Medicaid Provider Spending

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

BERKSHIRE MEDICAL CENTER, INC

NPI: 1295765261 · PITTSFIELD, MA 01201 · General Acute Care Hospital · NPI assigned 07/04/2006

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

Authorized official RODOWICZ, DARLENE controls 11+ related entities in our dataset. Read more

$150.13M
Total Medicaid Paid
3,855,758
Total Claims
3,268,118
Beneficiaries
688
Codes Billed
2018-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialRODOWICZ, DARLENE (CHIEF FINANCIAL OFFICER)
NPI Enumeration Date07/04/2006

Related Entities

Other providers sharing the same authorized official: RODOWICZ, DARLENE

ProviderCityStateTotal Paid
FAIRVIEW HOSPITAL GREAT BARRINGTON MA $17.67M
BERKSHIRE MEDICAL CENTER, INC PITTSFIELD MA $15.35M
BERKSHIRE FACULTY SERVICES INC PITTSFIELD MA $13.13M
FAIRVIEW HOSPITAL NORTH ADAMS MA $3.50M
BERKSHIRE MEDICAL CENTER, INC. PITTSFIELD MA $3.10M
FAIRVIEW HOSPITAL WILLIAMSTOWN MA $2.82M
FAIRVIEW HOSPITAL GREAT BARRINGTON MA $1.95M
BERKSHIRE MEDICAL CENTER, INC NORTH ADAMS MA $639K
NORTH ADAMS REGIONAL HOSPITAL CORPORATION NORTH ADAMS MA $306K
BHS URGENT CARE CENTER PITTSFIELD MA $126K
BERKSHIRE MEDICAL CENTER, INC. PITTSFIELD MA $4K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 533,018 $25.87M
2019 523,444 $20.89M
2020 493,389 $17.85M
2021 606,068 $22.34M
2022 621,492 $23.71M
2023 635,494 $23.78M
2024 442,853 $15.70M

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99284 Emergency department visit for the evaluation and management, high severity 183,622 167,937 $23.75M
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 90,503 78,622 $11.78M
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 57,755 48,763 $6.66M
99285 Emergency department visit for the evaluation and management, high severity with immediate threat to life 40,695 37,836 $5.74M
99283 Emergency department visit for the evaluation and management, moderate severity 31,962 30,119 $4.22M
G0463 Hospital outpatient clinic visit for assessment and management of a patient 153,029 110,074 $3.71M
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 31,232 23,809 $3.29M
64405 12,278 10,523 $3.11M
74177 Computed tomography, abdomen and pelvis; with contrast material 13,599 13,047 $2.96M
H0010 Alcohol and/or drug services; sub-acute detoxification (residential addiction program inpatient) 5,166 642 $2.94M
99215 Prolong outpt/office vis 18,272 16,612 $2.63M
87633 Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets 8,027 7,703 $2.53M
H0011 Alcohol and/or drug services; acute detoxification (residential addiction program inpatient) 788 716 $2.34M
87635 Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe 56,605 50,771 $2.19M
96361 Intravenous infusion, hydration; each additional hour 6,672 5,236 $1.93M
43239 Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple 4,111 4,073 $1.89M
96365 Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour 16,891 12,336 $1.85M
J0585 Injection, onabotulinumtoxina, 1 unit 4,388 2,887 $1.82M
45380 Colonoscopy, flexible; with biopsy, single or multiple 3,410 3,380 $1.76M
96366 Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour 6,784 4,589 $1.64M
70450 Computed tomography, head or brain; without contrast material 11,120 10,458 $1.43M
97110 Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion 26,480 9,572 $1.38M
45385 Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) 2,130 2,120 $1.32M
99232 Subsequent hospital care, per day, moderate complexity 50,682 20,379 $1.08M
85025 Blood count; complete (CBC), automated, and automated differential WBC count 215,816 176,613 $1.01M
93306 Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete 6,576 6,493 $961K
99395 Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years 10,262 10,112 $956K
S9485 Crisis intervention mental health services, per diem 2,113 1,601 $931K
