Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers

ROCHESTER GENERAL HOSPITAL

NPI: 1255360517 · ROCHESTER, NY 14621 · General Practice Dentistry · NPI assigned 06/30/2006

Billing Flags · Automated signals — not evidence of fraud
Entity Proliferation

Authorized official TINCH, PAULA controls 20+ related entities in our dataset. Read more

$226.97M
Total Medicaid Paid
3,230,816
Total Claims
2,838,851
Beneficiaries
702
Codes Billed
2018-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialTINCH, PAULA (SVP- FINANCE)
NPI Enumeration Date06/30/2006

Related Entities

Other providers sharing the same authorized official: TINCH, PAULA

ProviderCityStateTotal Paid
ROCHESTER GENERAL HOSPITAL ROCHESTER NY $25.15M
ROCHESTER GENERAL HOSPITAL ROCHESTER NY $21.62M
ROCHESTER GENERAL HOSPITAL ROCHESTER NY $14.54M
ROCHESTER GENERAL HOSPITAL ROCHESTER NY $14.22M
WESTERN NEW YORK MEDICAL PRACTICE P.C. ROCHESTER NY $13.41M
ROCHESTER GENERAL HOSPITAL SODUS NY $11.31M
ROCHESTER GENERAL HOSPITAL ROCHESTER NY $10.05M
BEHAVIORAL HEALTH NETWORK, INC. ROCHESTER NY $6.84M
WESTERN NEW YORK MEDICAL PRACTICE, P.C. GENEVA NY $6.32M
CLIFTON SPRINGS SANITARIUM CO CLIFTON SPRINGS NY $1.80M
NEWARK WAYNE COMMUNITY HOSPITAL-LAB NEWARK NY $1.61M
PENN STATE HEALTH COMMUNITY MEDICAL GROUP, LLC MECHANICSBURG PA $366K
ROCHESTER GENERAL HOSPITAL ROCHESTER NY $281K
NEWARK WAYNE COMMUNITY HOSPITAL NEWARK NY $176K
ROCHESTER GENERAL HOSPITAL WEBSTER NY $135K
PENN STATE HEALTH COMMUNITY MEDICAL GROUP, LLC CAMP HILL PA $56K
ROCHESTER GENERAL HOSPITAL ROCHESTER NY $54K
PENN STATE HEALTH COMMUNITY MEDICAL GROUP, LLC HARRISBURG PA $23K
ROCHESTER GENERAL HOSPITAL ROCHESTER NY $9K
WESTERN NEW YORK MEDICAL PRACTICE PC ROCHESTER NY $9K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 77,598 $3.79M
2019 212,646 $15.07M
2020 423,633 $34.42M
2021 675,135 $43.63M
2022 647,471 $48.29M
2023 675,490 $47.68M
2024 518,843 $34.11M

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 271,269 246,227 $22.32M
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 224,202 200,475 $19.99M
90834 Psychotherapy, 45 minutes with patient 105,344 70,684 $16.17M
99283 Emergency department visit for the evaluation and management, moderate severity 80,214 76,060 $12.14M
96361 Intravenous infusion, hydration; each additional hour 44,935 39,639 $10.44M
99285 Emergency department visit for the evaluation and management, high severity with immediate threat to life 53,496 50,560 $7.58M
99284 Emergency department visit for the evaluation and management, high severity 50,793 48,064 $7.21M
H2019 Therapeutic behavioral services, per 15 minutes 9,468 9,456 $6.76M
90832 Psychotherapy, 30 minutes with patient 56,672 43,995 $6.16M
J9271 Injection, pembrolizumab, 1 mg 365 271 $4.08M
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 51,976 50,037 $4.01M
90791 Psychiatric diagnostic evaluation 21,092 17,503 $3.80M
G0463 Hospital outpatient clinic visit for assessment and management of a patient 42,128 34,589 $3.38M
76856 Ultrasound, pelvic (nonobstetric), real time with image documentation; complete 11,781 11,525 $3.10M
99282 Emergency department visit for the evaluation and management, low to moderate severity 18,944 18,520 $2.88M
70450 Computed tomography, head or brain; without contrast material 10,279 10,041 $2.78M
74177 Computed tomography, abdomen and pelvis; with contrast material 9,369 9,223 $2.59M
97110 Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion 41,686 16,250 $2.47M
J2426 Injection, paliperidone palmitate extended release (invega sustenna), 1 mg 952 894 $2.38M
90847 Family psychotherapy with the patient present, 50 minutes 9,676 7,756 $2.18M
80053 Comprehensive metabolic panel 107,613 97,692 $2.04M
59025 Fetal non-stress test 11,136 6,389 $1.90M
99391 Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) 20,374 19,333 $1.63M
