| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
53,566 |
38,973 |
$4.17M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
28,925 |
26,083 |
$3.66M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
28,026 |
25,659 |
$3.16M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
16,334 |
14,357 |
$2.49M |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
30,346 |
21,523 |
$1.98M |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
3,615 |
3,335 |
$1.25M |
| 90834 |
Psychotherapy, 45 minutes with patient |
8,139 |
4,111 |
$1.22M |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
16,614 |
4,424 |
$1.09M |
| 70450 |
Computed tomography, head or brain; without contrast material |
4,546 |
4,104 |
$1.03M |
| 80053 |
Comprehensive metabolic panel |
56,197 |
48,169 |
$922K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
6,222 |
5,465 |
$752K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
2,224 |
1,995 |
$559K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
2,296 |
1,999 |
$556K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
4,584 |
3,644 |
$489K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
11,194 |
9,571 |
$484K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
4,968 |
4,606 |
$477K |
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
4,954 |
699 |
$445K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
1,882 |
1,759 |
$428K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
15,444 |
10,900 |
$420K |
| 36415 |
Collection of venous blood by venipuncture |
55,546 |
46,316 |
$400K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
1,049 |
989 |
$395K |
| G0382 |
Level 3 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room or emergency department; (2) it is held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment; or (3) during the calendar year immediately preceding the calendar year in which a determination under 42 cfr 489.24 is being made, based on a representative sample of patient visits that occurred during that calendar year, it provides at least one-third of all of its outpatient visits for the treatment of emergency medical conditions on an urgent basis without requiring a previously scheduled appointment) |
3,158 |
3,010 |
$330K |
| G0378 |
Hospital observation service, per hour |
5,299 |
2,267 |
$319K |
| 97014 |
|
7,145 |
2,008 |
$298K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
61,316 |
49,310 |
$278K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
1,548 |
914 |
$271K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
13,966 |
11,156 |
$269K |
| 84443 |
Thyroid stimulating hormone (TSH) |
14,157 |
12,978 |
$256K |
| 45378 |
Colonoscopy, flexible; diagnostic, including collection of specimen(s) |
585 |
519 |
$230K |
| 90791 |
Psychiatric diagnostic evaluation |
1,031 |
951 |
$221K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
7,575 |
7,125 |
$204K |
| 71046 |
Radiologic examination, chest; 2 views |
13,309 |
11,413 |
$183K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
572 |
455 |
$182K |
| G0381 |
Level 2 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room or emergency department; (2) it is held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment; or (3) during the calendar year immediately preceding the calendar year in which a determination under 42 cfr 489.24 is being made, based on a representative sample of patient visits that occurred during that calendar year, it provides at least one-third of all of its outpatient visits for the treatment of emergency medical conditions on an urgent basis without requiring a previously scheduled appointment) |
