| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
Emergency department visit for the evaluation and management, high severity |
70,169 |
62,514 |
$8.78M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
75,140 |
69,312 |
$8.62M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
35,760 |
30,628 |
$4.84M |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
48,092 |
35,481 |
$3.88M |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
34,388 |
8,048 |
$2.47M |
| 70450 |
Computed tomography, head or brain; without contrast material |
8,383 |
6,672 |
$2.09M |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
18,168 |
16,497 |
$1.86M |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
5,647 |
4,262 |
$1.29M |
| 96361 |
Intravenous infusion, hydration; each additional hour |
2,921 |
1,817 |
$937K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
4,805 |
2,175 |
$935K |
| 80053 |
Comprehensive metabolic panel |
72,083 |
56,687 |
$779K |
| J9271 |
Injection, pembrolizumab, 1 mg |
96 |
50 |
$680K |
| G0378 |
Hospital observation service, per hour |
8,172 |
3,107 |
$678K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
2,667 |
2,119 |
$663K |
| 0202U |
Oncology (prostate), multianalyte, gene expression profiling |
4,010 |
3,174 |
$643K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
6,128 |
4,870 |
$622K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
2,098 |
1,575 |
$584K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
13,897 |
11,918 |
$553K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
3,590 |
2,575 |
$482K |
| 93458 |
|
377 |
262 |
$440K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
48,518 |
38,628 |
$431K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
1,597 |
758 |
$426K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
132,940 |
104,146 |
$421K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
4,099 |
1,893 |
$420K |
| 96367 |
|
2,769 |
1,183 |
$410K |
| 58661 |
|
265 |
118 |
$392K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
901 |
686 |
$391K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
1,334 |
1,014 |
$373K |
| 74160 |
|
1,111 |
819 |
$340K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
1,935 |
1,538 |
$332K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
13,762 |
11,788 |
$308K |
| 84443 |
Thyroid stimulating hormone (TSH) |
16,653 |
14,199 |
$282K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
4,539 |
2,045 |
$281K |
| 95810 |
Polysomnography; sleep staging with 4 or more additional parameters |
440 |
364 |
$273K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
967 |
810 |
$251K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
1,543 |
1,275 |
$245K |
| 59025 |
Fetal non-stress test |
1,384 |
900 |
$236K |
| 86592 |
|
8,088 |
7,112 |
$224K |
| 36415 |
Collection of venous blood by venipuncture |
170,975 |
131,223 |
$220K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
8,110 |
2,452 |
$215K |
| 93976 |
|
1,516 |
1,134 |
$208K |
