| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
32,679 |
31,071 |
$2.97M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
16,153 |
15,627 |
$1.75M |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
4,555 |
4,437 |
$1.34M |
| 96361 |
Intravenous infusion, hydration; each additional hour |
5,555 |
4,975 |
$1.21M |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
10,690 |
10,353 |
$1.06M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
6,415 |
6,119 |
$1.05M |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
4,109 |
3,120 |
$592K |
| 80053 |
Comprehensive metabolic panel |
28,004 |
23,706 |
$557K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
885 |
884 |
$476K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
1,618 |
1,597 |
$460K |
| 70450 |
Computed tomography, head or brain; without contrast material |
2,015 |
1,971 |
$443K |
| 36415 |
Collection of venous blood by venipuncture |
58,052 |
30,556 |
$361K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
7,503 |
2,761 |
$298K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
1,661 |
1,487 |
$295K |
| 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 |
6,014 |
5,626 |
$259K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
965 |
946 |
$253K |
| 59025 |
Fetal non-stress test |
1,146 |
736 |
$236K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
340 |
339 |
$236K |
| 93975 |
|
639 |
633 |
$214K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
758 |
750 |
$198K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
2,515 |
2,515 |
$194K |
| 45385 |
Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) |
330 |
330 |
$194K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
1,512 |
1,498 |
$193K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
1,043 |
904 |
$159K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
2,393 |
712 |
$135K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
1,035 |
852 |
$126K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
2,661 |
2,523 |
$97K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
695 |
428 |
$81K |
| 97161 |
|
929 |
923 |
$80K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
1,531 |
1,503 |
$80K |
| 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 |
3,748 |
3,604 |
$76K |
| 86900 |
|
2,262 |
2,138 |
$75K |
| 83880 |
|
2,449 |
2,290 |
$72K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
3,553 |
2,965 |
$70K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
2,571 |
2,441 |
$70K |
| 86850 |
|
2,234 |
2,099 |
$67K |
| 76830 |
Ultrasound, transvaginal |
1,164 |
1,154 |
$66K |
| 76642 |
|
1,033 |
1,023 |
$66K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
5,171 |
4,085 |
$65K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
2,660 |
1,111 |
$63K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
27,170 |
22,765 |
$61K |
| 97162 |
|
685 |
680 |
$58K |
| 97597 |
|
128 |
61 |
$53K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
2,451 |
2,451 |
$49K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
546 |
527 |
$48K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
2,030 |
1,913 |
$47K |
| 76801 |
|
473 |
434 |
$45K |
| 84443 |
Thyroid stimulating hormone (TSH) |
6,532 |
6,261 |
$43K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
1,657 |
1,651 |
$41K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
828 |
821 |
$40K |
| C9803 |
Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
4,398 |
4,198 |
$38K |
| 71046 |
Radiologic examination, chest; 2 views |
3,615 |
3,524 |
$36K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
103 |
100 |
$36K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
164 |
164 |
$34K |
| 80061 |
Lipid panel |
2,822 |
2,813 |
$33K |
| 69436 |
Tympanostomy (requiring insertion of ventilating tube), general anesthesia |
24 |
24 |
$32K |
| G0108 |
Diabetes outpatient self-management training services, individual, per 30 minutes |
295 |
284 |
$31K |
| 0202U |
Oncology (prostate), multianalyte, gene expression profiling |
3,797 |
3,737 |
$30K |
| 45378 |
Colonoscopy, flexible; diagnostic, including collection of specimen(s) |
43 |
43 |
$28K |
| 93971 |
|
484 |
481 |
$26K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
712 |
705 |
$25K |
| 77065 |
Tomosynthesis, mammo |
310 |
292 |
$24K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
3,020 |
3,009 |
$23K |
| 71271 |
|