76856 Ultrasound, pelvic (nonobstetric), real time with image documentation; complete 6,222 6,115 $925K
99204 Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity 6,116 6,007 $881K
59025 Fetal non-stress test 3,680 1,887 $877K
80307 Drug test(s), presumptive, any number of drug classes; immunoassay 26,413 22,200 $866K
87491 Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe 25,517 24,516 $863K
87591 Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe 25,259 24,259 $854K
80053 Comprehensive metabolic panel 171,257 148,548 $834K
99396 Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years 9,054 8,906 $819K
87637 Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV 8,053 7,743 $812K
20552 10,125 8,517 $798K
H0035 Mental health partial hospitalization, treatment, less than 24 hours 1,352 205 $791K
97140 Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) 14,265 5,651 $729K
45378 Colonoscopy, flexible; diagnostic, including collection of specimen(s) 538 537 $714K
76705 Ultrasound, abdominal, real time with image documentation; limited 6,442 6,165 $684K
82306 Vitamin D; 25 hydroxy, includes fraction(s), if performed 41,894 41,244 $682K
93971 3,981 3,843 $657K
84443 Thyroid stimulating hormone (TSH) 67,833 65,934 $657K
70553 Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences 1,835 1,812 $645K
70551 Magnetic resonance imaging, brain; without contrast material 2,657 2,631 $644K
74176 Computed tomography, abdomen and pelvis; without contrast material 3,901 3,758 $643K
41899 Unlisted procedure, dentoalveolar structures 470 454 $614K
77067 Screening mammography, bilateral, including computer-aided detection 12,269 12,214 $597K
99203 Office or other outpatient visit for the evaluation and management of a new patient, low complexity 4,249 4,161 $581K
96367 7,126 4,401 $526K
76801 4,010 3,693 $523K
71046 Radiologic examination, chest; 2 views 23,880 22,598 $514K
72148 Magnetic resonance imaging, lumbar spine; without contrast material 2,410 2,397 $499K
64450 6,201 5,231 $483K
73721 Magnetic resonance imaging, any joint of lower extremity; without contrast material 1,557 1,536 $475K
G0378 Hospital observation service, per hour 9,008 6,250 $473K
90935 Hemodialysis procedure with single evaluation by a physician 1,078 87 $465K
97597 7,210 4,331 $440K
64615 1,573 1,560 $426K
97535 Self-care/home management training, each 15 minutes 8,824 5,700 $418K
64493 997 982 $402K
62323 1,306 1,288 $388K
99211 Office or other outpatient visit for the evaluation and management of an established patient, minimal severity 2,828 2,571 $374K
G0108 Diabetes outpatient self-management training services, individual, per 30 minutes 6,371 5,667 $356K
80061 Lipid panel 58,734 57,911 $356K
96127 9,206 8,771 $349K
G2023 Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source 20,548 18,855 $346K
99205 Prolong outpt/office vis 2,166 2,145 $336K
76816 Ultrasound, pregnant uterus, real time with image documentation, follow-up 2,593 2,435 $331K
99239 Hospital discharge day management, more than 30 minutes 9,540 9,271 $329K
77063 Screening digital breast tomosynthesis, bilateral 7,241 7,205 $321K
76642 2,963 2,903 $316K
96413 Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance 7,105 4,190 $308K
87507 2,242 2,156 $302K
76775 3,640 3,558 $300K
G0399 Home sleep test (hst) with type iii portable monitor, unattended; minimum of 4 channels: 2 respiratory movement/airflow, 1 ecg/heart rate and 1 oxygen saturation 518 517 $299K
20610 2,671 2,502 $299K
87070 27,580 26,304 $296K
20553 4,152 3,912 $293K
97112 Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination 5,445 2,641 $276K
71275 Computed tomographic angiography, chest, with contrast material 2,300 2,242 $274K
J7298 Levonorgestrel-releasing intrauterine contraceptive system (mirena), 52 mg 177 176 $270K
76770 1,619 1,578 $266K
59899 394 316 $261K