| 80061 |
Lipid panel |
14,746 |
12,943 |
$196K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
17,352 |
13,735 |
$196K |
| 70491 |
|
661 |
473 |
$185K |
| J0897 |
Injection, denosumab, 1 mg |
102 |
51 |
$184K |
| 86703 |
|
6,956 |
6,168 |
$172K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
851 |
510 |
$162K |
| 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 |
1,324 |
1,262 |
$155K |
| 62323 |
|
346 |
248 |
$151K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
895 |
749 |
$139K |
| 86850 |
|
7,134 |
5,450 |
$139K |
| 97161 |
|
2,607 |
2,184 |
$133K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
6,713 |
5,936 |
$130K |
| 71046 |
Radiologic examination, chest; 2 views |
8,797 |
7,478 |
$130K |
| 86900 |
|
6,972 |
5,299 |
$128K |
| U0004 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc, making use of high throughput technologies as described by cms-2020-01-r |
911 |
836 |
$124K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
9,764 |
8,504 |
$118K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
1,259 |
983 |
$118K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
1,531 |
1,352 |
$116K |
| 76642 |
|
1,081 |
918 |
$116K |
| 78815 |
Positron emission tomography (PET) for limited area imaging |
222 |
173 |
$115K |
| 95811 |
|
195 |
160 |
$115K |
| 70496 |
|
439 |
319 |
$111K |
| 93798 |
|
1,898 |
256 |
$110K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
2,455 |
2,072 |
$106K |
| 76770 |
|
735 |
612 |
$103K |
| 71271 |
|
650 |
558 |
$101K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
3,941 |
2,882 |
$98K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
747 |
509 |
$98K |
| 77336 |
|
767 |
277 |
$98K |
| 12001 |
|
624 |
533 |
$97K |
| 93017 |
|
1,055 |
827 |
$96K |
| 87081 |
|
4,000 |
3,550 |
$95K |
| 95886 |
|
411 |
222 |
$95K |
| C8929 |
Transthoracic echocardiography with contrast, or without contrast followed by with contrast, real-time with image documentation (2d), includes m-mode recording, when performed, complete, with spectral doppler echocardiography, and with color flow doppler echocardiography |
561 |
494 |
$93K |
| 86803 |
|
4,953 |
4,334 |
$93K |
| 84484 |
|
23,004 |
18,288 |
$91K |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
4,967 |
4,406 |
$88K |
| 93971 |
|
1,192 |
953 |
$88K |
| 87340 |
|
4,706 |
4,123 |
$86K |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
2,743 |
2,322 |
$84K |
| 97162 |
|
1,761 |
1,463 |
$83K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
43,111 |
36,330 |
$81K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
502 |
376 |
$81K |
| 84439 |
|
4,233 |
3,586 |
$78K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
441 |
375 |
$75K |
| 76801 |
|
1,464 |
1,101 |
$73K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
4,558 |
3,510 |
$72K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
2,271 |
1,825 |
$71K |
| 76536 |
|
728 |
635 |
$71K |
| 97035 |
|
1,338 |
436 |
$69K |
| 71250 |
|
738 |
645 |
$67K |
| 71045 |
