| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
44,927 |
41,431 |
$8.19M |
| 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 |
57,520 |
53,719 |
$5.05M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
24,204 |
23,170 |
$3.25M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
21,139 |
19,626 |
$2.99M |
| G0378 |
Hospital observation service, per hour |
2,595 |
2,434 |
$2.21M |
| T1015 |
Clinic visit/encounter, all-inclusive |
51,623 |
21,203 |
$2.11M |
| 81513 |
|
5,290 |
5,132 |
$556K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
19,346 |
18,871 |
$497K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
5,846 |
5,728 |
$475K |
| 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 |
7,768 |
7,095 |
$470K |
| 80053 |
Comprehensive metabolic panel |
47,985 |
45,062 |
$458K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
3,222 |
3,122 |
$438K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
16,821 |
16,372 |
$380K |
| 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 |
34,259 |
31,789 |
$377K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
3,896 |
3,845 |
$342K |
| 36415 |
Collection of venous blood by venipuncture |
103,408 |
90,143 |
$339K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
69,445 |
64,323 |
$322K |
| 0202U |
Oncology (prostate), multianalyte, gene expression profiling |
2,236 |
2,154 |
$321K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
6,653 |
6,219 |
$306K |
| 80061 |
Lipid panel |
19,874 |
19,474 |
$285K |
| 80050 |
General health panel |
5,969 |
5,839 |
$282K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
2,385 |
2,294 |
$254K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
28,938 |
27,147 |
$243K |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
7,420 |
7,328 |
$241K |
| 84702 |
|
16,824 |
15,262 |
$217K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
10,269 |
9,516 |
$211K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
6,410 |
6,244 |
$208K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
5,314 |
5,220 |
$206K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
4,013 |
3,756 |
$202K |
| 87536 |
|
1,684 |
1,656 |
$197K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
5,911 |
1,850 |
$194K |
| 84443 |
Thyroid stimulating hormone (TSH) |
8,492 |
8,229 |
$191K |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
3,585 |
3,520 |
$151K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
646 |
638 |
$151K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
5,027 |
4,936 |
$147K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
21,281 |
18,780 |
$147K |
| 71046 |
Radiologic examination, chest; 2 views |
11,170 |
10,759 |
$146K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
2,563 |
1,493 |
$141K |
| 87481 |
|
2,413 |
2,241 |
$137K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
1,310 |
1,295 |
$132K |
| 62323 |
|
663 |
655 |
$131K |
| 92507 |
Treatment of speech, language, voice, communication, and/or auditory processing disorder |
6,780 |
2,336 |
$125K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
18,066 |
17,703 |
$125K |
| 97161 |
|
2,181 |
2,069 |
$124K |
| 80081 |
|
1,339 |
1,319 |