87624 Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types 10,679 10,516 $261K
J1050 Injection, medroxyprogesterone acetate, 1 mg 4,741 4,709 $258K
87088 40,182 36,178 $257K
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular 27,579 20,515 $253K
96360 Intravenous infusion, hydration; initial, 31 minutes to 1 hour 2,505 2,102 $253K
76830 Ultrasound, transvaginal 3,947 3,859 $250K
71250 4,933 4,853 $249K
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 13,030 10,141 $248K
83036 Hemoglobin; glycosylated (A1C) 51,497 50,633 $247K
76819 Fetal biophysical profile; without non-stress testing 2,052 1,037 $241K
87486 8,092 7,765 $240K
88142 12,839 12,428 $234K
72125 Computed tomography, cervical spine; without contrast material 5,664 5,389 $234K
99223 Prolong inpt eval add15 m 3,272 3,228 $233K
76805 Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation 1,337 1,331 $233K
58300 941 915 $231K
64483 790 779 $231K
96374 Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance 30,975 27,339 $230K
97530 Therapeutic activities, direct patient contact, each 15 minutes 5,635 2,928 $223K
88305 Level IV - Surgical pathology, gross and microscopic examination 16,408 15,803 $223K
94060 2,884 2,855 $218K
95886 926 923 $214K
87389 Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies 11,229 11,064 $211K
76813 1,402 1,320 $208K
92507 Treatment of speech, language, voice, communication, and/or auditory processing disorder 1,659 705 $206K
93005 Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report 50,312 42,016 $203K
97803 2,575 2,203 $203K
93017 2,501 2,470 $196K
82728 21,130 20,407 $190K
71260 Computed tomography, thorax, diagnostic; with contrast material 3,953 3,881 $187K
99233 Prolong inpt eval add15 m 5,967 2,891 $184K
80048 Basic metabolic panel (calcium, ionized) 57,893 47,545 $184K
96375 Therapeutic injection; each additional sequential IV push 25,504 20,020 $179K
76536 1,477 1,466 $177K
87510 8,951 8,687 $176K
87660 8,948 8,685 $176K
86003 1,339 1,187 $176K
97161 2,976 2,936 $175K
87480 8,949 8,686 $174K
72141 721 718 $173K
11042 Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm 2,286 1,485 $170K
84439 28,954 28,197 $169K
73221 564 551 $166K
12001 881 858 $166K
86803 15,646 15,350 $166K
84466 19,805 19,189 $165K
84484 26,020 19,588 $164K
84703 19,898 17,819 $146K
83655 7,271 7,083 $145K
87798 Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism 5,238 3,635 $145K
73030 3,982 3,711 $140K
87481 3,363 2,730 $140K
73110 2,606 2,470 $138K
76817 Ultrasound, pregnant uterus, real time with image documentation, transvaginal 1,170 1,037 $137K
94640 Pressurized or nonpressurized inhalation treatment for acute airway obstruction 3,013 1,935 $134K
70486 1,367 1,346 $133K
87502 Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets 2,792 2,714 $130K
73630 4,440 4,259 $128K
83690 24,480 21,857 $126K
83880 10,742 9,451 $122K
81513 2,853 2,728 $119K
74018 2,246 2,132 $119K
77080 4,850 4,820 $118K
73562 4,328 4,058 $115K
73610 3,540 3,418 $115K
72100 2,831 2,797 $113K
99222 Initial hospital care, per day, moderate complexity 2,187 1,955 $112K
Q0222 Injection, bebtelovimab, 175 mg 118 111 $110K
82607 12,866 12,642 $109K
86618 7,881 7,592 $108K
86780 9,891 9,677 $108K
J2469 Injection, palonosetron hcl, 25 mcg 1,669 963 $108K
83605 15,335 13,195 $107K
90715 3,874 3,841 $105K
87522 Neg quan hep c or qual rna 2,689 2,653 $104K
73130 3,507 3,364 $104K
G0297 Low dose ct scan (ldct) for lung cancer screening 1,114 1,106 $103K
83735 27,994 22,716 $103K
97750 3,819 2,940 $102K
84702 6,293 4,697 $101K
ATP14 27,818 24,030 $95K
83970 5,854 5,711 $95K
87340 9,648 9,459 $93K
78452 Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress 461 457 $93K
87625 6,737 6,653 $91K
81220 CFTR (cystic fibrosis transmembrane conductance regulator) gene analysis; common variants 455 448 $91K
81329 1,015 1,005 $91K
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 11,615 11,049 $90K
