| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
64,453 |
58,966 |
$9.74M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
54,860 |
50,246 |
$8.09M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
46,451 |
41,616 |
$7.34M |
| 96361 |
Intravenous infusion, hydration; each additional hour |
19,178 |
16,506 |
$7.12M |
| G0378 |
Hospital observation service, per hour |
35,610 |
17,434 |
$5.48M |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
43,149 |
13,046 |
$2.65M |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
16,858 |
15,054 |
$2.44M |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
17,329 |
12,362 |
$2.14M |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
11,841 |
11,195 |
$1.94M |
| 87637 |
Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV |
14,237 |
13,497 |
$1.93M |
| 70450 |
Computed tomography, head or brain; without contrast material |
13,580 |
12,521 |
$1.57M |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
8,866 |
4,905 |
$1.54M |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
10,662 |
4,544 |
$1.52M |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
35,081 |
29,318 |
$1.40M |
| S9485 |
Crisis intervention mental health services, per diem |
2,764 |
1,948 |
$1.36M |
| 80053 |
Comprehensive metabolic panel |
152,591 |
130,489 |
$1.12M |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
203,512 |
166,261 |
$1.10M |
| 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 |
16,838 |
15,939 |
$1.07M |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
6,654 |
6,237 |
$1.02M |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
6,387 |
6,140 |
$978K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
13,598 |
13,453 |
$886K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
33,476 |
32,067 |
$849K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
33,135 |
31,761 |
$837K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
6,093 |
5,833 |
$826K |
| 71046 |
Radiologic examination, chest; 2 views |
36,853 |
34,402 |
$757K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
4,811 |
4,436 |
$756K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
5,755 |
4,473 |
$721K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
4,843 |
4,070 |
$712K |
| 93971 |
|
3,794 |
3,526 |
$659K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
6,859 |
4,362 |
$595K |
| 76830 |
Ultrasound, transvaginal |
5,219 |
4,993 |
$583K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
8,838 |
6,458 |
$568K |
| 76642 |
|
5,021 |
4,887 |
$559K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
2,894 |
2,738 |
$550K |
| 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 |
14,065 |
12,217 |
$542K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
5,309 |
5,064 |
$534K |
| 83735 |
|
25,976 |
20,016 |
$494K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
911 |
869 |
$492K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
4,751 |
4,047 |
$487K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
18,547 |
15,771 |
$483K |
| Q0081 |
Infusion therapy, using other than chemotherapeutic drugs, per visit |
4,980 |
2,951 |
$467K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
27,382 |
26,825 |
$466K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
3,244 |
3,114 |
$463K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
27,760 |
21,674 |
$450K |