$119K |
| 70450 |
Computed tomography, head or brain; without contrast material |
2,348 |
2,231 |
$116K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
14,686 |
13,788 |
$116K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
831 |
800 |
$111K |
| 95700 |
|
598 |
588 |
$106K |
| 86803 |
|
5,195 |
5,102 |
$105K |
| C9803 |
Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
9,327 |
8,684 |
$104K |
| 78815 |
Positron emission tomography (PET) for limited area imaging |
104 |
102 |
$101K |
| J7307 |
Etonogestrel (contraceptive) implant system, including implant and supplies |
261 |
250 |
$101K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
595 |
587 |
$100K |
| 95708 |
|
654 |
568 |
$99K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
477 |
464 |
$96K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
341 |
334 |
$93K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
1,210 |
1,189 |
$91K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
3,895 |
3,844 |
$90K |
| 76830 |
Ultrasound, transvaginal |
1,913 |
1,832 |
$87K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
14,802 |
13,400 |
$83K |
| 72141 |
|
338 |
335 |
$80K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
991 |
957 |
$78K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
1,239 |
1,143 |
$77K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
7,136 |
6,482 |
$75K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
5,735 |
4,930 |
$72K |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
2,763 |
2,691 |
$70K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
1,645 |
1,595 |
$68K |
| 87902 |
|
293 |
279 |
$66K |
| 95800 |
|
617 |
606 |
$63K |
| 73221 |
|
223 |
216 |
$61K |
| 81001 |
|
24,354 |
22,977 |
$60K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
1,094 |
926 |
$59K |
| 78431 |
|
132 |
130 |
$59K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
1,755 |
1,699 |
$57K |
| 97162 |
|
1,249 |
1,188 |
$56K |
| 93971 |
|
880 |
836 |
$56K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
6,406 |
5,197 |
$56K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
3,379 |
3,245 |
$54K |
| 64483 |
|
211 |
207 |
$51K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
2,047 |
1,708 |
$48K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,378 |
1,099 |
$47K |
| 84466 |
|
2,766 |
2,693 |
$46K |
| 93975 |
|
433 |
415 |
$45K |
| 70498 |
|
410 |
399 |
$43K |
| 71250 |
|
678 |
673 |
$43K |
| 73610 |
|
2,146 |
1,896 |
$42K |
| 73630 |
|
3,250 |
2,838 |
$42K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
620 |
602 |
$41K |
| 84484 |
|
5,160 |
4,355 |
$41K |
| 85027 |
|
7,062 |
5,984 |
$41K |
| 77066 |
Tomosynthesis, mammo |
447 |
435 |
$41K |
| 86359 |
|
804 |
791 |
$41K |
| 70496 |
|
384 |
373 |
$41K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
763 |
750 |
$40K |
| 87653 |
|
980 |
964 |
$40K |
| 93970 |
|
492 |
477 |
$40K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
590 |
582 |
$40K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
379 |
314 |
$39K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
1,022 |
792 |
$39K |
| 82607 |
|
3,159 |
3,083 |
$39K |
| 86480 |
|
511 |
500 |
$39K |
