| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
Emergency department visit for the evaluation and management, high severity |
63,430 |
54,676 |
$5.58M |
| 0111 |
|
262 |
232 |
$4.78M |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
22,491 |
22,347 |
$3.57M |
| 70450 |
Computed tomography, head or brain; without contrast material |
8,936 |
8,588 |
$2.19M |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
5,980 |
5,810 |
$1.79M |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
18,366 |
16,927 |
$1.73M |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
10,457 |
10,307 |
$1.21M |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
32,031 |
29,027 |
$1.18M |
| 99199 |
Unlisted special service, procedure or report |
9,776 |
8,270 |
$987K |
| 80053 |
Comprehensive metabolic panel |
53,077 |
47,605 |
$918K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
7,263 |
6,846 |
$880K |
| 0450 |
Emergency room services |
11,195 |
9,876 |
$878K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
13,538 |
12,060 |
$854K |
| J3490 |
Unclassified drugs |
23,990 |
13,741 |
$797K |
| 99231 |
Subsequent hospital care, per day, straightforward or low complexity |
12,123 |
10,404 |
$741K |
| 77066 |
Tomosynthesis, mammo |
4,440 |
4,385 |
$729K |
| 0250 |
|
5,538 |
4,277 |
$718K |
| 99070 |
|
20,515 |
11,311 |
$703K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
6,488 |
5,925 |
$607K |
| 76642 |
|
6,314 |
6,204 |
$521K |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
2,309 |
2,266 |
$486K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
10,720 |
9,175 |
$484K |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
4,498 |
2,266 |
$477K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
1,782 |
1,745 |
$475K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
54,936 |
48,428 |
$463K |
| 82077 |
|
4,317 |
4,015 |
$442K |
| 87637 |
Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV |
2,175 |
2,130 |
$421K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
10,513 |
10,487 |
$416K |
| 71045 |
Radiologic examination, chest; single view |
20,263 |
18,828 |
$405K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
6,104 |
5,857 |
$404K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
2,950 |
2,816 |
$384K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
7,156 |
6,586 |
$383K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
2,373 |
2,293 |
$372K |
| 77065 |
Tomosynthesis, mammo |
2,646 |
2,579 |
$358K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
3,613 |
3,541 |
$349K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
1,113 |
1,093 |
$325K |
| 76830 |
Ultrasound, transvaginal |
3,241 |
3,181 |
$319K |
| 71250 |
|
1,550 |
1,470 |
$312K |
| 93971 |
|
2,009 |
1,910 |
$302K |
| 84484 |
|
23,051 |
17,583 |
$244K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
9,109 |
7,992 |
$241K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
17,193 |
9,807 |
$232K |
| 0214 |
|
27 |
24 |
$226K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
2,428 |
2,357 |
$218K |
| 76981 |
|
2,024 |
1,990 |
$214K |
| 71046 |
Radiologic examination, chest; 2 views |
6,370 |
6,021 |
$213K |
| G0279 |
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) |
5,776 |
5,721 |
$188K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
728 |
699 |
$187K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
3,142 |
3,047 |
$173K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
3,139 |
3,045 |
$172K |
| 97802 |
|
1,004 |
1,002 |
$171K |
| 76770 |
|
1,659 |
1,622 |
$167K |
| 83880 |
|
4,664 |
4,390 |
$159K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
13,674 |
12,005 |
$159K |
| G0297 |
Low dose ct scan (ldct) for lung cancer screening |
531 |
525 |
$157K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
2,695 |
2,496 |
$149K |
| 76536 |
|
1,599 |
1,574 |
$136K |
| 83690 |
|
14,973 |
13,680 |
$119K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
2,126 |
1,990 |
$114K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
241 |
238 |
$110K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
8,335 |
7,813 |
$96K |
| 0301 |
|
499 |
270 |
$92K |
| 97803 |
|
905 |
886 |
$90K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