| 80050 |
General health panel |
29,899 |
29,183 |
$425K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
12,978 |
4,766 |
$425K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
24,818 |
24,187 |
$414K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
15,488 |
15,319 |
$413K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
1,850 |
1,790 |
$412K |
| J1170 |
Injection, hydromorphone, up to 4 mg |
5,539 |
4,041 |
$392K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
32,398 |
20,978 |
$355K |
| 83690 |
|
60,140 |
53,262 |
$341K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
1,732 |
1,634 |
$333K |
| 97161 |
|
5,536 |
5,231 |
$328K |
| 84443 |
Thyroid stimulating hormone (TSH) |
40,059 |
38,559 |
$311K |
| J1642 |
Injection, heparin sodium, (heparin lock flush), per 10 units |
1,433 |
761 |
$301K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
48,242 |
39,563 |
$296K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
1,680 |
1,644 |
$280K |
| ATP14 |
|
38,577 |
32,715 |
$279K |
| 96415 |
|
1,410 |
1,161 |
$268K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
43,777 |
40,023 |
$264K |
| 76536 |
|
2,240 |
2,193 |
$261K |
| 92567 |
|
2,864 |
2,814 |
$256K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
46,491 |
45,264 |
$252K |
| 81513 |
|
2,207 |
2,141 |
$244K |
| 86780 |
|
23,430 |
22,936 |
$232K |
| 84484 |
|
29,242 |
21,841 |
$227K |
| 84702 |
|
17,281 |
13,846 |
$226K |
| 71250 |
|
3,474 |
3,328 |
$220K |
| 76770 |
|
1,673 |
1,617 |
$219K |
| 80061 |
Lipid panel |
68,369 |
66,606 |
$215K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
5,262 |
4,967 |
$213K |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
425 |
299 |
$204K |
| 74018 |
|
4,709 |
4,354 |
$201K |
| 87902 |
|
1,193 |
1,166 |
$199K |
| 86481 |
|
3,327 |
3,240 |
$198K |
| 87480 |
|
12,755 |
12,200 |
$193K |
| 87070 |
|
27,276 |
25,769 |
$193K |
| 87660 |
|
12,761 |
12,202 |
$192K |
| 87510 |
|
12,756 |
12,201 |
$192K |
| 86803 |
|
18,051 |
17,685 |
$186K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
8,483 |
7,453 |
$184K |
| 82607 |
|
18,122 |
17,547 |
$174K |
| 84703 |
|
21,517 |
19,807 |
$169K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
43,037 |
35,331 |
$167K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
28,043 |
25,054 |
$165K |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
3,311 |
3,024 |
$162K |
| 82728 |
|
15,793 |
15,082 |
$152K |
| 92587 |
|
1,150 |
1,134 |
$146K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
928 |
911 |
$146K |
| 72100 |
|
5,811 |
5,558 |
$144K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
4,755 |
4,301 |
$143K |
| 87522 |
Neg quan hep c or qual rna |
3,989 |
3,901 |
$136K |
| 82962 |
|
22,122 |
8,656 |
$131K |
| 83550 |
|
19,435 |
18,618 |
$129K |
| 36415 |
Collection of venous blood by venipuncture |
131,040 |
93,568 |
$129K |
| 81001 |
|
47,460 |
43,587 |
$123K |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
8,801 |
7,062 |
$122K |
| 87653 |
|
4,153 |
4,097 |
$120K |
| 85610 |
|
46,921 |
30,599 |
$118K |
| 83970 |
|
5,734 |
5,498 |
$117K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
1,800 |
1,715 |
$113K |
| 83540 |
|
20,634 |
19,343 |
$111K |
| 77080 |
|
2,289 |
2,254 |
$108K |
| 87340 |
|
12,861 |
12,583 |
$108K |
| 83880 |
|
6,889 |
5,834 |
$105K |
| 87400 |
|
5,659 |
5,149 |
$102K |
| 84439 |
|