77065 Tomosynthesis, mammo 1,831 1,689 $89K
87186 14,463 13,480 $87K
71271 2,670 2,658 $87K
10060 477 456 $86K
83540 20,431 19,791 $86K
71045 Radiologic examination, chest; single view 11,503 10,662 $86K
70498 784 752 $84K
J7050 Infusion, normal saline solution, 250 cc 29,361 9,450 $84K
58301 417 417 $84K
83520 7,205 5,010 $84K
J0185 Injection, aprepitant, 1 mg 626 385 $82K
84153 6,515 6,363 $81K
97162 2,074 2,043 $81K
92567 1,912 1,875 $80K
J0131 Injection, acetaminophen, not otherwise specified,10 mg 4,540 3,757 $78K
87661 Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe 2,890 2,761 $75K
98929 2,466 2,029 $75K
J2505 Injection, pegfilgrastim, 6 mg 65 52 $75K
86141 9,850 8,999 $71K
86850 8,944 8,349 $70K
72131 1,887 1,841 $69K
94729 2,601 2,570 $69K
76376 45,903 38,185 $67K
87653 1,965 1,946 $66K
J1644 Injection, heparin sodium, per 1000 units 17,056 4,530 $64K
77066 Tomosynthesis, mammo 1,171 1,167 $64K
87902 310 308 $64K
76815 Ultrasound, pregnant uterus, real time with image documentation, limited 748 687 $63K
M0243 Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring 231 230 $62K
86704 6,907 6,748 $62K
99406 9,234 8,827 $62K
86706 7,589 7,413 $62K
84403 2,872 2,791 $60K
77062 686 686 $60K
87040 7,790 5,090 $59K
80076 13,522 12,612 $59K
90791 Psychiatric diagnostic evaluation 486 469 $58K
99238 Hospital discharge day management, 30 minutes or less 1,637 1,615 $58K
57454 157 156 $58K
90686 3,613 3,575 $57K
88341 2,068 1,994 $57K
99282 Emergency department visit for the evaluation and management, low to moderate severity 1,607 1,586 $56K
81000 26,049 23,229 $56K
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A 4,068 3,979 $56K
M0222 Intravenous injection, bebtelovimab, includes injection and post administration monitoring 326 317 $56K
J3490 Unclassified drugs 3,247 2,693 $53K
86480 1,740 1,681 $53K
81001 16,357 14,781 $52K
88342 5,208 5,096 $52K
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 1,882 1,757 $51K
90834 Psychotherapy, 45 minutes with patient 678 491 $51K
00170 Anesthesia for intraoral procedures, including biopsy 420 406 $51K
85610 33,154 21,098 $50K
73502 2,423 2,224 $50K
95806 39 39 $50K
86709 6,909 6,735 $49K
Q9967 Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml 23,665 22,369 $49K
86762 3,013 2,988 $49K
85027 10,410 8,871 $48K
83516 3,213 2,903 $47K
90792 Psychiatric diagnostic evaluation with medical services 544 521 $46K
77061 507 496 $45K
94726 1,601 1,583 $45K
84481 4,222 4,062 $45K
90832 Psychotherapy, 30 minutes with patient 881 689 $43K
86787 3,059 3,028 $43K
29125 273 268 $42K
81508 717 713 $41K
97116 1,753 800 $40K
86140 11,244 10,031 $39K
87631 517 506 $39K
86038 4,475 4,408 $39K
93296 2,245 2,225 $37K
J0882 Injection, darbepoetin alfa, 1 microgram (for esrd on dialysis) 239 75 $37K
52000 192 190 $37K
99202 Office or other outpatient visit for the evaluation and management of a new patient, straightforward 274 269 $36K
J1100 Injection, dexamethasone sodium phosphate, 1 mg 24,221 14,948 $36K
87426 Infectious agent antigen detection, SARS-CoV-2 (COVID-19) 1,531 1,386 $36K
81002 22,231 20,676 $36K
88304 2,409 2,375 $36K
82746 4,256 4,197 $35K
0002A 821 809 $35K
86765 2,223 2,195 $34K
76818 159 82 $34K
82784 4,066 3,466 $34K
99496 703 691 $34K
85652 17,262 15,566 $33K
J7307 Etonogestrel (contraceptive) implant system, including implant and supplies 66 66 $33K
84146 1,732 1,696 $32K
84425 2,170 2,159 $32K
98928 1,057 891 $32K
J1756 Injection, iron sucrose, 1 mg 901 395 $32K
76942 246 227 $31K
ATP08 14,653 11,578 $31K
84182 1,686 1,668 $31K
00731 825 808 $30K
85730 9,204 8,742 $30K
82043 11,397 11,221 $30K
83001 1,217 1,202 $30K
0001A 694 689 $29K
96376 10,116 6,993 $29K
C9290 Injection, bupivacaine liposome, 1 mg 1,101 1,076 $29K
11102 53 53 $29K
82570 11,552 10,803 $28K
70496 755 738 $28K
85379 3,778 3,669 $28K
92557 415 409 $28K
