| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
16,998 |
14,301 |
$4.82M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
15,269 |
13,336 |
$4.26M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
19,081 |
16,112 |
$3.48M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
19,623 |
14,276 |
$3.32M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
20,553 |
16,797 |
$3.11M |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
15,288 |
4,303 |
$1.86M |
| 96361 |
Intravenous infusion, hydration; each additional hour |
4,212 |
3,589 |
$1.69M |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
3,787 |
3,084 |
$731K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
4,247 |
3,490 |
$547K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
5,061 |
4,409 |
$529K |
| 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 |
8,244 |
6,611 |
$484K |
| 70450 |
Computed tomography, head or brain; without contrast material |
3,020 |
2,661 |
$468K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
2,181 |
1,921 |
$429K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
1,041 |
925 |
$306K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
1,243 |
1,135 |
$291K |
| 71046 |
Radiologic examination, chest; 2 views |
6,689 |
5,819 |
$242K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
2,957 |
1,973 |
$210K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
5,859 |
1,785 |
$205K |
| G0378 |
Hospital observation service, per hour |
1,319 |
854 |
$203K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
6,737 |
5,419 |
$195K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
766 |
734 |
$164K |
| G2023 |
Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
1,698 |
1,567 |
$150K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
1,072 |
1,045 |
$143K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
2,889 |
2,201 |
$135K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
29,569 |
23,500 |
$131K |
| 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 |
6,839 |
5,316 |
$121K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
671 |
555 |
$103K |
| 97161 |
|
702 |
666 |
$84K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
9,265 |
7,176 |
$83K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
3,580 |
2,957 |
$83K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
471 |
435 |
$82K |
| 96127 |
|
2,956 |
2,595 |
$81K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
580 |
381 |
$79K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
55 |
53 |
$73K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
12,865 |
10,771 |
$69K |
| 80053 |
Comprehensive metabolic panel |
25,391 |
21,121 |
$68K |
| G0481 |
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; 8-14 drug class(es), including metabolite(s) if performed |
945 |
694 |
$61K |
| ATP14 |
|
12,783 |
9,702 |
$58K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
3,308 |
3,139 |
$57K |
| 92507 |
Treatment of speech, language, voice, communication, and/or auditory processing disorder |
280 |
86 |
$56K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
4,108 |
3,523 |
$52K |
| 84443 |
Thyroid stimulating hormone (TSH) |
5,618 |
5,276 |
$45K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
432 |
377 |
$45K |
| 73630 |
|
1,602 |
1,315 |
$44K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
6,701 |
6,246 |
$41K |
| 97162 |
|
363 |
331 |
$37K |
| 84484 |
|
6,983 |
5,840 |
$35K |
| 99406 |
|
911 |
796 |
$33K |
| 90686 |
|
326 |
318 |
$32K |
| 80050 |
General health panel |
2,101 |
1,913 |
$32K |
| 83690 |
|
6,981 |
5,968 |
$31K |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
8,844 |
7,590 |
$29K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
149 |
135 |
$28K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
302 |
185 |
$27K |
| 82607 |
|
3,153 |
2,910 |
$26K |
| 80061 |
Lipid panel |
7,586 |
7,053 |
$26K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
106 |
105 |
$26K |
| 87143 |
|
4,382 |
3,539 |
$25K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
85 |
78 |
$24K |
| 73610 |
|
897 |
796 |
$24K |
| 82728 |
|
3,197 |
2,879 |
$23K |
| 97035 |
|
