| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
35,339 |
32,342 |
$3.66M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
44,166 |
35,492 |
$2.90M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
21,620 |
19,104 |
$2.65M |
| 96361 |
Intravenous infusion, hydration; each additional hour |
6,708 |
5,416 |
$1.90M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
30,615 |
25,457 |
$1.82M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
12,550 |
10,255 |
$1.48M |
| 70450 |
Computed tomography, head or brain; without contrast material |
3,463 |
2,797 |
$815K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
2,955 |
2,278 |
$693K |
| 0202U |
Oncology (prostate), multianalyte, gene expression profiling |
3,776 |
3,136 |
$593K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
7,186 |
2,127 |
$527K |
| 92507 |
Treatment of speech, language, voice, communication, and/or auditory processing disorder |
6,673 |
2,245 |
$443K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
7,028 |
4,741 |
$439K |
| 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 |
2,404 |
2,282 |
$418K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
1,519 |
1,149 |
$387K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
11,086 |
9,742 |
$363K |
| 93458 |
|
397 |
302 |
$319K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
5,104 |
3,984 |
$304K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
4,770 |
1,608 |
$303K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
1,565 |
675 |
$300K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
2,568 |
1,562 |
$296K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
816 |
682 |
$278K |
| G0378 |
Hospital observation service, per hour |
3,854 |
1,274 |
$266K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
1,377 |
1,194 |
$260K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
2,252 |
1,496 |
$258K |
| 87631 |
|
2,746 |
2,273 |
$253K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
3,994 |
3,308 |
$218K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
3,756 |
3,240 |
$206K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
3,210 |
2,755 |
$188K |
| 59025 |
Fetal non-stress test |
1,271 |
646 |
$185K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
23,047 |
17,266 |
$180K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
796 |
574 |
$178K |
| 80053 |
Comprehensive metabolic panel |
20,520 |
16,673 |
$176K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
1,662 |
1,436 |
$168K |
| 81513 |
|
1,433 |
1,086 |
$158K |
| 90999 |
Unlisted dialysis procedure, inpatient or outpatient |
7,161 |
402 |
$156K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,341 |
1,170 |
$142K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
538 |
382 |
$135K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
2,340 |
2,024 |
$126K |
| 84443 |
Thyroid stimulating hormone (TSH) |
6,580 |
5,373 |
$118K |
| 96161 |
|
1,199 |
1,041 |
$113K |
| 64488 |
|
739 |
418 |
$109K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
2,158 |
1,796 |
$100K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
45,944 |
35,082 |
$99K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
597 |
258 |
$97K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
2,580 |
988 |
$95K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
806 |
718 |
$87K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,956 |