J2405 Injection, ondansetron hydrochloride, per 1 mg 30,225 23,604 $28K
J2704 Injection, propofol, 10 mg 20,055 13,910 $28K
81025 3,483 3,423 $27K
82670 791 763 $27K
C9803 Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source 8,634 8,076 $27K
96415 595 457 $27K
82105 1,827 1,772 $26K
86900 8,791 8,148 $26K
86901 8,721 8,148 $25K
V5266 Battery for use in hearing device 660 631 $25K
0003A 1,007 993 $25K
ATP15 6,541 5,355 $25K
99408 3,151 2,241 $25K
99217 728 710 $24K
J7030 Infusion, normal saline solution , 1000 cc 23,546 16,649 $24K
87205 8,001 7,230 $24K
85007 10,351 8,834 $23K
86481 360 351 $23K
80050 General health panel 272 266 $23K
84520 10,634 9,302 $23K
76870 175 170 $23K
73140 396 383 $22K
ATP17 15,620 14,083 $22K
95885 82 82 $22K
87581 722 707 $22K
99219 747 712 $22K
69436 Tympanostomy (requiring insertion of ventilating tube), general anesthesia 12 12 $22K
83921 2,174 2,149 $22K
27096 49 49 $21K
84207 1,048 1,044 $20K
29581 321 87 $20K
70491 122 121 $19K
99495 515 509 $19K
93299 971 954 $19K
96160 816 811 $19K
93225 368 363 $18K
81003 8,032 7,533 $17K
99462 407 206 $17K
74183 48 48 $17K
84100 17,912 14,963 $17K
99291 Critical care, evaluation and management of the critically ill patient, first 30-74 minutes 80 75 $17K
J1885 Injection, ketorolac tromethamine, per 15 mg 24,477 16,557 $17K
J3010 Injection, fentanyl citrate, 0.1 mg 23,731 19,610 $16K
J0897 Injection, denosumab, 1 mg 150 148 $16K
90677 548 545 $16K
80164 3,037 2,791 $16K
72110 219 215 $16K
G0270 Medical nutrition therapy; reassessment and subsequent intervention(s) following second referral in same year for change in diagnosis, medical condition or treatment regimen (including additional hours needed for renal disease), individual, face to face with the patient, each 15 minutes 405 397 $15K
95810 Polysomnography; sleep staging with 4 or more additional parameters 12 12 $15K
86235 438 414 $15K
74019 470 455 $15K
12011 81 81 $15K
84134 1,984 1,708 $15K
86430 3,066 3,012 $14K
92587 136 136 $14K
86376 946 937 $14K
99385 182 181 $14K
83525 1,128 1,117 $14K
91320 200 198 $14K
J2250 Injection, midazolam hydrochloride, per 1 mg 19,586 16,979 $13K
82378 2,231 2,043 $13K
11981 51 51 $13K
83002 481 471 $13K
97166 186 183 $12K
51705 193 165 $12K
90674 627 618 $12K
76882 113 108 $12K
12002 53 53 $12K
82077 7,921 6,792 $12K
J0696 Injection, ceftriaxone sodium, per 250 mg 4,172 2,764 $12K
82150 1,943 1,860 $12K
82131 536 528 $12K
93923 318 308 $12K
82805 257 226 $11K
87634 275 268 $11K
0124A 457 438 $11K
72128 467 457 $11K
73080 370 356 $11K
72040 215 213 $11K
84460 4,208 4,036 $11K
G0279 Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) 707 691 $11K
94761 379 364 $11K
93970 111 108 $11K
93308 74 69 $11K
82977 2,466 2,361 $11K
97035 243 102 $10K
82565 5,594 5,319 $10K
J2543 Injection, piperacillin sodium/tazobactam sodium, 1 gram/0.125 grams (1.125 grams) 695 385 $10K
84132 4,669 2,877 $10K
83615 6,853 5,722 $10K
81420 Fetal chromosomal aneuploidy genomic sequence analysis panel 13 13 $10K
91200 67 67 $10K
84165 2,444 2,370 $10K
J0690 Injection, cefazolin sodium, 500 mg 7,938 6,163 $9K
J1650 Injection, enoxaparin sodium, 10 mg 1,917 840 $9K
77336 212 79 $9K
86666 344 279 $9K
83721 2,093 2,054 $9K
93270 186 185 $9K
82550 5,428 4,963 $9K
J1170 Injection, hydromorphone, up to 4 mg 10,289 5,999 $9K
86708 772 766 $8K
88307 148 143 $8K
0012A 321 316 $8K
00813 174 174 $8K
76857 196 193 $8K
17110 33 33 $8K
84450 3,129 2,949 $8K
96523 448 420 $7K
51798 2,179 2,104 $7K
46600 24 24 $7K
J2270 Injection, morphine sulfate, up to 10 mg 9,864 6,910 $7K
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg 5,269 4,948 $7K
99460 70 68 $7K
86696 351 240 $7K
J2930 Injection, methylprednisolone sodium succinate, up to 125 mg 2,331 1,777 $7K
87804 Infectious agent antigen detection by immunoassay; Influenza, each type 677 658 $7K
J1200 Injection, diphenhydramine hcl, up to 50 mg 6,847 4,978 $7K