246 |
246 |
$21K |
| 76536 |
|
250 |
250 |
$20K |
| 12001 |
|
50 |
50 |
$20K |
| 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 |
2,259 |
2,083 |
$20K |
| 96367 |
|
287 |
235 |
$19K |
| 66984 |
Extracapsular cataract removal with insertion of intraocular lens prosthesis |
17 |
12 |
$19K |
| 71250 |
|
178 |
178 |
$17K |
| 82607 |
|
1,544 |
1,533 |
$17K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
383 |
346 |
$16K |
| 82728 |
|
1,773 |
1,673 |
$15K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
65 |
65 |
$14K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
710 |
703 |
$14K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
9,954 |
8,781 |
$14K |
| 90715 |
|
482 |
482 |
$13K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
131 |
131 |
$13K |
| 85027 |
|
4,134 |
3,787 |
$13K |
| 82746 |
|
1,234 |
1,224 |
$12K |
| 86901 |
|
689 |
646 |
$11K |
| 81025 |
|
3,542 |
3,470 |
$11K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
981 |
978 |
$11K |
| 84439 |
|
1,698 |
1,672 |
$11K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
1,647 |
1,254 |
$11K |
| G0378 |
Hospital observation service, per hour |
965 |
821 |
$10K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
7,134 |
6,619 |
$10K |
| 95810 |
Polysomnography; sleep staging with 4 or more additional parameters |
12 |
12 |
$10K |
| 77066 |
Tomosynthesis, mammo |
106 |
106 |
$10K |
| 43235 |
|
16 |
16 |
$9K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
246 |
243 |
$9K |
| J1756 |
Injection, iron sucrose, 1 mg |
146 |
92 |
$9K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
50 |
50 |
$8K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
36 |
36 |
$8K |
| 82805 |
|
820 |
740 |
$7K |
| 83550 |
|
1,128 |
1,106 |
$6K |
| 95816 |
|
24 |
24 |
$6K |
| 62323 |
|
12 |
12 |
$6K |
| 70486 |
|
65 |
65 |
$6K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
226 |
223 |
$6K |
| 84702 |
|
1,175 |
916 |
$6K |
| 83540 |
|
1,220 |
1,202 |
$5K |
| 83735 |
|
5,918 |
5,129 |
$5K |
| 74183 |
|
13 |
12 |
$5K |
| 73630 |
|
692 |
689 |
$5K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
6,463 |
5,492 |
$4K |
| 88304 |
|
244 |
243 |
$4K |
| 85610 |
|
3,790 |
3,276 |
$4K |
| 82962 |
|
4,013 |
2,329 |
$4K |
| 71045 |
Radiologic examination, chest; single view |
3,146 |
3,038 |
$4K |
| 86140 |
|
2,772 |
2,566 |
$4K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
2,419 |
2,327 |
$3K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
1,732 |
943 |
$3K |
| 85651 |
|
1,905 |
1,774 |
$3K |
| 70496 |
|
12 |
12 |
$3K |
| 83970 |
|
75 |
74 |
$2K |
| 81003 |
|
7,388 |
7,064 |
$2K |
| 83615 |
|
748 |
643 |
$2K |
| 82570 |
|
568 |
521 |
$2K |
| 83690 |
|
7,164 |
6,648 |
$2K |
| 74018 |
|
82 |
72 |
$2K |
| G2023 |
Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
84 |
81 |
$2K |
| 73610 |
|
689 |
679 |
$2K |
| 87468 |
|
43 |
43 |
$2K |
| 81001 |
|
4,181 |
3,983 |
$1K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
18 |
15 |
$1K |
| 85730 |
|
2,265 |
2,149 |
$1K |
| 86803 |
|
238 |
236 |
$1K |
| 73130 |
|
452 |
450 |
$1K |
| 82043 |
|
241 |
240 |
$1K |
| 0352U |
|
29 |
28 |
$1K |
| 84484 |
|
6,015 |
4,611 |
$1K |
| 87637 |
Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV |
1,144 |
1,115 |
$984.18 |
| 84703 |
|
4,469 |
4,268 |
$854.99 |
| 87484 |
|
43 |
43 |
$793.91 |
| 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 |
109 |
69 |
$791.06 |
| 82784 |
|
84 |
78 |
$779.56 |
| 90686 |
|
29 |
29 |
$774.63 |
| 87469 |
|
43 |
43 |
$774.57 |
| 87478 |
|
43 |
43 |
$774.57 |
| 87186 |
|
792 |
760 |
$768.24 |
| 73110 |
|
257 |
253 |
$764.14 |
| 87040 |
|
2,543 |
1,573 |
$753.77 |
| 85378 |
|
1,217 |
1,192 |
$705.34 |
| A9585 |
Injection, gadobutrol, 0.1 ml |
1,237 |
1,206 |
$615.76 |
| 73030 |
|
84 |
77 |
$584.85 |
| 72110 |
|
28 |
27 |
$574.08 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
7,046 |
6,741 |
$510.09 |
| 83525 |
|
51 |
51 |
$493.92 |
| 86592 |
|
124 |
124 |
$443.81 |
| 86703 |
|
46 |
46 |
$429.38 |
| 87807 |
|
135 |
135 |
$429.29 |
| 83605 |
|
3,704 |
3,197 |
$411.26 |
| 85007 |
|
190 |
141 |
$406.57 |
| 82550 |
|
456 |
407 |
$382.54 |
| 84100 |
|
448 |
416 |
$364.71 |
| G0008 |
Administration of influenza virus vaccine |
26 |
25 |
$317.52 |
| 82950 |
|
68 |
68 |
$292.50 |
| J7030 |
Infusion, normal saline solution , 1000 cc |
1,859 |
1,328 |
$291.31 |
| 87641 |
|
12 |
12 |
$263.60 |
| 85652 |
