| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
259,946 |
230,784 |
$10.05M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
166,268 |
153,716 |
$8.49M |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
125,118 |
52,742 |
$1.82M |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
13,989 |
13,084 |
$799K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
14,565 |
13,752 |
$724K |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
34,369 |
14,365 |
$666K |
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
883 |
839 |
$537K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
9,774 |
9,424 |
$458K |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
66,736 |
59,787 |
$436K |
| 99233 |
Prolong inpt eval add15 m |
15,094 |
7,044 |
$414K |
| 59025 |
Fetal non-stress test |
19,377 |
13,596 |
$375K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
12,209 |
10,901 |
$363K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
5,441 |
5,185 |
$316K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
9,768 |
9,285 |
$311K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
11,106 |
4,471 |
$246K |
| 76818 |
|
10,206 |
8,201 |
$245K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
3,933 |
3,633 |
$228K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
3,157 |
3,062 |
$214K |
| 59514 |
|
270 |
258 |
$184K |
| 99215 |
Prolong outpt/office vis |
3,514 |
2,733 |
$163K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
6,581 |
6,052 |
$150K |
| 87428 |
|
3,543 |
3,338 |
$144K |
| 99308 |
Subsequent nursing facility care, per day, straightforward |
11,281 |
9,870 |
$142K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
4,632 |
4,247 |
$140K |
| 20610 |
|
3,692 |
3,107 |
$139K |
| J0585 |
Injection, onabotulinumtoxina, 1 unit |
265 |
177 |
$135K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
2,362 |
2,282 |
$133K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
6,134 |
5,450 |
$132K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
1,363 |
1,271 |
$120K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
2,223 |
2,152 |
$115K |
| 99223 |
Prolong inpt eval add15 m |
2,129 |
1,964 |
$107K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
5,376 |
5,145 |
$91K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
911 |
896 |
$84K |
| 59430 |
|
1,829 |
1,777 |
$82K |
| 99309 |
Subsequent nursing facility care, per day, low to moderate complexity |
3,601 |
3,019 |
$63K |
| 76801 |
|
2,330 |
2,190 |
$62K |
| 59410 |
|
94 |
85 |
$59K |
| 0002A |
|
1,438 |
1,435 |
$56K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
4,465 |
4,048 |
$54K |
| 99239 |
Hospital discharge day management, more than 30 minutes |
1,670 |
1,581 |
$53K |
| 0001A |
|
1,391 |
1,375 |
$53K |
| 93971 |
|
3,176 |
3,036 |
$50K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
2,511 |
2,316 |
$48K |
| 11721 |
|
3,778 |
3,376 |
$48K |
| 93970 |
|
2,072 |
1,971 |
$47K |
| 99231 |
Subsequent hospital care, per day, straightforward or low complexity |
3,744 |
1,874 |
$47K |
| 90791 |
Psychiatric diagnostic evaluation |
598 |
576 |
$45K |
| 90832 |
Psychotherapy, 30 minutes with patient |
1,290 |
1,072 |
$45K |
| 95886 |
|
1,077 |
1,048 |
$45K |
| 90670 |
|
7,695 |
7,324 |
$44K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
924 |
409 |
$44K |
| 97803 |
|
2,677 |
2,558 |
$43K |
| 73630 |
|
2,759 |
1,720 |
$42K |
| 90686 |
|
15,091 |
14,303 |
$41K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
805 |
799 |
$35K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
520 |
497 |
$34K |
| 99442 |
|
1,641 |
1,578 |
$30K |
| 99243 |
|
543 |
537 |
$28K |
| 54150 |
|
622 |
592 |
$28K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
2,377 |
1,190 |
$28K |
| 95810 |
Polysomnography; sleep staging with 4 or more additional parameters |