1,964 |
1,885 |
$179K |
| 80061 |
Lipid panel |
11,368 |
10,607 |
$155K |
| 93458 |
|
299 |
263 |
$154K |
| 90832 |
Psychotherapy, 30 minutes with patient |
1,502 |
977 |
$146K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
1,862 |
1,040 |
$127K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
7,689 |
7,195 |
$121K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
472 |
417 |
$120K |
| 96367 |
|
924 |
458 |
$109K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
1,112 |
671 |
$103K |
| 78815 |
Positron emission tomography (PET) for limited area imaging |
233 |
219 |
$100K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
521 |
475 |
$99K |
| 85027 |
|
8,075 |
6,937 |
$97K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
5,517 |
5,369 |
$91K |
| 36591 |
|
3,964 |
2,219 |
$90K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
569 |
514 |
$86K |
| 84439 |
|
4,261 |
3,985 |
$86K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
16,095 |
11,364 |
$85K |
| J9271 |
Injection, pembrolizumab, 1 mg |
15 |
12 |
$85K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
337 |
300 |
$82K |
| 0202U |
Oncology (prostate), multianalyte, gene expression profiling |
517 |
478 |
$80K |
| 93017 |
|
959 |
895 |
$80K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
20,268 |
17,292 |
$76K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
2,700 |
733 |
$73K |
| 84484 |
|
13,535 |
11,293 |
$72K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
229 |
149 |
$72K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
12,161 |
9,917 |
$70K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
325 |
306 |
$68K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
2,224 |
1,985 |
$65K |
| 72110 |
|
1,556 |
1,390 |
$64K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
10,292 |
9,081 |
$62K |
| 97161 |
|
1,146 |
1,051 |
$61K |
| 71250 |
|
687 |
625 |
$61K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
190 |
174 |
$59K |
| 87081 |
|
6,570 |
6,033 |
$59K |
| 82607 |
|
2,988 |
2,775 |
$58K |
| 76642 |
|
444 |
388 |
$58K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
579 |
530 |
$58K |
| 87070 |
|
6,569 |
6,174 |
$56K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
2,260 |
2,017 |
$55K |
| 80076 |
|
3,528 |
3,308 |
$53K |
| 95885 |
|
203 |
185 |
$52K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
19,093 |
16,549 |
$52K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
11,710 |
9,607 |
$49K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
874 |
807 |
$49K |
| 73564 |
|
2,070 |
1,710 |
$48K |
| 73610 |
|
2,096 |
1,745 |
$48K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
11,863 |
9,560 |
$48K |
| 95810 |
Polysomnography; sleep staging with 4 or more additional parameters |
64 |
55 |
$46K |
| 97012 |
|
1,209 |
363 |
$46K |
| 91200 |
|
430 |
412 |
$45K |
| 97162 |
|
938 |
844 |
$45K |
| G0383 |
Level 4 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room or emergency department; (2) it is held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment; or (3) during the calendar year immediately preceding the calendar year in which a determination under 42 cfr 489.24 is being made, based on a representative sample of patient visits that occurred during that calendar year, it provides at least one-third of all of its outpatient visits for the treatment of emergency medical conditions on an urgent basis without requiring a previously scheduled appointment) |
