| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
Emergency department visit for the evaluation and management, high severity |
48,979 |
44,958 |
$6.88M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
53,754 |
50,031 |
$5.19M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
25,110 |
22,864 |
$4.87M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
136,192 |
124,481 |
$4.33M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
92,711 |
83,385 |
$4.24M |
| J9271 |
Injection, pembrolizumab, 1 mg |
507 |
325 |
$2.64M |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
99,684 |
88,466 |
$2.53M |
| 99215 |
Prolong outpt/office vis |
47,909 |
43,411 |
$2.13M |
| 20610 |
|
6,750 |
5,432 |
$1.63M |
| J1745 |
Injection, infliximab, excludes biosimilar, 10 mg |
419 |
345 |
$1.49M |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
10,373 |
6,464 |
$1.09M |
| 80053 |
Comprehensive metabolic panel |
136,119 |
109,913 |
$1.04M |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
2,990 |
2,723 |
$919K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
23,733 |
20,598 |
$884K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
43,663 |
35,311 |
$754K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
128,580 |
104,949 |
$714K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
9,336 |
8,798 |
$598K |
| 31575 |
|
2,135 |
1,901 |
$587K |
| 80050 |
General health panel |
14,684 |
13,176 |
$564K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
11,506 |
9,949 |
$526K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
2,473 |
2,243 |
$489K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
6,058 |
5,398 |
$484K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
30,063 |
27,149 |
$471K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
5,587 |
5,220 |
$463K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
15,963 |
12,318 |
$441K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
15,837 |
12,289 |
$436K |
| 87536 |
|
7,928 |
6,630 |
$434K |
| 71046 |
Radiologic examination, chest; 2 views |
11,668 |
10,743 |
$418K |
| 36415 |
Collection of venous blood by venipuncture |
190,242 |
155,352 |
$417K |
| 80061 |
Lipid panel |
38,188 |
34,324 |
$399K |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
3,215 |
3,079 |
$393K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
13,640 |
11,843 |
$381K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
18,543 |
16,072 |
$378K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
3,915 |
3,132 |
$363K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
11,808 |
7,745 |
$344K |
| 0240U |
|
3,892 |
2,979 |
$331K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
40,892 |
36,343 |
$295K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
10,260 |
8,281 |
$283K |
| 70450 |
Computed tomography, head or brain; without contrast material |
1,579 |
1,436 |
$268K |
| 71045 |
Radiologic examination, chest; single view |
9,566 |
8,695 |
$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 |
4,603 |
3,419 |
$242K |
| 73564 |
|
4,290 |
3,114 |
$239K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
3,713 |
3,523 |
$228K |
| 84443 |
Thyroid stimulating hormone (TSH) |
17,993 |
15,765 |
$221K |
| 81025 |
|
34,613 |
30,012 |
$212K |
| J3490 |
Unclassified drugs |
44,657 |
17,665 |
$202K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
10,806 |
9,188 |
$201K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
11,327 |
9,070 |
$194K |