| 76818 |
|
585 |
330 |
$38K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
1,710 |
688 |
$38K |
| 76642 |
|
898 |
870 |
$38K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
1,547 |
535 |
$38K |
| 76801 |
|
953 |
875 |
$37K |
| 81002 |
|
1,537 |
1,225 |
$37K |
| 83735 |
|
7,834 |
6,502 |
$37K |
| 83880 |
|
1,370 |
1,250 |
$37K |
| Q9957 |
Injection, perflutren lipid microspheres, per ml |
1,461 |
1,430 |
$36K |
| 73564 |
|
1,704 |
1,471 |
$36K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
698 |
662 |
$35K |
| 76536 |
|
681 |
666 |
$34K |
| 87633 |
Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets |
61 |
60 |
$33K |
| 76813 |
|
597 |
590 |
$33K |
| 77065 |
Tomosynthesis, mammo |
478 |
437 |
$33K |
| 64493 |
|
162 |
143 |
$33K |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
304 |
304 |
$33K |
| 87522 |
Neg quan hep c or qual rna |
768 |
731 |
$32K |
| 95886 |
|
664 |
651 |
$32K |
| 85610 |
|
9,056 |
6,152 |
$32K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
926 |
924 |
$31K |
| 87799 |
|
402 |
387 |
$31K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,101 |
1,019 |
$29K |
| 87563 |
|
903 |
872 |
$28K |
| 82570 |
|
3,875 |
3,711 |
$28K |
| 83690 |
|
7,308 |
6,854 |
$27K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
1,328 |
1,194 |
$26K |
| G0108 |
Diabetes outpatient self-management training services, individual, per 30 minutes |
504 |
437 |
$26K |
| 93017 |
|
759 |
734 |
$26K |
| 83540 |
|
3,059 |
2,983 |
$25K |
| J2785 |
Injection, regadenoson, 0.1 mg |
888 |
857 |
$25K |
| 95810 |
Polysomnography; sleep staging with 4 or more additional parameters |
95 |
95 |
$25K |
| 87077 |
|
3,300 |
3,158 |
$25K |
| 12001 |
|
137 |
130 |
$25K |
| 86361 |
|
830 |
815 |
$25K |
| 95911 |
|
358 |
351 |
$25K |
| 96376 |
|
1,789 |
1,084 |
$25K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
980 |
463 |
$24K |
| 84439 |
|
2,946 |
2,855 |
$24K |
| 76770 |
|
549 |
539 |
$24K |
| 87340 |
|
1,616 |
1,581 |
$24K |
| 19083 |
|
69 |
67 |
$24K |
| 82728 |
|
2,071 |
2,012 |
$24K |
| 0042T |
|
143 |
137 |
$24K |
| 82043 |
|
2,812 |
2,744 |
$23K |
| 86618 |
|
931 |
909 |
$23K |
| 75574 |
|
119 |
117 |
$23K |
| 74183 |
|
52 |
52 |
$22K |
| 83655 |
|
1,936 |
1,886 |
$22K |
| 87186 |
|
2,640 |
2,527 |
$22K |
| 95811 |
|
48 |
47 |
$22K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
378 |
368 |
$22K |
| 84403 |
|
746 |
736 |
$22K |
| 73030 |
|
1,473 |
1,333 |
$22K |
| 97165 |
|
423 |
409 |
$21K |
| 94729 |
|
727 |
711 |
$21K |
| 88342 |
|
512 |
496 |
$20K |
| 72100 |
|
963 |
944 |
$20K |
| 83970 |
|
520 |
508 |
$20K |
| 70486 |
|
309 |
303 |
$20K |
| 83013 |
|
295 |
288 |
$19K |
| 72110 |
|
889 |
874 |
$19K |
| 87529 |
|
357 |
350 |
$19K |
| 84146 |
|
756 |
748 |
$19K |
| 86850 |
|
2,514 |
2,375 |
$19K |
| 86592 |
|
4,386 |
4,312 |
$18K |
| 73502 |
|
998 |
897 |
$18K |
| 82784 |
|
912 |
884 |
$18K |
| 76820 |
|
692 |
339 |
$18K |
| 87801 |
Infectious agent detection by nucleic acid; amplified probe, multiple organisms |
447 |
435 |
$17K |
| A9577 |
Injection, gadobenate dimeglumine (multihance), per ml |
2,467 |
2,391 |
$17K |
| 93325 |
|
417 |
409 |
$17K |
| 86038 |
|
1,054 |
1,024 |