18,621 |
17,931 |
$98K |
| J1756 |
Injection, iron sucrose, 1 mg |
1,791 |
894 |
$97K |
| 73560 |
|
2,934 |
2,622 |
$97K |
| 87186 |
|
16,935 |
14,747 |
$95K |
| 77065 |
Tomosynthesis, mammo |
1,999 |
1,938 |
$95K |
| 87481 |
|
2,759 |
2,143 |
$95K |
| 86850 |
|
14,159 |
13,061 |
$93K |
| 92507 |
Treatment of speech, language, voice, communication, and/or auditory processing disorder |
772 |
269 |
$93K |
| 92579 |
|
1,633 |
1,606 |
$92K |
| 73030 |
|
4,063 |
3,812 |
$91K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
13,067 |
12,028 |
$90K |
| 97597 |
|
1,953 |
1,180 |
$87K |
| J2060 |
Injection, lorazepam, 2 mg |
5,696 |
4,667 |
$83K |
| 73630 |
|
4,885 |
4,546 |
$83K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
2,947 |
2,856 |
$82K |
| 84403 |
|
4,844 |
4,672 |
$81K |
| 87521 |
Neg quan hep c or qual rna |
3,172 |
3,023 |
$80K |
| 97165 |
|
1,338 |
1,251 |
$78K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
695 |
669 |
$77K |
| J1644 |
Injection, heparin sodium, per 1000 units |
9,907 |
4,982 |
$77K |
| 82746 |
|
9,545 |
9,230 |
$77K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
4,457 |
4,176 |
$76K |
| 86317 |
|
2,179 |
2,107 |
$75K |
| 73130 |
|
3,834 |
3,531 |
$74K |
| 93970 |
|
361 |
336 |
$74K |
| 93226 |
|
1,493 |
1,462 |
$74K |
| 86762 |
|
5,727 |
5,622 |
$71K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
6,138 |
5,915 |
$71K |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
3,392 |
3,330 |
$70K |
| 73610 |
|
4,039 |
3,762 |
$70K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
374 |
358 |
$70K |
| 84550 |
|
17,555 |
12,989 |
$70K |
| 85730 |
|
12,805 |
11,807 |
$67K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
25,375 |
21,106 |
$66K |
| 86141 |
|
4,920 |
4,596 |
$66K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
383 |
349 |
$65K |
| 87147 |
|
10,349 |
9,089 |
$65K |
| 86901 |
|
14,585 |
13,434 |
$64K |
| 84100 |
|
3,417 |
2,712 |
$64K |
| 73564 |
|
3,596 |
3,372 |
$63K |
| 81003 |
|
24,548 |
22,905 |
$62K |
| 87040 |
|
6,028 |
4,046 |
$61K |
| 83655 |
|
5,613 |
5,538 |
$61K |
| 86706 |
|
7,518 |
7,347 |
$61K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
16,373 |
14,935 |
$60K |
| 96367 |
|
1,291 |
994 |
$60K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
560 |
492 |
$60K |
| 87536 |
|
1,340 |
1,316 |
$60K |
| 88142 |
|
4,425 |
4,348 |
$59K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
68 |
66 |
$59K |
| 77062 |
|
606 |
603 |
$59K |
| 97162 |
|
1,409 |
1,273 |
$58K |
| 77061 |
|
561 |
551 |
$58K |
| J2704 |
Injection, propofol, 10 mg |
14,116 |
12,304 |
$57K |
| 12001 |
|
306 |
292 |
$57K |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
11,244 |
10,417 |
$56K |
| 71045 |
Radiologic examination, chest; single view |
10,545 |
9,618 |
$55K |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
2,143 |
1,831 |
$54K |
| 87088 |
|
9,272 |
8,716 |
$52K |
| 73502 |
|
2,466 |
2,344 |
$52K |
| 83615 |
|
14,337 |
9,956 |
$51K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
7,263 |
5,625 |
$51K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
23,797 |
20,490 |
$49K |
| 85027 |
|
10,817 |
10,143 |
$48K |
| 84146 |
|
3,426 |
3,321 |
$47K |
| 0001A |
|
2,064 |
2,035 |
$47K |
| 80076 |
|
14,558 |
13,956 |
$47K |
| 86900 |
|
14,610 |
13,461 |
$46K |
| 86704 |
|
4,971 |
4,876 |
$45K |
| 0002A |
|
1,947 |
1,919 |
$44K |