497 |
487 |
$28K |
| 36415 |
Collection of venous blood by venipuncture |
12,745 |
11,717 |
$28K |
| 99222 |
Initial hospital care, per day, moderate complexity |
793 |
744 |
$27K |
| 99205 |
Prolong outpt/office vis |
283 |
281 |
$27K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
3,076 |
2,571 |
$26K |
| 99255 |
|
285 |
273 |
$26K |
| 93000 |
|
2,347 |
2,196 |
$25K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
377 |
360 |
$23K |
| 99307 |
|
2,007 |
1,827 |
$22K |
| 95117 |
|
2,370 |
1,073 |
$21K |
| 95816 |
|
1,103 |
1,023 |
$20K |
| 81025 |
|
3,230 |
3,060 |
$20K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
1,448 |
1,411 |
$20K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
636 |
631 |
$20K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
670 |
647 |
$19K |
| 93016 |
|
1,152 |
1,114 |
$18K |
| 77014 |
|
762 |
225 |
$18K |
| 90671 |
|
1,734 |
1,647 |
$18K |
| 92551 |
|
2,992 |
2,891 |
$18K |
| J0702 |
Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg |
806 |
757 |
$16K |
| 0003A |
|
194 |
194 |
$15K |
| 90698 |
|
4,794 |
4,666 |
$15K |
| H1002 |
Prenatal care, at risk enhanced service; care coordination |
1,302 |
1,241 |
$15K |
| 99254 |
|
234 |
228 |
$15K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
1,133 |
571 |
$14K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
1,256 |
538 |
$14K |
| 43450 |
|
520 |
471 |
$13K |
| 99244 |
Office or other outpatient consultation, moderate to high complexity |
172 |
165 |
$12K |
| J1030 |
Injection, methylprednisolone acetate, 40 mg |
1,293 |
1,217 |
$12K |
| 73562 |
|
707 |
532 |
$12K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
324 |
320 |
$11K |
| 87210 |
|
2,618 |
2,529 |
$11K |
| 64615 |
|
178 |
175 |
$11K |
| 93018 |
|
1,152 |
1,114 |
$11K |
| 31579 |
|
128 |
122 |
$11K |
| 99441 |
|
1,049 |
992 |
$11K |
| 0011A |
|
274 |
269 |
$11K |
| 76820 |
|
595 |
399 |
$10K |
| H1000 |
Prenatal care, at-risk assessment |
854 |
820 |
$10K |
| 99177 |
|
1,195 |
1,126 |
$10K |
| 90833 |
Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) |
368 |
174 |
$10K |
| 93298 |
|
607 |
584 |
$10K |
| 92557 |
|
410 |
378 |
$10K |
| 20611 |
|
183 |
162 |
$10K |
| 0072A |
|
102 |
102 |
$10K |
| 0012A |
|
244 |
243 |
$9K |
| 93296 |
|
676 |
663 |
$9K |
| 93880 |
|
632 |
600 |
$9K |
| 0071A |
|
89 |
89 |
$8K |
| 97802 |
|
309 |
303 |
$8K |
| 99173 |
|
3,275 |
3,146 |
$8K |
| 11056 |
|
522 |
484 |
$7K |
| 59425 |
|
86 |
62 |
$7K |
| 95004 |
Percutaneous tests with allergenic extracts, immediate type reaction |
78 |
77 |
$7K |
| 45385 |
Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) |
24 |
24 |
$6K |
| 99406 |
|
943 |
763 |
$6K |
| 0064A |
|
67 |
67 |
$6K |
| 99385 |
|
76 |
76 |
$6K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
924 |
885 |
$5K |
| 0031A |
|
82 |
82 |
$5K |
| 81002 |
|
2,356 |
1,778 |
$5K |
| 97161 |
|
93 |
93 |
$5K |
| 93295 |
|
142 |
139 |
$5K |
| 92567 |
|
524 |
481 |
$5K |
| 96127 |
|
846 |
698 |
$5K |
| 45378 |
Colonoscopy, flexible; diagnostic, including collection of specimen(s) |
24 |
24 |
$4K |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
834 |
776 |
$4K |
| 90837 |
Psychotherapy, 53 minutes with patient |
90 |
68 |
$4K |
| 97162 |
|
88 |
82 |
$4K |
| G0179 |
Physician or allowed practitioner re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and allowed practitioners to affirm the initial implementation of the plan of care |
837 |
565 |
$4K |
| 99443 |
|
154 |
149 |
$4K |
| 95811 |
|
66 |
64 |
$4K |
| 99253 |
|
66 |
63 |
$3K |
| 93227 |
|
136 |
136 |
$3K |
| 90633 |
|
1,239 |
1,137 |
$3K |
| 11720 |
|
566 |
531 |
$3K |
| 94060 |
|
236 |
226 |
$3K |
| 64483 |
|
82 |
78 |
$3K |
| 99386 |
|
27 |
27 |
$3K |
| 73610 |
|
152 |
119 |
$3K |
| 99174 |
|
246 |