1,842 |
1,667 |
$90K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
3,712 |
3,526 |
$86K |
| 71271 |
|
557 |
555 |
$85K |
| 77080 |
|
1,509 |
1,498 |
$82K |
| 86803 |
|
3,749 |
3,680 |
$80K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
7,873 |
7,480 |
$80K |
| 76801 |
|
862 |
769 |
$75K |
| T1999 |
Miscellaneous therapeutic items and supplies, retail purchases, not otherwise classified; identify product in "remarks" |
4,080 |
2,441 |
$74K |
| 76999 |
|
279 |
278 |
$72K |
| 73030 |
|
1,802 |
1,732 |
$71K |
| 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 |
804 |
787 |
$71K |
| 87040 |
|
5,893 |
3,717 |
$71K |
| 83605 |
|
5,769 |
4,015 |
$70K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
1,975 |
1,747 |
$68K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
645 |
608 |
$68K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
266 |
260 |
$67K |
| 73562 |
|
1,895 |
1,815 |
$66K |
| 70496 |
|
271 |
268 |
$66K |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
4,659 |
4,044 |
$62K |
| 70498 |
|
279 |
276 |
$61K |
| 84702 |
|
3,741 |
3,534 |
$60K |
| 86703 |
|
3,640 |
3,572 |
$59K |
| 70486 |
|
208 |
203 |
$58K |
| 72100 |
|
1,331 |
1,309 |
$57K |
| 0510 |
|
1,115 |
978 |
$55K |
| 81001 |
|
14,252 |
13,428 |
$54K |
| 73610 |
|
1,302 |
1,248 |
$51K |
| 94729 |
|
857 |
837 |
$49K |
| 84703 |
|
6,651 |
6,378 |
$49K |
| 73630 |
|
1,334 |
1,283 |
$49K |
| J1953 |
Injection, levetiracetam, 10 mg |
559 |
331 |
$49K |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
3,654 |
3,383 |
$47K |
| 84443 |
Thyroid stimulating hormone (TSH) |
2,324 |
2,266 |
$46K |
| 83735 |
|
5,910 |
5,438 |
$45K |
| 90715 |
|
796 |
786 |
$45K |
| 72131 |
|
174 |
172 |
$43K |
| 74174 |
|
143 |
138 |
$41K |
| J0561 |
Injection, penicillin g benzathine, 100,000 units |
79 |
64 |
$40K |
| 93970 |
|
182 |
173 |
$40K |
| 73130 |
|
1,014 |
965 |
$40K |
| A9502 |
Technetium tc-99m tetrofosmin, diagnostic, per study dose |
253 |
248 |
$37K |
| 85610 |
|
8,382 |
7,961 |
$36K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
1,165 |
1,010 |
$35K |
| J1170 |
Injection, hydromorphone, up to 4 mg |
2,118 |
1,529 |
$35K |
| 73502 |
|
727 |
709 |
$34K |
| 85730 |
|
4,978 |
4,785 |
$33K |
| 0306 |
|
336 |
269 |
$32K |
| 93017 |
|
521 |
498 |
$32K |
| 90653 |
|
269 |
267 |
$32K |
| 81025 |
|
5,321 |
5,124 |
$32K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
370 |
340 |
$31K |
| 74240 |
|
300 |
300 |
$31K |
| 90662 |
|
342 |
331 |
$30K |
| 80047 |
|
1,787 |
1,700 |
$30K |
| 94010 |
|
708 |
695 |
$28K |
| 0305 |
|
356 |
272 |
$28K |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
2,898 |
2,610 |
$26K |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
1,813 |
1,545 |
$26K |
| 87077 |
|
2,814 |
2,459 |
$26K |
| 80143 |
|
195 |
186 |
$26K |
| 82947 |
|
3,807 |
3,561 |
$25K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
1,986 |
1,836 |
$25K |
| 87186 |
|
2,593 |
2,340 |
$24K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
697 |
647 |
$24K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
2,890 |
2,797 |
$24K |
| 99221 |
|
221 |
124 |
$23K |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
1,522 |
1,209 |
$22K |
| 94727 |
|
527 |
512 |
$21K |
| J1815 |
Injection, insulin, per 5 units |
440 |
316 |
$20K |
| S0164 |
Injection, pantoprazole sodium, 40 mg |
1,055 |
977 |
$19K |
| 81003 |
|
6,662 |
6,420 |
$19K |
| 96367 |
|
310 |
285 |
$19K |
| 87081 |
|
1,974 |
1,927 |
$17K |
| 85379 |
|
1,319 |
1,302 |
$17K |
| J2060 |
Injection, lorazepam, 2 mg |
1,670 |
1,520 |
$16K |
| J2704 |
Injection, propofol, 10 mg |
423 |
374 |
$15K |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
1,647 |
1,542 |
$14K |
| 0270 |
|
375 |
203 |
$13K |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
51 |
51 |
$13K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
172 |
169 |
$13K |
| 94726 |
|
174 |
174 |
$13K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
882 |
876 |
$13K |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
1,425 |
1,310 |
$13K |
| 91322 |
|
47 |
47 |
$13K |
| 76775 |
|
131 |
123 |
$12K |
| 86900 |
|
2,655 |
2,259 |
$10K |
| 82607 |
|
512 |
510 |
$10K |
| J1171 |
Injection, hydromorphone, 0.1 mg |
113 |
77 |
$10K |
| 86901 |