1,666 |
$85K |
| 95810 |
Polysomnography; sleep staging with 4 or more additional parameters |
165 |
156 |
$83K |
| 76830 |
Ultrasound, transvaginal |
1,174 |
920 |
$79K |
| 93017 |
|
1,176 |
1,003 |
$77K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
1,061 |
804 |
$73K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
313 |
253 |
$73K |
| 71045 |
Radiologic examination, chest; single view |
15,489 |
13,471 |
$66K |
| 99215 |
Prolong outpt/office vis |
1,033 |
871 |
$66K |
| 71046 |
Radiologic examination, chest; 2 views |
1,895 |
1,568 |
$62K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
1,733 |
1,484 |
$60K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
24,695 |
20,712 |
$57K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,245 |
1,031 |
$54K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
3,949 |
3,020 |
$54K |
| 69436 |
Tympanostomy (requiring insertion of ventilating tube), general anesthesia |
35 |
25 |
$52K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
348 |
252 |
$52K |
| 90834 |
Psychotherapy, 45 minutes with patient |
415 |
191 |
$52K |
| 90837 |
Psychotherapy, 53 minutes with patient |
439 |
317 |
$49K |
| 97535 |
Self-care/home management training, each 15 minutes |
1,282 |
648 |
$49K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
723 |
564 |
$48K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
1,074 |
993 |
$47K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
615 |
434 |
$47K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
438 |
341 |
$46K |
| 80061 |
Lipid panel |
4,727 |
3,999 |
$46K |
| 93971 |
|
633 |
530 |
$44K |
| 76642 |
|
470 |
344 |
$44K |
| 36415 |
Collection of venous blood by venipuncture |
22,873 |
19,281 |
$43K |
| 93970 |
|
325 |
275 |
$42K |
| 84484 |
|
12,032 |
9,610 |
$42K |
| 97161 |
|
974 |
816 |
$41K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
1,930 |
1,638 |
$40K |
| 97113 |
|
537 |
137 |
$38K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
254 |
213 |
$36K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
3,104 |
2,535 |
$35K |
| 92557 |
|
583 |
501 |
$33K |
| 95811 |
|
46 |
37 |
$32K |
| 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 |
1,517 |
1,421 |
$32K |
| Q5105 |
Injection, epoetin alfa-epbx, biosimilar, (retacrit) (for esrd on dialysis), 100 units |
2,144 |
129 |
$30K |
| 96160 |
|
279 |
234 |
$30K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
907 |
674 |
$29K |
| C9600 |
Percutaneous transcatheter placement of drug eluting intracoronary stent(s), with coronary angioplasty when performed; single major coronary artery or branch |
17 |
12 |
$28K |
| 84439 |
|
2,515 |
2,092 |
$27K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
1,088 |
845 |
$26K |
| 95886 |
|
145 |
103 |
$26K |
| J0585 |
Injection, onabotulinumtoxina, 1 unit |
23 |
12 |
$25K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
3,143 |
2,550 |
$25K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
9,373 |
7,636 |
$25K |
| 83735 |
|
9,069 |
5,584 |
$25K |
| 97165 |
|
551 |
427 |
$25K |
| 76770 |
|
153 |
133 |
$24K |
| 87070 |
|
4,282 |
3,671 |
$23K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
6,330 |
5,233 |
$23K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
66 |
51 |
$23K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
2,942 |
2,345 |
$23K |
| 86850 |
|
1,301 |
1,002 |
$22K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