$17K |
| 94726 |
|
597 |
584 |
$16K |
| 87493 |
|
421 |
407 |
$16K |
| 82105 |
|
722 |
708 |
$15K |
| 84402 |
|
542 |
536 |
$15K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
369 |
365 |
$15K |
| 73562 |
|
930 |
789 |
$14K |
| 12011 |
|
54 |
53 |
$14K |
| 86140 |
|
4,979 |
4,346 |
$14K |
| 82947 |
|
5,580 |
4,353 |
$14K |
| 71045 |
Radiologic examination, chest; single view |
2,672 |
2,504 |
$14K |
| 85652 |
|
4,594 |
4,114 |
$13K |
| 83516 |
|
712 |
688 |
$13K |
| 73130 |
|
1,220 |
1,016 |
$13K |
| 84153 |
|
529 |
514 |
$13K |
| 74178 |
|
60 |
58 |
$12K |
| 70491 |
|
157 |
155 |
$12K |
| 86003 |
|
128 |
120 |
$12K |
| 76870 |
|
280 |
271 |
$12K |
| 80076 |
|
1,264 |
1,198 |
$12K |
| 95819 |
|
978 |
967 |
$12K |
| 72050 |
|
435 |
427 |
$11K |
| 82248 |
|
2,148 |
1,908 |
$11K |
| 87512 |
|
454 |
439 |
$11K |
| 83001 |
|
583 |
572 |
$11K |
| 82746 |
|
1,011 |
983 |
$10K |
| 87040 |
|
804 |
729 |
$10K |
| 86235 |
|
189 |
181 |
$10K |
| 73110 |
|
924 |
825 |
$10K |
| 84481 |
|
411 |
400 |
$10K |
| G0471 |
Collection of venous blood by venipuncture or urine sample by catheterization from an individual in a skilled nursing facility (snf) or by a laboratory on behalf of a home health agency (hha) |
2,061 |
1,103 |
$10K |
| 77336 |
|
304 |
139 |
$10K |
| 93350 |
|
239 |
232 |
$10K |
| 81220 |
CFTR (cystic fibrosis transmembrane conductance regulator) gene analysis; common variants |
27 |
27 |
$10K |
| 86706 |
|
696 |
681 |
$10K |
| 74018 |
|
780 |
738 |
$10K |
| 77062 |
|
408 |
399 |
$10K |
| 85379 |
|
1,268 |
1,217 |
$9K |
| 82565 |
|
1,985 |
1,827 |
$9K |
| G0472 |
Hepatitis c antibody screening, for individual at high risk and other covered indication(s) |
442 |
435 |
$9K |
| 80074 |
|
170 |
166 |
$9K |
| 12002 |
|
30 |
27 |
$9K |
| 93880 |
|
115 |
113 |
$9K |
| 72197 |
|
25 |
24 |
$9K |
| 82803 |
|
561 |
521 |
$9K |
| 83605 |
|
1,904 |
1,714 |
$9K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
240 |
230 |
$9K |
| 86765 |
|
683 |
667 |
$9K |
| 93320 |
|
262 |
253 |
$9K |
| 86900 |
|
2,497 |
2,236 |
$9K |
| 11981 |
|
38 |
38 |
$9K |
| 97166 |
|
277 |
267 |
$9K |
| C1769 |
Guide wire |
259 |
246 |
$9K |
| 86901 |
|
2,480 |
2,227 |
$8K |
| 86762 |
|
447 |
436 |
$8K |
| G0476 |
Infectious agent detection by nucleic acid (dna or rna); human papillomavirus (hpv), high-risk types (e.g., 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68) for cervical cancer screening, must be performed in addition to pap test |
273 |
273 |
$8K |
| 90715 |
|
1,680 |
1,568 |
$8K |
| 97014 |
|
398 |
176 |
$8K |
| 87209 |
|
362 |
356 |
$8K |
| 95909 |
|
165 |
164 |
$8K |
| 82670 |
|
346 |
324 |
$8K |
| 82950 |
|
1,104 |
1,088 |
$8K |
| 86696 |
|
280 |
268 |
$8K |
| 85730 |
|
1,648 |
1,520 |
$8K |
| C1894 |
Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser |
175 |
168 |
$7K |
| 77061 |
|
329 |
325 |
$7K |
| 81025 |
|
1,497 |
1,432 |
$7K |
| 86160 |
|
247 |
238 |
$7K |
| 80164 |
|
422 |
398 |
$7K |
| 73590 |
|
509 |
440 |
$7K |
| 81596 |
|
118 |
114 |
$7K |
| 80069 |
|
798 |
658 |
$7K |
| 73560 |
|
446 |
387 |
$7K |
| 94060 |
|
702 |
686 |
$7K |
| 77412 |
|
245 |
25 |
$7K |
| 72040 |
|
455 |
443 |