99392 Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) 20,654 20,168 $1.58M
93306 Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete 5,019 4,920 $1.52M
99393 Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) 18,951 18,604 $1.48M
96360 Intravenous infusion, hydration; initial, 31 minutes to 1 hour 7,895 7,500 $1.45M
T1015 Clinic visit/encounter, all-inclusive 4,756 4,754 $1.34M
99215 Prolong outpt/office vis 11,841 10,649 $1.32M
87502 Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets 23,604 23,095 $1.29M
87491 Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe 34,056 32,869 $1.15M
43239 Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple 1,649 1,611 $1.13M
87631 15,511 15,173 $1.08M
74176 Computed tomography, abdomen and pelvis; without contrast material 3,625 3,597 $1.07M
45378 Colonoscopy, flexible; diagnostic, including collection of specimen(s) 1,419 1,387 $1.04M
99394 Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) 12,461 12,253 $1.02M
H2018 Psychosocial rehabilitation services, per diem 2,129 2,125 $980K
80048 Basic metabolic panel (calcium, ionized) 51,821 44,651 $976K
76770 3,884 3,838 $975K
G0396 Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and brief intervention 15 to 30 minutes 8,320 4,883 $964K
96415 2,034 1,641 $925K
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 8,708 8,315 $909K
77067 Screening mammography, bilateral, including computer-aided detection 13,434 13,384 $869K
80307 Drug test(s), presumptive, any number of drug classes; immunoassay 30,505 22,570 $859K
96110 Developmental screening, with scoring and documentation, per standardized instrument 5,674 5,653 $857K
99395 Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years 9,719 9,484 $848K
87591 Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe 34,178 32,981 $848K
71275 Computed tomographic angiography, chest, with contrast material 2,545 2,522 $823K
96413 Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance 3,911 2,635 $797K
12001 1,891 1,884 $790K
H0005 Alcohol and/or drug services; group counseling by a clinician 12,332 3,429 $787K
96365 Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour 5,027 4,450 $783K
36415 Collection of venous blood by venipuncture 106,178 66,185 $749K
G0378 Hospital observation service, per hour 3,581 3,491 $736K
94760 15,701 4,806 $728K
92551 13,118 7,013 $714K
45385 Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) 1,097 1,076 $713K
97161 7,668 7,645 $679K
93458 469 455 $674K
90792 Psychiatric diagnostic evaluation with medical services 2,713 2,704 $667K
70553 Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences 1,799 1,766 $648K
45380 Colonoscopy, flexible; with biopsy, single or multiple 907 882 $631K
88305 Level IV - Surgical pathology, gross and microscopic examination 9,602 9,063 $631K
78452 Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress 975 964 $626K
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 8,567 6,649 $611K
76801 9,243 8,365 $609K
76816 Ultrasound, pregnant uterus, real time with image documentation, follow-up 18,356 15,002 $604K
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular 35,282 28,952 $584K
96366 Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour 3,434 2,771 $583K
G0397 Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and intervention, greater than 30 minutes 3,879 2,520 $582K
Q5103 Injection, infliximab-dyyb, biosimilar, (inflectra), 10 mg 547 483 $554K
76700 Ultrasound, abdominal, real time with image documentation; complete 4,494 4,477 $529K
S9335 Home therapy, hemodialysis; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing services coded separately), per diem 2,814 249 $514K
99281 Emergency department visit for the evaluation and management, self-limited or minor 3,410 3,370 $509K
12011 1,207 1,204 $499K
41899 Unlisted procedure, dentoalveolar structures 405 404 $487K
10060 1,571 1,548 $486K
