| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
Emergency department visit for the evaluation and management, high severity |
27,944 |
25,999 |
$5.93M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
34,641 |
33,159 |
$1.70M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
5,222 |
4,820 |
$1.12M |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
961 |
473 |
$527K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
9,465 |
8,499 |
$392K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
3,660 |
3,572 |
$355K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
37,963 |
33,147 |
$282K |
| 80053 |
Comprehensive metabolic panel |
22,702 |
20,433 |
$271K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
1,629 |
1,554 |
$249K |
| 71045 |
Radiologic examination, chest; single view |
9,620 |
8,861 |
$231K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
3,330 |
3,263 |
$176K |
| C9803 |
Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
10,037 |
9,724 |
$173K |
| 70450 |
Computed tomography, head or brain; without contrast material |
2,783 |
2,631 |
$168K |
| 87637 |
Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV |
1,324 |
1,279 |
$167K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
2,861 |
2,729 |
$124K |
| 87631 |
|
1,077 |
1,049 |
$112K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
1,013 |
966 |
$93K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
2,474 |
2,424 |
$90K |
| 76801 |
|
1,225 |
1,004 |
$88K |
| 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 |
1,850 |
1,769 |
$83K |
| CP007 |
|
1,798 |
1,430 |
$80K |
| 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 |
1,144 |
995 |
$78K |
| 93976 |
|
1,110 |
967 |
$69K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
1,563 |
1,401 |
$68K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
719 |
675 |
$65K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
1,347 |
1,295 |
$64K |
| 81001 |
|
18,477 |
17,053 |
$61K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
1,175 |
1,123 |
$57K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
6,956 |
6,038 |
$53K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
5,653 |
5,174 |
$50K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
52 |
50 |
$44K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
9,189 |
7,602 |
$44K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
3,799 |
3,332 |
$44K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
1,800 |
1,711 |
$44K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
1,801 |
1,712 |
$44K |
| 84703 |
|
6,270 |
5,863 |
$42K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
1,335 |
684 |
$37K |
| 95819 |
|
138 |
132 |
$36K |
| 84484 |
|
4,932 |
3,873 |
$35K |
| 83880 |
|
1,490 |
1,375 |
$29K |
| 84702 |
|
2,912 |
2,476 |
$27K |
| 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 |
1,722 |
1,668 |
$26K |
| 87800 |
|
865 |
820 |
$24K |
| 87634 |
|
205 |
202 |
$22K |
| 71046 |
Radiologic examination, chest; 2 views |
757 |
732 |
$20K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
489 |
133 |
$20K |
| 93975 |
|
181 |
162 |
$20K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
182 |
180 |
$19K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
2,275 |
1,896 |
$19K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
469 |
445 |
$18K |
| 83605 |
|
2,729 |
2,272 |
$18K |
| 83690 |
|
3,855 |
3,535 |
$14K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
96 |
96 |
$13K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
174 |
173 |
$13K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
925 |
829 |
$11K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
2,054 |
1,882 |
$10K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
172 |
136 |
$10K |
| 96376 |
|
924 |
700 |
$10K |
| 87040 |
|
1,942 |
960 |
$9K |
| 83735 |
|
2,345 |
1,658 |
$8K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
344 |
326 |
$8K |
| 81025 |
|
1,217 |
1,169 |
$8K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
1,777 |