$7K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
76 |
76 |
$7K |
| 93923 |
|
145 |
140 |
$7K |
| 86704 |
|
414 |
400 |
$7K |
| 86695 |
|
285 |
273 |
$7K |
| 82652 |
|
162 |
160 |
$7K |
| 87210 |
|
644 |
628 |
$7K |
| 96040 |
|
228 |
226 |
$6K |
| 82627 |
|
260 |
259 |
$6K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
309 |
289 |
$6K |
| 82550 |
|
964 |
840 |
$6K |
| 83002 |
|
334 |
321 |
$6K |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
3,439 |
2,682 |
$6K |
| 84100 |
|
1,505 |
1,135 |
$6K |
| 83993 |
|
234 |
229 |
$6K |
| 87427 |
|
440 |
436 |
$5K |
| 77334 |
|
72 |
54 |
$5K |
| 71271 |
|
58 |
58 |
$5K |
| 72131 |
|
89 |
87 |
$5K |
| 86431 |
|
605 |
589 |
$5K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
44 |
42 |
$5K |
| 84134 |
|
370 |
324 |
$5K |
| 83921 |
|
250 |
245 |
$5K |
| 74174 |
|
25 |
25 |
$5K |
| 73090 |
|
409 |
340 |
$5K |
| 73080 |
|
427 |
378 |
$5K |
| J1756 |
Injection, iron sucrose, 1 mg |
1,429 |
697 |
$5K |
| 86708 |
|
283 |
274 |
$5K |
| 97164 |
|
119 |
116 |
$5K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
72 |
71 |
$5K |
| 82805 |
|
198 |
182 |
$4K |
| 87640 |
|
108 |
105 |
$4K |
| 84550 |
|
694 |
652 |
$4K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
522 |
476 |
$4K |
| 99215 |
Prolong outpt/office vis |
40 |
38 |
$4K |
| 86705 |
|
251 |
242 |
$4K |
| 82951 |
|
306 |
303 |
$4K |
| 84156 |
|
1,043 |
932 |
$4K |
| 83021 |
|
198 |
194 |
$4K |
| 72072 |
|
197 |
194 |
$4K |
| 87070 |
|
573 |
546 |
$4K |
| 86200 |
|
268 |
264 |
$4K |
| 36430 |
|
32 |
24 |
$4K |
| 76942 |
|
145 |
139 |
$4K |
| 77080 |
|
76 |
75 |
$4K |
| 86360 |
|
56 |
55 |
$4K |
| 83721 |
|
374 |
369 |
$4K |
| 86147 |
|
42 |
42 |
$4K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
111 |
107 |
$4K |
| 75561 |
|
12 |
12 |
$4K |
| J1170 |
Injection, hydromorphone, up to 4 mg |
1,505 |
951 |
$4K |
| 73140 |
|
449 |
420 |
$4K |
| 84520 |
|
1,196 |
1,091 |
$4K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
595 |
415 |
$4K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
552 |
514 |
$4K |
| 88312 |
|
71 |
69 |
$4K |
| 87150 |
|
86 |
86 |
$4K |
| 73552 |
|
258 |
233 |
$4K |
| 84165 |
|
247 |
238 |
$4K |
| 88341 |
|
96 |
92 |
$4K |
| G0008 |
Administration of influenza virus vaccine |
599 |
589 |
$4K |
| 87339 |
|
271 |
269 |
$4K |
| 87081 |
|
682 |
671 |
$4K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
14 |
13 |
$4K |
| 72146 |
|
24 |
24 |
$4K |
| 80051 |
|
823 |
780 |
$4K |
| 87328 |
|
240 |
235 |
$4K |
| 62321 |
|
12 |
12 |
$4K |
| A9585 |
Injection, gadobutrol, 0.1 ml |
602 |
580 |
$4K |
| 72082 |
|
93 |
92 |
$4K |
| 73718 |
|
13 |
13 |
$3K |
| 96367 |
|
367 |
305 |
$3K |
| 83615 |
|
532 |
486 |
$3K |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
1,246 |
1,163 |
$3K |
| 83020 |
|
275 |
269 |
$3K |
| 86039 |
|
212 |
205 |
$3K |
| 87045 |
|
444 |
440 |
$3K |
| 84425 |
|
430 |
425 |
$3K |
| 86255 |
|
180 |
173 |
$3K |
| 87329 |
|
240 |
235 |
$3K |
| 81329 |
|
25 |
25 |
$3K |
| 83498 |
|
137 |
137 |
$3K |
| 97802 |
|
41 |
39 |
$3K |
| 82977 |
|
342 |
291 |
$3K |
| 87177 |
|
360 |
354 |
$3K |
| 73100 |
|
221 |
187 |
$3K |
| 78434 |
|
132 |
130 |
$3K |
| 97535 |
Self-care/home management training, each 15 minutes |