364 |
354 |
$44K |
| 81001 |
|
18,128 |
16,201 |
$44K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
1,727 |
427 |
$43K |
| 45385 |
Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) |
100 |
84 |
$43K |
| 76830 |
Ultrasound, transvaginal |
431 |
393 |
$42K |
| 70496 |
|
182 |
162 |
$41K |
| 86850 |
|
1,804 |
1,569 |
$40K |
| 93880 |
|
538 |
504 |
$40K |
| 73630 |
|
2,197 |
1,854 |
$40K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
3,952 |
3,528 |
$39K |
| 76801 |
|
197 |
176 |
$38K |
| 82728 |
|
3,421 |
3,151 |
$38K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
1,449 |
1,099 |
$38K |
| 93454 |
|
53 |
44 |
$37K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
227 |
210 |
$37K |
| 76536 |
|
330 |
314 |
$36K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
1,983 |
1,894 |
$36K |
| 72050 |
|
644 |
584 |
$34K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
179 |
164 |
$34K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
237 |
195 |
$34K |
| 96523 |
|
946 |
694 |
$33K |
| 73030 |
|
1,374 |
1,183 |
$31K |
| J2704 |
Injection, propofol, 10 mg |
8,497 |
7,561 |
$28K |
| 99215 |
Prolong outpt/office vis |
244 |
138 |
$28K |
| 88142 |
|
1,123 |
1,054 |
$26K |
| 85610 |
|
5,640 |
4,136 |
$25K |
| 71045 |
Radiologic examination, chest; single view |
7,251 |
6,294 |
$25K |
| 86140 |
|
1,585 |
1,325 |
$25K |
| 70486 |
|
322 |
290 |
$25K |
| 74018 |
|
631 |
554 |
$25K |
| 94060 |
|
267 |
249 |
$25K |
| 81220 |
CFTR (cystic fibrosis transmembrane conductance regulator) gene analysis; common variants |
121 |
111 |
$24K |
| 83970 |
|
686 |
643 |
$24K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
106 |
94 |
$24K |
| 73502 |
|
813 |
718 |
$23K |
| 73130 |
|
1,413 |
1,177 |
$23K |
| 83735 |
|
4,574 |
3,521 |
$23K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
81 |
74 |
$23K |
| 81025 |
|
6,411 |
5,594 |
$22K |
| 12001 |
|
144 |
138 |
$22K |
| 86900 |
|
1,889 |
1,592 |
$22K |
| 86592 |
|
993 |
922 |
$22K |
| 81003 |
|
6,170 |
5,568 |
$21K |
| 76770 |
|
114 |
106 |
$21K |
| 87077 |
|
4,002 |
3,544 |
$21K |
| 70491 |
|
61 |
55 |
$20K |
| 72141 |
|
112 |
107 |
$20K |
| 71271 |
|
103 |
92 |
$20K |
| 82565 |
|
1,967 |
1,762 |
$20K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
911 |
832 |
$20K |
| 80074 |
|
731 |
671 |
$19K |
| 90837 |
Psychotherapy, 53 minutes with patient |
112 |
73 |
$19K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
4,419 |
3,956 |
$19K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
217 |
185 |
$18K |
| 93970 |
|
145 |
128 |
$18K |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
8,517 |
7,097 |
$17K |
| 83550 |
|
2,609 |
2,404 |
$17K |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
3,281 |
2,734 |
$17K |
| 93971 |
|
225 |
212 |
$16K |
| 83690 |
|
6,092 |
5,274 |
$16K |
| 84153 |
|
808 |
735 |
$16K |
| 87040 |
|
2,096 |
1,703 |
$16K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
936 |
862 |
$16K |
| 73110 |
|
879 |
732 |
$15K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
64 |
57 |
$15K |
| 96376 |
|
2,936 |
1,634 |
$14K |
| 82570 |
|
1,327 |
1,205 |
$14K |
| 73562 |
|
310 |
266 |
$14K |
| 86762 |
|
423 |
392 |
$14K |
| 0002A |
|
416 |
393 |
$14K |
| 70498 |
|
296 |
268 |
$13K |
| 43235 |
|
39 |
38 |
$13K |
| 97116 |
|
794 |
341 |
$13K |
| 0001A |
|
433 |
413 |