| 83516 |
|
4,050 |
3,906 |
$43K |
| 70486 |
|
845 |
806 |
$43K |
| 83605 |
|
4,474 |
3,865 |
$42K |
| J1630 |
Injection, haloperidol, up to 5 mg |
1,096 |
873 |
$42K |
| 81025 |
|
6,178 |
5,949 |
$42K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
13,598 |
11,184 |
$42K |
| 87077 |
|
8,542 |
7,266 |
$41K |
| 84402 |
|
2,559 |
2,478 |
$41K |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
3,965 |
1,505 |
$40K |
| 86618 |
|
3,485 |
3,359 |
$40K |
| 86787 |
|
3,192 |
3,020 |
$40K |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
9,209 |
6,748 |
$39K |
| 84153 |
|
4,788 |
4,611 |
$39K |
| 83001 |
|
3,050 |
2,964 |
$38K |
| 73110 |
|
1,751 |
1,632 |
$38K |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
1,195 |
1,006 |
$37K |
| 45378 |
Colonoscopy, flexible; diagnostic, including collection of specimen(s) |
40 |
40 |
$37K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
116 |
108 |
$36K |
| 80074 |
|
973 |
951 |
$35K |
| 82784 |
|
4,470 |
3,875 |
$34K |
| 74183 |
|
154 |
148 |
$34K |
| 87430 |
|
2,351 |
2,274 |
$33K |
| 77066 |
Tomosynthesis, mammo |
1,237 |
1,218 |
$33K |
| 82043 |
|
13,129 |
12,835 |
$32K |
| 82670 |
|
1,637 |
1,561 |
$32K |
| 87338 |
|
3,186 |
3,129 |
$32K |
| 71271 |
|
810 |
797 |
$31K |
| ATP08 |
|
10,377 |
8,260 |
$31K |
| 86708 |
|
3,603 |
3,547 |
$31K |
| 82950 |
|
7,278 |
7,191 |
$30K |
| 86038 |
|
3,817 |
3,719 |
$29K |
| 86003 |
|
418 |
366 |
$29K |
| 83002 |
|
2,118 |
2,035 |
$28K |
| G0123 |
Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, screening by cytotechnologist under physician supervision |
1,422 |
1,420 |
$28K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
285 |
193 |
$26K |
| 93458 |
|
26 |
25 |
$26K |
| 86235 |
|
498 |
407 |
$25K |
| 80164 |
|
1,591 |
1,413 |
$25K |
| 85379 |
|
3,130 |
2,947 |
$25K |
| 72141 |
|
148 |
143 |
$25K |
| 87808 |
|
2,540 |
2,400 |
$24K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
892 |
364 |
$23K |
| 11045 |
|
140 |
65 |
$23K |
| J0690 |
Injection, cefazolin sodium, 500 mg |
4,584 |
3,717 |
$23K |
| 82570 |
|
6,699 |
6,162 |
$23K |
| 88112 |
|
886 |
857 |
$23K |
| 76882 |
|
215 |
212 |
$22K |
| 84481 |
|
2,089 |
2,035 |
$22K |
| 85652 |
|
11,554 |
10,864 |
$22K |
| 87205 |
|
6,036 |
5,505 |
$21K |
| 90715 |
|
862 |
814 |
$20K |
| J9271 |
Injection, pembrolizumab, 1 mg |
18 |
12 |
$20K |
| 99218 |
|
120 |
55 |
$20K |
| 88342 |
|
709 |
612 |
$19K |
| 82550 |
|
6,092 |
5,593 |
$19K |
| 17250 |
|
258 |
158 |
$18K |
| 86709 |
|
2,385 |
2,339 |
$18K |
| 86696 |
|
901 |
762 |
$18K |
| 93017 |
|
261 |
244 |
$17K |
| J0689 |
Injection, cefazolin sodium (baxter), not therapeutically equivalent to j0690, 500 mg |
1,579 |
1,385 |
$17K |
| 87450 |
|
2,825 |
2,611 |
$17K |
| 10060 |
|
108 |
105 |
$17K |
| 82652 |
|
711 |
703 |
$17K |
| 84156 |
|
5,763 |
5,005 |
$17K |
| 82565 |
|
7,552 |
7,046 |
$17K |
| 70491 |
|
111 |
107 |
$17K |
| G0103 |
Prostate cancer screening; prostate specific antigen test (psa) |
2,453 |
2,423 |
$16K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
232 |
146 |
$16K |
| 86376 |
|
1,513 |
1,460 |
$16K |
| ATP17 |
|
10,544 |
9,404 |
$16K |
| 74019 |
|
421 |
407 |
$15K |
| 82951 |
|
1,292 |
1,270 |
$15K |
| 87468 |
|
976 |
928 |
$15K |
| 87469 |
|
976 |
928 |
$15K |
| ATP16 |
|
2,567 |
1,691 |
$15K |
| 87484 |
|
974 |
926 |
$15K |
| 87478 |
|
976 |
927 |