289 |
90 |
$23K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
1,941 |
1,789 |
$22K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
2,140 |
2,059 |
$22K |
| 83880 |
|
2,406 |
1,976 |
$21K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
479 |
184 |
$21K |
| 71045 |
Radiologic examination, chest; single view |
4,873 |
4,137 |
$21K |
| 94760 |
|
20,165 |
16,165 |
$20K |
| 84466 |
|
2,824 |
2,574 |
$20K |
| 36415 |
Collection of venous blood by venipuncture |
32,846 |
25,305 |
$20K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
8,697 |
7,099 |
$18K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
118 |
81 |
$16K |
| 90839 |
|
272 |
174 |
$16K |
| ATP08 |
|
5,230 |
3,622 |
$15K |
| 73030 |
|
512 |
469 |
$15K |
| 97750 |
|
266 |
240 |
$14K |
| 82746 |
|
1,857 |
1,698 |
$14K |
| 87070 |
|
2,406 |
2,131 |
$14K |
| ATP15 |
|
2,640 |
2,012 |
$14K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
3,549 |
2,997 |
$13K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
130 |
65 |
$13K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
296 |
139 |
$13K |
| 87077 |
|
2,970 |
2,593 |
$13K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
93 |
90 |
$12K |
| 72100 |
|
216 |
209 |
$12K |
| 85027 |
|
3,823 |
3,337 |
$12K |
| 83735 |
|
3,518 |
2,905 |
$12K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
71 |
68 |
$12K |
| 83540 |
|
3,264 |
2,993 |
$12K |
| 87186 |
|
2,480 |
2,159 |
$11K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
265 |
247 |
$11K |
| 87634 |
|
454 |
223 |
$11K |
| 99223 |
Prolong inpt eval add15 m |
72 |
70 |
$10K |
| 81001 |
|
6,676 |
5,689 |
$10K |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
408 |
369 |
$10K |
| 95831 |
|
269 |
208 |
$9K |
| 87088 |
|
2,188 |
1,918 |
$9K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
342 |
312 |
$9K |
| 84702 |
|
936 |
767 |
$9K |
| ATP17 |
|
2,451 |
2,105 |
$9K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
28 |
28 |
$9K |
| 73130 |
|
397 |
330 |
$9K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
458 |
348 |
$9K |
| 74019 |
|
115 |
105 |
$8K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
414 |
335 |
$8K |
| 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 |
924 |
772 |
$8K |
| 85610 |
|
4,476 |
3,014 |
$8K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
6,891 |
5,855 |
$8K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
53 |
51 |
$8K |
| 71250 |
|
187 |
177 |
$7K |
| 99218 |
|
237 |
137 |
$7K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
489 |
375 |
$7K |
| 99215 |
Prolong outpt/office vis |
38 |
37 |
$7K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
3,657 |
3,152 |
$7K |
| 87040 |
|
1,541 |
1,254 |
$6K |
| 73562 |
|
270 |
237 |
$6K |
| 81025 |
|
1,235 |
1,109 |
$6K |
| 76830 |
Ultrasound, transvaginal |
14 |
14 |
$6K |
| 73110 |
|
258 |
232 |
$6K |
| ATP03 |
|
1,292 |
1,084 |
$6K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
175 |
164 |
$6K |
| C9803 |
Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
520 |
386 |
$5K |
| 99220 |
|
38 |
38 |
$5K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
837 |
756 |
$5K |
| 76770 |
|
16 |
16 |
$5K |
| 73560 |
|
26 |
24 |
$5K |
| 86803 |
|
594 |
566 |
$5K |
| 94664 |
|
1,062 |
863 |
$4K |
| 81003 |
|
3,951 |
3,552 |
$4K |
| 82248 |
|
3,006 |
2,651 |
$4K |
| 90715 |
|
82 |
78 |
$4K |
| 82948 |
|
1,810 |
1,157 |
$4K |
| 81002 |
|
1,692 |
1,588 |
$3K |
| 84439 |
|
680 |
654 |
$3K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
121 |
114 |
$3K |
| G0283 |
Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care |
267 |
91 |
$3K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
81 |
81 |
$3K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
5,056 |
3,819 |
$3K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
740 |
511 |
$3K |
| 97803 |
|
24 |
24 |
$3K |
| 83605 |
|
834 |
698 |
$3K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
3,691 |
3,184 |
$2K |
| 82043 |
|
942 |
910 |
$2K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
592 |
568 |
$2K |
| 86140 |
|
842 |
745 |
$2K |
| 90656 |
|
33 |
33 |
$2K |
| 87807 |
|
302 |
172 |
$2K |
| 94060 |
|
12 |