|
212 |
191 |
$242.17 |
| 87340 |
|
182 |
182 |
$218.17 |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
879 |
576 |
$212.86 |
| 87077 |
|
204 |
191 |
$183.64 |
| 82378 |
|
26 |
24 |
$161.48 |
| 87081 |
|
683 |
679 |
$148.73 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
1,746 |
1,502 |
$138.47 |
| 86762 |
|
138 |
138 |
$119.27 |
| G1004 |
Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program |
474 |
341 |
$117.55 |
| J7050 |
Infusion, normal saline solution, 250 cc |
862 |
482 |
$100.82 |
| J2704 |
Injection, propofol, 10 mg |
4,994 |
3,259 |
$95.75 |
| 83721 |
|
12 |
12 |
$94.50 |
| 73564 |
|
24 |
24 |
$91.62 |
| 73560 |
|
13 |
13 |
$88.12 |
| 87449 |
|
14 |
14 |
$80.34 |
| 87205 |
|
289 |
266 |
$77.52 |
| 87324 |
|
12 |
12 |
$75.46 |
| J0330 |
Injection, succinylcholine chloride, up to 20 mg |
346 |
345 |
$73.75 |
| 73090 |
|
26 |
26 |
$68.08 |
| 85045 |
|
29 |
29 |
$67.82 |
| 73562 |
|
25 |
25 |
$67.25 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
4,261 |
3,564 |
$60.56 |
| J7060 |
5% dextrose/water (500 ml = 1 unit) |
455 |
323 |
$60.37 |
| 86431 |
|
13 |
13 |
$43.36 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
108 |
82 |
$43.09 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
3,794 |
3,673 |
$42.02 |
| J8540 |
Dexamethasone, oral, 0.25 mg |
337 |
216 |
$40.10 |
| J1642 |
Injection, heparin sodium, (heparin lock flush), per 10 units |
1,677 |
634 |
$39.84 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
2,291 |
1,911 |
$38.56 |
| 80143 |
|
1,307 |
1,216 |
$34.26 |
| J2175 |
Injection, meperidine hydrochloride, per 100 mg |
1,571 |
1,561 |
$32.32 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
603 |
599 |
$29.88 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
7,547 |
6,708 |
$28.22 |
| 84145 |
|
26 |
25 |
$25.48 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
6,176 |
5,220 |
$23.03 |
| 86618 |
|
49 |
48 |
$20.61 |
| 87660 |
|
71 |
70 |
$18.05 |
| 87480 |
|
71 |
70 |
$18.05 |
| 87510 |
|
71 |
70 |
$18.05 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
1,643 |
1,528 |
$17.42 |
| 80179 |
|
1,272 |
1,190 |
$17.12 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
1,562 |
1,429 |
$16.94 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
7,192 |
6,249 |
$16.70 |
| 86308 |
|
12 |
12 |
$14.60 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
438 |
432 |
$13.23 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
331 |
277 |
$7.22 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
1,049 |
747 |
$6.96 |
| J3490 |
Unclassified drugs |
295 |
270 |
$4.50 |
| J2272 |
Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg |
159 |
137 |
$3.66 |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
260 |
230 |
$2.28 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
1,315 |
1,245 |
$1.25 |
| 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 |
1,516 |
1,423 |
$0.18 |
| J0171 |
Injection, adrenalin, epinephrine, 0.1 mg |
100 |
57 |
$0.00 |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
422 |
384 |
$0.00 |
| 82010 |
|
30 |
28 |
$0.00 |
| J3372 |
Injection, vancomycin hcl (xellia), not therapeutically equivalent to j3370, 500 mg |
21 |
12 |
$0.00 |
| J2710 |
Injection, neostigmine methylsulfate, up to 0.5 mg |
90 |
90 |
$0.00 |
| J1596 |
Injection, glycopyrrolate, 0.1 mg |
101 |
101 |
$0.00 |
| 73080 |
|
12 |
12 |
$0.00 |
| C9113 |
Injection, pantoprazole sodium, per vial |
87 |
67 |
$0.00 |
| C1713 |
Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) |
39 |
39 |
$0.00 |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
518 |
357 |
$0.00 |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
122 |
51 |
$0.00 |
| J1171 |
Injection, hydromorphone, 0.1 mg |
44 |
44 |
$0.00 |
| 96376 |
|
1,726 |
1,216 |
$0.00 |
| 82150 |
|
15 |
15 |
$0.00 |
| J2060 |
Injection, lorazepam, 2 mg |
272 |
221 |
$0.00 |
| J2003 |
Injection, lidocaine hydrochloride, 1 mg |
78 |
77 |
$0.00 |
| J1790 |
Injection, droperidol, up to 5 mg |
172 |
149 |
$0.00 |
| J1815 |
Injection, insulin, per 5 units |
42 |
26 |
$0.00 |
| J2543 |
Injection, piperacillin sodium/tazobactam sodium, 1 gram/0.125 grams (1.125 grams) |
49 |
26 |
$0.00 |
| J1040 |
Injection, methylprednisolone acetate, 80 mg |
14 |
14 |
$0.00 |
| J1836 |
Injection, metronidazole, 10 mg |
13 |
12 |
$0.00 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
24 |
24 |
$0.00 |