4,926 |
4,257 |
$22K |
| 97116 |
|
1,014 |
441 |
$20K |
| 81001 |
|
23,693 |
19,969 |
$19K |
| 80076 |
|
2,807 |
2,226 |
$19K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
9,590 |
6,800 |
$19K |
| C9803 |
Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
535 |
519 |
$18K |
| 90670 |
|
1,032 |
808 |
$18K |
| 82607 |
|
1,422 |
1,189 |
$18K |
| 82728 |
|
1,483 |
1,235 |
$17K |
| J1644 |
Injection, heparin sodium, per 1000 units |
5,966 |
870 |
$17K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
129 |
102 |
$17K |
| 74018 |
|
716 |
544 |
$17K |
| 93225 |
|
304 |
279 |
$16K |
| 86900 |
|
1,505 |
1,152 |
$15K |
| 96367 |
|
500 |
296 |
$15K |
| 76536 |
|
157 |
135 |
$15K |
| 99381 |
|
327 |
281 |
$15K |
| 86140 |
|
984 |
759 |
$13K |
| 72100 |
|
735 |
583 |
$13K |
| J1756 |
Injection, iron sucrose, 1 mg |
668 |
116 |
$13K |
| 94060 |
|
113 |
102 |
$13K |
| 70486 |
|
244 |
199 |
$12K |
| 71250 |
|
174 |
158 |
$12K |
| 85027 |
|
1,998 |
1,618 |
$11K |
| 83540 |
|
1,679 |
1,374 |
$11K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
326 |
265 |
$11K |
| 92567 |
|
1,004 |
838 |
$11K |
| 73630 |
|
1,438 |
1,105 |
$11K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
944 |
750 |
$11K |
| 84466 |
|
1,561 |
1,279 |
$11K |
| 82746 |
|
1,248 |
1,035 |
$10K |
| 84702 |
|
1,018 |
641 |
$10K |
| 73130 |
|
827 |
588 |
$10K |
| 83655 |
|
441 |
342 |
$10K |
| 86780 |
|
1,196 |
978 |
$10K |
| 82570 |
|
1,433 |
1,175 |
$9K |
| 86703 |
|
699 |
541 |
$9K |
| 93296 |
|
721 |
662 |
$9K |
| 90686 |
|
1,174 |
889 |
$9K |
| 87340 |
|
872 |
699 |
$9K |
| 99385 |
|
249 |
216 |
$9K |
| 71271 |
|
66 |
63 |
$9K |
| 90648 |
|
1,014 |
799 |
$8K |
| J3490 |
Unclassified drugs |
1,555 |
757 |
$8K |
| 12001 |
|
53 |
50 |
$8K |
| G0108 |
Diabetes outpatient self-management training services, individual, per 30 minutes |
176 |
139 |
$8K |
| 87428 |
|
6,782 |
5,448 |
$8K |
| 73030 |
|
634 |
490 |
$8K |
| 10060 |
|
51 |
41 |
$8K |
| S9472 |
Cardiac rehabilitation program, non-physician provider, per diem |
131 |
24 |
$7K |
| 73610 |
|
842 |
687 |
$7K |
| 86803 |
|
744 |
609 |
$7K |
| 90833 |
Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) |
87 |
68 |
$7K |
| 85610 |
|
11,208 |
8,066 |
$7K |
| 83690 |
|
9,667 |
7,985 |
$6K |
| 82043 |
|
1,006 |
875 |
$6K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
12,438 |
10,331 |
$6K |
| 87481 |
|
1,454 |
1,106 |
$6K |
| 86038 |
|
258 |
209 |
$6K |
| 93925 |
|
59 |
55 |
$6K |
| 93880 |
|
98 |
79 |
$5K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
365 |
136 |
$5K |
| 90681 |
|
425 |
325 |
$5K |
| 87641 |
|
835 |
632 |
$5K |
| 90633 |
|
726 |
572 |
$5K |
| 87510 |
|
202 |
197 |
$5K |
| 83880 |
|
1,547 |
1,259 |
$5K |
| 90723 |
|
791 |
624 |
$5K |
| 87077 |
|
1,959 |
1,563 |
$5K |
| 83970 |
|
365 |
294 |
$5K |
| 78815 |
Positron emission tomography (PET) for limited area imaging |
14 |
12 |
$5K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
8,237 |
5,841 |
$4K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
1,468 |
1,262 |
$4K |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
747 |
597 |
$4K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
1,528 |
1,133 |
$4K |
| 84153 |
|
346 |
300 |
$4K |
| 81025 |
|
9,221 |
7,316 |
$4K |
| 93298 |
|
1,026 |
939 |
$4K |
| 72040 |
|
121 |
104 |
$4K |
| 88142 |
|
1,342 |
1,074 |
$4K |
| 76818 |
|
201 |
100 |
$4K |
| 87480 |
|