86316 503 491 $7K
99231 Subsequent hospital care, per day, straightforward or low complexity 636 335 $7K
90656 367 367 $7K
97165 55 53 $6K
M0247 Intravenous infusion, sotrovimab, includes infusion and post administration monitoring 27 27 $6K
V5160 Dispensing fee, binaural 13 13 $6K
00812 140 140 $6K
94664 568 533 $6K
90678 46 46 $6K
84550 4,808 4,502 $6K
93298 247 247 $6K
36415 Collection of venous blood by venipuncture 84,100 69,855 $6K
J7620 Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme 1,249 842 $6K
86665 202 103 $6K
82040 4,512 4,148 $6K
82248 2,917 2,578 $6K
98927 227 194 $5K
99308 Subsequent nursing facility care, per day, straightforward 398 388 $5K
72072 100 100 $5K
A9585 Injection, gadobutrol, 0.1 ml 6,126 5,815 $5K
M0239 Intravenous infusion, bamlanivimab-xxxx, includes infusion and post administration monitoring 51 49 $5K
ATP03 6,861 5,823 $5K
82310 2,544 1,859 $5K
J0248 Injection, remdesivir, 1 mg 47 17 $5K
0054A 249 248 $5K
01967 Neuraxial labor analgesia/anesthesia for planned vaginal delivery 35 34 $5K
90688 381 380 $5K
82533 322 283 $5K
76700 Ultrasound, abdominal, real time with image documentation; complete 26 26 $5K
82950 763 758 $5K
90480 202 200 $5K
ATP09 1,895 1,585 $5K
99224 114 44 $5K
97163 174 173 $5K
J7120 Ringers lactate infusion, up to 1000 cc 4,226 3,116 $5K
86308 556 550 $4K
64494 1,181 925 $4K
88112 478 447 $4K
97802 56 50 $4K
84156 1,619 1,437 $4K
84255 172 172 $4K
82785 187 184 $4K
84630 373 370 $4K
J7512 Prednisone, immediate release or delayed release, oral, 1 mg 2,188 1,769 $4K
99225 90 58 $4K
J2550 Injection, promethazine hcl, up to 50 mg 2,685 1,962 $4K
87536 107 106 $4K
99386 63 63 $4K
82247 1,403 1,016 $4K
59430 30 30 $4K
J2060 Injection, lorazepam, 2 mg 5,369 4,148 $4K
73590 169 160 $4K
84270 184 179 $4K
97167 66 63 $4K
86695 240 160 $3K
80179 221 215 $3K
ATP07 1,471 1,351 $3K
86735 264 264 $3K
82947 1,747 1,664 $3K
G0444 Annual depression screening, 5 to 15 minutes 2,476 2,450 $3K
62321 12 12 $3K
86256 350 336 $3K
73120 61 55 $3K
36430 18 14 $3K
0053A 79 79 $3K
84591 182 180 $3K
00811 103 103 $3K
80178 1,104 991 $3K
86300 494 473 $3K
0031A 105 103 $3K
ATP02 1,523 1,379 $3K
J7040 Infusion, normal saline solution, sterile (500 ml = 1 unit) 2,507 1,799 $3K
86160 121 119 $3K
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 2,446 1,950 $3K
J1030 Injection, methylprednisolone acetate, 40 mg 5,116 4,735 $3K
90746 53 53 $3K
72193 112 109 $3K
ATP11 2,188 1,988 $2K
90694 458 447 $2K
99152 4,620 4,514 $2K
99221 45 44 $2K
86200 190 186 $2K
11719 74 72 $2K
J3475 Injection, magnesium sulfate, per 500 mg 1,282 1,009 $2K
90732 242 237 $2K
0134A 100 98 $2K
G0396 Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and brief intervention 15 to 30 minutes 282 212 $2K
93880 80 79 $2K
86664 106 103 $2K
J1610 Injection, glucagon hydrochloride, per 1 mg 99 98 $2K
90714 120 120 $2K
86663 106 103 $2K
82140 378 328 $2K
G0008 Administration of influenza virus vaccine 2,687 2,664 $2K
86769 258 256 $2K
J1790 Injection, droperidol, up to 5 mg 723 592 $2K
94010 12 12 $2K
87255 49 48 $2K
J0171 Injection, adrenalin, epinephrine, 0.1 mg 219 144 $2K
ATP18 1,321 1,165 $2K
J2710 Injection, neostigmine methylsulfate, up to 0.5 mg 1,092 1,046 $2K
87476 55 54 $2K
99459 934 924 $2K
80329 280 179 $2K
87468 904 889 $2K
93798 80 15 $2K
99407 116 116 $1K
ATP16 330 239 $1K
J3370 Injection, vancomycin hcl, 500 mg 452 268 $1K
99220 12 12 $1K
A9500 Technetium tc-99m sestamibi, diagnostic, per study dose 1,093 1,082 $1K
80197 1,962 1,311 $1K
87081 141 137 $1K
0013A 66 66 $1K
87338 136 133 $1K
87469 908 897 $1K
82652 39 38 $1K
80143 293 286 $1K
82962 20,333 7,938 $1K
86360 38 38 $1K
84155 1,994 1,926 $1K
85384 172 168 $1K
86258 80 78 $1K
G0103 Prostate cancer screening; prostate specific antigen test (psa) 2,901 2,877 $1K
11720 81 79 $996.11
11721 138 137 $992.61
97168 35 34 $977.71
73600 33 33 $929.43