Radiologic examination, chest; single view |
23,943 |
20,218 |
$65K |
| 82607 |
|
3,779 |
3,202 |
$65K |
| 93970 |
|
522 |
415 |
$64K |
| 12011 |
|
431 |
359 |
$63K |
| 76937 |
|
4,267 |
2,757 |
$62K |
| 82728 |
|
4,562 |
3,779 |
$62K |
| 88307 |
|
688 |
382 |
$61K |
| 87480 |
|
5,059 |
4,070 |
$60K |
| 87660 |
|
5,066 |
4,077 |
$59K |
| 87653 |
|
2,049 |
1,661 |
$58K |
| 97165 |
|
922 |
713 |
$58K |
| 70498 |
|
602 |
442 |
$57K |
| 93975 |
|
427 |
342 |
$57K |
| 10060 |
|
354 |
287 |
$54K |
| 47562 |
|
25 |
14 |
$54K |
| 77386 |
|
152 |
12 |
$54K |
| 87633 |
Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets |
406 |
390 |
$52K |
| 97113 |
|
825 |
201 |
$51K |
| 73562 |
|
2,115 |
1,562 |
$50K |
| J1756 |
Injection, iron sucrose, 1 mg |
1,386 |
518 |
$48K |
| 11045 |
|
231 |
144 |
$47K |
| 86787 |
|
2,710 |
2,424 |
$47K |
| 12002 |
|
315 |
264 |
$47K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
42,073 |
33,914 |
$47K |
| 86762 |
|
2,697 |
2,406 |
$46K |
| 76830 |
Ultrasound, transvaginal |
1,703 |
1,358 |
$46K |
| 87077 |
|
3,823 |
3,079 |
$45K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
1,554 |
676 |
$45K |
| J3490 |
Unclassified drugs |
5,252 |
2,951 |
$43K |
| 94060 |
|
319 |
265 |
$43K |
| 52000 |
|
86 |
70 |
$42K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
184 |
141 |
$41K |
| 80320 |
|
4,188 |
3,083 |
$41K |
| 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 |
1,513 |
1,433 |
$41K |
| 84702 |
|
2,629 |
1,615 |
$40K |
| 97014 |
|
1,207 |
382 |
$40K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
2,349 |
1,846 |
$38K |
| 73630 |
|
2,287 |
1,794 |
$38K |
| 73030 |
|
1,635 |
1,267 |
$36K |
| 87510 |
|
5,055 |
4,069 |
$36K |
| 83540 |
|
4,573 |
3,807 |
$36K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
822 |
701 |
$35K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
12,289 |
6,754 |
$35K |
| 81001 |
|
14,739 |
11,751 |
$34K |
| 82947 |
|
2,547 |
2,226 |
$34K |
| 72100 |
|
1,242 |
999 |
$33K |
| 83735 |
|
9,949 |
6,153 |
$30K |
| 82570 |
|
3,618 |
2,942 |
$30K |
| 97535 |
Self-care/home management training, each 15 minutes |
806 |
474 |
$28K |
| 73130 |
|
1,692 |
1,274 |
$28K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
2,462 |
2,079 |
$27K |
| 76000 |
|
290 |
143 |
$27K |
| 73610 |
|
1,722 |
1,336 |
$27K |
| 77334 |
|
72 |
44 |
$27K |
| 70486 |
|
718 |
596 |
$27K |
| 83615 |
|
6,868 |
4,712 |
$26K |
| 94726 |
|
348 |
290 |
$26K |
| 94729 |
|
377 |
314 |
$26K |
| 74018 |
|
1,105 |
870 |
$25K |
| 80076 |
|
2,704 |
2,142 |
$24K |
| 97166 |
|
418 |
326 |
$24K |
| 86140 |
|
1,901 |
1,459 |
$24K |
| 83880 |
|
4,390 |
3,350 |
$23K |
| 86038 |
|
928 |
778 |
$23K |
| 81003 |
|
17,289 |
13,537 |
$22K |
| 77080 |
|
362 |
317 |
$22K |
| 77066 |
Tomosynthesis, mammo |
654 |
551 |
$22K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
526 |
296 |
$22K |
| P9016 |
Red blood cells, leukocytes reduced, each unit |
137 |
89 |
$21K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