202 |
197 |
$4K |
| 87493 |
|
650 |
487 |
$4K |
| 92587 |
|
61 |
55 |
$4K |
| 87500 |
|
713 |
524 |
$4K |
| 85652 |
|
1,101 |
853 |
$4K |
| 73110 |
|
310 |
240 |
$4K |
| 82565 |
|
1,049 |
794 |
$4K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
121 |
120 |
$4K |
| 86225 |
|
290 |
229 |
$4K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
1,274 |
1,051 |
$4K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
939 |
749 |
$4K |
| 83605 |
|
2,149 |
1,642 |
$4K |
| 94726 |
|
63 |
53 |
$4K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
23 |
13 |
$4K |
| 96376 |
|
1,779 |
803 |
$3K |
| 93922 |
|
49 |
45 |
$3K |
| 73562 |
|
548 |
402 |
$3K |
| 88307 |
|
31 |
13 |
$3K |
| 82077 |
|
1,187 |
917 |
$3K |
| 87430 |
|
7,186 |
5,777 |
$3K |
| 87507 |
|
22 |
15 |
$3K |
| 92552 |
|
61 |
45 |
$3K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
126 |
70 |
$3K |
| 86901 |
|
1,505 |
1,152 |
$3K |
| 84156 |
|
881 |
665 |
$3K |
| A4657 |
Syringe, with or without needle, each |
4,232 |
216 |
$3K |
| 87660 |
|
221 |
214 |
$3K |
| 72072 |
|
106 |
82 |
$3K |
| 84550 |
|
663 |
540 |
$3K |
| 0002A |
|
72 |
67 |
$3K |
| 93270 |
|
20 |
12 |
$2K |
| 73502 |
|
134 |
100 |
$2K |
| 86430 |
|
167 |
130 |
$2K |
| 82950 |
|
559 |
465 |
$2K |
| 86695 |
|
156 |
124 |
$2K |
| 87186 |
|
1,881 |
1,482 |
$2K |
| 77065 |
Tomosynthesis, mammo |
133 |
97 |
$2K |
| 86696 |
|
156 |
124 |
$2K |
| 84703 |
|
654 |
487 |
$2K |
| 90716 |
|
295 |
221 |
$2K |
| G2066 |
Interrogation device evaluation(s), (remote) up to 30 days; implantable cardiovascular physiologic monitor system, implantable loop recorder system, or subcutaneous cardiac rhythm monitor system, remote data acquisition(s), receipt of transmissions and technician review, technical support and distribution of results |
99 |
92 |
$2K |
| 0001A |
|
73 |
73 |
$2K |
| 84100 |
|
1,400 |
939 |
$2K |
| 87081 |
|
701 |
510 |
$2K |
| 83525 |
|
109 |
76 |
$2K |
| 80143 |
|
487 |
382 |
$2K |
| 95816 |
|
14 |
12 |
$2K |
| 85379 |
|
1,385 |
1,069 |
$2K |
| 86762 |
|
353 |
275 |
$2K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
233 |
188 |
$2K |
| 72141 |
|
14 |
12 |
$2K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
9,473 |
7,305 |
$2K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
1,725 |
1,020 |
$2K |
| 51798 |
|
501 |
426 |
$2K |
| 87486 |
|
68 |
68 |
$2K |
| 88174 |
|
77 |
75 |
$2K |
| 99383 |
|
27 |
26 |
$2K |
| 90651 |
|
92 |
69 |
$2K |
| 83615 |
|
694 |
487 |
$1K |
| 85730 |
|
2,157 |
1,579 |
$1K |
| 31575 |
|
40 |
40 |
$1K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,640 |
1,351 |
$1K |
| 90715 |
|
133 |
104 |
$1K |
| 84145 |
|
337 |
234 |
$1K |
| 84450 |
|
223 |
178 |
$1K |
| 90707 |
|
297 |
230 |
$1K |
| H1000 |
Prenatal care, at-risk assessment |
189 |
141 |
$1K |
| 82803 |
|
665 |
483 |
$1K |
| 90696 |
|
168 |
128 |
$1K |
| 86141 |
|
27 |
26 |
$1K |
| 77062 |
|
46 |
32 |
$1K |
| 97150 |
Therapeutic procedure(s), group (2 or more individuals) |
117 |
30 |
$1K |
| 00731 |
|
426 |
321 |
$1K |
| 99406 |
|
66 |
58 |
$1K |
| 82040 |
|
431 |
348 |
$1K |
| 87150 |
|
295 |
237 |
$980.02 |
| 84403 |
|
61 |
51 |
$921.86 |
| 85014 |
|
727 |
457 |
$921.51 |
| 81003 |
|
2,340 |
1,936 |
$918.67 |
| 92523 |
|
12 |
12 |
$914.57 |
| J2785 |
Injection, regadenoson, 0.1 mg |
620 |
508 |
$913.16 |
| 00840 |
|
282 |
144 |
$892.30 |
| 82150 |
|
327 |
272 |
$861.73 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
