| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
35,849 |
32,970 |
$4.25M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
22,541 |
19,626 |
$2.76M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
9,785 |
8,004 |
$1.22M |
| 96361 |
Intravenous infusion, hydration; each additional hour |
2,827 |
2,151 |
$707K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
2,715 |
2,224 |
$659K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
9,322 |
7,115 |
$615K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
9,732 |
2,927 |
$548K |
| 70450 |
Computed tomography, head or brain; without contrast material |
2,397 |
1,981 |
$512K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
4,100 |
3,865 |
$446K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
1,252 |
1,066 |
$401K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
1,128 |
666 |
$263K |
| G0378 |
Hospital observation service, per hour |
3,389 |
1,272 |
$252K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
783 |
661 |
$191K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
1,734 |
1,321 |
$182K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
4,688 |
1,509 |
$181K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
1,755 |
1,171 |
$176K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
659 |
580 |
$125K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
978 |
489 |
$99K |
| 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 |
524 |
508 |
$97K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
886 |
749 |
$94K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
515 |
435 |
$92K |
| 45385 |
Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) |
161 |
133 |
$83K |
| 76642 |
|
595 |
532 |
$70K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
16,664 |
13,367 |
$70K |
| 70496 |
|
337 |
275 |
$65K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
222 |
163 |
$65K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
453 |
403 |
$62K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
323 |
289 |
$56K |
| 71046 |
Radiologic examination, chest; 2 views |
6,956 |
6,042 |
$56K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
1,262 |
1,158 |
$56K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
157 |
118 |
$43K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
2,928 |
1,058 |
$43K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
3,240 |
1,109 |
$40K |
| G0382 |
Level 3 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room or emergency department; (2) it is held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment; or (3) during the calendar year immediately preceding the calendar year in which a determination under 42 cfr 489.24 is being made, based on a representative sample of patient visits that occurred during that calendar year, it provides at least one-third of all of its outpatient visits for the treatment of emergency medical conditions on an urgent basis without requiring a previously scheduled appointment) |
427 |
423 |
$39K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
402 |
331 |
$37K |
| 97161 |
|
1,334 |
1,135 |
$35K |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
1,273 |
1,126 |
$32K |
| 71250 |
|
373 |
339 |
$29K |
| 93017 |
|
346 |
279 |
$28K |
| 80053 |
Comprehensive metabolic panel |
9,815 |
8,033 |
$25K |
| 12001 |
|
159 |
131 |
$24K |
| C1713 |
Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) |
335 |
225 |
$22K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
117 |
97 |
$22K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
771 |
660 |
$20K |
| 72100 |
|
587 |
538 |
$19K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
119 |
102 |
$18K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
11,709 |
9,421 |
$18K |
| 76536 |
|
127 |
120 |
$16K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
202 |
186 |
$16K |
| 93971 |
|
226 |
208 |
$15K |
| 97116 |
|
617 |
358 |
$14K |
| 73562 |
|
762 |
669 |
$14K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
29,924 |
24,404 |
$14K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
1,040 |
954 |
$13K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
5,803 |
3,867 |
$12K |
| 84484 |
|
8,501 |
4,687 |
$12K |
| 73630 |
|
1,145 |
981 |
$12K |
| 70486 |
|
162 |
144 |
$11K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
864 |
702 |
$11K |
| 86900 |
|
811 |
617 |
$11K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
10,309 |
8,400 |
$10K |
| 97016 |
|
319 |
63 |
