| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
191,945 |
171,072 |
$11.31M |
| X4011 |
State-specific procedure code |
13,285 |
12,587 |
$4.90M |
| X4003 |
|
65,379 |
57,910 |
$3.53M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
5,110 |
4,861 |
$1.59M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
8,103 |
7,850 |
$1.45M |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
37,483 |
33,610 |
$1.20M |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
12,018 |
11,008 |
$637K |
| 80053 |
Comprehensive metabolic panel |
29,593 |
26,277 |
$632K |
| X4006 |
|
591 |
447 |
$552K |
| Y7506 |
|
3,266 |
1,590 |
$505K |
| G0480 |
Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 1-7 drug class(es), including metabolite(s) if performed |
5,392 |
4,730 |
$498K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
3,110 |
1,774 |
$465K |
| 81001 |
|
11,506 |
10,966 |
$421K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
2,720 |
2,668 |
$354K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
6,347 |
6,285 |
$333K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
6,220 |
6,153 |
$317K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
3,817 |
3,462 |
$274K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
2,547 |
2,455 |
$245K |
| J3490 |
Unclassified drugs |
8,497 |
6,626 |
$214K |
| 80306 |
|
6,468 |
6,061 |
$210K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
8,816 |
8,671 |
$179K |
| 76820 |
|
2,395 |
1,020 |
$161K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
8,222 |
8,104 |
$156K |
| G0378 |
Hospital observation service, per hour |
757 |
570 |
$127K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
5,470 |
5,053 |
$125K |
| 78815 |
Positron emission tomography (PET) for limited area imaging |
147 |
132 |
$121K |
| 90999 |
Unlisted dialysis procedure, inpatient or outpatient |
3,667 |
333 |
$121K |
| 81002 |
|
10,626 |
7,851 |
$102K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
1,939 |
787 |
$100K |
| 20610 |
|
837 |
798 |
$97K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
1,590 |
1,280 |
$96K |
| 95810 |
Polysomnography; sleep staging with 4 or more additional parameters |
153 |
152 |
$89K |
| J0585 |
Injection, onabotulinumtoxina, 1 unit |
286 |
174 |
$83K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
1,651 |
1,573 |
$83K |
| 95811 |
|
170 |
166 |
$81K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
639 |
403 |
$74K |
| 71046 |
Radiologic examination, chest; 2 views |
1,203 |
1,162 |
$74K |
| Y7507 |
|
739 |
501 |
$73K |
| 94726 |
|
768 |
754 |
$73K |
| 62323 |
|
395 |
351 |
$73K |
| 84443 |
Thyroid stimulating hormone (TSH) |
3,464 |
3,347 |
$64K |
| Q3014 |
Telehealth originating site facility fee |
3,297 |
2,223 |
$60K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,428 |
1,389 |
$57K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
872 |
853 |
$55K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
679 |
662 |
$53K |
| 77336 |
|
961 |
463 |
$50K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
1,666 |
1,599 |
$46K |
| 77334 |
|
281 |
217 |
$39K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
902 |
867 |
$38K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
837 |
808 |
$38K |
| 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 |
1,383 |
1,360 |
$38K |
| 29581 |
|
528 |
223 |
$37K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
763 |
692 |
$33K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
586 |
475 |
$29K |
| 87400 |
|
207 |