727 |
346 |
$21K |
| 72110 |
|
499 |
438 |
$21K |
| 84153 |
|
1,528 |
1,323 |
$20K |
| 83550 |
|
3,346 |
2,735 |
$20K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
147 |
131 |
$19K |
| 97163 |
|
493 |
350 |
$19K |
| 11043 |
|
51 |
29 |
$19K |
| 93880 |
|
272 |
216 |
$19K |
| 77301 |
|
32 |
26 |
$18K |
| 90715 |
|
1,373 |
1,115 |
$18K |
| 72131 |
|
235 |
185 |
$18K |
| 73110 |
|
1,104 |
872 |
$18K |
| 85027 |
|
1,592 |
1,408 |
$17K |
| 73502 |
|
627 |
489 |
$17K |
| 72050 |
|
329 |
284 |
$17K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
24,276 |
17,439 |
$17K |
| 87186 |
|
2,811 |
2,287 |
$16K |
| 87522 |
Neg quan hep c or qual rna |
474 |
417 |
$16K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
3,632 |
2,833 |
$16K |
| 88341 |
|
239 |
145 |
$15K |
| 77065 |
Tomosynthesis, mammo |
429 |
347 |
$15K |
| 84481 |
|
1,503 |
1,227 |
$14K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
327 |
310 |
$14K |
| J1453 |
Injection, fosaprepitant, 1 mg |
952 |
414 |
$14K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
30 |
12 |
$14K |
| 77300 |
|
35 |
28 |
$13K |
| 84146 |
|
581 |
507 |
$12K |
| 82043 |
|
2,021 |
1,780 |
$12K |
| 49083 |
|
33 |
12 |
$12K |
| 87070 |
|
1,299 |
1,040 |
$12K |
| 83970 |
|
540 |
475 |
$11K |
| 84436 |
|
681 |
573 |
$11K |
| 97116 |
|
352 |
151 |
$11K |
| 85610 |
|
8,234 |
4,697 |
$11K |
| 85652 |
|
2,620 |
1,906 |
$11K |
| 86706 |
|
670 |
584 |
$11K |
| 83690 |
|
11,323 |
8,966 |
$11K |
| 83516 |
|
422 |
356 |
$11K |
| J2469 |
Injection, palonosetron hcl, 25 mcg |
1,925 |
757 |
$11K |
| 84403 |
|
653 |
578 |
$10K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
39,610 |
31,476 |
$10K |
| 82951 |
|
440 |
367 |
$10K |
| 87536 |
|
293 |
256 |
$10K |
| 82746 |
|
1,480 |
1,220 |
$10K |
| G0279 |
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) |
867 |
734 |
$10K |
| 82670 |
|
401 |
343 |
$10K |
| 36430 |
|
71 |
42 |
$9K |
| 83001 |
|
480 |
418 |
$8K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
1,060 |
848 |
$8K |
| 86901 |
|
2,856 |
2,127 |
$8K |
| 86480 |
|
230 |
201 |
$8K |
| 80069 |
|
583 |
504 |
$8K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
384 |
332 |
$8K |
| 86431 |
|
524 |
456 |
$8K |
| 71100 |
|
383 |
285 |
$8K |
| 97167 |
|
111 |
88 |
$7K |
| 83655 |
|
303 |
263 |
$7K |
| 88342 |
|
647 |
475 |
$7K |
| 73503 |
|
488 |
361 |
$7K |
| 73080 |
|
574 |
459 |
$7K |
| 86359 |
|
196 |
165 |
$7K |
| 80074 |
|
654 |
508 |
$7K |
| 82550 |
|
2,065 |
1,456 |
$7K |
| 86704 |
|
500 |
434 |
$6K |
| 82565 |
|
928 |
739 |
$6K |
| 29580 |
|
64 |
24 |
$6K |
| 80329 |
|
3,596 |
2,635 |
$6K |
| 82784 |
|
529 |
440 |
$6K |
| 87493 |
|
210 |
158 |
$6K |
| 84156 |
|
1,607 |
1,175 |
$6K |
| 87205 |
|
1,384 |
1,098 |
$6K |
| 77338 |
|
31 |
25 |
$6K |
| 82952 |
|
381 |
315 |
$6K |
| 85007 |
|
1,544 |
1,130 |
$5K |
| J2791 |
Injection, rho(d) immune globulin (human), (rhophylac), intramuscular or intravenous, 100 iu |
79 |
45 |
$5K |
| 73590 |
|
555 |
432 |
$5K |
| 84480 |
|
485 |
406 |