109 |
55 |
$3K |
| 86800 |
|
146 |
142 |
$3K |
| 88142 |
|
150 |
145 |
$3K |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
2,311 |
1,998 |
$3K |
| J3490 |
Unclassified drugs |
3,237 |
1,197 |
$3K |
| 81003 |
|
779 |
766 |
$3K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
14,212 |
12,445 |
$3K |
| 83525 |
|
213 |
210 |
$3K |
| 92611 |
|
95 |
95 |
$3K |
| C1729 |
Catheter, drainage |
67 |
46 |
$3K |
| 97163 |
|
53 |
50 |
$3K |
| 86787 |
|
120 |
117 |
$2K |
| 82533 |
|
210 |
202 |
$2K |
| 76882 |
|
331 |
321 |
$2K |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
2,694 |
2,185 |
$2K |
| 84295 |
|
729 |
674 |
$2K |
| 87797 |
|
112 |
111 |
$2K |
| 76641 |
|
42 |
42 |
$2K |
| 80178 |
|
297 |
262 |
$2K |
| 84132 |
|
731 |
670 |
$2K |
| 96415 |
|
63 |
57 |
$2K |
| 86376 |
|
279 |
275 |
$2K |
| 86146 |
|
30 |
30 |
$2K |
| 84460 |
|
361 |
327 |
$2K |
| 87480 |
|
112 |
112 |
$2K |
| 87015 |
|
327 |
302 |
$2K |
| 82310 |
|
552 |
485 |
$2K |
| 84450 |
|
361 |
326 |
$2K |
| 87046 |
|
445 |
440 |
$2K |
| 82247 |
|
359 |
303 |
$2K |
| 93321 |
|
103 |
102 |
$2K |
| 86617 |
|
65 |
65 |
$2K |
| 87147 |
|
418 |
403 |
$2K |
| 87660 |
|
113 |
112 |
$2K |
| 94375 |
|
142 |
137 |
$2K |
| 82435 |
|
661 |
617 |
$2K |
| S9470 |
Nutritional counseling, dietitian visit |
93 |
91 |
$2K |
| 83520 |
|
139 |
131 |
$2K |
| 87205 |
|
457 |
440 |
$2K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
4,523 |
3,785 |
$2K |
| A9552 |
Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries |
24 |
24 |
$2K |
| 88304 |
|
325 |
312 |
$2K |
| 71101 |
|
126 |
122 |
$2K |
| 80055 |
|
136 |
135 |
$2K |
| 93976 |
|
29 |
27 |
$2K |
| 73700 |
|
32 |
32 |
$2K |
| A4648 |
Tissue marker, implantable, any type, each |
14 |
14 |
$2K |
| 20553 |
|
67 |
66 |
$2K |
| 88313 |
|
26 |
25 |
$2K |
| 72070 |
|
102 |
101 |
$2K |
| 90686 |
|
612 |
600 |
$2K |
| T1001 |
Nursing assessment / evaluation |
12 |
12 |
$2K |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
536 |
420 |
$2K |
| 95816 |
|
134 |
130 |
$2K |
| 85046 |
|
261 |
246 |
$2K |
| 82103 |
|
88 |
87 |
$2K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
6,624 |
5,796 |
$2K |
| 87631 |
|
14 |
14 |
$2K |
| 84145 |
|
194 |
131 |
$2K |
| 73660 |
|
177 |
168 |
$2K |
| 72158 |
|
13 |
13 |
$2K |
| 84144 |
|
101 |
82 |
$2K |
| 85014 |
|
689 |
642 |
$1K |
| 82150 |
|
274 |
262 |
$1K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
2,458 |
2,015 |
$1K |
| 87517 |
|
36 |
34 |
$1K |
| 73060 |
|
148 |
132 |
$1K |
| 64494 |
|
49 |
26 |
$1K |
| J2704 |
Injection, propofol, 10 mg |
2,815 |
2,486 |
$1K |
| 88307 |
|
151 |
146 |
$1K |
| 82140 |
|
310 |
232 |
$1K |
| 51701 |
|
84 |
84 |
$1K |
| A9270 |
Non-covered item or service |
2,160 |
461 |
$1K |
| 73000 |
|
108 |
97 |
$1K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
11,219 |
9,040 |
$1K |
| 73200 |
|
12 |
12 |
$1K |
| 86308 |
|
167 |
165 |
$1K |
| 84480 |
|
131 |
130 |
$1K |
| 84305 |
|
39 |
39 |
$1K |
| 77073 |
|
48 |
48 |
$1K |
| 82952 |
|
304 |
300 |
$1K |
| 74230 |
|
56 |
56 |
$1K |
| 72170 |
|
134 |
129 |
$1K |
| 84155 |
|
264 |
253 |
$1K |
| 82274 |
|
317 |
310 |
$1K |
| 87075 |
|
129 |
121 |
$1K |