| 81001 |
|
81,019 |
69,995 |
$184K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
978 |
908 |
$177K |
| J2469 |
Injection, palonosetron hcl, 25 mcg |
1,442 |
790 |
$173K |
| J2505 |
Injection, pegfilgrastim, 6 mg |
54 |
39 |
$173K |
| 52000 |
|
642 |
604 |
$172K |
| 80074 |
|
5,499 |
4,602 |
$172K |
| 93458 |
|
127 |
111 |
$165K |
| 90686 |
|
5,934 |
5,329 |
$161K |
| 87637 |
Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV |
1,292 |
1,221 |
$149K |
| G0378 |
Hospital observation service, per hour |
1,496 |
558 |
$149K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
8,099 |
5,799 |
$147K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
5,183 |
4,731 |
$146K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
2,449 |
1,449 |
$141K |
| 51700 |
|
974 |
498 |
$139K |
| 86780 |
|
13,651 |
10,996 |
$136K |
| 96417 |
|
2,704 |
1,767 |
$135K |
| J0585 |
Injection, onabotulinumtoxina, 1 unit |
1,066 |
552 |
$129K |
| 84484 |
|
15,097 |
12,566 |
$119K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
9,890 |
5,624 |
$118K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
24,391 |
21,998 |
$108K |
| J0185 |
Injection, aprepitant, 1 mg |
407 |
248 |
$98K |
| 67028 |
Intravitreal injection of a pharmacologic agent |
407 |
320 |
$95K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
4,117 |
2,529 |
$94K |
| 84439 |
|
13,951 |
11,774 |
$92K |
| 92557 |
|
1,865 |
1,716 |
$89K |
| 86361 |
|
5,177 |
4,385 |
$89K |
| 90651 |
|
513 |
483 |
$86K |
| 74178 |
|
240 |
219 |
$85K |
| 96367 |
|
3,364 |
1,962 |
$84K |
| J0897 |
Injection, denosumab, 1 mg |
86 |
81 |
$84K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
5,619 |
5,168 |
$76K |
| 96415 |
|
3,290 |
2,326 |
$75K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
236 |
224 |
$71K |
| 83880 |
|
2,996 |
2,619 |
$68K |
| 66984 |
Extracapsular cataract removal with insertion of intraocular lens prosthesis |
179 |
147 |
$67K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
238 |
202 |
$65K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
1,917 |
1,446 |
$65K |
| 83735 |
|
14,923 |
11,201 |
$65K |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
2,423 |
2,163 |
$62K |
| 87088 |
|
9,955 |
8,909 |
$62K |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
6,071 |
5,662 |
$58K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
1,824 |
1,723 |
$58K |
| 87522 |
Neg quan hep c or qual rna |
1,645 |
1,422 |
$58K |
| 92133 |
|
3,323 |
2,462 |
$57K |
| 96523 |
|
3,330 |
2,507 |
$54K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
1,602 |
1,492 |
$54K |
| 86803 |
|
5,135 |
4,241 |
$54K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
2,017 |
1,936 |
$53K |
| 74019 |
|
1,480 |
1,355 |
$52K |
| 41899 |
Unlisted procedure, dentoalveolar structures |
76 |
70 |
$52K |
| 92134 |
|
3,906 |
2,962 |
$51K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
7,412 |
6,646 |
$49K |
| 92567 |
|
2,679 |
2,443 |
$49K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
634 |
590 |
$48K |
| 83690 |
|
8,720 |
7,689 |
$44K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
1,558 |
1,432 |
$44K |
| 90750 |
|
456 |
412 |
$43K |
| J1950 |
Injection, leuprolide acetate (for depot suspension), per 3.75 mg |
26 |
25 |
$43K |
| 92250 |
|
3,127 |
2,642 |
$43K |
| 88174 |
|
2,583 |
2,341 |
$40K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
1,443 |
1,345 |
$40K |
| 73130 |
|
1,299 |
1,018 |
$39K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