1,308 |
563 |
$853.19 |
| 80179 |
|
446 |
348 |
$852.42 |
| 87040 |
|
652 |
471 |
$819.13 |
| 90677 |
|
59 |
58 |
$814.92 |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
69 |
68 |
$802.60 |
| 87581 |
|
68 |
68 |
$788.37 |
| 87801 |
Infectious agent detection by nucleic acid; amplified probe, multiple organisms |
21 |
20 |
$784.33 |
| 84132 |
|
728 |
505 |
$775.95 |
| 90700 |
|
212 |
155 |
$769.37 |
| 85018 |
|
768 |
486 |
$761.55 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
1,995 |
1,118 |
$740.63 |
| 84146 |
|
179 |
147 |
$737.11 |
| 82330 |
|
176 |
85 |
$717.10 |
| 82550 |
|
198 |
150 |
$686.39 |
| 87420 |
|
825 |
659 |
$676.84 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
8,739 |
6,417 |
$645.60 |
| 94729 |
|
16 |
14 |
$629.57 |
| 72131 |
|
14 |
14 |
$595.17 |
| 73590 |
|
60 |
39 |
$580.56 |
| 76801 |
|
72 |
50 |
$563.84 |
| 85045 |
|
295 |
246 |
$542.94 |
| 84481 |
|
29 |
24 |
$524.73 |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
102 |
101 |
$524.00 |
| 90710 |
|
148 |
115 |
$523.56 |
| A9500 |
Technetium tc-99m sestamibi, diagnostic, per study dose |
835 |
696 |
$518.70 |
| 90734 |
|
97 |
72 |
$498.62 |
| J7999 |
Compounded drug, not otherwise classified |
327 |
177 |
$468.71 |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
696 |
287 |
$452.16 |
| 84520 |
|
645 |
364 |
$433.33 |
| 71101 |
|
18 |
14 |
$408.88 |
| 87205 |
|
590 |
431 |
$386.88 |
| 80074 |
|
26 |
14 |
$385.26 |
| 77066 |
Tomosynthesis, mammo |
99 |
64 |
$361.54 |
| 73090 |
|
63 |
49 |
$360.69 |
| J2704 |
Injection, propofol, 10 mg |
4,270 |
2,687 |
$342.99 |
| 82248 |
|
58 |
38 |
$336.53 |
| 87633 |
Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets |
24 |
24 |
$327.21 |
| 97162 |
|
15 |
12 |
$321.06 |
| 82310 |
|
431 |
308 |
$312.54 |
| 84075 |
|
344 |
288 |
$308.64 |
| 74022 |
|
96 |
70 |
$306.66 |
| 82140 |
|
63 |
46 |
$303.01 |
| 83001 |
|
16 |
13 |
$298.17 |
| 83874 |
|
41 |
39 |
$297.72 |
| 72170 |
|
58 |
47 |
$293.62 |
| J3420 |
Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg |
499 |
328 |
$253.56 |
| 73080 |
|
45 |
37 |
$243.72 |
| 99382 |
|
15 |
13 |
$243.17 |
| 84402 |
|
12 |
12 |
$228.33 |
| 88304 |
|
472 |
284 |
$227.21 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
4,489 |
2,905 |
$219.48 |
| 86308 |
|
47 |
37 |
$215.48 |
| 87088 |
|
148 |
109 |
$162.64 |
| 36416 |
|
3,942 |
2,643 |
$162.00 |
| 84460 |
|
85 |
82 |
$159.96 |
| 90694 |
|
47 |
43 |
$154.46 |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
764 |
436 |
$152.36 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
7,837 |
5,301 |
$141.07 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
1,004 |
568 |
$140.32 |
| J2272 |
Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg |
256 |
213 |
$128.23 |
| J2919 |
Injection, methylprednisolone sodium succinate, 5 mg |
225 |
150 |
$125.03 |
| 85384 |
|
98 |
79 |
$116.18 |
| 73552 |
|
17 |
12 |
$115.68 |
| 82947 |
|
33 |
24 |
$115.58 |
| J3360 |
Injection, diazepam, up to 5 mg |
40 |
27 |
$110.18 |
| 76604 |
|
38 |
37 |
$104.51 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
383 |
245 |
$101.42 |
| 84295 |
|
341 |
248 |
$101.01 |
| 90714 |
|
16 |
15 |
$96.66 |
| 87400 |
|
492 |
375 |
$83.71 |
| J0360 |
Injection, hydralazine hcl, up to 20 mg |
165 |
105 |
$81.88 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
1,177 |
585 |