| 74019 |
|
78 |
76 |
$995.77 |
| 87350 |
|
98 |
96 |
$962.31 |
| 82390 |
|
89 |
87 |
$960.50 |
| 93308 |
|
54 |
51 |
$959.22 |
| 93304 |
|
50 |
50 |
$950.48 |
| 84432 |
|
39 |
36 |
$901.92 |
| 83986 |
|
53 |
53 |
$898.95 |
| 82040 |
|
322 |
299 |
$891.37 |
| G2023 |
Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
37 |
36 |
$883.75 |
| J1750 |
Injection, iron dextran, 50 mg |
397 |
359 |
$878.20 |
| 94618 |
|
112 |
107 |
$853.59 |
| 80177 |
|
53 |
50 |
$849.92 |
| J1630 |
Injection, haloperidol, up to 5 mg |
2,355 |
1,811 |
$832.39 |
| 82164 |
|
40 |
39 |
$821.87 |
| 84681 |
|
26 |
26 |
$812.59 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
1,020 |
710 |
$809.44 |
| 80175 |
|
64 |
63 |
$803.10 |
| 86304 |
|
39 |
37 |
$766.25 |
| 85384 |
|
98 |
89 |
$738.12 |
| A9555 |
Rubidium rb-82, diagnostic, per study dose, up to 60 millicuries |
115 |
95 |
$713.20 |
| 88173 |
|
14 |
12 |
$709.36 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
3,768 |
3,169 |
$688.84 |
| 86735 |
|
42 |
42 |
$681.98 |
| J1644 |
Injection, heparin sodium, per 1000 units |
3,659 |
1,510 |
$668.06 |
| 89051 |
|
77 |
73 |
$662.12 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
3,664 |
2,726 |
$658.47 |
| 82010 |
|
194 |
171 |
$608.99 |
| J3370 |
Injection, vancomycin hcl, 500 mg |
178 |
85 |
$607.73 |
| 84075 |
|
135 |
125 |
$573.89 |
| 86665 |
|
13 |
13 |
$564.11 |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
2,159 |
1,005 |
$561.59 |
| 80197 |
|
38 |
24 |
$553.54 |
| J1815 |
Injection, insulin, per 5 units |
1,957 |
866 |
$545.12 |
| 73070 |
|
47 |
40 |
$532.26 |
| 80305 |
|
57 |
48 |
$528.45 |
| 82330 |
|
153 |
126 |
$527.92 |
| 0001A |
|
14 |
14 |
$521.17 |
| 74220 |
|
38 |
38 |
$511.70 |
| 73600 |
|
43 |
39 |
$486.36 |
| J2060 |
Injection, lorazepam, 2 mg |
2,334 |
1,720 |
$478.32 |
| Q3014 |
Telehealth originating site facility fee |
187 |
166 |
$476.44 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
1,865 |
1,577 |
$469.75 |
| 77002 |
|
14 |
14 |
$467.07 |
| 82378 |
|
28 |
27 |
$466.65 |
| 74246 |
|
13 |
13 |
$426.39 |
| G0103 |
Prostate cancer screening; prostate specific antigen test (psa) |
27 |
27 |
$397.71 |
| J2795 |
Injection, ropivacaine hydrochloride, 1 mg |
68 |
63 |
$391.13 |
| J2550 |
Injection, promethazine hcl, up to 50 mg |
531 |
374 |
$386.25 |
| 85018 |
|
117 |
113 |
$384.78 |
| J3480 |
Injection, potassium chloride, per 2 meq |
435 |
304 |
$382.66 |
| 86923 |
|
16 |
12 |
$382.20 |
| 86334 |
|
12 |
12 |
$375.20 |
| J1030 |
Injection, methylprednisolone acetate, 40 mg |
505 |
494 |
$364.99 |
| 90688 |
|
44 |
44 |
$358.50 |
| 89055 |
|
77 |
77 |
$347.92 |
| 77280 |
|
14 |
12 |
$343.96 |
| 85613 |
|
28 |
26 |
$314.19 |
| 82374 |
|
62 |
62 |
$290.83 |
| 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 |
1,512 |
1,213 |
$288.37 |
| 88112 |
|
12 |
12 |
$287.18 |
| 84445 |
|
12 |
12 |
$276.00 |
| J2710 |
Injection, neostigmine methylsulfate, up to 0.5 mg |
347 |
243 |
$266.53 |
| J1720 |
Injection, hydrocortisone sodium succinate, up to 100 mg |
27 |
24 |
$261.97 |
| 93922 |
|
13 |
12 |
$224.97 |
| 83883 |
|
13 |
13 |
$219.19 |
| 80047 |
|
128 |
99 |
$204.88 |
| 80183 |
|
13 |
12 |
$203.32 |