$5K |
| 82533 |
|
665 |
410 |
$5K |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
475 |
226 |
$5K |
| J1815 |
Injection, insulin, per 5 units |
1,130 |
491 |
$5K |
| 72170 |
|
685 |
539 |
$5K |
| 88142 |
|
372 |
358 |
$5K |
| 83020 |
|
216 |
174 |
$5K |
| 73560 |
|
380 |
271 |
$5K |
| 20553 |
|
27 |
15 |
$5K |
| 81025 |
|
20,372 |
16,810 |
$5K |
| 72070 |
|
212 |
175 |
$4K |
| 97164 |
|
140 |
99 |
$4K |
| 74183 |
|
14 |
12 |
$4K |
| 84550 |
|
630 |
539 |
$4K |
| 76870 |
|
347 |
272 |
$4K |
| 76981 |
|
43 |
39 |
$4K |
| 87040 |
|
2,134 |
1,473 |
$4K |
| 86360 |
|
196 |
165 |
$4K |
| 84100 |
|
1,182 |
676 |
$4K |
| 84450 |
|
488 |
415 |
$4K |
| 85379 |
|
3,026 |
2,252 |
$4K |
| 86355 |
|
196 |
165 |
$3K |
| 86357 |
|
196 |
165 |
$3K |
| 86880 |
|
245 |
167 |
$3K |
| J2272 |
Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg |
3,627 |
2,331 |
$3K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
64 |
40 |
$3K |
| 86304 |
|
296 |
195 |
$3K |
| 74022 |
|
107 |
93 |
$3K |
| 72141 |
|
32 |
27 |
$3K |
| 96368 |
|
444 |
183 |
$3K |
| 82150 |
|
501 |
388 |
$3K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
209 |
163 |
$3K |
| 78227 |
|
15 |
14 |
$3K |
| 93356 |
|
152 |
128 |
$3K |
| 87507 |
|
33 |
27 |
$3K |
| 72158 |
|
12 |
12 |
$3K |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
7,087 |
4,300 |
$3K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
12 |
12 |
$3K |
| 51702 |
|
321 |
248 |
$3K |
| 93923 |
|
39 |
31 |
$3K |
| 83002 |
|
201 |
174 |
$3K |
| 83605 |
|
2,117 |
1,532 |
$3K |
| 87529 |
|
84 |
66 |
$3K |
| 80164 |
|
228 |
194 |
$3K |
| 87210 |
|
3,464 |
1,166 |
$3K |
| 84460 |
|
522 |
441 |
$3K |
| 93325 |
|
22 |
12 |
$3K |
| 85014 |
|
699 |
507 |
$3K |
| 82977 |
|
396 |
225 |
$2K |
| 85730 |
|
2,393 |
1,708 |
$2K |
| 82105 |
|
210 |
165 |
$2K |
| 82247 |
|
180 |
108 |
$2K |
| 81002 |
|
7,218 |
6,516 |
$2K |
| 82140 |
|
400 |
280 |
$2K |
| J3486 |
Injection, ziprasidone mesylate, 10 mg |
119 |
82 |
$2K |
| 73140 |
|
310 |
265 |
$2K |
| 73700 |
|
24 |
14 |
$2K |
| 86920 |
|
154 |
95 |
$2K |
| 85018 |
|
770 |
556 |
$2K |
| 84165 |
|
332 |
246 |
$2K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
18 |
13 |
$2K |
| 82378 |
|
706 |
422 |
$2K |
| 88304 |
|
777 |
477 |
$2K |
| 73090 |
|
339 |
284 |
$2K |
| 77370 |
|
17 |
12 |
$2K |
| 36591 |
|
116 |
84 |
$2K |
| J1170 |
Injection, hydromorphone, up to 4 mg |
4,144 |
2,308 |
$2K |
| 86147 |
|
55 |
25 |
$2K |
| 86708 |
|
139 |
116 |
$2K |
| 89060 |
|
1,810 |
1,139 |
$2K |
| 94664 |
|
126 |
84 |
$2K |
| J1644 |
Injection, heparin sodium, per 1000 units |
3,497 |
1,602 |
$2K |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
362 |
332 |
$1K |
| 83525 |
|
76 |
68 |
$1K |
| 80047 |
|
1,819 |
1,134 |
$1K |
| J0694 |
Injection, cefoxitin sodium, 1 gm |
145 |
78 |
$1K |
| 87581 |
|
278 |
266 |
$1K |
| 96376 |
|
1,684 |
1,120 |
$1K |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
1,424 |
495 |
$1K |
| 86255 |
|
105 |
88 |
$1K |
| J0702 |
Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg |
45 |
17 |
$1K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
13,707 |
10,314 |
$1K |
| C9113 |
Injection, pantoprazole sodium, per vial |
554 |
244 |
$1K |
| J2543 |
Injection, piperacillin sodium/tazobactam sodium, 1 gram/0.125 grams (1.125 grams) |
575 |
248 |
$1K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
2,962 |
1,726 |
$1K |
| 85597 |
|
15 |
13 |
$1K |
| 86800 |
|
83 |
73 |
$1K |
| 84144 |
|
52 |
40 |
$1K |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
1,886 |
826 |
$1K |
| 82330 |
|
126 |
89 |
$1K |
| 82627 |
|
33 |
24 |
$1K |
| 84402 |
|
77 |
72 |
$1K |
| 80202 |
|
42 |
12 |
$1K |
| 76857 |
|
12 |
12 |
$1K |
| 87088 |
|
144 |
111 |
$1K |
| 84703 |
|
416 |
346 |
$942.18 |
| 87486 |
|
278 |
266 |
$941.88 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
12,201 |
8,676 |
$931.46 |
| 86039 |
|
62 |
46 |
$922.32 |
| J3370 |
Injection, vancomycin hcl, 500 mg |
819 |
356 |
$906.91 |
| 86709 |
|
62 |
47 |
$879.23 |
| 82962 |
|
2,069 |
1,459 |
$869.52 |
| 00840 |
|
933 |
507 |
$869.44 |
| 84132 |
|
226 |
137 |
$866.05 |
| 86665 |
|
46 |
40 |
$864.83 |
| 82803 |
|
532 |
359 |
$830.60 |
| 88112 |
|
48 |
39 |
$814.02 |
| 51798 |
|
697 |
618 |
$812.92 |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
66 |
59 |
$803.45 |
| 72040 |
|
18 |
16 |
$741.43 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
2,122 |
1,480 |
$725.48 |
| J0295 |
Injection, ampicillin sodium/sulbactam sodium, per 1.5 gm |
328 |
127 |
$722.49 |
| 73060 |
|
84 |
70 |
$716.43 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
23,976 |
17,246 |
$703.72 |
| 87075 |
|
273 |
187 |
$661.20 |
| 83986 |
|
1,889 |
1,196 |
$635.81 |
| 86301 |
|
96 |
49 |
$605.27 |
| 85384 |
|
441 |
311 |
$599.98 |
| 36416 |
|
627 |
482 |
$599.17 |
| 86003 |
|
16 |
12 |
$585.20 |
| 86146 |
|
34 |
25 |
$555.29 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
2,996 |
1,808 |
$483.81 |
| 86300 |
|
156 |
104 |
$472.43 |
| 85049 |
|
452 |
323 |
$461.09 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
858 |
503 |
$445.15 |
| J2360 |
Injection, orphenadrine citrate, up to 60 mg |
710 |
502 |
$437.54 |
| 82800 |
|
331 |
219 |
$435.77 |
| 80347 |
|
76 |
73 |
$429.96 |
| J0360 |
Injection, hydralazine hcl, up to 20 mg |
536 |
345 |
$424.09 |
| 87015 |
|
35 |
25 |
$423.07 |
| 90686 |
|
26 |
13 |
$418.58 |
| 82677 |
|
12 |
12 |
$390.84 |
| 51701 |
|
64 |
53 |
$388.20 |
| G0008 |
Administration of influenza virus vaccine |
27 |
16 |
$386.22 |
| 86308 |
|
54 |
40 |
$385.93 |
| J1953 |
Injection, levetiracetam, 10 mg |
96 |
52 |
$383.05 |
| 84630 |
|
38 |
36 |
$381.46 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
9,110 |
5,130 |
$377.20 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
588 |
499 |
$376.01 |
| 73552 |
|
54 |
38 |
$375.25 |
| 96523 |
|
14 |
12 |
$373.02 |
| 86870 |
|
22 |
12 |
$372.70 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
2,136 |
1,344 |
$334.44 |
| 29125 |
|
257 |
224 |
$310.01 |