12002 1,140 1,133 $477K
71260 Computed tomography, thorax, diagnostic; with contrast material 2,438 2,420 $471K
82306 Vitamin D; 25 hydroxy, includes fraction(s), if performed 15,348 15,268 $471K
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 18,771 18,175 $457K
99396 Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years 4,805 4,703 $448K
47562 194 190 $447K
97140 Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) 18,425 7,514 $446K
D7240 Removal of impacted tooth - completely bony 1,413 459 $437K
70551 Magnetic resonance imaging, brain; without contrast material 1,288 1,281 $435K
76830 Ultrasound, transvaginal 7,684 7,507 $403K
D0120 Periodic oral evaluation - established patient 9,897 8,200 $395K
72148 Magnetic resonance imaging, lumbar spine; without contrast material 1,181 1,176 $386K
76705 Ultrasound, abdominal, real time with image documentation; limited 5,222 5,104 $385K
67028 Intravitreal injection of a pharmacologic agent 1,550 943 $367K
U0002 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc 9,961 9,622 $356K
73721 Magnetic resonance imaging, any joint of lower extremity; without contrast material 1,092 1,069 $356K
93970 922 915 $355K
D0140 Limited oral evaluation - problem focused 9,131 7,583 $349K
80061 Lipid panel 33,705 33,521 $338K
D7140 Extraction, erupted tooth or exposed root 3,819 2,071 $336K
H0001 Alcohol and/or drug assessment 2,112 1,770 $336K
11042 Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm 852 535 $329K
H2011 Crisis intervention service, per 15 minutes 1,953 1,768 $307K
84443 Thyroid stimulating hormone (TSH) 32,730 32,130 $306K
76811 Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed 4,346 4,264 $298K
87624 Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types 9,510 9,502 $293K
D2392 Resin-based composite - two surfaces, posterior, primary or permanent 3,470 2,510 $277K
85025 Blood count; complete (CBC), automated, and automated differential WBC count 68,232 59,278 $271K
D7210 Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth 2,006 757 $270K
71046 Radiologic examination, chest; 2 views 20,188 19,661 $268K
90460 Immunization administration through 18 years of age via any route, first or only component 12,455 12,054 $267K
88142 10,389 10,379 $263K
83036 Hemoglobin; glycosylated (A1C) 30,394 29,784 $258K
95004 Percutaneous tests with allergenic extracts, immediate type reaction 850 848 $258K
86850 9,113 8,795 $256K
70496 959 952 $254K
C8929 Transthoracic echocardiography with contrast, or without contrast followed by with contrast, real-time with image documentation (2d), includes m-mode recording, when performed, complete, with spectral doppler echocardiography, and with color flow doppler echocardiography 816 815 $247K
87635 Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe 4,987 4,831 $243K
93017 1,589 1,585 $240K
93225 1,726 1,724 $227K
93005 Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report 20,516 19,110 $226K
D1120 Prophylaxis - child 4,507 4,349 $223K
90846 Family psychotherapy without the patient present, 50 minutes 1,778 1,552 $217K
20610 935 873 $213K
83880 6,500 6,003 $212K
93971 2,302 2,274 $212K
71250 1,750 1,743 $204K
87389 Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies 13,164 13,092 $203K
87637 Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV 2,205 2,170 $203K
70491 704 694 $200K
90853 Group psychotherapy (other than of a multiple-family group) 2,734 1,210 $194K
70486 1,257 1,255 $194K
93351 684 676 $193K
87660 17,037 16,542 $192K
90715 7,054 7,043 $189K
D1110 Prophylaxis - adult 3,533 3,443 $187K
86481 3,048 3,027 $185K
93296 3,105 3,027 $185K
87480 16,561 16,015 $184K
76817 Ultrasound, pregnant uterus, real time with image documentation, transvaginal 3,486 3,004 $183K
87634 6,279 6,205 $180K
J7307 Etonogestrel (contraceptive) implant system, including implant and supplies 157 157 $180K
87510 16,186 15,707 $177K