$15K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,802 |
1,617 |
$15K |
| ATP03 |
|
5,184 |
4,592 |
$14K |
| ATP15 |
|
3,528 |
2,865 |
$14K |
| 71101 |
|
975 |
923 |
$14K |
| 86705 |
|
1,411 |
1,384 |
$14K |
| 70496 |
|
117 |
101 |
$14K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
92 |
84 |
$14K |
| 86431 |
|
3,331 |
3,169 |
$14K |
| 0031A |
|
506 |
461 |
$13K |
| 82172 |
|
804 |
800 |
$13K |
| 85007 |
|
4,908 |
4,574 |
$13K |
| 91300 |
|
40 |
39 |
$13K |
| 83883 |
|
1,207 |
1,148 |
$13K |
| 87046 |
|
1,064 |
883 |
$13K |
| 97116 |
|
385 |
227 |
$13K |
| 86665 |
|
519 |
471 |
$13K |
| 82248 |
|
3,292 |
2,709 |
$12K |
| 83010 |
|
1,079 |
1,059 |
$12K |
| 86695 |
|
892 |
756 |
$12K |
| C9113 |
Injection, pantoprazole sodium, per vial |
1,360 |
902 |
$12K |
| 97802 |
|
124 |
122 |
$11K |
| 87210 |
|
2,921 |
2,762 |
$11K |
| 96376 |
|
3,123 |
1,942 |
$11K |
| J2469 |
Injection, palonosetron hcl, 25 mcg |
152 |
88 |
$11K |
| 86140 |
|
3,548 |
3,332 |
$11K |
| 80178 |
|
2,959 |
2,717 |
$10K |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
1,179 |
1,049 |
$10K |
| 82952 |
|
1,298 |
1,119 |
$10K |
| 85014 |
|
4,040 |
3,708 |
$10K |
| 85018 |
|
4,021 |
3,700 |
$9K |
| 84460 |
|
7,292 |
6,932 |
$9K |
| 82803 |
|
984 |
874 |
$9K |
| ATP07 |
|
1,908 |
1,782 |
$9K |
| 83721 |
|
1,543 |
1,500 |
$9K |
| 84425 |
|
567 |
556 |
$9K |
| 86160 |
|
628 |
511 |
$9K |
| 87427 |
|
928 |
893 |
$9K |
| 97535 |
Self-care/home management training, each 15 minutes |
223 |
133 |
$8K |
| G0279 |
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) |
484 |
468 |
$8K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
5,522 |
4,015 |
$8K |
| 12011 |
|
40 |
38 |
$8K |
| 94060 |
|
67 |
63 |
$8K |
| 72197 |
|
27 |
26 |
$8K |
| 76870 |
|
54 |
52 |
$8K |
| 72050 |
|
194 |
184 |
$7K |
| ATP02 |
|
1,840 |
1,410 |
$7K |
| 87045 |
|
927 |
892 |
$7K |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
3,275 |
2,797 |
$7K |
| 88307 |
|
56 |
48 |
$7K |
| 87015 |
|
1,124 |
1,077 |
$7K |
| 97803 |
|
87 |
80 |
$7K |
| P9604 |
Travel allowance one way in connection with medically necessary laboratory specimen collection drawn from home bound or nursing home bound patient; prorated trip charge |
22,292 |
11,794 |
$6K |
| 82150 |
|
1,373 |
1,273 |
$6K |
| 86225 |
|
601 |
586 |
$6K |
| C1769 |
Guide wire |
1,712 |
1,503 |
$6K |
| 86308 |
|
1,226 |
1,166 |
$6K |
| 90686 |
|
294 |
274 |
$6K |
| 82977 |
|
1,831 |
1,804 |
$6K |
| 72070 |
|
211 |
200 |
$6K |
| 84450 |
|
5,880 |
5,554 |
$6K |
| G1004 |
Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program |
10,508 |
8,910 |
$6K |
| 86664 |
|
473 |
452 |
$5K |
| 83520 |
|
1,070 |
695 |
$5K |
| 73140 |
|
400 |
381 |
$5K |
| 73700 |
|
131 |
118 |
$5K |
| 29125 |
|
29 |
29 |
$5K |
| 82247 |
|
1,403 |
1,047 |
$5K |
| 73080 |
|
446 |
413 |
$5K |
| 93880 |
|
167 |
147 |
$5K |
| M0243 |
Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring |
23 |
21 |
$5K |
| 87801 |
Infectious agent detection by nucleic acid; amplified probe, multiple organisms |
103 |
100 |
$5K |
| C1894 |
Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser |
1,474 |
1,299 |
$5K |
| 84144 |
|
378 |
350 |
$5K |
| 74420 |
|
54 |
51 |
$5K |
| ATP18 |
|
4,269 |
3,824 |
$5K |
| 93225 |
|
54 |
54 |
$5K |
| 77049 |
|
12 |
12 |
$5K |
| J0134 |
Injection, acetaminophen (fresenius kabi), not therapeutically equivalent to j0131, 10 mg |