$13K |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
270 |
233 |
$12K |
| 93925 |
|
122 |
113 |
$12K |
| 87186 |
|
3,341 |
2,917 |
$12K |
| 84436 |
|
726 |
665 |
$12K |
| 86038 |
|
490 |
454 |
$12K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
2,548 |
2,030 |
$11K |
| 86901 |
|
1,884 |
1,592 |
$11K |
| 87633 |
Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets |
342 |
332 |
$11K |
| 84403 |
|
475 |
433 |
$11K |
| J1170 |
Injection, hydromorphone, up to 4 mg |
3,541 |
2,565 |
$11K |
| 77336 |
|
170 |
66 |
$11K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
8,342 |
7,614 |
$10K |
| 86480 |
|
190 |
177 |
$10K |
| 83605 |
|
2,194 |
1,834 |
$10K |
| 82947 |
|
3,102 |
2,057 |
$10K |
| 84702 |
|
791 |
539 |
$10K |
| 94726 |
|
198 |
185 |
$9K |
| 94664 |
|
1,925 |
1,656 |
$9K |
| 86618 |
|
573 |
481 |
$9K |
| 86803 |
|
325 |
295 |
$9K |
| 85652 |
|
1,545 |
1,299 |
$8K |
| 87486 |
|
333 |
324 |
$8K |
| 94729 |
|
215 |
199 |
$8K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
915 |
809 |
$8K |
| 90715 |
|
478 |
423 |
$8K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
2,641 |
2,232 |
$8K |
| 84481 |
|
524 |
478 |
$8K |
| 82533 |
|
376 |
326 |
$8K |
| 83516 |
|
231 |
209 |
$8K |
| 85014 |
|
1,220 |
1,051 |
$8K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
651 |
565 |
$8K |
| 95811 |
|
16 |
15 |
$8K |
| 87522 |
Neg quan hep c or qual rna |
178 |
157 |
$8K |
| A9552 |
Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries |
256 |
242 |
$8K |
| 82043 |
|
1,041 |
971 |
$8K |
| 82962 |
|
1,878 |
1,269 |
$7K |
| 77062 |
|
169 |
149 |
$7K |
| 82746 |
|
1,089 |
986 |
$7K |
| 81513 |
|
51 |
41 |
$7K |
| 73590 |
|
371 |
321 |
$7K |
| 84100 |
|
2,045 |
1,600 |
$7K |
| 87340 |
|
265 |
235 |
$7K |
| 88304 |
|
348 |
293 |
$6K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
59 |
55 |
$6K |
| 82553 |
|
415 |
382 |
$6K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
464 |
174 |
$6K |
| 82248 |
|
527 |
478 |
$6K |
| J1756 |
Injection, iron sucrose, 1 mg |
260 |
65 |
$6K |
| 84156 |
|
1,850 |
1,683 |
$6K |
| 73221 |
|
28 |
27 |
$6K |
| 73700 |
|
36 |
28 |
$5K |
| 72100 |
|
214 |
178 |
$5K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
66 |
64 |
$5K |
| 64493 |
|
12 |
12 |
$5K |
| 86376 |
|
239 |
212 |
$5K |
| 73080 |
|
341 |
298 |
$5K |
| 84480 |
|
477 |
425 |
$5K |
| 84550 |
|
698 |
589 |
$5K |
| 77065 |
Tomosynthesis, mammo |
268 |
226 |
$5K |
| 87205 |
|
1,127 |
977 |
$4K |
| 86704 |
|
138 |
122 |
$4K |
| 77334 |
|
19 |
12 |
$4K |
| 87581 |
|
333 |
324 |
$4K |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
334 |
324 |
$4K |
| 86431 |
|
237 |
216 |
$4K |
| 73100 |
|
66 |
55 |
$4K |
| 82550 |
|
1,074 |
838 |
$4K |
| 77066 |
Tomosynthesis, mammo |
333 |
298 |
$4K |
| 86706 |
|
189 |
175 |
$4K |
| 72070 |
|
83 |
70 |
$4K |
| 82784 |
|
316 |
273 |
$4K |
| 83540 |
|
329 |
291 |
$4K |
| 83880 |
|
784 |
696 |
$4K |
| 96415 |
|
29 |
14 |
$4K |
| 83615 |
|
1,654 |
1,447 |
$4K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
5,832 |
4,932 |
$3K |
| 85007 |
|
396 |
358 |
$3K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
624 |
520 |
$3K |
| 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 |
18 |
18 |
$3K |
| 84520 |
|
823 |
720 |
$3K |
| 85730 |
|
1,241 |
930 |
$3K |
| 73560 |
|
176 |
134 |
$3K |
| 88342 |
|
1,623 |
1,439 |
$3K |
| Q0138 |
Injection, ferumoxytol, for treatment of iron deficiency anemia, 1 mg (non-esrd use) |
38 |
24 |
$3K |
| 87480 |
|
117 |
113 |
$3K |
| 85018 |
|
962 |
814 |