86901 9,573 9,238 $173K
99385 1,554 1,518 $165K
99223 Prolong inpt eval add15 m 1,241 1,170 $165K
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 1,797 1,736 $163K
95886 1,752 1,496 $161K
76805 Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation 2,405 2,321 $160K
73564 4,877 4,399 $156K
86900 9,564 9,229 $150K
C8930 Transthoracic echocardiography, with contrast, or without contrast followed by with contrast, real-time with image documentation (2d), includes m-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or pharmacologically induced stress, with interpretation and report; including performance of continuous electrocardiographic monitoring, with physician supervision 499 499 $148K
99173 8,307 7,821 $148K
92014 Ophthalmological services: medical examination and evaluation, comprehensive, established patient 2,096 1,676 $147K
87661 Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe 5,444 5,390 $144K
Q0138 Injection, ferumoxytol, for treatment of iron deficiency anemia, 1 mg (non-esrd use) 320 221 $143K
42820 Tonsillectomy and adenoidectomy; younger than age 12 98 98 $143K
90686 9,626 9,613 $142K
H0002 Behavioral health screening to determine eligibility for admission to treatment program 857 856 $142K
77063 Screening digital breast tomosynthesis, bilateral 10,923 10,872 $140K
77066 Tomosynthesis, mammo 1,903 1,877 $135K
74183 347 344 $132K
87086 Culture, bacterial; quantitative colony count, urine 21,654 20,333 $127K
76536 2,821 2,808 $127K
76813 3,218 3,157 $125K
96367 1,158 886 $124K
86780 12,152 11,869 $122K
92134 1,657 1,597 $122K
93226 1,424 1,422 $122K
88307 1,206 1,180 $116K
J1050 Injection, medroxyprogesterone acetate, 1 mg 2,286 2,286 $115K
72197 327 325 $114K
82728 10,826 10,657 $111K
77065 Tomosynthesis, mammo 1,616 1,529 $111K
77080 1,456 1,452 $111K
97162 939 939 $110K
81025 23,409 22,130 $106K
73630 5,940 5,385 $105K
29125 491 485 $104K
90677 1,902 1,893 $102K
H0049 Alcohol and/or drug screening 2,280 2,206 $100K
J1756 Injection, iron sucrose, 1 mg 2,599 808 $98K
84702 12,538 10,892 $98K
82607 8,467 8,408 $98K
92012 Ophthalmological services: medical examination and evaluation, intermediate, established patient 1,094 949 $97K
36591 1,746 1,138 $96K
D0150 Comprehensive oral evaluation - new or established patient 2,238 1,874 $94K
80076 8,425 8,128 $94K
0071A 2,285 2,282 $93K
D2391 Resin-based composite - one surface, posterior, primary or permanent 1,444 1,103 $93K
88342 1,755 1,739 $93K
97165 1,178 1,175 $93K
77336 264 116 $92K
76641 1,743 1,736 $91K
99204 Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity 1,023 1,015 $91K
72100 3,592 3,566 $91K
84439 11,556 11,222 $90K
85027 23,719 22,343 $90K
90651 2,292 2,272 $88K
D1206 Topical application of fluoride varnish 2,931 2,911 $84K
83970 2,104 2,013 $83K
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A 7,944 7,083 $83K
0072A 1,984 1,982 $81K
73221 248 246 $81K
93246 558 557 $81K
86480 1,368 1,362 $80K
73030 4,176 3,931 $80K
84484 15,910 8,789 $79K
99232 Subsequent hospital care, per day, moderate complexity 1,671 563 $78K
73610 4,913 4,552 $77K
96374 Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance 11,510 10,556 $77K
H0004 Behavioral health counseling and therapy, per 15 minutes 1,260 1,030 $76K
G0123 Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, screening by cytotechnologist under physician supervision 5,054 5,052 $74K
99233 Prolong inpt eval add15 m 979 433 $73K
83655 5,403 5,310 $73K
92133 1,028 1,022 $72K
69436 Tympanostomy (requiring insertion of ventilating tube), general anesthesia 43 43 $71K
17110 268 254 $70K
76820 2,726 1,218 $70K
91320 566 566 $69K
J0882 Injection, darbepoetin alfa, 1 microgram (for esrd on dialysis) 310 86 $69K
97597 204 137 $68K
73130 3,941 3,489 $68K
93320 313 307 $67K
76870 1,004 995 $67K
73562 3,015 2,911 $66K
D9243 885 873 $65K
88304 1,567 1,551 $65K