432 |
396 |
$39K |
| 82728 |
|
3,992 |
3,346 |
$38K |
| 76830 |
Ultrasound, transvaginal |
403 |
377 |
$38K |
| 73610 |
|
1,362 |
1,085 |
$38K |
| 83970 |
|
1,200 |
1,143 |
$37K |
| 86480 |
|
915 |
715 |
$37K |
| 90715 |
|
620 |
579 |
$37K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
1,239 |
1,105 |
$36K |
| 99205 |
Prolong outpt/office vis |
945 |
879 |
$35K |
| 45385 |
Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) |
136 |
111 |
$34K |
| 78306 |
|
261 |
241 |
$34K |
| 99201 |
|
1,313 |
1,264 |
$33K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
9,586 |
6,588 |
$32K |
| 51798 |
|
1,263 |
1,136 |
$32K |
| 96416 |
|
337 |
211 |
$32K |
| C1713 |
Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) |
600 |
537 |
$32K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
1,234 |
1,041 |
$31K |
| 86481 |
|
545 |
499 |
$31K |
| 64615 |
|
365 |
357 |
$30K |
| 82570 |
|
7,260 |
6,612 |
$29K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
2,242 |
2,044 |
$28K |
| 92083 |
|
1,468 |
1,090 |
$28K |
| 82553 |
|
3,796 |
3,300 |
$28K |
| 20611 |
|
93 |
77 |
$28K |
| 87210 |
|
7,009 |
6,084 |
$28K |
| 93017 |
|
293 |
268 |
$27K |
| J7321 |
Hyaluronan or derivative, hyalgan, supartz or visco-3, for intra-articular injection, per dose |
179 |
74 |
$27K |
| J8499 |
Prescription drug, oral, non chemotherapeutic, nos |
5,935 |
3,352 |
$26K |
| 82043 |
|
6,041 |
5,267 |
$26K |
| 73030 |
|
791 |
695 |
$26K |
| J0640 |
Injection, leucovorin calcium, per 50 mg |
336 |
187 |
$25K |
| 83550 |
|
4,089 |
3,409 |
$25K |
| J1642 |
Injection, heparin sodium, (heparin lock flush), per 10 units |
6,349 |
4,583 |
$25K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
3,864 |
2,684 |
$24K |
| 84153 |
|
1,909 |
1,648 |
$24K |
| 73110 |
|
783 |
629 |
$23K |
| 87340 |
|
2,941 |
2,494 |
$23K |
| J2916 |
Injection, sodium ferric gluconate complex in sucrose injection, 12.5 mg |
216 |
77 |
$22K |
| 87081 |
|
3,941 |
3,583 |
$22K |
| G0108 |
Diabetes outpatient self-management training services, individual, per 30 minutes |
924 |
736 |
$22K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
58 |
51 |
$21K |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
7,591 |
5,707 |
$21K |
| 82607 |
|
1,842 |
1,577 |
$21K |
| 82550 |
|
4,785 |
4,134 |
$20K |
| 76801 |
|
204 |
187 |
$19K |
| 82378 |
|
1,454 |
1,151 |
$18K |
| 73630 |
|
590 |
463 |
$18K |
| 83540 |
|
4,127 |
3,446 |
$18K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
9,585 |
7,337 |
$17K |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
5,265 |
3,412 |
$17K |
| 86360 |
|
544 |
460 |
$17K |
| J1453 |
Injection, fosaprepitant, 1 mg |
125 |
90 |
$16K |
| 82077 |
|
1,587 |
1,359 |
$16K |
| 80179 |
|
1,535 |
1,287 |
$16K |
| 86850 |
|
2,110 |
1,499 |
$15K |
| 81002 |
|
6,136 |
4,994 |
$15K |
| J7050 |
Infusion, normal saline solution, 250 cc |
1,251 |
887 |
$15K |
| 85027 |
|
2,969 |
2,441 |
$15K |
| 80320 |
|
2,878 |
2,019 |
$15K |
| 90734 |
|
137 |
124 |
$15K |
| 86160 |
|
1,340 |
959 |
$14K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
364 |
330 |
$14K |
| 86359 |
|
542 |
460 |
$14K |
| J9190 |
Injection, fluorouracil, 500 mg |
447 |
237 |
$13K |
| 86762 |
|
998 |
896 |
$13K |
| 85610 |
|
4,451 |
3,594 |
$12K |
| 69210 |
|
384 |
341 |
$12K |
| 96411 |
|
299 |
196 |
$12K |
| 92593 |
|
744 |
673 |
$11K |
| 86787 |
|
1,074 |
944 |
$11K |
| 92652 |
|
119 |
96 |
$11K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
180 |
167 |