168 |
$27K |
| 73030 |
|
1,058 |
971 |
$26K |
| G0379 |
Direct admission of patient for hospital observation care |
155 |
135 |
$26K |
| 86803 |
|
534 |
507 |
$26K |
| 86063 |
|
380 |
367 |
$25K |
| 0202U |
Oncology (prostate), multianalyte, gene expression profiling |
89 |
88 |
$23K |
| 83655 |
|
1,093 |
1,060 |
$23K |
| 73100 |
|
437 |
339 |
$23K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
2,440 |
2,374 |
$21K |
| 80061 |
Lipid panel |
1,661 |
1,606 |
$19K |
| 84484 |
|
2,069 |
1,813 |
$18K |
| 77386 |
|
115 |
12 |
$18K |
| 88300 |
|
674 |
660 |
$18K |
| 77300 |
|
150 |
143 |
$17K |
| 94729 |
|
620 |
611 |
$16K |
| 82550 |
|
2,240 |
1,975 |
$16K |
| 71045 |
Radiologic examination, chest; single view |
647 |
599 |
$15K |
| 87653 |
|
430 |
425 |
$14K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
53 |
53 |
$13K |
| 85018 |
|
1,199 |
1,160 |
$13K |
| 84439 |
|
1,239 |
1,203 |
$13K |
| 77290 |
|
92 |
91 |
$12K |
| 64493 |
|
38 |
36 |
$12K |
| 82553 |
|
1,480 |
1,272 |
$12K |
| 83690 |
|
1,003 |
970 |
$12K |
| 70450 |
Computed tomography, head or brain; without contrast material |
183 |
161 |
$12K |
| 87807 |
|
477 |
472 |
$12K |
| 94060 |
|
104 |
104 |
$11K |
| 88304 |
|
246 |
243 |
$11K |
| 84703 |
|
802 |
761 |
$10K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
92 |
89 |
$10K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
170 |
142 |
$10K |
| 84436 |
|
193 |
181 |
$9K |
| 84479 |
|
194 |
182 |
$9K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
599 |
587 |
$9K |
| 31575 |
|
135 |
130 |
$9K |
| 87428 |
|
439 |
431 |
$9K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
55 |
50 |
$9K |
| 94681 |
|
66 |
66 |
$8K |
| 77295 |
|
26 |
24 |
$8K |
| 17110 |
|
77 |
77 |
$8K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
246 |
221 |
$7K |
| 77470 |
|
38 |
38 |
$7K |
| 73564 |
|
128 |
113 |
$7K |
| 84481 |
|
100 |
94 |
$6K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
111 |
74 |
$6K |
| 84482 |
|
43 |
43 |
$6K |
| 71250 |
|
104 |
104 |
$5K |
| 94750 |
|
135 |
130 |
$5K |
| 29075 |
|
52 |
40 |
$5K |
| 87633 |
Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets |
13 |
13 |
$5K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
55 |
52 |
$5K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
53 |
52 |
$5K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
126 |
121 |
$5K |
| 93296 |
|
422 |
376 |
$5K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
29 |
26 |
$5K |
| 64615 |
|
55 |
54 |
$4K |
| 80081 |
|
71 |
68 |
$4K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
68 |
64 |
$4K |
| 85027 |
|
151 |
118 |
$4K |
| 94200 |
|
134 |
132 |
$4K |
| J1040 |
Injection, methylprednisolone acetate, 80 mg |
515 |
453 |
$4K |
| 69210 |
|
183 |
181 |
$4K |
| J1642 |
Injection, heparin sodium, (heparin lock flush), per 10 units |
723 |
422 |
$4K |
| 85007 |
|
129 |
99 |
$4K |
| 80055 |
|
39 |
38 |
$3K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
235 |
72 |
$3K |
| 81000 |
|
499 |
478 |
$3K |
| 83735 |
|
744 |
715 |
$3K |
| 73502 |
|
77 |
70 |
$3K |
| 11102 |
|
26 |
26 |
$3K |
| 82950 |
|
161 |
159 |
$3K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
30 |
30 |
$2K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
13 |
13 |
$2K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
72 |
51 |
$2K |
| 95117 |
|
519 |
174 |
$2K |
| 77338 |
|
12 |
12 |
$2K |
| 90686 |
|
456 |
454 |
$2K |
| 82784 |
|
353 |
339 |
$2K |
| 84145 |
|
87 |
77 |
$2K |
| 82947 |
|
330 |
221 |
$2K |
| 81025 |
|
400 |