1,497 |
$7K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
121 |
118 |
$7K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
1,447 |
1,313 |
$6K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
6,177 |
5,419 |
$6K |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
4,026 |
3,161 |
$6K |
| 73562 |
|
285 |
238 |
$6K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
1,236 |
1,154 |
$5K |
| 84443 |
Thyroid stimulating hormone (TSH) |
419 |
408 |
$5K |
| 84145 |
|
374 |
357 |
$4K |
| 95816 |
|
14 |
14 |
$4K |
| 93971 |
|
40 |
36 |
$4K |
| 85379 |
|
925 |
890 |
$4K |
| 86850 |
|
345 |
328 |
$4K |
| 87430 |
|
358 |
346 |
$3K |
| 85610 |
|
1,487 |
1,371 |
$3K |
| 73630 |
|
102 |
93 |
$2K |
| 71250 |
|
32 |
32 |
$2K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
2,447 |
2,229 |
$2K |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
931 |
799 |
$2K |
| 72170 |
|
195 |
190 |
$2K |
| 73030 |
|
95 |
82 |
$2K |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
449 |
396 |
$2K |
| 70498 |
|
28 |
26 |
$2K |
| 76830 |
Ultrasound, transvaginal |
14 |
13 |
$2K |
| 86901 |
|
1,171 |
1,099 |
$2K |
| 85730 |
|
625 |
596 |
$2K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
342 |
331 |
$1K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
1,240 |
1,055 |
$1K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
1,270 |
1,220 |
$989.47 |
| 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 |
1,585 |
1,516 |
$922.34 |
| 84100 |
|
333 |
286 |
$887.08 |
| 70486 |
|
12 |
12 |
$884.82 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
122 |
121 |
$869.96 |
| 81003 |
|
567 |
538 |
$811.90 |
| 86900 |
|
402 |
300 |
$554.68 |
| 90715 |
|
109 |
108 |
$546.26 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
780 |
641 |
$500.70 |
| M0243 |
Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring |
16 |
16 |
$450.00 |
| J2550 |
Injection, promethazine hcl, up to 50 mg |
462 |
411 |
$413.70 |
| J2704 |
Injection, propofol, 10 mg |
787 |
722 |
$381.74 |
| 84132 |
|
194 |
167 |
$378.54 |
| 73610 |
|
16 |
14 |
$318.39 |
| J3490 |
Unclassified drugs |
91 |
70 |
$317.78 |
| 86140 |
|
177 |
159 |
$300.73 |
| 82550 |
|
89 |
84 |
$287.85 |
| 85027 |
|
86 |
67 |
$284.00 |
| 73502 |
|
16 |
14 |
$273.46 |
| J2060 |
Injection, lorazepam, 2 mg |
188 |
159 |
$265.15 |
| 74018 |
|
15 |
13 |
$262.76 |
| 70496 |
|
14 |
13 |
$238.79 |
| 87186 |
|
108 |
106 |
$229.18 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
28 |
28 |
$207.21 |
| 36415 |
Collection of venous blood by venipuncture |
6,539 |
5,393 |
$165.98 |
| 80069 |
|
58 |
25 |
$147.13 |
| J0692 |
Injection, cefepime hydrochloride, 500 mg |
208 |
181 |
$136.72 |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
49 |
46 |
$132.56 |
| 73590 |
|
14 |
13 |
$121.52 |
| 80076 |
|
13 |
13 |
$110.73 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
229 |
223 |
$85.60 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
98 |
91 |
$78.44 |
| 80061 |
Lipid panel |
14 |
14 |
$73.97 |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
26 |
25 |
$57.13 |
| 90686 |
|
12 |
12 |
$43.16 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
101 |
83 |
$35.34 |
| 73130 |
|
14 |
13 |
$30.08 |
| 87077 |
|
25 |
24 |
$20.20 |
| 87205 |
|
13 |
12 |
$14.28 |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
13 |
12 |
$7.00 |
| J0360 |
Injection, hydralazine hcl, up to 20 mg |
15 |
15 |
$6.45 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
15 |
13 |
$3.20 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
175 |
145 |
$1.88 |
| A9270 |
Non-covered item or service |
10,549 |
9,359 |
$0.84 |
| J1644 |
Injection, heparin sodium, per 1000 units |
19 |
12 |
$0.00 |
| 90662 |
|
13 |
13 |
$0.00 |
| J1642 |
Injection, heparin sodium, (heparin lock flush), per 10 units |
14 |
12 |
$0.00 |
| J2003 |
Injection, lidocaine hydrochloride, 1 mg |
51 |
46 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
62 |
62 |
$0.00 |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
19 |
13 |
$0.00 |