$11K |
| Q0138 |
Injection, ferumoxytol, for treatment of iron deficiency anemia, 1 mg (non-esrd use) |
16 |
12 |
$10K |
| 87902 |
|
50 |
39 |
$10K |
| 87449 |
|
770 |
725 |
$10K |
| 58100 |
|
245 |
214 |
$10K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
1,628 |
1,486 |
$10K |
| 92587 |
|
240 |
215 |
$10K |
| A9502 |
Technetium tc-99m tetrofosmin, diagnostic, per study dose |
61 |
52 |
$9K |
| 86140 |
|
2,558 |
2,214 |
$9K |
| 96402 |
|
510 |
406 |
$9K |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
680 |
566 |
$8K |
| J1644 |
Injection, heparin sodium, per 1000 units |
2,326 |
1,392 |
$8K |
| 84156 |
|
3,019 |
2,679 |
$8K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
643 |
528 |
$8K |
| J2785 |
Injection, regadenoson, 0.1 mg |
62 |
51 |
$8K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
95 |
77 |
$7K |
| 72100 |
|
211 |
198 |
$7K |
| 96368 |
|
853 |
480 |
$7K |
| 90838 |
|
323 |
271 |
$7K |
| 86706 |
|
819 |
703 |
$6K |
| 84481 |
|
711 |
612 |
$6K |
| 29580 |
|
63 |
12 |
$6K |
| 82962 |
|
2,403 |
1,857 |
$6K |
| 87400 |
|
1,008 |
449 |
$6K |
| 84100 |
|
1,841 |
1,514 |
$6K |
| 11719 |
|
259 |
230 |
$6K |
| 82274 |
|
357 |
349 |
$6K |
| 81003 |
|
2,967 |
2,482 |
$6K |
| 86708 |
|
605 |
534 |
$6K |
| 80143 |
|
549 |
461 |
$5K |
| 71270 |
|
36 |
29 |
$5K |
| 20526 |
|
27 |
27 |
$5K |
| 83615 |
|
1,142 |
925 |
$5K |
| 90677 |
|
163 |
110 |
$4K |
| 76775 |
|
80 |
78 |
$4K |
| 85660 |
|
882 |
783 |
$4K |
| 82150 |
|
774 |
725 |
$4K |
| 85651 |
|
1,477 |
1,260 |
$4K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
1,206 |
1,021 |
$4K |
| A9503 |
Technetium tc-99m medronate, diagnostic, per study dose, up to 30 millicuries |
222 |
199 |
$4K |
| 83605 |
|
574 |
403 |
$4K |
| J2704 |
Injection, propofol, 10 mg |
7,775 |
6,057 |
$4K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
174 |
114 |
$4K |
| 57456 |
|
12 |
12 |
$4K |
| 95816 |
|
45 |
41 |
$4K |
| 58558 |
|
13 |
12 |
$4K |
| 80329 |
|
1,099 |
439 |
$4K |
| 86900 |
|
1,908 |
1,545 |
$4K |
| 88108 |
|
238 |
215 |
$4K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
192 |
98 |
$4K |
| 86901 |
|
1,907 |
1,544 |
$4K |
| 31525 |
|
13 |
13 |
$4K |
| 85379 |
|
518 |
435 |
$4K |
| 86235 |
|
154 |
84 |
$4K |
| 71250 |
|
21 |
21 |
$3K |
| 95812 |
|
33 |
29 |
$3K |
| 82746 |
|
333 |
267 |
$3K |
| J7324 |
Hyaluronan or derivative, orthovisc, for intra-articular injection, per dose |
210 |
103 |
$3K |
| 83655 |
|
292 |
256 |
$3K |
| J9263 |
Injection, oxaliplatin, 0.5 mg |
17 |
12 |
$3K |
| 55700 |
|
12 |
12 |
$3K |
| 31576 |
|
15 |
12 |
$3K |
| 57454 |
|
17 |
12 |
$3K |
| 85730 |
|
769 |
694 |
$3K |
| 86225 |
|
266 |
245 |
$3K |
| 86704 |
|
346 |
284 |
$3K |
| 73562 |
|
88 |
78 |
$3K |
| 85652 |
|
1,360 |
1,222 |
$3K |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
4,869 |
4,014 |
$3K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
13 |
12 |
$3K |
| 91200 |
|
319 |
275 |
$3K |
| 86300 |
|
224 |
117 |
$3K |
| 82784 |
|
314 |
214 |
$2K |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
4,593 |
3,850 |
$2K |
| 85007 |
|
1,709 |
1,301 |
$2K |
| 86334 |
|
192 |
170 |
$2K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
4,766 |
4,090 |
$2K |
| J9267 |
Injection, paclitaxel, 1 mg |
51 |
25 |
$2K |
| J0702 |
Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg |
72 |
67 |
$2K |
| 83521 |
|
205 |
137 |
$2K |
| 87807 |
|
190 |
172 |
$2K |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
590 |
447 |
$2K |
| 88307 |