$9K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
65 |
40 |
$9K |
| 73130 |
|
864 |
738 |
$9K |
| 88341 |
|
148 |
66 |
$9K |
| 73030 |
|
752 |
649 |
$9K |
| 71045 |
Radiologic examination, chest; single view |
3,525 |
2,910 |
$8K |
| 97166 |
|
254 |
196 |
$8K |
| 76830 |
Ultrasound, transvaginal |
254 |
227 |
$8K |
| 70491 |
|
31 |
25 |
$8K |
| 77066 |
Tomosynthesis, mammo |
244 |
222 |
$8K |
| C9290 |
Injection, bupivacaine liposome, 1 mg |
81 |
52 |
$8K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
2,656 |
2,309 |
$7K |
| 80047 |
|
480 |
412 |
$7K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
5,560 |
4,199 |
$7K |
| 99152 |
|
611 |
467 |
$7K |
| 72131 |
|
84 |
65 |
$7K |
| 97535 |
Self-care/home management training, each 15 minutes |
474 |
297 |
$7K |
| 94060 |
|
56 |
51 |
$7K |
| 77065 |
Tomosynthesis, mammo |
224 |
186 |
$7K |
| 90715 |
|
479 |
405 |
$7K |
| 94664 |
|
408 |
336 |
$7K |
| 73502 |
|
498 |
421 |
$7K |
| 71271 |
|
42 |
41 |
$6K |
| 97162 |
|
442 |
349 |
$6K |
| 73610 |
|
840 |
741 |
$6K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
3,225 |
2,747 |
$6K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
2,647 |
2,300 |
$6K |
| 86850 |
|
795 |
607 |
$5K |
| 10060 |
|
34 |
27 |
$5K |
| G0279 |
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) |
497 |
455 |
$4K |
| 84703 |
|
10,750 |
9,174 |
$4K |
| 88307 |
|
75 |
50 |
$4K |
| 94726 |
|
65 |
59 |
$4K |
| 96376 |
|
1,818 |
953 |
$4K |
| 36415 |
Collection of venous blood by venipuncture |
11,052 |
7,573 |
$4K |
| 80076 |
|
2,946 |
2,419 |
$4K |
| 94729 |
|
75 |
70 |
$4K |
| 73110 |
|
472 |
420 |
$4K |
| 83605 |
|
2,353 |
1,587 |
$4K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
1,028 |
908 |
$4K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
5,984 |
2,621 |
$3K |
| 81001 |
|
10,776 |
9,371 |
$3K |
| 83735 |
|
3,664 |
2,436 |
$3K |
| 75574 |
|
15 |
15 |
$3K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
25 |
24 |
$3K |
| 72040 |
|
87 |
83 |
$3K |
| J3490 |
Unclassified drugs |
140 |
62 |
$3K |
| 97014 |
|
100 |
37 |
$3K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
2,083 |
1,753 |
$3K |
| 74018 |
|
116 |
81 |
$2K |
| 70498 |
|
294 |
240 |
$2K |
| 80069 |
|
609 |
341 |
$2K |
| 73560 |
|
261 |
191 |
$2K |
| 83690 |
|
5,817 |
4,574 |
$2K |
| 83880 |
|
2,186 |
1,775 |
$2K |
| 82565 |
|
268 |
229 |
$2K |
| 73590 |
|
189 |
169 |
$2K |
| 87210 |
|
1,810 |
1,559 |
$2K |
| 85027 |
|
1,308 |
955 |
$2K |
| 90674 |
|
63 |
57 |
$1K |
| 93975 |
|
15 |
14 |
$1K |
| 85610 |
|
2,252 |
1,531 |
$1K |
| 82077 |
|
933 |
722 |
$1K |
| C1769 |
Guide wire |
541 |
397 |
$1K |
| 99153 |
Mod sedat endo service >5yrs |
118 |
78 |
$1K |
| 81003 |
|
3,145 |
2,641 |
$1K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
3,373 |
2,051 |
$1K |
| 90686 |
|
88 |
82 |
$1K |
| 82803 |
|
1,977 |
1,559 |
$1K |
| 84443 |
Thyroid stimulating hormone (TSH) |
376 |
317 |
$1K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
513 |
432 |
$881.60 |
| 80061 |
Lipid panel |
116 |
89 |
$803.78 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
3,009 |
1,705 |
$787.39 |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
1,634 |
698 |
$734.42 |
| 97165 |
|
14 |
12 |
$650.97 |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
15 |
15 |
$644.77 |
| 86140 |
|
422 |
345 |
$628.97 |
| 85379 |
|
1,086 |
910 |
$619.97 |
| 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 |
522 |
503 |
$576.51 |
| 87077 |
|
949 |
668 |
$568.84 |
| 87081 |
|
1,205 |
1,022 |
$568.13 |
| 80143 |
|
338 |
274 |
$557.55 |
| 84702 |
|
491 |
396 |
$499.28 |
| 88342 |
|
463 |
327 |
$461.33 |
| 87186 |
|
818 |
619 |
$460.74 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,531 |
1,336 |
$452.70 |
| 73140 |
|
144 |
127 |
$451.56 |
| 85730 |
|
517 |
366 |
$422.03 |
| 86901 |
|
811 |
617 |
$386.77 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
1,329 |
875 |
$374.09 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
6,767 |
5,367 |
$373.46 |
| J2800 |
Injection, methocarbamol, up to 10 ml |
377 |
263 |
$370.02 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
4,913 |
3,972 |
$358.60 |
| J2704 |
Injection, propofol, 10 mg |
7,095 |
3,509 |
$350.41 |
| 00731 |
|
866 |
724 |
$344.85 |
| 80179 |
|
322 |
261 |
$305.96 |
| 87040 |
|
717 |
352 |
$304.62 |
| 72070 |
|
13 |
13 |
$254.12 |
| 00813 |
|
186 |
135 |
$223.55 |
| J7030 |
Infusion, normal saline solution , 1000 cc |
844 |
657 |
$221.14 |
| 84132 |
|
366 |
287 |
$211.05 |