| 84445 |
|
15 |
12 |
$298.42 |
| J7070 |
Infusion, d5w, 1000 cc |
1,626 |
842 |
$292.65 |
| J0137 |
Injection, acetaminophen (hikma), not therapeutically equivalent to j0131, 10 mg |
825 |
514 |
$290.50 |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
864 |
539 |
$279.42 |
| 82010 |
|
414 |
284 |
$278.51 |
| 86644 |
|
15 |
12 |
$264.21 |
| J0153 |
Injection, adenosine, 1 mg (not to be used to report any adenosine phosphate compounds) |
18 |
12 |
$263.54 |
| J2704 |
Injection, propofol, 10 mg |
5,687 |
3,776 |
$262.07 |
| 85046 |
|
140 |
110 |
$261.10 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
3,953 |
2,234 |
$253.91 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
7,681 |
5,140 |
$248.40 |
| 87427 |
|
35 |
25 |
$240.61 |
| 36600 |
|
115 |
77 |
$239.17 |
| J2060 |
Injection, lorazepam, 2 mg |
1,506 |
953 |
$235.65 |
| 82103 |
|
15 |
12 |
$235.21 |
| 82652 |
|
31 |
29 |
$233.18 |
| 87045 |
|
35 |
25 |
$232.55 |
| 87046 |
|
35 |
25 |
$225.25 |
| 86645 |
|
15 |
12 |
$218.14 |
| 00400 |
|
391 |
230 |
$212.66 |
| 96402 |
|
13 |
12 |
$196.94 |
| 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 |
675 |
534 |
$191.03 |
| 93321 |
|
22 |
12 |
$190.97 |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
2,413 |
1,454 |
$184.43 |
| 86200 |
|
15 |
12 |
$183.36 |
| J7050 |
Infusion, normal saline solution, 250 cc |
4,794 |
2,160 |
$176.47 |
| 85613 |
|
15 |
13 |
$171.76 |
| 83921 |
|
21 |
13 |
$170.87 |
| 86376 |
|
15 |
12 |
$170.52 |
| 86364 |
|
12 |
12 |
$158.36 |
| 87449 |
|
40 |
25 |
$148.25 |
| 80178 |
|
16 |
12 |
$145.42 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
7,091 |
4,688 |
$142.65 |
| 86141 |
|
13 |
12 |
$140.73 |
| 87641 |
|
14 |
12 |
$124.98 |
| 83883 |
|
39 |
28 |
$108.88 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
1,199 |
914 |
$102.69 |
| 71101 |
|
15 |
12 |
$99.18 |
| 29515 |
|
164 |
128 |
$93.94 |
| 86334 |
|
21 |
12 |
$90.03 |
| J0171 |
Injection, adrenalin, epinephrine, 0.1 mg |
168 |
112 |
$88.78 |
| 86738 |
|
16 |
12 |
$85.80 |
| 83721 |
|
12 |
12 |
$82.05 |
| 86618 |
|
16 |
15 |
$77.60 |
| 84466 |
|
13 |
12 |
$77.27 |
| 96417 |
|
748 |
378 |
$62.58 |
| J1630 |
Injection, haloperidol, up to 5 mg |
755 |
492 |
$59.04 |
| 84134 |
|
12 |
12 |
$53.26 |
| 87276 |
|
12 |
12 |
$45.86 |
| 84520 |
|
22 |
13 |
$43.05 |
| G0123 |
Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, screening by cytotechnologist under physician supervision |
17 |
14 |
$38.87 |
| J3480 |
Injection, potassium chloride, per 2 meq |
414 |
230 |
$35.47 |
| J3420 |
Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg |
71 |
52 |
$35.40 |
| J0330 |
Injection, succinylcholine chloride, up to 20 mg |
316 |
208 |
$34.01 |
| Q9969 |
Tc-99m from non-highly enriched uranium source, full cost recovery add-on, per study dose |
530 |
425 |
$23.60 |
| 87275 |
|
12 |
12 |
$22.92 |
| 29130 |
|
39 |
25 |
$22.50 |
| 83521 |
|
13 |
12 |
$21.86 |
| J1642 |
Injection, heparin sodium, (heparin lock flush), per 10 units |
650 |
