
480 |
292 |
$125.71 |
| 82435 |
|
591 |
428 |
$122.10 |
| 84100 |
|
75 |
61 |
$119.29 |
| C1725 |
Catheter, transluminal angioplasty, non-laser (may include guidance, infusion/perfusion capability) |
51 |
40 |
$105.23 |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
652 |
499 |
$102.38 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
2,032 |
1,566 |
$91.48 |
| 86695 |
|
12 |
12 |
$88.24 |
| 86141 |
|
154 |
137 |
$86.56 |
| J2919 |
Injection, methylprednisolone sodium succinate, 5 mg |
610 |
447 |
$63.87 |
| J2785 |
Injection, regadenoson, 0.1 mg |
595 |
482 |
$61.15 |
| 73060 |
|
30 |
25 |
$56.35 |
| J1644 |
Injection, heparin sodium, per 1000 units |
608 |
348 |
$56.22 |
| J3370 |
Injection, vancomycin hcl, 500 mg |
566 |
264 |
$54.97 |
| 83615 |
|
18 |
12 |
$48.58 |
| 94761 |
|
1,788 |
1,307 |
$45.53 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
3,008 |
2,226 |
$38.91 |
| J2272 |
Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg |
215 |
192 |
$38.35 |
| A9577 |
Injection, gadobenate dimeglumine (multihance), per ml |
153 |
129 |
$36.80 |
| J0702 |
Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg |
23 |
20 |
$35.89 |
| J2404 |
Injection, nicardipine, 0.1 mg |
30 |
30 |
$30.42 |
| 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 |
613 |
550 |
$23.12 |
| J2795 |
Injection, ropivacaine hydrochloride, 1 mg |
762 |
491 |
$21.18 |
| J1040 |
Injection, methylprednisolone acetate, 80 mg |
35 |
25 |
$12.22 |
| J1010 |
Injection, methylprednisolone acetate, 1 mg |
16 |
16 |
$10.50 |
| J2550 |
Injection, promethazine hcl, up to 50 mg |
72 |
53 |
$9.59 |
| J7050 |
Infusion, normal saline solution, 250 cc |
338 |
275 |
$9.52 |
| J1920 |
Injection, labetalol hydrochloride, 5 mg |
143 |
104 |
$8.91 |
| 82948 |
|
39 |
25 |
$7.99 |
| J3411 |
Injection, thiamine hcl, 100 mg |
96 |
77 |
$7.48 |
| J2371 |
Injection, phenylephrine hydrochloride, 20 micrograms |
408 |
317 |
$6.07 |
| J1171 |
Injection, hydromorphone, 0.1 mg |
98 |
70 |
$5.92 |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
557 |
400 |
$4.68 |
| J2470 |
Injection, pantoprazole sodium, 40 mg |
63 |
46 |
$4.35 |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
48 |
41 |
$1.33 |
| J2305 |
Injection, nitroglycerin, 5 mg |
59 |
56 |
$1.31 |
| J3480 |
Injection, potassium chloride, per 2 meq |
53 |
37 |
$1.20 |
| J1940 |
Injection, furosemide, up to 20 mg |
109 |
69 |
$0.58 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
730 |
535 |
$0.46 |
| 00813 |
|
129 |
119 |
$0.00 |
| J2370 |
Injection, phenylephrine hcl, up to 1 ml |
131 |
98 |
$0.00 |
| 99153 |
Mod sedat endo service >5yrs |
15 |
14 |
$0.00 |
| 00790 |
|
15 |
12 |
$0.00 |
| J1642 |
Injection, heparin sodium, (heparin lock flush), per 10 units |
27 |
12 |
$0.00 |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
15 |
15 |
$0.00 |
| A9579 |
Injection, gadolinium-based magnetic resonance contrast agent, not otherwise specified (nos), per ml |
278 |
223 |
$0.00 |
| J2003 |
Injection, lidocaine hydrochloride, 1 mg |
97 |
95 |
$0.00 |
| J0330 |
Injection, succinylcholine chloride, up to 20 mg |
273 |
127 |
$0.00 |
| G0283 |
Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care |
44 |
17 |
$0.00 |
| C9399 |
Unclassified drugs or biologicals |
83 |
62 |
$0.00 |
| J8540 |
Dexamethasone, oral, 0.25 mg |
12 |
12 |
$0.00 |
| 86308 |
|
29 |
28 |
$0.00 |
| A4217 |
Sterile water/saline, 500 ml |
17 |
14 |
$0.00 |
| G2066 |
Interrogation device evaluation(s), (remote) up to 30 days; implantable cardiovascular physiologic monitor system, implantable loop recorder system, or subcutaneous cardiac rhythm monitor system, remote data acquisition(s), receipt of transmissions and technician review, technical support and distribution of results |
28 |
26 |
$0.00 |
| G0330 |
Facility services for dental rehabilitation procedure(s) performed on a patient who requires monitored anesthesia (e.g., general, intravenous sedation (monitored anesthesia care) and use of an operating room |
91 |
85 |
$0.00 |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
63 |
62 |
$0.00 |
| 00840 |
|
77 |
53 |
$0.00 |
| 76942 |
|
22 |
13 |
$0.00 |
| J2916 |
Injection, sodium ferric gluconate complex in sucrose injection, 12.5 mg |
58 |
25 |
$0.00 |
| 73562 |
|
13 |
12 |
$0.00 |
| 29125 |
|
16 |
14 |
$0.00 |
| J0688 |
Injection, cefazolin sodium (hikma), not therapeutically equivalent to j0690, 500 mg |
19 |
12 |
$0.00 |
| 94150 |
|
24 |
12 |
$0.00 |