D0274 Bitewings - four radiographic images 1,853 1,832 $65K
73502 3,228 3,067 $64K
86803 7,496 7,464 $64K
72125 Computed tomography, cervical spine; without contrast material 626 616 $64K
94010 1,320 1,257 $62K
D0220 Intraoral - periapical first radiographic image 2,639 2,476 $59K
72141 187 187 $59K
92004 Ophthalmological services: medical examination and evaluation, comprehensive, new patient 600 528 $59K
94060 630 593 $58K
0001A 1,473 1,469 $58K
Q9967 Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml 6,877 6,755 $57K
76642 1,927 1,890 $57K
90750 344 338 $57K
H0050 Alcohol and/or drug services, brief intervention, per 15 minutes 1,238 1,214 $57K
93975 255 254 $56K
93880 428 422 $56K
87081 13,505 13,272 $54K
A9579 Injection, gadolinium-based magnetic resonance contrast agent, not otherwise specified (nos), per ml 1,878 1,793 $50K
19083 39 37 $50K
J0401 Injection, aripiprazole (abilify maintena), 1 mg 24 24 $49K
82803 1,691 1,563 $49K
92250 566 537 $48K
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 178 178 $48K
96375 Therapeutic injection; each additional sequential IV push 8,568 7,096 $47K
76882 1,104 1,043 $47K
87340 6,715 6,640 $46K
99188 860 837 $46K
71271 1,354 1,354 $46K
83550 8,559 8,428 $45K
85610 11,410 9,166 $45K
0124A 1,055 1,054 $44K
86762 3,898 3,881 $44K
83540 9,481 9,329 $44K
87186 6,966 6,390 $43K
84403 1,807 1,784 $43K
43235 73 68 $43K
0002A 1,059 1,059 $42K
99442 856 819 $42K
96160 925 740 $42K
90833 Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) 716 701 $42K
84153 2,632 2,594 $41K
C1769 Guide wire 714 684 $41K
99383 325 325 $40K
82746 3,420 3,400 $40K
83690 12,713 11,546 $39K
92083 461 455 $39K
94729 1,502 1,443 $39K
99406 1,013 961 $38K
T1013 Sign language or oral interpretive services, per 15 minutes 1,984 1,817 $38K
95885 336 299 $37K
87077 5,677 4,971 $37K
95117 1,369 740 $37K
74018 2,668 2,582 $37K
73110 2,226 2,079 $37K
94640 Pressurized or nonpressurized inhalation treatment for acute airway obstruction 2,620 2,167 $37K
90882 624 558 $37K
A9575 Injection, gadoterate meglumine, 0.1 ml 1,474 1,432 $36K
58558 28 28 $36K
83735 8,517 7,331 $36K
88341 380 367 $36K
72050 1,355 1,349 $35K
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 9,808 9,636 $34K
G0500 Moderate sedation services provided by the same physician or other qualified health care professional performing a gastrointestinal endoscopic service that sedation supports, requiring the presence of an independent trained observer to assist in the monitoring of the patient's level of consciousness and physiological status; initial 15 minutes of intra-service time; patient age 5 years or older (additional time may be reported with 99153, as appropriate) 902 864 $34K
90688 1,075 1,073 $34K
69210 247 246 $33K
80362 4,463 3,126 $33K
76819 Fetal biophysical profile; without non-stress testing 795 608 $32K
72110 1,036 1,031 $32K
86706 4,019 3,999 $32K
0054A 767 767 $32K
71045 Radiologic examination, chest; single view 3,320 2,870 $31K
81001 15,394 14,674 $31K
82570 7,480 7,237 $31K
J0178 Injection, aflibercept, 1 mg 12 12 $30K
87070 4,568 4,399 $30K
90680 2,784 2,782 $30K
80349 5,362 3,858 $29K
G0008 Administration of influenza virus vaccine 2,510 2,510 $29K
G0297 Low dose ct scan (ldct) for lung cancer screening 385 384 $29K
99239 Hospital discharge day management, more than 30 minutes 371 343 $29K
99386 251 249 $28K
74178 145 143 $28K
99211 Office or other outpatient visit for the evaluation and management of an established patient, minimal severity 1,005 980 $28K
84402 1,224 1,212 $28K
84146 1,520 1,508 $27K
90682 788 787 $27K
80348 4,315 3,021 $27K
20611 62 59 $26K
80069 2,017 1,731 $26K
0052A 608 608 $26K
90697 1,454 1,451 $25K
73140 1,677 1,645 $25K
D9239 883 868 $25K
87088 3,514 3,368 $25K
82043 5,440 5,417 $25K
82670 941 906 $24K
0004A 585 585 $24K
86140 7,168 6,652 $24K
81002 9,643 9,033 $24K
36430 55 40 $23K