945 |
819 |
$4K |
| 82627 |
|
237 |
228 |
$4K |
| ATP09 |
|
1,401 |
1,216 |
$4K |
| 86360 |
|
248 |
244 |
$4K |
| 85045 |
|
1,660 |
1,558 |
$4K |
| 87449 |
|
625 |
577 |
$4K |
| 93296 |
|
175 |
163 |
$4K |
| 20610 |
|
40 |
36 |
$4K |
| 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 |
1,925 |
1,814 |
$4K |
| 87209 |
|
271 |
263 |
$4K |
| 87324 |
|
541 |
505 |
$4K |
| 93325 |
|
71 |
65 |
$3K |
| 92557 |
|
56 |
55 |
$3K |
| 86359 |
|
228 |
225 |
$3K |
| 93000 |
|
150 |
137 |
$3K |
| 86663 |
|
305 |
295 |
$3K |
| G8979 |
Mobility: walking & moving around functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting |
599 |
527 |
$3K |
| G8978 |
Mobility: walking & moving around functional limitation, current status, at therapy episode outset and at reporting intervals |
482 |
455 |
$3K |
| 72040 |
|
77 |
75 |
$3K |
| 84165 |
|
1,025 |
966 |
$3K |
| 97035 |
|
69 |
26 |
$3K |
| 82947 |
|
2,534 |
2,422 |
$3K |
| 70360 |
|
40 |
39 |
$3K |
| 73590 |
|
109 |
99 |
$3K |
| 82105 |
|
247 |
241 |
$3K |
| ATP11 |
|
1,209 |
1,068 |
$3K |
| Q5106 |
Injection, epoetin alfa-epbx, biosimilar, (retacrit) (for non-esrd use), 1000 units |
56 |
36 |
$2K |
| 84520 |
|
3,470 |
3,223 |
$2K |
| Q3014 |
Telehealth originating site facility fee |
719 |
684 |
$2K |
| 36430 |
|
15 |
12 |
$2K |
| 85651 |
|
1,022 |
957 |
$2K |
| 0012A |
|
106 |
106 |
$2K |
| 94729 |
|
29 |
27 |
$2K |
| 82533 |
|
207 |
185 |
$2K |
| 92650 |
|
28 |
15 |
$2K |
| 84480 |
|
244 |
235 |
$2K |
| ATP10 |
|
874 |
750 |
$2K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
12 |
12 |
$2K |
| 87177 |
|
271 |
263 |
$2K |
| 99292 |
|
41 |
37 |
$2K |
| 99152 |
|
697 |
621 |
$2K |
| J2543 |
Injection, piperacillin sodium/tazobactam sodium, 1 gram/0.125 grams (1.125 grams) |
115 |
41 |
$2K |
| 82140 |
|
169 |
131 |
$2K |
| J2370 |
Injection, phenylephrine hcl, up to 1 ml |
849 |
762 |
$2K |
| 88304 |
|
610 |
576 |
$2K |
| 45385 |
Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) |
12 |
12 |
$1K |
| 86200 |
|
162 |
160 |
$1K |
| 87420 |
|
131 |
128 |
$1K |
| 86039 |
|
130 |
126 |
$1K |
| A9575 |
Injection, gadoterate meglumine, 0.1 ml |
3,648 |
3,435 |
$1K |
| 0011A |
|
105 |
101 |
$1K |
| 83630 |
|
103 |
99 |
$1K |
| 70498 |
|
128 |
112 |
$1K |
| 82785 |
|
76 |
73 |
$1K |
| 80051 |
|
1,351 |
1,293 |
$1K |
| 84436 |
|
184 |
176 |
$899.16 |
| 86800 |
|
73 |
73 |
$896.37 |
| 83993 |
|
77 |
76 |
$851.79 |
| C1713 |
Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) |
19 |
16 |
$827.66 |
| ATP04 |
|
170 |
160 |
$770.40 |
| 93312 |
|
12 |
12 |
$730.56 |
| 97166 |
|
30 |
29 |
$684.31 |
| 88341 |
|
74 |
49 |
$665.44 |
| 82040 |
|
510 |
474 |
$661.56 |
| 80069 |
|
401 |
372 |
$654.84 |
| 87150 |
|
36 |
36 |
$608.19 |
| 87563 |
|
15 |
15 |
$464.25 |
| 84479 |
|
103 |
96 |
$460.23 |
| 93797 |
|
32 |
14 |
$445.50 |
| 87625 |
|
12 |
12 |
$357.70 |
| 85347 |
|
90 |
40 |
$347.10 |
| 36600 |
|
144 |
136 |
$338.85 |
| 82378 |
|
91 |
76 |
$335.25 |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
56 |
55 |
$328.95 |
| P9016 |
Red blood cells, leukocytes reduced, each unit |
15 |
12 |
$302.80 |
| ATP19 |
|
335 |
283 |
$301.14 |
| 83021 |
|
18 |
18 |
$297.56 |
| 83525 |
|
25 |
24 |
$289.99 |
| 86735 |
|
24 |
24 |
$280.92 |
| 83921 |
|
40 |
39 |
$261.94 |
| 84155 |
|
239 |
230 |
$237.26 |
| 96402 |
|
16 |
14 |
$230.03 |
| 87081 |
|
39 |
39 |
$223.48 |
| 80177 |
|