$3K |
| 82670 |
|
81 |
51 |
$3K |
| 73090 |
|
212 |
181 |
$3K |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
3,711 |
2,693 |
$3K |
| 82977 |
|
284 |
241 |
$3K |
| A9500 |
Technetium tc-99m sestamibi, diagnostic, per study dose |
1,039 |
980 |
$2K |
| 80164 |
|
117 |
103 |
$2K |
| 36600 |
|
381 |
330 |
$2K |
| 86709 |
|
83 |
77 |
$2K |
| 72131 |
|
50 |
43 |
$2K |
| J1642 |
Injection, heparin sodium, (heparin lock flush), per 10 units |
1,437 |
942 |
$2K |
| 87660 |
|
117 |
113 |
$2K |
| 97166 |
|
116 |
86 |
$2K |
| 84460 |
|
292 |
260 |
$2K |
| 86800 |
|
100 |
93 |
$2K |
| 94799 |
|
163 |
78 |
$2K |
| 94618 |
|
12 |
12 |
$2K |
| J2785 |
Injection, regadenoson, 0.1 mg |
642 |
605 |
$2K |
| 99152 |
|
522 |
472 |
$2K |
| 83655 |
|
54 |
49 |
$2K |
| 83921 |
|
153 |
142 |
$2K |
| 86308 |
|
179 |
154 |
$2K |
| 84132 |
|
426 |
346 |
$2K |
| 82803 |
|
449 |
383 |
$1K |
| 84703 |
|
1,189 |
1,013 |
$1K |
| 84165 |
|
179 |
162 |
$1K |
| 85379 |
|
720 |
641 |
$1K |
| 88300 |
|
110 |
92 |
$1K |
| 93270 |
|
13 |
12 |
$1K |
| 97113 |
|
70 |
14 |
$1K |
| 96417 |
|
15 |
12 |
$1K |
| 80051 |
|
57 |
53 |
$1K |
| 81002 |
|
2,233 |
2,035 |
$1K |
| 36592 |
|
348 |
297 |
$1K |
| 87510 |
|
117 |
113 |
$1K |
| 87481 |
|
51 |
41 |
$1K |
| 85045 |
|
715 |
630 |
$1K |
| 80050 |
General health panel |
29 |
15 |
$1K |
| 82040 |
|
77 |
65 |
$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 |
266 |
237 |
$1K |
| C9113 |
Injection, pantoprazole sodium, per vial |
728 |
379 |
$921.82 |
| 77061 |
|
13 |
12 |
$838.72 |
| 80177 |
|
53 |
45 |
$815.81 |
| 84450 |
|
116 |
105 |
$793.95 |
| 72128 |
|
14 |
13 |
$754.92 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
12 |
12 |
$727.32 |
| J1644 |
Injection, heparin sodium, per 1000 units |
3,241 |
1,459 |
$600.79 |
| 84146 |
|
33 |
25 |
$545.38 |
| 71101 |
|
64 |
53 |
$534.23 |
| 83883 |
|
28 |
25 |
$521.99 |
| 72040 |
|
13 |
12 |
$478.92 |
| 90686 |
|
57 |
56 |
$468.40 |
| 86606 |
|
13 |
12 |
$467.78 |
| J2543 |
Injection, piperacillin sodium/tazobactam sodium, 1 gram/0.125 grams (1.125 grams) |
83 |
40 |
$464.61 |
| 82140 |
|
54 |
43 |
$460.02 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
1,742 |
1,522 |
$443.49 |
| 0031A |
|
12 |
12 |
$427.28 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
1,392 |
1,049 |
$420.16 |
| 87430 |
|
1,441 |
1,375 |
$407.05 |
| 86617 |
|
12 |
12 |
$393.12 |
| 86256 |
|
12 |
12 |
$391.86 |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
486 |
228 |
$387.33 |
| 80354 |
|
17 |
15 |
$360.50 |
| 87385 |
|
12 |
12 |
$333.83 |
| 80143 |
|
314 |
256 |
$332.34 |
| 86920 |
|
26 |
24 |
$331.26 |
| 85049 |
|
233 |
207 |
$317.35 |
| J1010 |
Injection, methylprednisolone acetate, 1 mg |
383 |
347 |
$310.62 |
| 86300 |
|
73 |
61 |
$304.02 |
| 83001 |
|
13 |
12 |
$301.17 |
| 82948 |
|
104 |
58 |
$299.66 |
| 82103 |
|
12 |
12 |
$286.93 |
| 73140 |
|
13 |
12 |
$281.48 |
| 90756 |
|
16 |
15 |
$273.70 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
3,084 |
2,030 |
$270.29 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
29 |
26 |
$235.79 |
| 86331 |
|
12 |
12 |
$233.82 |
| 83002 |
|
17 |
12 |
$225.48 |
| 80179 |
|
303 |
248 |
$204.62 |
| J3370 |
Injection, vancomycin hcl, 500 mg |
152 |
75 |
$204.59 |
| J2919 |
Injection, methylprednisolone sodium succinate, 5 mg |
399 |
287 |
$201.41 |
| J1030 |
Injection, methylprednisolone acetate, 40 mg |
1,399 |
1,214 |
$191.31 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
1,574 |
1,032 |
$181.80 |
