| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
17,430 |
15,861 |
$6.61M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
34,585 |
32,062 |
$6.20M |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
72,428 |
62,025 |
$5.42M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
21,097 |
18,873 |
$5.27M |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
11,920 |
10,652 |
$1.34M |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
7,108 |
6,583 |
$717K |
| 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 |
7,344 |
6,928 |
$376K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
7,968 |
2,793 |
$287K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
3,298 |
2,959 |
$126K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
203 |
190 |
$124K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
14,806 |
13,112 |
$108K |
| 71046 |
Radiologic examination, chest; 2 views |
1,860 |
1,622 |
$89K |
| 80053 |
Comprehensive metabolic panel |
36,660 |
32,921 |
$73K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
730 |
555 |
$65K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
822 |
477 |
$63K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
47,292 |
41,815 |
$61K |
| 45385 |
Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) |
69 |
66 |
$53K |
| 45378 |
Colonoscopy, flexible; diagnostic, including collection of specimen(s) |
67 |
67 |
$53K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
2,073 |
1,928 |
$51K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
1,457 |
1,399 |
$50K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
2,045 |
1,902 |
$50K |
| 84443 |
Thyroid stimulating hormone (TSH) |
4,342 |
4,059 |
$44K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
105 |
97 |
$40K |
| 71045 |
Radiologic examination, chest; single view |
844 |
761 |
$38K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
1,891 |
1,742 |
$36K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
2,193 |
2,065 |
$34K |
| 36415 |
Collection of venous blood by venipuncture |
52,878 |
46,320 |
$33K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
130 |
119 |
$33K |
| G0396 |
Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and brief intervention 15 to 30 minutes |
906 |
733 |
$33K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
1,388 |
1,316 |
$29K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
503 |
471 |
$28K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
5,934 |
5,412 |
$26K |
| 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 |
411 |
249 |
$21K |
| 87634 |
|
1,591 |
1,521 |
$18K |
| 80061 |
Lipid panel |
1,803 |
1,674 |
$16K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
943 |
413 |
$14K |
| 70450 |
Computed tomography, head or brain; without contrast material |
130 |
119 |
$14K |
| 82728 |
|
1,302 |
1,237 |
$13K |
| G0008 |
Administration of influenza virus vaccine |
566 |
489 |
$12K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
678 |
632 |
$11K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
29 |
28 |
$9K |
| 80055 |
|
96 |
93 |
$8K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
1,487 |
1,424 |
$7K |
| 86803 |
|
675 |
626 |
$7K |
| 81513 |
|
121 |
116 |
$6K |
| 90686 |
|
316 |
282 |
$5K |
| 90674 |
|
197 |
186 |
$5K |
| 87081 |
|
1,097 |
1,067 |
$5K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
3,562 |
3,098 |
$5K |
| 97803 |
|
117 |
114 |
$4K |
| 82607 |
|
407 |
386 |
$4K |
| 51798 |
|
122 |
107 |
$4K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
33 |
24 |
$3K |
| 84484 |
|
4,739 |
4,009 |
$3K |
| 86900 |
|
278 |
267 |
$3K |
| 85027 |
|
923 |
856 |
$3K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
32 |
32 |
$3K |
| 81003 |
|
11,848 |
10,717 |
$3K |
| 83690 |
|
7,921 |
7,276 |
$3K |
| 90656 |
|
108 |
106 |
$3K |
| 73140 |
|
44 |
29 |
$3K |
| 94060 |
|
17 |
13 |
$2K |
| 73562 |
|
90 |
75 |
$2K |
| 20610 |
|
14 |
13 |
$2K |
| 87481 |
|
121 |
116 |
$2K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
412 |
388 |
$2K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
6,301 |
3,414 |
$2K |
| 81025 |
|
873 |
785 |
$2K |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
53 |
51 |
$2K |
| 94761 |
|
34,522 |
32,108 |
$2K |
| 86403 |
|
347 |
339 |
$1K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
65 |
59 |
$1K |
| 0001A |