|
2,515 |
2,275 |
$10K |
| 86850 |
|
1,615 |
1,552 |
$10K |
| 70491 |
|
25 |
25 |
$10K |
| 96376 |
|
257 |
221 |
$10K |
| 90651 |
|
27 |
26 |
$10K |
| 84439 |
|
889 |
876 |
$9K |
| 73110 |
|
216 |
209 |
$9K |
| 87210 |
|
1,625 |
1,584 |
$9K |
| J1940 |
Injection, furosemide, up to 20 mg |
623 |
547 |
$9K |
| 87633 |
Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets |
16 |
16 |
$8K |
| 0360 |
|
56 |
28 |
$8K |
| 85027 |
|
1,155 |
1,134 |
$8K |
| 0760 |
|
126 |
113 |
$8K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
174 |
169 |
$8K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
763 |
693 |
$7K |
| 80061 |
Lipid panel |
455 |
454 |
$7K |
| J2919 |
Injection, methylprednisolone sodium succinate, 5 mg |
115 |
102 |
$7K |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
407 |
379 |
$7K |
| 82728 |
|
336 |
334 |
$7K |
| 72040 |
|
169 |
168 |
$6K |
| 80179 |
|
85 |
84 |
$6K |
| 90686 |
|
158 |
157 |
$6K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
132 |
130 |
$6K |
| J3486 |
Injection, ziprasidone mesylate, 10 mg |
151 |
133 |
$5K |
| 85014 |
|
1,852 |
1,749 |
$5K |
| 84425 |
|
360 |
360 |
$5K |
| 83540 |
|
550 |
545 |
$5K |
| 82550 |
|
583 |
526 |
$5K |
| 74246 |
|
39 |
39 |
$5K |
| 73560 |
|
135 |
125 |
$4K |
| 94060 |
|
56 |
55 |
$4K |
| 0324 |
|
94 |
88 |
$3K |
| 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 |
54 |
54 |
$3K |
| Z7502 |
|
88 |
88 |
$3K |
| 87400 |
|
323 |
317 |
$3K |
| 74018 |
|
70 |
65 |
$3K |
| 0730 |
|
115 |
106 |
$3K |
| 86592 |
|
352 |
349 |
$2K |
| 94644 |
|
71 |
68 |
$2K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
75 |
66 |
$2K |
| 71101 |
|
28 |
27 |
$2K |
| 87522 |
Neg quan hep c or qual rna |
37 |
32 |
$2K |
| 76870 |
|
25 |
24 |
$2K |
| 36415 |
Collection of venous blood by venipuncture |
1,151 |
1,018 |
$2K |
| 73590 |
|
66 |
65 |
$2K |
| 0124A |
|
49 |
49 |
$2K |
| 84145 |
|
95 |
91 |
$2K |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
19 |
16 |
$2K |
| 0258 |
|
123 |
113 |
$2K |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
235 |
222 |
$2K |
| A9585 |
Injection, gadobutrol, 0.1 ml |
40 |
32 |
$2K |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
59 |
53 |
$2K |
| 96368 |
|
51 |
51 |
$2K |
| 0001A |
|
33 |
33 |
$1K |
| J2003 |
Injection, lidocaine hydrochloride, 1 mg |
35 |
24 |
$1K |
| 72110 |
|
17 |
17 |
$1K |
| 0710 |
|
29 |
29 |
$1K |
| J0360 |
Injection, hydralazine hcl, up to 20 mg |
81 |
77 |
$1K |
| J2470 |
Injection, pantoprazole sodium, 40 mg |
185 |
170 |
$1K |
| J7050 |
Infusion, normal saline solution, 250 cc |
63 |
51 |
$1K |
| 84132 |
|
286 |
265 |
$1K |
| J7620 |
Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme |
868 |
759 |
$1K |
| 84100 |
|
209 |
179 |
$1K |
| J2785 |
Injection, regadenoson, 0.1 mg |
12 |
12 |
$840.00 |
| 0272 |
|
27 |
25 |
$781.19 |
| J7611 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, concentrated form, 1 mg |
223 |
198 |
$701.78 |
| 0949 |
|
13 |
13 |
$684.00 |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
16 |
16 |
$653.12 |
| S9470 |
Nutritional counseling, dietitian visit |
12 |
12 |
$642.72 |
| 99218 |
|
13 |
12 |
$632.30 |
| S0020 |
Injection, bupivicaine hydrochloride, 30 ml |
40 |
39 |
$608.16 |
| 73080 |
|
15 |
15 |
$581.67 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
45 |
42 |
$543.46 |
| 0300 |
|
88 |
85 |
$527.04 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
48 |
48 |
$501.89 |
| 72070 |
|
13 |
13 |
$493.15 |
| 87147 |
|
69 |
38 |
$440.42 |
| J3370 |
Injection, vancomycin hcl, 500 mg |
14 |
12 |
$384.02 |
| 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 |
17 |
17 |
$375.00 |
| 73140 |
|
15 |
13 |
$367.78 |
| S0028 |
Injection, famotidine, 20 mg |
89 |
84 |
$366.08 |
| 36591 |
|
25 |
25 |
$308.36 |
| 85651 |
|
94 |
93 |
$270.61 |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
16 |
16 |
$198.36 |
| 84590 |
|
16 |
16 |
$197.92 |
| 84630 |
|
16 |
16 |
$196.32 |
| 0307 |
|
49 |
48 |
$160.19 |
| 87088 |
|
12 |
12 |
$83.86 |
| 0255 |
|
12 |
12 |
$67.46 |
| 0420 |
|
18 |
12 |
$23.21 |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
28 |
28 |
$6.84 |
| 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 |
29 |
26 |
$1.85 |
| 0250R |
|
384 |
355 |
$0.00 |