| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
Emergency department visit for the evaluation and management, high severity |
27,023 |
25,754 |
$6.14M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
12,230 |
11,509 |
$3.67M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
23,224 |
22,231 |
$3.51M |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
19,246 |
17,227 |
$1.30M |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
8,382 |
7,781 |
$1.02M |
| 0202U |
Oncology (prostate), multianalyte, gene expression profiling |
2,509 |
2,426 |
$811K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
64,462 |
61,423 |
$737K |
| 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 |
8,888 |
8,640 |
$685K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
17,601 |
17,017 |
$576K |
| 0240U |
|
3,293 |
3,198 |
$408K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
1,003 |
953 |
$259K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
4,049 |
3,761 |
$215K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
6,689 |
6,385 |
$202K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
1,335 |
637 |
$197K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
6,689 |
6,384 |
$191K |
| G0330 |
Facility services for dental rehabilitation procedure(s) performed on a patient who requires monitored anesthesia (e.g., general, intravenous sedation (monitored anesthesia care) and use of an operating room |
72 |
71 |
$179K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
1,313 |
1,197 |
$153K |
| 71045 |
Radiologic examination, chest; single view |
2,936 |
2,800 |
$142K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
3,752 |
3,492 |
$142K |
| 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 |
5,548 |
5,429 |
$114K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
554 |
304 |
$106K |
| 71046 |
Radiologic examination, chest; 2 views |
1,908 |
1,788 |
$100K |
| 59025 |
Fetal non-stress test |
704 |
594 |
$90K |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
2,129 |
2,030 |
$77K |
| 36415 |
Collection of venous blood by venipuncture |
44,299 |
38,551 |
$68K |
| D2930 |
Prefabricated stainless steel crown - primary tooth |
123 |
121 |
$61K |
| 86900 |
|
645 |
575 |
$55K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
87 |
82 |
$49K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
6,796 |
6,596 |
$44K |
| 80053 |
Comprehensive metabolic panel |
26,081 |
24,383 |
$36K |
| 87631 |
|
630 |
616 |
$34K |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
222 |
220 |
$30K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
313 |
299 |
$27K |
| 97597 |
|
392 |
224 |
$27K |
| 84443 |
Thyroid stimulating hormone (TSH) |
2,016 |
1,950 |
$25K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
41 |
40 |
$23K |
| 80061 |
Lipid panel |
2,151 |
2,085 |
$23K |
| 85027 |
|
11,064 |
10,154 |
$21K |
| 94060 |
|
123 |
118 |
$20K |
| 87480 |
|
1,068 |
1,009 |
$19K |
| 69436 |
Tympanostomy (requiring insertion of ventilating tube), general anesthesia |
17 |
16 |
$19K |
| 87510 |
|
1,068 |
1,009 |
$19K |
| 87660 |
|
1,067 |
1,009 |
$18K |
| 70450 |
Computed tomography, head or brain; without contrast material |
144 |
136 |
$18K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
26,546 |
24,670 |
$17K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
54 |
53 |
$15K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
2,793 |
2,573 |
$15K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
318 |
311 |
$14K |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
527 |
495 |
$10K |
| 93017 |
|
359 |
335 |
$9K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
7,245 |
6,880 |
$9K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
5,073 |
4,794 |
$8K |
| D3220 |
Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction |
14 |
13 |
$8K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
38 |
38 |
$8K |
| 11043 |
|
52 |
26 |
$8K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
373 |
330 |
$6K |
| D1120 |
Prophylaxis - child |
12 |
12 |
$6K |
| 93296 |
|
457 |
439 |
$5K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
57 |
54 |
$5K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
676 |
653 |
$5K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
41 |
37 |
$4K |
| 87653 |
|
169 |
159 |
$4K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
4,904 |
4,569 |
$4K |
| 84702 |
|
361 |
305 |
$4K |
| 86592 |
|
909 |
841 |
$4K |
| 95813 |
|
24 |
24 |
$4K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
199 |
194 |
$4K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
40 |
40 |
$3K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
281 |
270 |
$3K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
40 |
37 |
$3K |
| 86762 |
|
300 |
266 |
$3K |
| 83655 |
|
256 |
252 |
$3K |
| 81001 |
|
17,124 |
16,221 |
$3K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
25 |
25 |
$3K |
| 91200 |
|
40 |
39 |
$3K |
| 71250 |
|
42 |
40 |
$3K |
| 80076 |
|
589 |
545 |
$2K |
| 93880 |
|
26 |
25 |
$2K |
| 93225 |
|
47 |
44 |
$2K |
| 87340 |
|
306 |
272 |
$2K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
7,660 |
6,967 |
$2K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