0051A 559 559 $23K
90633 2,275 2,274 $22K
87522 Neg quan hep c or qual rna 513 498 $22K
90619 973 968 $22K
D1208 Topical application of fluoride, excluding varnish 1,368 1,367 $22K
82784 2,082 1,670 $22K
87040 3,647 2,162 $22K
D0330 Panoramic radiographic image 468 454 $22K
83001 1,333 1,328 $22K
99443 377 353 $21K
D2393 Resin-based composite - three surfaces, posterior, primary or permanent 193 175 $21K
90746 560 556 $20K
93356 320 305 $20K
86765 2,114 2,107 $20K
90670 3,169 3,169 $20K
95913 168 162 $20K
90656 779 779 $20K
88112 482 475 $20K
96161 464 442 $20K
0081A 467 466 $20K
95910 253 246 $20K
93325 253 248 $19K
D0210 Intraoral - complete series of radiographic images 276 269 $19K
99381 153 152 $19K
99203 Office or other outpatient visit for the evaluation and management of a new patient, low complexity 222 218 $18K
90480 502 502 $18K
82565 4,688 4,615 $18K
49585 12 12 $17K
73080 906 870 $17K
70487 49 49 $17K
90710 1,475 1,472 $17K
99222 Initial hospital care, per day, moderate complexity 190 178 $17K
82533 1,342 1,052 $17K
95909 150 142 $16K
90732 360 357 $16K
Q9957 Injection, perflutren lipid microspheres, per ml 393 389 $16K
86787 2,228 2,223 $16K
J7298 Levonorgestrel-releasing intrauterine contraceptive system (mirena), 52 mg 14 14 $16K
99384 130 130 $16K
84207 560 560 $16K
29130 78 78 $15K
80306 2,657 2,535 $15K
90698 2,292 2,290 $15K
11102 29 29 $15K
83002 890 885 $15K
95115 601 348 $15K
29581 87 39 $15K
99291 Critical care, evaluation and management of the critically ill patient, first 30-74 minutes 95 37 $14K
86704 1,755 1,747 $14K
86038 2,300 2,278 $14K
94727 309 299 $14K
81508 434 432 $14K
76857 320 311 $14K
74174 53 53 $14K
D1351 Sealant - per tooth 289 106 $14K
72070 531 529 $14K
84460 4,183 4,090 $14K
99441 313 300 $14K
90707 632 630 $13K
86618 950 938 $13K
86923 169 150 $13K
86735 1,955 1,948 $13K
86235 1,050 628 $13K
82947 3,699 3,284 $13K
G0103 Prostate cancer screening; prostate specific antigen test (psa) 825 819 $13K
90696 950 949 $13K
80353 1,657 1,266 $13K
86708 1,796 1,795 $12K
81003 5,743 5,527 $12K
90716 588 588 $12K
93010 Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only 1,681 1,540 $12K
84425 778 775 $12K
0082A 279 279 $12K
73590 921 873 $12K
87506 96 96 $12K
71101 446 443 $11K
90673 287 287 $11K
86376 904 894 $11K
80347 2,099 1,643 $11K
84450 2,539 2,479 $11K
80050 General health panel 443 434 $11K
87505 140 138 $11K
96376 2,452 1,705 $11K
80326 1,924 1,587 $11K
84480 1,419 1,401 $11K
84132 3,081 2,829 $11K
86696 824 822 $11K
99153 Mod sedat endo service >5yrs 363 357 $10K
87252 394 388 $10K
96402 253 238 $10K
87272 847 842 $10K
83605 2,164 1,882 $10K
85652 6,306 5,967 $9K
83013 196 194 $9K
75561 27 27 $9K
P9016 Red blood cells, leukocytes reduced, each unit 20 17 $9K
85014 2,536 2,439 $9K
87798 Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism 290 237 $9K
87269 705 702 $9K
85730 2,304 2,197 $9K
58300 40 40 $9K
90620 298 297 $8K
90734 1,183 1,182 $8K
83520 878 797 $8K
C1894 Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser 559 553 $8K
D4341 92 37 $8K
99152 393 377 $8K
82247 2,391 2,055 $8K
86141 792 786 $8K
D7230 50 24 $8K
84550 2,227 2,104 $8K
83615 2,117 1,571 $8K
A9541 Technetium tc-99m sulfur colloid, diagnostic, per study dose, up to 20 millicuries 26 26 $8K
87529 201 124 $8K
70498 68 67 $8K
86705 869 866 $8K
0074A 185 185 $8K
99401 152 152 $8K
82550 2,098 1,913 $7K
99411 210 117 $7K
72040 404 402 $7K
82248 1,684 1,337 $7K
73090 615 564 $7K
D0230 Intraoral - periapical each additional radiographic image 443 405 $7K
85379 1,505 1,471 $7K
87147 2,198 2,142 $7K
86431 1,621 1,615 $7K
73560 328 295 $7K
83020 619 618 $7K
99238 Hospital discharge day management, 30 minutes or less 123 120 $7K
84100 2,021 1,624 $7K
90662 461 461 $6K
77049 24 24 $6K
0154A 155 155 $6K
82950 1,688 1,687 $6K
J0690 Injection, cefazolin sodium, 500 mg 1,272 1,146 $6K