| A9577 |
Injection, gadobenate dimeglumine (multihance), per ml |
543 |
506 |
$166.41 |
| 82105 |
|
15 |
12 |
$146.09 |
| 82164 |
|
12 |
12 |
$143.49 |
| 82785 |
|
12 |
12 |
$143.49 |
| 87400 |
|
307 |
271 |
$134.61 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
1,531 |
1,199 |
$132.14 |
| 84425 |
|
12 |
12 |
$132.01 |
| 82668 |
|
47 |
41 |
$130.19 |
| 84155 |
|
78 |
73 |
$123.71 |
| 82310 |
|
14 |
14 |
$109.41 |
| J2060 |
Injection, lorazepam, 2 mg |
620 |
444 |
$99.99 |
| 91300 |
|
854 |
720 |
$90.63 |
| 82150 |
|
70 |
67 |
$83.99 |
| J2371 |
Injection, phenylephrine hydrochloride, 20 micrograms |
132 |
104 |
$82.00 |
| 88311 |
|
21 |
12 |
$68.04 |
| J0171 |
Injection, adrenalin, epinephrine, 0.1 mg |
174 |
82 |
$67.10 |
| 82378 |
|
16 |
13 |
$64.02 |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
151 |
122 |
$63.98 |
| J3480 |
Injection, potassium chloride, per 2 meq |
168 |
105 |
$54.94 |
| 87807 |
|
70 |
68 |
$54.78 |
| G0283 |
Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care |
1,177 |
341 |
$54.72 |
| J0330 |
Injection, succinylcholine chloride, up to 20 mg |
61 |
47 |
$47.23 |
| J7050 |
Infusion, normal saline solution, 250 cc |
301 |
192 |
$42.80 |
| 87075 |
|
20 |
17 |
$36.58 |
| J2470 |
Injection, pantoprazole sodium, 40 mg |
125 |
81 |
$34.28 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
161 |
129 |
$27.88 |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
47 |
40 |
$21.71 |
| J2710 |
Injection, neostigmine methylsulfate, up to 0.5 mg |
635 |
524 |
$20.70 |
| J2370 |
Injection, phenylephrine hcl, up to 1 ml |
142 |
115 |
$19.85 |
| 83721 |
|
28 |
27 |
$17.71 |
| J2550 |
Injection, promethazine hcl, up to 50 mg |
124 |
109 |
$12.39 |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
232 |
170 |
$8.13 |
| J1630 |
Injection, haloperidol, up to 5 mg |
49 |
36 |
$6.50 |
| J3490 |
Unclassified drugs |
49 |
37 |
$6.36 |
| J0360 |
Injection, hydralazine hcl, up to 20 mg |
17 |
13 |
$5.78 |
| J1171 |
Injection, hydromorphone, 0.1 mg |
102 |
57 |
$1.20 |
| Q9966 |
Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml |
467 |
407 |
$0.77 |
| 91303 |
|
12 |
12 |
$0.11 |
| C1769 |
Guide wire |
758 |
670 |
$0.00 |
| G0103 |
Prostate cancer screening; prostate specific antigen test (psa) |
15 |
12 |
$0.00 |
| 94760 |
|
66 |
39 |
$0.00 |
| J2360 |
Injection, orphenadrine citrate, up to 60 mg |
64 |
62 |
$0.00 |
| J2795 |
Injection, ropivacaine hydrochloride, 1 mg |
131 |
70 |
$0.00 |
| C1894 |
Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser |
611 |
539 |
$0.00 |
| C1887 |
Catheter, guiding (may include infusion/perfusion capability) |
532 |
476 |
$0.00 |
| C1713 |
Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) |
51 |
40 |
$0.00 |
| 69209 |
|
26 |
26 |
$0.00 |
| J1598 |
Injection, glycopyrrolate (fresenius kabi), not therapeutically equivalent to j1596, 0.1 mg |
67 |
66 |
$0.00 |
| G8979 |
Mobility: walking & moving around functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting |
16 |
14 |
$0.00 |
| G1004 |
Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program |
315 |
216 |
$0.00 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
42 |
38 |
$0.00 |
| G8978 |
Mobility: walking & moving around functional limitation, current status, at therapy episode outset and at reporting intervals |
14 |
12 |
$0.00 |
| G0279 |
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) |
14 |
14 |
$0.00 |
| A9270 |
Non-covered item or service |
1,072 |
707 |
$-0.42 |