232 |
$2K |
| 93458 |
|
25 |
24 |
$2K |
| 99152 |
|
292 |
260 |
$2K |
| 81003 |
|
1,236 |
1,157 |
$2K |
| 36416 |
|
675 |
654 |
$2K |
| 58300 |
|
41 |
40 |
$2K |
| 90656 |
|
1,614 |
1,570 |
$2K |
| 99349 |
|
81 |
73 |
$2K |
| 73030 |
|
86 |
77 |
$2K |
| 11100 |
|
53 |
51 |
$2K |
| 91200 |
|
68 |
66 |
$2K |
| 73564 |
|
71 |
48 |
$2K |
| 11043 |
|
50 |
28 |
$1K |
| J1040 |
Injection, methylprednisolone acetate, 80 mg |
117 |
110 |
$1K |
| 20550 |
|
26 |
24 |
$1K |
| 90710 |
|
210 |
186 |
$1K |
| 11055 |
|
119 |
113 |
$1K |
| 43235 |
|
14 |
12 |
$1K |
| 94727 |
|
282 |
271 |
$1K |
| 95909 |
|
13 |
13 |
$1K |
| 87807 |
|
103 |
95 |
$1K |
| 99381 |
|
15 |
15 |
$1K |
| 95911 |
|
13 |
12 |
$990.24 |
| 99336 |
|
34 |
30 |
$988.86 |
| 93925 |
|
55 |
50 |
$950.52 |
| 90682 |
|
13 |
13 |
$899.47 |
| 99188 |
|
44 |
44 |
$861.05 |
| 94729 |
|
267 |
257 |
$851.33 |
| 31231 |
|
13 |
12 |
$731.80 |
| 99383 |
|
15 |
13 |
$681.30 |
| 90680 |
|
3,362 |
3,206 |
$671.50 |
| 90688 |
|
56 |
56 |
$639.34 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
50 |
37 |
$629.80 |
| 97760 |
|
36 |
12 |
$599.46 |
| 69210 |
|
33 |
27 |
$560.63 |
| 99220 |
|
15 |
13 |
$554.99 |
| 11102 |
|
12 |
12 |
$495.37 |
| 93294 |
|
26 |
26 |
$495.29 |
| 99242 |
|
12 |
12 |
$450.45 |
| 73100 |
|
35 |
26 |
$444.29 |
| 64493 |
|
14 |
14 |
$437.35 |
| 90715 |
|
13 |
13 |
$420.91 |
| 92504 |
|
32 |
28 |
$401.27 |
| 73620 |
|
34 |
24 |
$399.66 |
| 90673 |
|
12 |
12 |
$382.14 |
| 11719 |
|
188 |
173 |
$358.58 |
| 93308 |
|
25 |
25 |
$354.06 |
| 97016 |
|
57 |
25 |
$337.89 |
| 93297 |
|
28 |
27 |
$314.40 |
| 73560 |
|
26 |
24 |
$295.11 |
| J3420 |
Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg |
154 |
143 |
$287.90 |
| 64494 |
|
13 |
13 |
$252.48 |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
14 |
13 |
$245.28 |
| 99221 |
|
17 |
15 |
$235.06 |
| G2211 |
Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established) |
7,091 |
6,754 |
$221.79 |
| 96380 |
|
16 |
14 |
$213.62 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
12 |
12 |
$195.88 |
| 85018 |
|
81 |
79 |
$152.91 |
| 90744 |
|
653 |
639 |
$125.50 |
| 90461 |
|
2,731 |
780 |
$123.05 |
| 82044 |
|
39 |
38 |
$112.90 |
| 98967 |
|
13 |
13 |
$52.97 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
12 |
12 |
$42.16 |
| 76000 |
|
14 |
13 |
$39.41 |
| 93325 |
|
12 |
12 |
$33.46 |
| J7510 |
Prednisolone oral, per 5 mg |
19 |
14 |
$32.41 |
| 90674 |
|
195 |
188 |
$32.28 |
| 90685 |
|
355 |
350 |
$29.04 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
14 |
13 |
$28.05 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
49 |
37 |
$21.04 |
| G0008 |
Administration of influenza virus vaccine |
73 |
54 |
$19.30 |
| 99078 |
|
14 |
12 |
$16.80 |
| 91300 |
|
1,639 |
1,594 |
$15.65 |
| 91301 |
|
239 |
238 |
$2.31 |
| 91303 |
|
47 |
47 |
$0.39 |
| 91305 |
|
32 |
31 |
$0.30 |
| G8427 |
Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications |
623 |
587 |
$0.00 |
| G8484 |
Influenza immunization was not administered, reason not given |
175 |
168 |
$0.00 |
| 90662 |
|
49 |
30 |
$0.00 |
| 90707 |
|
12 |
12 |
$0.00 |
| G8752 |
Most recent systolic blood pressure < 140 mmhg |
13 |
12 |
$0.00 |
| 90648 |
|
12 |
12 |
$0.00 |
| G8732 |
No documentation of pain assessment, reason not given |
237 |
220 |
$0.00 |
| 90697 |
|
1,705 |
1,550 |
$0.00 |
| 1036F |
|
100 |
96 |
$0.00 |
| 0503F |
|
353 |
352 |
$0.00 |
| 90651 |
|
42 |
41 |
$0.00 |
| G8419 |
Bmi documented outside normal parameters, no follow-up plan documented, no reason given |
87 |
85 |
$0.00 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
32 |
26 |
$0.00 |
| 90381 |
|
14 |
12 |
$0.00 |
| 3017F |
|
82 |
79 |
$0.00 |
| G8754 |
Most recent diastolic blood pressure < 90 mmhg |
13 |
12 |
$0.00 |
| 90696 |
|
12 |
12 |
$0.00 |