90472 Immunization administration, each additional vaccine (list separately) 1,848 1,834 $6K
82310 2,123 2,040 $6K
11721 73 71 $6K
86160 662 403 $6K
82105 705 698 $6K
75574 50 49 $6K
G0009 Administration of pneumococcal vaccine 602 600 $6K
86709 751 747 $6K
87209 501 498 $6K
J1885 Injection, ketorolac tromethamine, per 15 mg 8,518 5,591 $6K
72156 14 14 $6K
97035 305 142 $6K
84520 3,183 2,643 $6K
82525 467 466 $6K
84156 2,014 1,813 $6K
72157 12 12 $6K
82040 1,692 1,634 $5K
J2469 Injection, palonosetron hcl, 25 mcg 180 122 $5K
86800 428 426 $5K
99493 67 43 $5K
J0561 Injection, penicillin g benzathine, 100,000 units 41 39 $5K
83921 301 299 $5K
85018 5,073 4,685 $5K
86580 842 807 $5K
99382 36 36 $5K
93786 31 30 $5K
90744 1,012 1,012 $5K
87150 137 136 $5K
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 158 157 $5K
76942 26 26 $5K
76821 132 72 $5K
82274 610 609 $5K
87177 529 529 $5K
84630 534 528 $5K
84295 1,745 1,711 $5K
86225 711 697 $5K
76825 37 36 $4K
99404 59 51 $4K
99051 405 380 $4K
G0257 Unscheduled or emergency dialysis treatment for an esrd patient in a hospital outpatient department that is not certified as an esrd facility 20 12 $4K
84144 191 168 $4K
90713 159 159 $4K
76937 26 26 $4K
J8540 Dexamethasone, oral, 0.25 mg 1,387 1,009 $4K
84681 208 207 $4K
82374 1,680 1,648 $4K
82435 1,724 1,690 $4K
69209 27 27 $4K
64615 13 12 $4K
80352 657 434 $4K
29075 14 12 $4K
87338 402 399 $4K
87255 147 144 $4K
73718 12 12 $4K
87641 136 136 $4K
C1887 Catheter, guiding (may include infusion/perfusion capability) 64 64 $4K
87102 463 406 $4K
84590 331 329 $4K
82150 1,106 1,056 $4K
87253 195 192 $4K
J1644 Injection, heparin sodium, per 1000 units 6,191 2,375 $3K
0012A 164 164 $3K
97116 92 76 $3K
84155 1,712 1,685 $3K
J9217 Leuprolide acetate (for depot suspension), 7.5 mg 12 12 $3K
86003 179 127 $3K
80074 116 116 $3K
J2250 Injection, midazolam hydrochloride, per 1 mg 4,924 4,821 $3K
84075 1,009 983 $3K
73660 147 143 $3K
C1726 Catheter, balloon dilatation, non-vascular 30 30 $3K
D2332 27 13 $3K
84163 235 235 $3K
G0279 Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) 95 89 $3K
51798 17 12 $3K
J3489 Injection, zoledronic acid, 1 mg 54 52 $3K
95816 27 27 $3K
94664 71 15 $3K
97164 41 41 $3K
84481 271 269 $3K
84446 218 218 $3K
84597 214 213 $3K
84703 919 903 $3K
83021 168 167 $3K
J2310 Injection, naloxone hydrochloride, per 1 mg 130 122 $3K
J0689 Injection, cefazolin sodium (baxter), not therapeutically equivalent to j0690, 500 mg 517 479 $3K
82627 131 131 $3K
93788 31 30 $3K
J1170 Injection, hydromorphone, up to 4 mg 1,896 1,588 $3K
99177 745 744 $2K
82977 498 327 $2K
0083A 59 59 $2K
0011A 176 176 $2K
J0330 Injection, succinylcholine chloride, up to 20 mg 560 508 $2K
86665 118 76 $2K
86200 369 368 $2K
80164 241 231 $2K
73100 159 145 $2K
84165 398 384 $2K
87536 25 25 $2K
83993 161 160 $2K
92567 186 183 $2K
D0272 Bitewings - two radiographic images 105 105 $2K
J2405 Injection, ondansetron hydrochloride, per 1 mg 6,268 5,432 $2K
88141 94 94 $2K
99460 40 40 $2K
91319 81 81 $2K
J3010 Injection, fentanyl citrate, 0.1 mg 4,708 4,600 $2K
90837 Psychotherapy, 53 minutes with patient 14 12 $2K
83721 862 855 $2K
83525 165 162 $2K
D0240 95 92 $2K
74220 38 38 $2K
87430 373 369 $2K
72170 42 42 $2K
86039 246 241 $2K
36410 70 67 $2K
80321 85 65 $2K
84145 96 94 $2K
0053A 36 36 $1K
76827 37 36 $1K
95911 17 17 $1K
D9420 215 209 $1K
80323 168 136 $1K
80354 225 178 $1K
92082 16 15 $1K
80178 236 220 $1K
97530 Therapeutic activities, direct patient contact, each 15 minutes 53 30 $1K
98967 16 13 $1K
90381 49 49 $1K
D2331 14 12 $1K
98968 21 14 $1K
H0038 Self-help/peer services, per 15 minutes 36 12 $1K
0173A 29 29 $1K
87449 164 161 $1K
88184 12 12 $1K
92557 43 42 $1K
96127 243 243 $1K
86364 115 115 $1K
96116 26 13 $1K
88312 24 24 $1K
99221 14 14 $1K
J2785 Injection, regadenoson, 0.1 mg 12 12 $1K
97112 Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination 37 28 $1K