42 |
38 |
$217.76 |
| 73090 |
|
13 |
12 |
$211.44 |
| G0008 |
Administration of influenza virus vaccine |
266 |
253 |
$198.35 |
| 84132 |
|
37 |
29 |
$187.39 |
| G8980 |
Mobility: walking & moving around functional limitation, discharge status, at discharge from therapy or to end reporting |
208 |
196 |
$185.60 |
| G0472 |
Hepatitis c antibody screening, for individual at high risk and other covered indication(s) |
1,058 |
1,046 |
$182.99 |
| G8988 |
Self care functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting |
213 |
190 |
$182.66 |
| G8987 |
Self care functional limitation, current status, at therapy episode outset and at reporting intervals |
193 |
180 |
$182.66 |
| 92610 |
|
15 |
12 |
$176.19 |
| 77002 |
|
13 |
13 |
$169.96 |
| 99153 |
Mod sedat endo service >5yrs |
407 |
358 |
$164.90 |
| 86617 |
|
21 |
17 |
$159.32 |
| 82330 |
|
15 |
14 |
$149.64 |
| 86765 |
|
12 |
12 |
$141.00 |
| ATP05 |
|
51 |
38 |
$138.78 |
| C1887 |
Catheter, guiding (may include infusion/perfusion capability) |
137 |
117 |
$136.72 |
| J2360 |
Injection, orphenadrine citrate, up to 60 mg |
406 |
375 |
$131.67 |
| Q9966 |
Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml |
133 |
130 |
$98.40 |
| 96523 |
|
43 |
36 |
$85.20 |
| J2710 |
Injection, neostigmine methylsulfate, up to 0.5 mg |
76 |
69 |
$84.74 |
| J2920 |
Injection, methylprednisolone sodium succinate, up to 40 mg |
614 |
423 |
$83.86 |
| J2272 |
Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg |
108 |
77 |
$74.36 |
| A9500 |
Technetium tc-99m sestamibi, diagnostic, per study dose |
147 |
122 |
$72.81 |
| J3360 |
Injection, diazepam, up to 5 mg |
182 |
171 |
$55.84 |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
302 |
261 |
$54.23 |
| J0500 |
Injection, dicyclomine hcl, up to 20 mg |
12 |
12 |
$52.83 |
| 0013A |
|
13 |
13 |
$45.87 |
| 86334 |
|
14 |
12 |
$39.40 |
| 82270 |
|
13 |
12 |
$33.60 |
| 80175 |
|
12 |
12 |
$21.83 |
| J2785 |
Injection, regadenoson, 0.1 mg |
42 |
40 |
$20.23 |
| 90662 |
|
13 |
13 |
$19.08 |
| 80185 |
|
18 |
13 |
$13.67 |
| A6219 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing |
104 |
96 |
$11.85 |
| J3370 |
Injection, vancomycin hcl, 500 mg |
133 |
94 |
$10.80 |
| 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 |
594 |
584 |
$9.32 |
| J2470 |
Injection, pantoprazole sodium, 40 mg |
105 |
68 |
$2.90 |
| G0297 |
Low dose ct scan (ldct) for lung cancer screening |
13 |
13 |
$0.81 |
| A9573 |
Injection, gadopiclenol, 1 ml |
195 |
187 |
$0.00 |
| 94760 |
|
24 |
12 |
$0.00 |
| J3480 |
Injection, potassium chloride, per 2 meq |
14 |
12 |
$0.00 |
| J1030 |
Injection, methylprednisolone acetate, 40 mg |
14 |
13 |
$0.00 |
| 93320 |
|
12 |
12 |
$0.00 |
| J1171 |
Injection, hydromorphone, 0.1 mg |
30 |
27 |
$0.00 |
| J2919 |
Injection, methylprednisolone sodium succinate, 5 mg |
243 |
180 |
$0.00 |
| G8985 |
Carrying, moving and handling objects, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting |
57 |
53 |
$0.00 |
| C1760 |
Closure device, vascular (implantable/insertable) |
27 |
25 |
$0.00 |
| 76937 |
|
15 |
13 |
$0.00 |
| G8984 |
Carrying, moving & handling objects functional limitation, current status, at therapy episode outset and at reporting intervals |
28 |
26 |
$0.00 |
| G8989 |
Self care functional limitation, discharge status, at discharge from therapy or to end reporting |
14 |
13 |
$0.00 |