64495 494 460 $899.12
J0330 Injection, succinylcholine chloride, up to 20 mg 562 497 $891.72
87210 161 157 $871.45
C1769 Guide wire 583 548 $869.63
86359 38 38 $868.56
0011A 18 18 $825.68
80361 487 447 $766.17
G0442 Annual alcohol misuse screening, 5 to 15 minutes 451 447 $735.59
80354 2,582 2,111 $728.98
74160 129 126 $726.12
0064A 42 42 $690.34
ATP06 356 319 $680.12
80177 142 135 $679.60
73564 13 13 $677.52
96368 37 26 $625.79
J0780 Injection, prochlorperazine, up to 10 mg 107 102 $617.78
87521 Neg quan hep c or qual rna 16 16 $607.67
99490 Ccm add 20min 554 548 $566.47
86146 13 12 $557.04
V5014 Repair/modification of a hearing aid 14 13 $555.00
ATP10 349 327 $549.93
ATP04 201 174 $542.77
G0379 Direct admission of patient for hospital observation care 14 13 $532.40
C1760 Closure device, vascular (implantable/insertable) 64 64 $512.73
90651 12 12 $506.04
84295 572 505 $499.54
G0260 Injection procedure for sacroiliac joint; provision of anesthetic, steroid and/or other therapeutic agent, with or without arthrography 124 124 $434.83
J1815 Injection, insulin, per 5 units 4,908 1,279 $434.20
90653 130 129 $426.94
J3360 Injection, diazepam, up to 5 mg 150 82 $424.02
73020 50 45 $415.30
86800 24 24 $406.09
P9016 Red blood cells, leukocytes reduced, each unit 17 14 $404.36
80348 2,288 1,778 $383.07
82627 12 12 $378.30
ATP05 135 131 $377.87
80051 1,699 1,574 $371.30
J2370 Injection, phenylephrine hcl, up to 1 ml 1,843 1,712 $358.11
88313 235 231 $353.50
96417 144 104 $334.65
J3489 Injection, zoledronic acid, 1 mg 12 12 $328.98
83704 64 64 $328.96
80346 1,134 1,012 $326.83
99309 Subsequent nursing facility care, per day, low to moderate complexity 31 28 $323.22
J1630 Injection, haloperidol, up to 5 mg 377 296 $316.93
G0123 Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, screening by cytotechnologist under physician supervision 1,900 1,834 $312.09
J7042 5% dextrose/normal saline (500 ml = 1 unit) 1,997 1,404 $309.54
86617 12 12 $280.64
84075 482 423 $278.82
84144 15 12 $276.00
86658 12 12 $275.76
86039 28 27 $266.35
J2795 Injection, ropivacaine hydrochloride, 1 mg 280 239 $262.83
82274 29 29 $255.59
64484 92 85 $254.72
J2765 Injection, metoclopramide hcl, up to 10 mg 1,587 1,327 $247.37
86753 24 12 $244.06
82010 17 12 $239.46
G0447 Face-to-face behavioral counseling for obesity, 15 minutes 447 440 $232.42
J7060 5% dextrose/water (500 ml = 1 unit) 71 65 $232.08
84432 12 12 $228.94
93010 Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only 35 33 $214.17
90662 198 198 $203.15
74220 67 67 $193.63
C9113 Injection, pantoprazole sodium, per vial 621 409 $183.03
73620 15 12 $174.55
73090 13 13 $171.90
86225 14 14 $169.68
J1040 Injection, methylprednisolone acetate, 80 mg 240 226 $163.84
J7613 Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg 1,379 913 $156.66
88312 12 12 $153.04
M0220 Injection, tixagevimab and cilgavimab, for the pre-exposure prophylaxis only, for certain adults and pediatric individuals (12 years of age and older weighing at least 40kg) with no known sars-cov-2 exposure, who either have moderate to severely compromised immune systems or for whom vaccination with any available covid-19 vaccine is not recommended due to a history of severe adverse reaction to a covid-19 vaccine(s) and/or covid-19 vaccine component(s), includes injection and post administration monitoring 31 28 $150.50
99417 Prolong home eval add 15m 12 12 $149.60
95911 14 14 $148.47
85014 88 54 $146.45
85018 88 54 $146.45
J0665 Injection, bupivicaine, not otherwise specified, 0.5 mg 152 146 $143.13
J1596 Injection, glycopyrrolate, 0.1 mg 212 209 $142.31
89050 28 28 $142.08
92591 18 13 $139.96
J1010 Injection, methylprednisolone acetate, 1 mg 649 530 $138.67
90670 24 24 $130.82