1,631 |
1,485 |
$2K |
| 86850 |
|
768 |
692 |
$2K |
| 80069 |
|
455 |
340 |
$2K |
| 82805 |
|
98 |
80 |
$2K |
| 88142 |
|
92 |
89 |
$2K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
13 |
12 |
$2K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
40 |
40 |
$2K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
16 |
13 |
$2K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
32 |
32 |
$2K |
| 82950 |
|
310 |
297 |
$1K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
1,212 |
730 |
$1K |
| 93970 |
|
12 |
12 |
$1K |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
1,764 |
1,488 |
$1K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
613 |
573 |
$1K |
| J1642 |
Injection, heparin sodium, (heparin lock flush), per 10 units |
347 |
181 |
$1K |
| 86780 |
|
131 |
123 |
$1K |
| 87522 |
Neg quan hep c or qual rna |
64 |
62 |
$1K |
| 94726 |
|
128 |
123 |
$1K |
| 86140 |
|
485 |
446 |
$1K |
| 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 |
379 |
357 |
$1K |
| J2175 |
Injection, meperidine hydrochloride, per 100 mg |
806 |
752 |
$1K |
| 84439 |
|
132 |
131 |
$1K |
| 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 |
48 |
48 |
$994.14 |
| G0279 |
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) |
26 |
26 |
$931.40 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
1,108 |
1,001 |
$905.62 |
| 84480 |
|
70 |
69 |
$839.40 |
| 82105 |
|
75 |
63 |
$797.93 |
| 82677 |
|
45 |
37 |
$706.16 |
| 87070 |
|
108 |
100 |
$700.76 |
| 82785 |
|
194 |
161 |
$633.49 |
| 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 |
252 |
238 |
$620.25 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
336 |
319 |
$571.24 |
| 86003 |
|
61 |
25 |
$555.52 |
| J1040 |
Injection, methylprednisolone acetate, 80 mg |
213 |
203 |
$498.40 |
| 82728 |
|
44 |
42 |
$482.93 |
| 83970 |
|
13 |
13 |
$475.88 |
| 85651 |
|
317 |
281 |
$471.15 |
| 86336 |
|
46 |
38 |
$464.67 |
| J1790 |
Injection, droperidol, up to 5 mg |
366 |
354 |
$426.11 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
636 |
502 |
$422.18 |
| 82565 |
|
147 |
143 |
$419.15 |
| 87150 |
|
15 |
14 |
$366.74 |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
17 |
14 |
$366.74 |
| 82570 |
|
64 |
57 |
$362.51 |
| 84460 |
|
94 |
92 |
$355.40 |
| 84450 |
|
92 |
90 |
$341.08 |
| J2704 |
Injection, propofol, 10 mg |
98 |
91 |
$321.75 |
| 86803 |
|
29 |
29 |
$300.14 |
| 82375 |
|
98 |
80 |
$283.82 |
| 84520 |
|
79 |
78 |
$223.25 |
| 87077 |
|
61 |
47 |
$199.68 |
| 83880 |
|
69 |
63 |
$196.46 |
| J2785 |
Injection, regadenoson, 0.1 mg |
60 |
56 |
$189.40 |
| 87186 |
|
31 |
28 |
$164.40 |
| G0500 |
Moderate sedation services provided by the same physician or other qualified health care professional performing a gastrointestinal endoscopic service that sedation supports, requiring the presence of an independent trained observer to assist in the monitoring of the patient's level of consciousness and physiological status; initial 15 minutes of intra-service time; patient age 5 years or older (additional time may be reported with 99153, as appropriate) |
822 |
769 |
$145.50 |
| 86200 |
|
12 |
12 |
$135.30 |
| 85018 |
|
63 |
61 |
$123.75 |
| 86706 |
|
16 |
14 |
$122.40 |
| 84156 |
|
43 |
42 |
$117.33 |
| 85610 |
|
296 |
277 |
$112.37 |
| 93226 |
|
62 |
56 |
$102.66 |
| 87081 |
|
17 |
17 |
$100.71 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
44 |
38 |
$96.27 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
161 |
149 |
$93.76 |
| 81025 |
|
3,534 |
3,387 |
$85.63 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
55 |
50 |
$79.93 |
| 83690 |
|
2,319 |
2,204 |
$65.20 |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
17 |
16 |
$64.30 |
| 83735 |
|
3,538 |
3,368 |
$63.70 |
| 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 |
3,478 |
2,108 |
$56.11 |
| 99153 |
Mod sedat endo service >5yrs |
477 |
441 |
$40.52 |
| 83605 |
|
646 |
599 |
$26.31 |
| 84484 |
|
2,892 |
2,135 |
$16.57 |
| 85730 |
|
97 |
91 |
$7.05 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
16 |
13 |
$4.15 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
592 |
277 |
$3.12 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
13 |
12 |
$1.73 |
| Q9966 |
Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml |
515 |
474 |
$0.00 |
| 94729 |
|
128 |
123 |
$0.00 |
| 80143 |
|
59 |
52 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
14 |
14 |
$0.00 |
| 80179 |
|
45 |
40 |
$0.00 |
| 0064U |
|
483 |
442 |
$0.00 |
| 82077 |
|
355 |
331 |
$0.00 |
| 86901 |
|
643 |
574 |
$0.00 |
| 0352U |
|
495 |
478 |
$0.00 |
| 85379 |
|
39 |
38 |
$0.00 |
| A9500 |
Technetium tc-99m sestamibi, diagnostic, per study dose |
89 |
84 |
$0.00 |
| 82962 |
|
159 |
137 |
$0.00 |
| 87205 |
|
27 |
27 |
$0.00 |
| 99406 |
|
38 |
32 |
$0.00 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
112 |
102 |
$0.00 |
| A9579 |
Injection, gadolinium-based magnetic resonance contrast agent, not otherwise specified (nos), per ml |
59 |
50 |
$0.00 |
| 87040 |
|
21 |
12 |
$0.00 |
| Q9965 |
Low osmolar contrast material, 100-199 mg/ml iodine concentration, per ml |
15 |
12 |
$0.00 |
| G0378 |
Hospital observation service, per hour |
12 |
12 |
$0.00 |