| 96367 |
|
117 |
71 |
$204.68 |
| 71101 |
|
26 |
25 |
$172.72 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
6,624 |
4,539 |
$172.14 |
| 88304 |
|
230 |
163 |
$159.92 |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
805 |
490 |
$155.69 |
| J2371 |
Injection, phenylephrine hydrochloride, 20 micrograms |
680 |
460 |
$153.10 |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
773 |
583 |
$145.20 |
| 85652 |
|
363 |
304 |
$144.95 |
| J2785 |
Injection, regadenoson, 0.1 mg |
36 |
28 |
$142.66 |
| G0008 |
Administration of influenza virus vaccine |
171 |
155 |
$139.29 |
| J1644 |
Injection, heparin sodium, per 1000 units |
1,128 |
424 |
$131.78 |
| 73080 |
|
71 |
55 |
$130.48 |
| J1790 |
Injection, droperidol, up to 5 mg |
878 |
635 |
$130.27 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
1,292 |
681 |
$128.23 |
| 73090 |
|
61 |
53 |
$121.95 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
1,498 |
1,126 |
$112.26 |
| 00811 |
|
65 |
49 |
$108.70 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
3,008 |
1,896 |
$108.65 |
| J3370 |
Injection, vancomycin hcl, 500 mg |
568 |
314 |
$101.90 |
| 00812 |
|
62 |
44 |
$85.95 |
| 87088 |
|
90 |
82 |
$78.06 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
1,115 |
791 |
$76.66 |
| 84100 |
|
103 |
64 |
$72.99 |
| C1894 |
Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser |
344 |
247 |
$69.87 |
| 87205 |
|
300 |
154 |
$69.59 |
| 87070 |
|
218 |
130 |
$67.85 |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
674 |
472 |
$67.65 |
| 84145 |
|
38 |
36 |
$67.40 |
| A9502 |
Technetium tc-99m tetrofosmin, diagnostic, per study dose |
233 |
164 |
$63.60 |
| J0688 |
Injection, cefazolin sodium (hikma), not therapeutically equivalent to j0690, 500 mg |
568 |
423 |
$63.55 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
2,120 |
1,535 |
$61.37 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
632 |
443 |
$60.22 |
| A9579 |
Injection, gadolinium-based magnetic resonance contrast agent, not otherwise specified (nos), per ml |
445 |
381 |
$58.28 |
| J8501 |
Aprepitant, oral, 5 mg |
27 |
27 |
$57.12 |
| J2370 |
Injection, phenylephrine hcl, up to 1 ml |
269 |
166 |
$41.50 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
2,832 |
1,998 |
$36.72 |
| J0360 |
Injection, hydralazine hcl, up to 20 mg |
144 |
81 |
$35.72 |
| J2550 |
Injection, promethazine hcl, up to 50 mg |
94 |
51 |
$31.04 |
| 94761 |
|
875 |
573 |
$30.60 |
| J2060 |
Injection, lorazepam, 2 mg |
358 |
269 |
$29.87 |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
930 |
710 |
$23.29 |
| J2919 |
Injection, methylprednisolone sodium succinate, 5 mg |
105 |
84 |
$20.38 |
| 82550 |
|
112 |
89 |
$18.05 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
1,919 |
1,424 |
$16.63 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
60 |
41 |
$14.69 |
| J2470 |
Injection, pantoprazole sodium, 40 mg |
44 |
25 |
$9.89 |
| J1596 |
Injection, glycopyrrolate, 0.1 mg |
459 |
400 |
$9.53 |
| J1580 |
Injection, garamycin, gentamicin, up to 80 mg |
21 |
14 |
$8.76 |
| J7050 |
Infusion, normal saline solution, 250 cc |
88 |
62 |
$8.70 |
| J1171 |
Injection, hydromorphone, 0.1 mg |
257 |
122 |
$2.87 |
| J2003 |
Injection, lidocaine hydrochloride, 1 mg |
140 |
133 |
$1.67 |
| J3480 |
Injection, potassium chloride, per 2 meq |
109 |
74 |
$1.14 |
| J0330 |
Injection, succinylcholine chloride, up to 20 mg |
48 |
41 |
$0.36 |
| J8540 |
Dexamethasone, oral, 0.25 mg |
31 |
25 |
$0.00 |
| J1642 |
Injection, heparin sodium, (heparin lock flush), per 10 units |
44 |
30 |
$0.00 |
| C9399 |
Unclassified drugs or biologicals |
105 |
81 |
$0.00 |
| 94760 |
|
106 |
97 |
$0.00 |
| J2175 |
Injection, meperidine hydrochloride, per 100 mg |
193 |
174 |
$0.00 |
| J1940 |
Injection, furosemide, up to 20 mg |
16 |
12 |
$0.00 |
| 87807 |
|
15 |
12 |
$0.00 |
| A4217 |
Sterile water/saline, 500 ml |
12 |
12 |
$0.00 |
| J2795 |
Injection, ropivacaine hydrochloride, 1 mg |
51 |
25 |
$0.00 |
| A9576 |
Injection, gadoteridol, (prohance multipack), per ml |
308 |
272 |
$0.00 |
| Q9957 |
Injection, perflutren lipid microspheres, per ml |
61 |
51 |
$0.00 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
32 |
24 |
$0.00 |
| J0171 |
Injection, adrenalin, epinephrine, 0.1 mg |
39 |
27 |
$0.00 |
| 76376 |
|
13 |
12 |
$0.00 |
| A4641 |
Radiopharmaceutical, diagnostic, not otherwise classified |
14 |
12 |
$0.00 |
| 00400 |
|
14 |
12 |
$0.00 |
| C1776 |
Joint device (implantable) |
13 |
13 |
$0.00 |