|
122 |
84 |
$2K |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
350 |
207 |
$2K |
| 87625 |
|
96 |
64 |
$2K |
| 90636 |
|
217 |
94 |
$2K |
| A9577 |
Injection, gadobenate dimeglumine (multihance), per ml |
43 |
39 |
$2K |
| 84702 |
|
275 |
211 |
$2K |
| 83516 |
|
118 |
93 |
$2K |
| 87077 |
|
359 |
284 |
$2K |
| 86592 |
|
696 |
509 |
$2K |
| 90656 |
|
850 |
658 |
$2K |
| 84165 |
|
287 |
244 |
$2K |
| C1894 |
Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser |
128 |
115 |
$2K |
| 90670 |
|
13 |
12 |
$2K |
| A9150 |
Non-prescription drugs |
1,162 |
761 |
$2K |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
58 |
27 |
$2K |
| 76642 |
|
33 |
33 |
$2K |
| 99442 |
|
455 |
441 |
$2K |
| 83883 |
|
297 |
190 |
$2K |
| 59025 |
Fetal non-stress test |
102 |
56 |
$1K |
| J0500 |
Injection, dicyclomine hcl, up to 20 mg |
28 |
26 |
$1K |
| 87481 |
|
50 |
42 |
$1K |
| C1769 |
Guide wire |
139 |
127 |
$1K |
| 87511 |
|
50 |
42 |
$1K |
| 92558 |
|
26 |
24 |
$1K |
| 96401 |
|
74 |
57 |
$1K |
| 83010 |
|
130 |
116 |
$1K |
| 81005 |
|
1,369 |
1,151 |
$1K |
| 96376 |
|
100 |
30 |
$1K |
| 92020 |
|
87 |
78 |
$1K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
13 |
12 |
$1K |
| 72040 |
|
41 |
41 |
$1K |
| 84550 |
|
373 |
339 |
$1K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
827 |
711 |
$1K |
| 92015 |
Determination of refractive state |
95 |
85 |
$1K |
| 99443 |
|
261 |
243 |
$947.93 |
| 82565 |
|
289 |
273 |
$936.92 |
| C1887 |
Catheter, guiding (may include infusion/perfusion capability) |
73 |
71 |
$928.09 |
| 11055 |
|
31 |
25 |
$887.92 |
| 77080 |
|
13 |
13 |
$850.90 |
| 85018 |
|
335 |
288 |
$839.12 |
| 84703 |
|
152 |
122 |
$812.16 |
| 17000 |
|
28 |
27 |
$680.68 |
| J8597 |
Antiemetic drug, oral, not otherwise specified |
28 |
25 |
$611.20 |
| 17110 |
|
13 |
13 |
$605.85 |
| 86769 |
|
28 |
17 |
$591.75 |
| 80069 |
|
107 |
92 |
$587.70 |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
24 |
16 |
$568.20 |
| 90739 |
|
26 |
26 |
$543.06 |
| 86705 |
|
62 |
56 |
$541.42 |
| 92025 |
|
13 |
13 |
$540.30 |
| 94761 |
|
127 |
99 |
$530.65 |
| J2060 |
Injection, lorazepam, 2 mg |
116 |
100 |
$510.16 |
| 73140 |
|
16 |
13 |
$485.90 |
| A9578 |
Injection, gadobenate dimeglumine (multihance multipack), per ml |
12 |
12 |
$483.56 |
| 81511 |
|
38 |
36 |
$481.36 |
| 77065 |
Tomosynthesis, mammo |
15 |
14 |
$476.88 |
| 76001 |
|
46 |
43 |
$475.53 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
2,827 |
2,116 |
$466.34 |
| 86200 |
|
39 |
36 |
$451.73 |
| 87186 |
|
98 |
75 |
$451.09 |
| J2795 |
Injection, ropivacaine hydrochloride, 1 mg |
422 |
387 |
$443.10 |
| J7060 |
5% dextrose/water (500 ml = 1 unit) |
39 |
16 |
$440.30 |
| 96377 |
|
34 |
25 |
$427.78 |
| V5266 |
Battery for use in hearing device |
115 |
105 |
$423.50 |
| 82977 |
|
66 |
57 |
$418.40 |
| 92592 |
|
27 |
25 |
$409.14 |
| 86800 |
|
30 |
28 |
$397.75 |
| 86431 |
|
96 |
53 |
$393.50 |
| 84154 |
|
32 |
28 |
$386.19 |
| 92136 |
|
93 |
79 |
$366.93 |
| 86376 |
|
30 |
28 |
$363.75 |
| 86038 |
|
40 |
31 |
$358.62 |
| 82747 |
|
24 |
24 |
$353.00 |
| 84436 |
|
113 |
106 |
$340.76 |
| 93976 |
|
27 |
25 |
$335.46 |
| 92082 |
|
35 |
33 |
$330.93 |
| 86141 |
|
41 |
26 |
$310.80 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
84 |
65 |
$268.98 |
| 84630 |
|
40 |
27 |
$257.97 |
| 86256 |
|
27 |
25 |
$253.05 |
| 86039 |
|
28 |
26 |
$245.52 |
| Q9969 |
Tc-99m from non-highly enriched uranium source, full cost recovery add-on, per study dose |