381 |
$2K |
| 87071 |
|
41 |
41 |
$2K |
| 87040 |
|
113 |
96 |
$2K |
| 83605 |
|
163 |
144 |
$2K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
24 |
24 |
$2K |
| 36415 |
Collection of venous blood by venipuncture |
539 |
493 |
$1K |
| 87150 |
|
141 |
139 |
$1K |
| 73560 |
|
30 |
27 |
$1K |
| 17000 |
|
26 |
26 |
$1K |
| 86364 |
|
165 |
162 |
$1K |
| 92511 |
|
12 |
12 |
$1K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
253 |
211 |
$1K |
| 82248 |
|
345 |
328 |
$1K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
15 |
14 |
$991.80 |
| 92567 |
|
110 |
104 |
$939.97 |
| 29580 |
|
19 |
12 |
$923.28 |
| A9552 |
Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries |
13 |
13 |
$920.00 |
| 83516 |
|
156 |
146 |
$878.55 |
| 92557 |
|
42 |
39 |
$878.14 |
| 85730 |
|
253 |
226 |
$869.05 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
13 |
13 |
$859.56 |
| 77280 |
|
14 |
12 |
$839.97 |
| J1644 |
Injection, heparin sodium, per 1000 units |
129 |
90 |
$821.52 |
| 17250 |
|
14 |
14 |
$818.06 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
407 |
332 |
$815.09 |
| 87070 |
|
146 |
129 |
$789.13 |
| J2704 |
Injection, propofol, 10 mg |
198 |
171 |
$787.01 |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
16 |
15 |
$735.64 |
| 80069 |
|
115 |
82 |
$710.21 |
| 73610 |
|
17 |
13 |
$702.13 |
| 82803 |
|
32 |
24 |
$688.71 |
| 85610 |
|
286 |
258 |
$666.19 |
| 94010 |
|
12 |
12 |
$644.61 |
| 74018 |
|
28 |
25 |
$620.19 |
| 73070 |
|
14 |
13 |
$610.42 |
| 82607 |
|
52 |
50 |
$513.12 |
| 87077 |
|
71 |
67 |
$491.05 |
| J1815 |
Injection, insulin, per 5 units |
54 |
25 |
$486.83 |
| 83970 |
|
30 |
25 |
$469.72 |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
12 |
12 |
$462.73 |
| 82150 |
|
112 |
109 |
$458.23 |
| 87205 |
|
149 |
131 |
$410.14 |
| 87186 |
|
55 |
52 |
$402.78 |
| 80074 |
|
12 |
12 |
$389.25 |
| 86003 |
|
14 |
13 |
$370.38 |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
13 |
13 |
$350.04 |
| 95886 |
|
27 |
26 |
$311.07 |
| 87641 |
|
14 |
12 |
$259.29 |
| 87581 |
|
13 |
13 |
$253.50 |
| 87486 |
|
13 |
13 |
$253.50 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
71 |
63 |
$171.55 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
104 |
85 |
$167.91 |
| 86140 |
|
56 |
49 |
$158.29 |
| 84146 |
|
41 |
41 |
$145.12 |
| J1010 |
Injection, methylprednisolone acetate, 1 mg |
45 |
44 |
$131.71 |
| 87801 |
Infectious agent detection by nucleic acid; amplified probe, multiple organisms |
12 |
12 |
$126.36 |
| 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 |
27 |
25 |
$98.75 |
| 99070 |
|
466 |
119 |
$97.86 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
26 |
16 |
$93.30 |
| 80047 |
|
15 |
13 |
$60.50 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
28 |
24 |
$51.43 |
| 87081 |
|
25 |
25 |
$42.50 |
| A6261 |
Wound filler, gel/paste, per fluid ounce, not otherwise specified |
19 |
12 |
$21.76 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
168 |
150 |
$19.00 |
| 76937 |
|
12 |
12 |
$13.74 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
12 |
12 |
$11.61 |
| J7050 |
Infusion, normal saline solution, 250 cc |
21 |
15 |
$1.10 |
| J7030 |
Infusion, normal saline solution , 1000 cc |
42 |
40 |
$0.32 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
40 |
39 |
$0.00 |
| 64494 |
|
17 |
12 |
$0.00 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
26 |
26 |
$0.00 |
| Q9966 |
Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml |
253 |
220 |
$0.00 |
| 99152 |
|
56 |
52 |
$0.00 |