| 82785 |
|
17 |
15 |
$198.35 |
| 82272 |
|
88 |
85 |
$190.02 |
| A9503 |
Technetium tc-99m medronate, diagnostic, per study dose, up to 30 millicuries |
15 |
15 |
$189.77 |
| 82656 |
|
13 |
12 |
$169.90 |
| C9113 |
Injection, pantoprazole sodium, per vial |
240 |
145 |
$167.91 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
2,199 |
1,706 |
$165.37 |
| 73650 |
|
16 |
13 |
$155.20 |
| 86870 |
|
14 |
14 |
$133.09 |
| 86593 |
|
24 |
24 |
$128.16 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
1,673 |
1,396 |
$123.57 |
| 87102 |
|
15 |
15 |
$107.23 |
| 76937 |
|
17 |
16 |
$98.98 |
| 90480 |
|
12 |
12 |
$94.27 |
| G0009 |
Administration of pneumococcal vaccine |
12 |
12 |
$87.50 |
| J3411 |
Injection, thiamine hcl, 100 mg |
51 |
29 |
$70.31 |
| 84300 |
|
12 |
12 |
$62.16 |
| 88311 |
|
12 |
12 |
$47.98 |
| 82270 |
|
15 |
13 |
$47.03 |
| J7050 |
Infusion, normal saline solution, 250 cc |
1,692 |
1,083 |
$36.07 |
| 99152 |
|
12 |
12 |
$34.01 |
| J8597 |
Antiemetic drug, oral, not otherwise specified |
90 |
78 |
$25.29 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
28 |
28 |
$23.00 |
| J7510 |
Prednisolone oral, per 5 mg |
65 |
58 |
$20.76 |
| J2920 |
Injection, methylprednisolone sodium succinate, up to 40 mg |
55 |
40 |
$16.51 |
| J0330 |
Injection, succinylcholine chloride, up to 20 mg |
39 |
25 |
$15.82 |
| J0360 |
Injection, hydralazine hcl, up to 20 mg |
14 |
12 |
$13.04 |
| J1940 |
Injection, furosemide, up to 20 mg |
18 |
13 |
$1.38 |
| J7620 |
Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme |
14 |
14 |
$1.01 |
| G1010 |
Clinical decision support mechanism stanson, as defined by the medicare appropriate use criteria program |
924 |
841 |
$0.07 |
| J3420 |
Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg |
64 |
54 |
$0.00 |
| J2469 |
Injection, palonosetron hcl, 25 mcg |
144 |
94 |
$0.00 |
| J2470 |
Injection, pantoprazole sodium, 40 mg |
29 |
15 |
$0.00 |
| J3590 |
Unclassified biologics |
25 |
13 |
$0.00 |
| J2543 |
Injection, piperacillin sodium/tazobactam sodium, 1 gram/0.125 grams (1.125 grams) |
68 |
28 |
$0.00 |
| J1010 |
Injection, methylprednisolone acetate, 1 mg |
94 |
94 |
$0.00 |
| 90677 |
|
83 |
75 |
$0.00 |
| J2003 |
Injection, lidocaine hydrochloride, 1 mg |
12 |
12 |
$0.00 |
| A9500 |
Technetium tc-99m sestamibi, diagnostic, per study dose |
29 |
29 |
$0.00 |
| J2272 |
Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg |
1,119 |
919 |
$0.00 |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
1,236 |
935 |
$0.00 |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
252 |
216 |
$0.00 |
| J2919 |
Injection, methylprednisolone sodium succinate, 5 mg |
133 |
98 |
$0.00 |
| 36592 |
|
16 |
15 |
$0.00 |
| 91320 |
|
66 |
66 |
$0.00 |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
108 |
84 |
$0.00 |
| J1171 |
Injection, hydromorphone, 0.1 mg |
39 |
25 |
$0.00 |
| J1953 |
Injection, levetiracetam, 10 mg |
13 |
13 |
$0.00 |
| J9271 |
Injection, pembrolizumab, 1 mg |
15 |
12 |
$0.00 |
| J1745 |
Injection, infliximab, excludes biosimilar, 10 mg |
73 |
63 |
$0.00 |
| 90662 |
|
25 |
24 |
$0.00 |
| J1020 |
Injection, methylprednisolone acetate, 20 mg |
69 |
65 |
$0.00 |