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg 318 310 $1K
92136 14 14 $987.31
86308 294 293 $966.83
87804 Infectious agent antigen detection by immunoassay; Influenza, each type 149 147 $964.53
90700 39 39 $923.95
97802 28 28 $914.41
82465 257 255 $903.75
88173 14 13 $865.89
84466 75 75 $850.70
95812 14 14 $835.54
J1100 Injection, dexamethasone sodium phosphate, 1 mg 3,927 3,652 $826.06
J2270 Injection, morphine sulfate, up to 10 mg 1,340 1,194 $794.49
D1354 15 15 $745.05
J1200 Injection, diphenhydramine hcl, up to 50 mg 1,663 1,393 $740.89
85049 225 225 $719.91
85045 242 231 $714.70
96411 24 14 $690.48
J1030 Injection, methylprednisolone acetate, 40 mg 256 244 $677.58
99402 12 12 $663.86
87653 15 15 $661.41
73552 27 24 $655.73
90672 58 58 $649.34
83516 63 55 $595.79
A9576 Injection, gadoteridol, (prohance multipack), per ml 32 32 $578.26
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) 45 45 $570.92
J2765 Injection, metoclopramide hcl, up to 10 mg 1,027 945 $542.88
82785 58 52 $536.01
J0696 Injection, ceftriaxone sodium, per 250 mg 1,423 1,314 $525.03
D9999 Unspecified adjunctive procedure, by report 14 14 $512.40
J9045 Injection, carboplatin, 50 mg 17 12 $502.61
86617 25 17 $480.52
J2550 Injection, promethazine hcl, up to 50 mg 1,102 998 $454.81
74021 13 13 $449.86
A9577 Injection, gadobenate dimeglumine (multihance), per ml 13 13 $442.17
87205 183 164 $432.44
72072 24 24 $416.63
96417 20 12 $408.30
87324 51 51 $390.32
P9612 Catheterization for collection of specimen, single patient, all places of service 14 14 $386.75
80355 38 26 $372.26
80356 117 107 $368.34
87075 71 65 $367.14
86790 37 36 $365.05
93000 26 26 $348.40
82951 38 38 $333.58
72080 12 12 $324.36
76815 Ultrasound, pregnant uterus, real time with image documentation, limited 12 12 $291.18
G1004 Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program 215 170 $289.48
80177 31 27 $288.70
83014 65 64 $261.76
72190 12 12 $244.71
73060 27 25 $241.28
84152 16 16 $230.06
90714 12 12 $215.83
84255 15 15 $202.23
92015 Determination of refractive state 13 13 $189.80
73070 44 42 $186.87
72220 12 12 $182.92
J1650 Injection, enoxaparin sodium, 10 mg 360 251 $182.21
94726 12 12 $159.23
82378 12 12 $153.76
J3370 Injection, vancomycin hcl, 500 mg 37 24 $114.28
80143 394 380 $98.40
87101 14 14 $94.67
J0665 Injection, bupivicaine, not otherwise specified, 0.5 mg 157 105 $91.92
87207 15 15 $88.85
80179 355 346 $88.41
82330 12 12 $88.03
82952 38 38 $84.28
Q3014 Telehealth originating site facility fee 14 13 $83.94
95012 12 12 $80.39
84478 14 12 $61.07
J0171 Injection, adrenalin, epinephrine, 0.1 mg 15 13 $60.11
84436 12 12 $59.73
J2930 Injection, methylprednisolone sodium succinate, up to 125 mg 33 25 $53.89
73600 12 12 $52.26
J2272 Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg 583 505 $45.17
91318 12 12 $45.08
Q9966 Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml 70 54 $40.80
J3475 Injection, magnesium sulfate, per 500 mg 32 29 $20.39
99495 26 26 $17.02
C9113 Injection, pantoprazole sodium, per vial 194 140 $14.95
J2371 Injection, phenylephrine hydrochloride, 20 micrograms 26 13 $12.97
J0360 Injection, hydralazine hcl, up to 20 mg 13 12 $12.56
Q9969 Tc-99m from non-highly enriched uranium source, full cost recovery add-on, per study dose 13 13 $10.66
J7512 Prednisone, immediate release or delayed release, oral, 1 mg 684 542 $10.26
J2003 Injection, lidocaine hydrochloride, 1 mg 28 28 $3.36
J3420 Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg 15 14 $1.16
J2060 Injection, lorazepam, 2 mg 74 65 $0.40
J1630 Injection, haloperidol, up to 5 mg 181 167 $0.18
A4657 Syringe, with or without needle, each 515 115 $0.00
99024 16 12 $0.00
J2470 Injection, pantoprazole sodium, 40 mg 17 12 $0.00
86682 955 955 $0.00
J1171 Injection, hydromorphone, 0.1 mg 16 14 $0.00
90648 12 12 $0.00
J0780 Injection, prochlorperazine, up to 10 mg 15 13 $0.00