$81.71 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
1,274 |
829 |
$77.12 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
3,319 |
2,113 |
$76.37 |
| G0008 |
Administration of influenza virus vaccine |
146 |
138 |
$73.83 |
| 82044 |
|
228 |
200 |
$72.53 |
| 93288 |
|
13 |
12 |
$71.52 |
| 69210 |
|
16 |
12 |
$69.00 |
| J1642 |
Injection, heparin sodium, (heparin lock flush), per 10 units |
877 |
383 |
$67.50 |
| 92579 |
|
17 |
14 |
$65.90 |
| 86706 |
|
40 |
34 |
$58.15 |
| J2371 |
Injection, phenylephrine hydrochloride, 20 micrograms |
416 |
298 |
$51.55 |
| J1020 |
Injection, methylprednisolone acetate, 20 mg |
224 |
144 |
$49.44 |
| 82962 |
|
53 |
40 |
$44.40 |
| J2795 |
Injection, ropivacaine hydrochloride, 1 mg |
623 |
341 |
$43.96 |
| J2360 |
Injection, orphenadrine citrate, up to 60 mg |
156 |
111 |
$43.24 |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
203 |
102 |
$42.23 |
| 87210 |
|
54 |
39 |
$41.57 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
889 |
566 |
$35.87 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
6,387 |
4,947 |
$32.02 |
| C9113 |
Injection, pantoprazole sodium, per vial |
39 |
12 |
$29.04 |
| J2060 |
Injection, lorazepam, 2 mg |
315 |
197 |
$27.09 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
2,826 |
1,824 |
$21.79 |
| 92555 |
|
12 |
12 |
$21.78 |
| J1010 |
Injection, methylprednisolone acetate, 1 mg |
192 |
166 |
$17.60 |
| 87075 |
|
15 |
13 |
$15.99 |
| 85390 |
|
46 |
38 |
$15.83 |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
401 |
268 |
$14.99 |
| 82374 |
|
243 |
217 |
$7.32 |
| 88720 |
|
20 |
12 |
$7.00 |
| 83550 |
|
60 |
56 |
$6.56 |
| J1171 |
Injection, hydromorphone, 0.1 mg |
51 |
30 |
$5.62 |
| J7050 |
Infusion, normal saline solution, 250 cc |
466 |
289 |
$5.46 |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
60 |
52 |
$2.69 |
| 90662 |
|
12 |
12 |
$1.95 |
| J0171 |
Injection, adrenalin, epinephrine, 0.1 mg |
18 |
12 |
$1.44 |
| 91300 |
|
147 |
140 |
$1.42 |
| A9585 |
Injection, gadobutrol, 0.1 ml |
599 |
436 |
$0.33 |
| 88342 |
|
120 |
93 |
$0.00 |
| C1769 |
Guide wire |
1,010 |
766 |
$0.00 |
| 00790 |
|
29 |
12 |
$0.00 |
| 96368 |
|
19 |
14 |
$0.00 |
| 86580 |
|
16 |
15 |
$0.00 |
| 85576 |
|
44 |
41 |
$0.00 |
| 00126 |
|
12 |
12 |
$0.00 |
| A9270 |
Non-covered item or service |
129 |
54 |
$0.00 |
| C1725 |
Catheter, transluminal angioplasty, non-laser (may include guidance, infusion/perfusion capability) |
14 |
12 |
$0.00 |
| L8699 |
Prosthetic implant, not otherwise specified |
22 |
14 |
$0.00 |
| J0330 |
Injection, succinylcholine chloride, up to 20 mg |
15 |
14 |
$0.00 |
| C1887 |
Catheter, guiding (may include infusion/perfusion capability) |
464 |
333 |
$0.00 |
| Q9957 |
Injection, perflutren lipid microspheres, per ml |
40 |
36 |
$0.00 |
| C1894 |
Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser |
846 |
688 |
$0.00 |
| 85347 |
|
105 |
85 |
$0.00 |
| 82108 |
|
17 |
16 |
$0.00 |
| A9552 |
Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries |
14 |
12 |
$0.00 |
| 00811 |
|
40 |
26 |
$0.00 |
| J2550 |
Injection, promethazine hcl, up to 50 mg |
16 |
16 |
$0.00 |
| 90461 |
|
22 |
15 |
$0.00 |
| 00170 |
Anesthesia for intraoral procedures, including biopsy |
14 |
12 |
$0.00 |
| C1713 |
Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) |
18 |
14 |
$0.00 |
| C1874 |
Stent, coated/covered, with delivery system |
17 |
13 |
$0.00 |
| 82010 |
|
24 |
14 |
$0.00 |