240 |
220 |
$238.50 |
| Q2039 |
Influenza virus vaccine, not otherwise specified |
14 |
12 |
$220.06 |
| 92227 |
|
109 |
97 |
$216.92 |
| J2305 |
Injection, nitroglycerin, 5 mg |
63 |
51 |
$211.91 |
| 76514 |
|
14 |
14 |
$208.32 |
| 84160 |
|
65 |
59 |
$200.88 |
| 84146 |
|
13 |
12 |
$197.62 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
47 |
38 |
$196.82 |
| A9698 |
Non-radioactive contrast imaging material, not otherwise classified, per study |
118 |
111 |
$186.76 |
| J2003 |
Injection, lidocaine hydrochloride, 1 mg |
172 |
133 |
$184.06 |
| 77061 |
|
13 |
12 |
$169.38 |
| 90662 |
|
34 |
24 |
$168.07 |
| 82042 |
|
55 |
43 |
$167.00 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
52 |
48 |
$145.40 |
| 99152 |
|
167 |
129 |
$139.06 |
| 87040 |
|
13 |
12 |
$134.16 |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
13 |
13 |
$132.77 |
| 86707 |
|
12 |
12 |
$127.27 |
| 87350 |
|
12 |
12 |
$126.83 |
| 99441 |
|
76 |
74 |
$126.00 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
58 |
40 |
$124.98 |
| 86430 |
|
17 |
12 |
$122.78 |
| 85045 |
|
41 |
37 |
$116.64 |
| 86593 |
|
28 |
26 |
$110.99 |
| 99153 |
Mod sedat endo service >5yrs |
29 |
25 |
$102.17 |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
28,316 |
23,470 |
$92.65 |
| 87184 |
|
12 |
12 |
$89.76 |
| 82950 |
|
20 |
12 |
$82.25 |
| 76000 |
|
13 |
12 |
$79.18 |
| 86580 |
|
14 |
12 |
$63.10 |
| J0330 |
Injection, succinylcholine chloride, up to 20 mg |
17 |
14 |
$52.63 |
| 82947 |
|
16 |
14 |
$47.16 |
| V5275 |
Ear impression, each |
13 |
12 |
$38.55 |
| 99459 |
|
36 |
27 |
$35.99 |
| 84460 |
|
78 |
57 |
$33.07 |
| 82247 |
|
78 |
57 |
$28.82 |
| 84132 |
|
65 |
52 |
$25.80 |
| J2550 |
Injection, promethazine hcl, up to 50 mg |
258 |
227 |
$24.75 |
| J2175 |
Injection, meperidine hydrochloride, per 100 mg |
244 |
212 |
$22.54 |
| J0595 |
Injection, butorphanol tartrate, 1 mg |
13 |
12 |
$13.42 |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
149 |
102 |
$6.38 |
| J0171 |
Injection, adrenalin, epinephrine, 0.1 mg |
265 |
216 |
$6.38 |
| J2371 |
Injection, phenylephrine hydrochloride, 20 micrograms |
14 |
12 |
$6.38 |
| 94760 |
|
20 |
15 |
$1.85 |
| 02404 |
|
27 |
26 |
$0.00 |
| C1780 |
Lens, intraocular (new technology) |
170 |
142 |
$0.00 |
| 01810 |
|
12 |
12 |
$0.00 |
| 87631 |
|
786 |
724 |
$0.00 |
| G0101 |
Cervical or vaginal cancer screening; pelvic and clinical breast examination |
71 |
69 |
$0.00 |
| 82172 |
|
81 |
59 |
$0.00 |
| 90653 |
|
13 |
12 |
$0.00 |
| 00811 |
|
103 |
93 |
$0.00 |
| J9035 |
Injection, bevacizumab, 10 mg |
32 |
24 |
$0.00 |
| J2710 |
Injection, neostigmine methylsulfate, up to 0.5 mg |
30 |
24 |
$0.00 |
| 76942 |
|
48 |
47 |
$0.00 |
| 88312 |
|
133 |
110 |
$0.00 |
| 00731 |
|
28 |
28 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
16 |
13 |
$0.00 |
| 02414 |
|
12 |
12 |
$0.00 |
| Q2038 |
Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (fluzone) |
12 |
12 |
$0.00 |
| A9270 |
Non-covered item or service |
604 |
309 |
$0.00 |
| 64415 |
|
34 |
25 |
$0.00 |
| A4648 |
Tissue marker, implantable, any type, each |
17 |
12 |
$0.00 |
| 3008F |
|
28 |
28 |
$0.00 |
| 76872 |
|
12 |
12 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
106 |
103 |
$0.00 |
| 91305 |
|
15 |
12 |
$0.00 |
| J7999 |
Compounded drug, not otherwise classified |
103 |
46 |
$0.00 |
| 1031F |
|
19 |
19 |
$0.00 |
| V2632 |
Posterior chamber intraocular lens |
59 |
31 |
$0.00 |
| 98967 |
|
24 |
24 |
$0.00 |