G0499 Hepatitis b screening in non-pregnant, high risk individual includes hepatitis b surface antigen (hbsag), antibodies to hbsag (anti-hbs) and antibodies to hepatitis b core antigen (anti-hbc), and is followed by a neutralizing confirmatory test, when performed, only for an initially reactive hbsag result 1,797 1,606 $125.49
86334 51 51 $124.99
82390 13 13 $120.46
80156 44 42 $118.49
99307 26 26 $117.54
80355 307 241 $112.18
V5011 Fitting/orientation/checking of hearing aid 20 12 $109.08
99497 648 642 $108.66
87493 247 228 $90.79
80365 222 217 $87.56
85046 41 38 $84.99
93246 13 13 $82.77
82374 179 168 $79.84
90472 Immunization administration, each additional vaccine (list separately) 97 97 $78.37
87075 15 12 $77.76
J8540 Dexamethasone, oral, 0.25 mg 90 63 $61.94
94799 114 108 $60.35
J2470 Injection, pantoprazole sodium, 40 mg 17 12 $59.64
86364 79 78 $58.44
81596 40 39 $53.90
90833 Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) 312 88 $49.50
J1171 Injection, hydromorphone, 0.1 mg 50 33 $48.40
83550 314 310 $46.95
86301 205 173 $42.90
80185 39 24 $39.43
84154 28 26 $37.92
Q9966 Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml 287 276 $37.36
86920 15 13 $34.72
82232 49 42 $33.36
P9612 Catheterization for collection of specimen, single patient, all places of service 58 56 $30.84
80162 16 14 $27.38
80175 13 12 $24.18
82330 13 13 $24.13
84145 124 115 $24.01
82270 16 16 $20.16
51702 20 16 $16.92
87150 719 391 $16.84
J3480 Injection, potassium chloride, per 2 meq 271 174 $11.54
G0009 Administration of pneumococcal vaccine 841 834 $10.61
82465 40 39 $8.32
90756 34 33 $7.51
J7070 Infusion, d5w, 1000 cc 542 171 $6.00
Q0163 Diphenhydramine hydrochloride, 50 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at time of chemotherapy treatment not to exceed a 48 hour dosage regimen 774 408 $5.71
S5145 Foster care, therapeutic, child; per diem 24 24 $0.00
G8989 Self care functional limitation, discharge status, at discharge from therapy or to end reporting 37 37 $0.00
91300 1,401 1,315 $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 574 483 $0.00
91312 233 225 $0.00
G1004 Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program 397 372 $0.00
H0041 Foster care, child, non-therapeutic, per diem 61 60 $0.00
G8978 Mobility: walking & moving around functional limitation, current status, at therapy episode outset and at reporting intervals 440 408 $0.00
91313 35 35 $0.00
J2919 Injection, methylprednisolone sodium succinate, 5 mg 110 54 $0.00
C1713 Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) 12 12 $0.00
G0177 Training and educational services related to the care and treatment of patient's disabling mental health problems per session (45 minutes or more) 91 13 $0.00
96402 12 12 $0.00
80353 69 49 $0.00
J0461 Injection, atropine sulfate, 0.01 mg 15 12 $0.00
Q9965 Low osmolar contrast material, 100-199 mg/ml iodine concentration, per ml 173 168 $0.00
80324 875 829 $0.00
99153 Mod sedat endo service >5yrs 104 103 $0.00
G8987 Self care functional limitation, current status, at therapy episode outset and at reporting intervals 228 213 $0.00
G8988 Self care functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting 254 224 $0.00
J3420 Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg 191 160 $0.00
J1940 Injection, furosemide, up to 20 mg 35 28 $0.00
91305 200 199 $0.00
J2785 Injection, regadenoson, 0.1 mg 547 544 $0.00
91301 201 201 $0.00
G8980 Mobility: walking & moving around functional limitation, discharge status, at discharge from therapy or to end reporting 263 254 $0.00
74174 13 12 $0.00
95012 44 44 $0.00
91303 44 44 $0.00
G8982 Changing & maintaining body position functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting 12 12 $0.00
C1725 Catheter, transluminal angioplasty, non-laser (may include guidance, infusion/perfusion capability) 57 49 $0.00
80320 54 48 $0.00
C1819 Surgical tissue localization and excision device (implantable) 13 13 $0.00
73501 13 13 $0.00
91306 14 14 $0.00
J0280 Injection, aminophyllin, up to 250 mg 34 33 $0.00