525 |
$17.85 |
| A9270 |
Non-covered item or service |
968 |
647 |
$17.30 |
| J1940 |
Injection, furosemide, up to 20 mg |
107 |
67 |
$17.16 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
1,362 |
856 |
$15.86 |
| J8540 |
Dexamethasone, oral, 0.25 mg |
632 |
393 |
$12.14 |
| J2919 |
Injection, methylprednisolone sodium succinate, 5 mg |
361 |
281 |
$10.05 |
| G0432 |
Infectious agent antibody detection by enzyme immunoassay (eia) technique, hiv-1 and/or hiv-2, screening |
33 |
29 |
$7.82 |
| J8597 |
Antiemetic drug, oral, not otherwise specified |
361 |
213 |
$6.64 |
| J2550 |
Injection, promethazine hcl, up to 50 mg |
45 |
42 |
$1.86 |
| J1920 |
Injection, labetalol hydrochloride, 5 mg |
12 |
12 |
$0.36 |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
518 |
415 |
$0.06 |
| C1894 |
Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser |
1,097 |
766 |
$0.00 |
| Q9957 |
Injection, perflutren lipid microspheres, per ml |
789 |
629 |
$0.00 |
| A9577 |
Injection, gadobenate dimeglumine (multihance), per ml |
1,952 |
1,602 |
$0.00 |
| A9552 |
Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries |
205 |
165 |
$0.00 |
| C1887 |
Catheter, guiding (may include infusion/perfusion capability) |
803 |
559 |
$0.00 |
| 01992 |
|
75 |
42 |
$0.00 |
| 00731 |
|
19 |
12 |
$0.00 |
| 76376 |
|
139 |
130 |
$0.00 |
| C1760 |
Closure device, vascular (implantable/insertable) |
79 |
54 |
$0.00 |
| 76942 |
|
64 |
44 |
$0.00 |
| 88302 |
|
286 |
138 |
$0.00 |
| C1729 |
Catheter, drainage |
418 |
201 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
61 |
61 |
$0.00 |
| C1713 |
Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) |
47 |
30 |
$0.00 |
| C1788 |
Port, indwelling (implantable) |
64 |
43 |
$0.00 |
| C1874 |
Stent, coated/covered, with delivery system |
24 |
16 |
$0.00 |
| 01810 |
|
15 |
15 |
$0.00 |
| 00532 |
|
25 |
14 |
$0.00 |
| Q9966 |
Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml |
32 |
31 |
$0.00 |
| 88360 |
|
13 |
12 |
$0.00 |
| J1171 |
Injection, hydromorphone, 0.1 mg |
31 |
24 |
$0.00 |
| 86336 |
|
13 |
13 |
$0.00 |
| A9537 |
Technetium tc-99m mebrofenin, diagnostic, per study dose, up to 15 millicuries |
15 |
14 |
$0.00 |
| J2785 |
Injection, regadenoson, 0.1 mg |
605 |
461 |
$0.00 |
| C1769 |
Guide wire |
1,517 |
1,036 |
$0.00 |
| 00952 |
|
55 |
27 |
$0.00 |
| A9500 |
Technetium tc-99m sestamibi, diagnostic, per study dose |
937 |
717 |
$0.00 |
| 00790 |
|
134 |
63 |
$0.00 |
| C1781 |
Mesh (implantable) |
25 |
14 |
$0.00 |
| C1725 |
Catheter, transluminal angioplasty, non-laser (may include guidance, infusion/perfusion capability) |
110 |
83 |
$0.00 |
| J9045 |
Injection, carboplatin, 50 mg |
110 |
65 |
$0.00 |
| A9503 |
Technetium tc-99m medronate, diagnostic, per study dose, up to 30 millicuries |
20 |
13 |
$0.00 |
| J9267 |
Injection, paclitaxel, 1 mg |
51 |
24 |
$0.00 |
| 87807 |
|
12 |
12 |
$0.00 |
| 96411 |
|
16 |
12 |
$0.00 |
| A4648 |
Tissue marker, implantable, any type, each |
33 |
24 |
$0.00 |