12 |
$2K |
| 82570 |
|
821 |
757 |
$2K |
| 83970 |
|
93 |
90 |
$1K |
| 85007 |
|
901 |
773 |
$1K |
| 85379 |
|
299 |
267 |
$1K |
| 82805 |
|
55 |
52 |
$1K |
| 85018 |
|
1,206 |
930 |
$1K |
| 85014 |
|
1,204 |
928 |
$1K |
| 97535 |
Self-care/home management training, each 15 minutes |
14 |
14 |
$1K |
| 94761 |
|
5,497 |
4,397 |
$1K |
| 84146 |
|
70 |
68 |
$1K |
| 83655 |
|
104 |
98 |
$1K |
| 86618 |
|
99 |
94 |
$1K |
| 93041 |
|
2,839 |
2,481 |
$1K |
| 85651 |
|
629 |
558 |
$967.16 |
| 87340 |
|
146 |
137 |
$935.34 |
| 12001 |
|
26 |
24 |
$933.70 |
| 71271 |
|
13 |
12 |
$832.92 |
| 73502 |
|
46 |
39 |
$768.60 |
| 85730 |
|
401 |
352 |
$740.40 |
| 85652 |
|
602 |
565 |
$709.83 |
| S9485 |
Crisis intervention mental health services, per diem |
29 |
17 |
$695.29 |
| 82150 |
|
144 |
119 |
$592.73 |
| 84153 |
|
100 |
95 |
$584.50 |
| 84703 |
|
105 |
97 |
$567.34 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
476 |
338 |
$511.91 |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
24 |
24 |
$458.14 |
| 85049 |
|
187 |
166 |
$451.41 |
| 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 |
523 |
464 |
$447.25 |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
26 |
26 |
$430.64 |
| 80076 |
|
584 |
555 |
$366.99 |
| 82550 |
|
229 |
199 |
$365.18 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
949 |
557 |
$361.52 |
| 73564 |
|
21 |
13 |
$355.95 |
| 81000 |
|
161 |
147 |
$259.37 |
| 84436 |
|
43 |
43 |
$254.88 |
| 86317 |
|
30 |
29 |
$251.18 |
| 84100 |
|
847 |
729 |
$248.87 |
| 86141 |
|
57 |
53 |
$244.75 |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
37 |
29 |
$213.70 |
| 83615 |
|
187 |
170 |
$210.85 |
| 84480 |
|
16 |
16 |
$189.93 |
| ATP16 |
|
105 |
60 |
$174.24 |
| 11721 |
|
46 |
25 |
$152.60 |
| ATP07 |
|
66 |
50 |
$151.74 |
| ATP04 |
|
15 |
15 |
$108.60 |
| 86038 |
|
13 |
13 |
$99.18 |
| 83704 |
|
12 |
12 |
$97.62 |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
55 |
24 |
$97.57 |
| J2060 |
Injection, lorazepam, 2 mg |
747 |
528 |
$86.14 |
| 96376 |
|
935 |
833 |
$79.17 |
| J3420 |
Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg |
13 |
12 |
$65.61 |
| 82010 |
|
14 |
12 |
$57.68 |
| 83721 |
|
81 |
76 |
$54.51 |
| 87046 |
|
13 |
12 |
$48.70 |
| 82172 |
|
12 |
12 |
$47.97 |
| 83695 |
|
13 |
13 |
$40.05 |
| 85045 |
|
27 |
26 |
$40.04 |
| ATP02 |
|
21 |
14 |
$32.22 |
| 99000 |
|
75 |
66 |
$26.63 |
| 82565 |
|
181 |
162 |
$25.84 |
| 84460 |
|
298 |
278 |
$23.35 |
| 82803 |
|
14 |
12 |
$19.95 |
| 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 |
789 |
569 |
$19.70 |
| 80320 |
|
401 |
322 |
$19.55 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
31 |
17 |
$17.39 |
| 84450 |
|
68 |
61 |
$0.00 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
141 |
111 |
$0.00 |
| 84145 |
|
74 |
63 |
$0.00 |
| G9744 |
Patient not eligible due to active diagnosis of hypertension |
351 |
287 |
$0.00 |
| 80143 |
|
17 |
12 |
$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 |
17 |
12 |
$0.00 |
| G8979 |
Mobility: walking & moving around functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting |
99 |
83 |
$0.00 |
| J2919 |
Injection, methylprednisolone sodium succinate, 5 mg |
81 |
41 |
$0.00 |
| 91300 |
|
19 |
16 |
$0.00 |
| 80179 |
|
17 |
12 |
$0.00 |
| G8978 |
Mobility: walking & moving around functional limitation, current status, at therapy episode outset and at reporting intervals |
42 |
38 |
$0.00 |
| 94799 |
|
14 |
14 |
$0.00 |
| 84520 |
|
13 |
13 |
$0.00 |
| G8783 |
Normal blood pressure reading documented, follow-up not required |
24 |
17 |
$0.00 |
| G8952 |
Elevated or hypertensive blood pressure reading documented, indicated follow-up not documented, reason not given |
251 |
215 |
$0.00 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
109 |
39 |
$0.00 |
| ATP23 |
|
29 |
29 |
$0.00 |
| 95851 |
|
147 |
122 |
$0.00 |
| G8950 |
Elevated or hypertensive blood pressure reading documented, and the indicated follow-up is documented |
26 |
24 |
$0.00 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
31 |
25 |
$0.00 |
| J1010 |
Injection, methylprednisolone acetate, 1 mg |
21 |
14 |
$0.00 |
| 88342 |
|
50 |
46 |
$0.00 |