|
38 |
37 |
$1K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
1,141 |
999 |
$1K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
121 |
116 |
$1K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
23 |
15 |
$1K |
| 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) |
20 |
18 |
$1K |
| 91322 |
|
14 |
12 |
$1K |
| 82746 |
|
106 |
98 |
$1K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
248 |
233 |
$1K |
| 36416 |
|
896 |
804 |
$921.50 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
690 |
635 |
$902.26 |
| 88142 |
|
44 |
42 |
$891.36 |
| 86592 |
|
269 |
248 |
$880.96 |
| 73100 |
|
39 |
26 |
$875.54 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
1,400 |
865 |
$845.36 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
132 |
120 |
$741.84 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
654 |
583 |
$691.12 |
| G0123 |
Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, screening by cytotechnologist under physician supervision |
39 |
38 |
$669.16 |
| 90480 |
|
27 |
24 |
$647.10 |
| 86480 |
|
16 |
16 |
$626.03 |
| 97165 |
|
14 |
12 |
$601.27 |
| 86787 |
|
65 |
63 |
$577.36 |
| 84703 |
|
1,526 |
1,466 |
$547.28 |
| 73030 |
|
14 |
12 |
$525.61 |
| 0004A |
|
14 |
14 |
$517.54 |
| 88312 |
|
105 |
97 |
$478.90 |
| 87653 |
|
21 |
21 |
$475.80 |
| 81000 |
|
1,236 |
1,068 |
$448.56 |
| 84439 |
|
78 |
76 |
$397.36 |
| 86141 |
|
28 |
28 |
$360.48 |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
48 |
43 |
$345.78 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
52 |
37 |
$336.26 |
| 87186 |
|
62 |
61 |
$275.49 |
| J2704 |
Injection, propofol, 10 mg |
1,838 |
1,217 |
$267.40 |
| 87070 |
|
78 |
74 |
$266.00 |
| 88313 |
|
105 |
97 |
$239.45 |
| 87210 |
|
99 |
90 |
$214.26 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
91 |
43 |
$208.46 |
| 85018 |
|
108 |
105 |
$206.50 |
| 94760 |
|
20,439 |
19,148 |
$199.42 |
| 85652 |
|
107 |
98 |
$198.27 |
| J7030 |
Infusion, normal saline solution , 1000 cc |
19 |
17 |
$195.86 |
| 84481 |
|
12 |
12 |
$173.16 |
| 87660 |
|
13 |
12 |
$172.44 |
| 87480 |
|
13 |
12 |
$172.44 |
| 87510 |
|
13 |
12 |
$172.44 |
| 87147 |
|
69 |
67 |
$165.69 |
| 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 |
578 |
543 |
$159.79 |
| C9803 |
Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
278 |
208 |
$159.20 |
| 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 |
172 |
136 |
$142.20 |
| Q3014 |
Telehealth originating site facility fee |
103 |
74 |
$120.80 |
| 82950 |
|
28 |
26 |
$112.05 |
| 86140 |
|
39 |
37 |
$103.30 |
| 72170 |
|
14 |
12 |
$101.67 |
| 87340 |
|
12 |
12 |
$94.79 |
| 80047 |
|
25 |
25 |
$86.52 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
164 |
149 |
$84.61 |
| 87205 |
|
43 |
42 |
$79.48 |
| 82043 |
|
15 |
15 |
$66.66 |
| 82570 |
|
16 |
16 |
$65.84 |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
234 |
216 |
$60.20 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
15 |
13 |
$59.33 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
49 |
38 |
$50.99 |
| 80069 |
|
13 |
12 |
$38.00 |
| 84156 |
|
14 |
12 |
$37.82 |
| 81001 |
|
1,060 |
986 |
$36.99 |
| 82947 |
|
15 |
14 |
$25.62 |
| 86308 |
|
13 |
13 |
$23.00 |
| J8540 |
Dexamethasone, oral, 0.25 mg |
15 |
13 |
$19.44 |
| 85610 |
|
18 |
14 |
$11.72 |
| G1004 |
Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program |
3,778 |
2,932 |
$2.86 |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
21 |
14 |
$1.87 |
| 87641 |
|
41 |
37 |
$0.00 |
| 84702 |
|
25 |
24 |
$0.00 |
| J0689 |
Injection, cefazolin sodium (baxter), not therapeutically equivalent to j0690, 500 mg |
13 |
12 |
$0.00 |
| 86850 |
|
276 |
265 |
$0.00 |
| 83605 |
|
120 |
107 |
$0.00 |
| 82077 |
|
16 |
14 |
$0.00 |
| 86901 |
|
278 |
267 |
$0.00 |
| J2003 |
Injection, lidocaine hydrochloride, 1 mg |
36 |
34 |
$0.00 |
| J1010 |
Injection, methylprednisolone acetate, 1 mg |
25 |
24 |
$0.00 |
| J1642 |
Injection, heparin sodium, (heparin lock flush), per 10 units |
113 |
57 |
$0.00 |
| J1040 |
Injection, methylprednisolone acetate, 80 mg |
30 |
25 |
$0.00 |
| 87640 |
|
41 |
37 |
$0.00 |
| 72020 |
|
13 |
12 |
$0.00 |
| J1030 |
Injection, methylprednisolone acetate, 40 mg |
14 |
13 |
$0.00 |
| 83880 |
|
20 |
12 |
$0.00 |
| 95886 |
|
15 |
13 |
$0.00 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
21 |
13 |
$0.00 |