| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99199 |
Unlisted special service, procedure or report |
526,618 |
268,184 |
$3.26M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
73,827 |
57,592 |
$2.93M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
47,664 |
38,046 |
$2.43M |
| 59400 |
Routine obstetric care including antepartum care, vaginal delivery, and postpartum care |
1,444 |
1,240 |
$1.81M |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
23,974 |
8,830 |
$1.22M |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
16,760 |
12,886 |
$1.08M |
| 99238 |
Hospital discharge day management, 30 minutes or less |
18,292 |
15,874 |
$1.05M |
| 99460 |
|
10,504 |
9,211 |
$773K |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
10,024 |
8,263 |
$767K |
| 99215 |
Prolong outpt/office vis |
5,499 |
4,673 |
$547K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
12,900 |
10,648 |
$535K |
| 99222 |
Initial hospital care, per day, moderate complexity |
4,335 |
3,467 |
$433K |
| 59025 |
Fetal non-stress test |
15,670 |
12,069 |
$321K |
| 99239 |
Hospital discharge day management, more than 30 minutes |
3,965 |
3,004 |
$309K |
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
524 |
461 |
$289K |
| 90834 |
Psychotherapy, 45 minutes with patient |
5,175 |
3,446 |
$249K |
| 99462 |
|
7,399 |
6,165 |
$242K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
2,132 |
1,658 |
$197K |
| 90832 |
Psychotherapy, 30 minutes with patient |
4,346 |
3,075 |
$159K |
| 99231 |
Subsequent hospital care, per day, straightforward or low complexity |
5,438 |
2,775 |
$159K |
| 99233 |
Prolong inpt eval add15 m |
2,102 |
932 |
$151K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,855 |
1,515 |
$147K |
| 99223 |
Prolong inpt eval add15 m |
849 |
788 |
$137K |
| 99442 |
|
5,251 |
4,077 |
$137K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
4,300 |
2,948 |
$135K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
2,837 |
2,430 |
$130K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
4,729 |
3,845 |
$128K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
1,593 |
1,214 |
$121K |
| 90837 |
Psychotherapy, 53 minutes with patient |
1,492 |
1,085 |
$113K |
| 90791 |
Psychiatric diagnostic evaluation |
1,186 |
871 |
$112K |
| 54150 |
|
661 |
558 |
$107K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,257 |
1,049 |
$104K |
| S0281 |
Medical home program, comprehensive care coordination and planning, maintenance of plan |
781 |
695 |
$98K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
6,708 |
5,308 |
$88K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
1,421 |
998 |
$80K |
| S0280 |
Medical home program, comprehensive care coordination and planning, initial plan |
1,646 |
1,426 |
$70K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
2,431 |
1,333 |
$66K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
5,901 |
4,298 |
$62K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
764 |
587 |
$57K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
2,102 |
1,528 |
$51K |
| 59514 |
|
515 |
463 |
$51K |
| 81025 |
|
8,289 |
6,384 |
$49K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
2,018 |
1,675 |
$41K |
| 99205 |
Prolong outpt/office vis |
317 |
287 |
$40K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
504 |
442 |
$40K |
| 99443 |
|
774 |
612 |
$38K |
| 76813 |
|
430 |
348 |
$37K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
297 |
226 |
$36K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
3,135 |
2,373 |
$36K |
| 76801 |
|
349 |
293 |
$30K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
913 |
396 |
$29K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
695 |
405 |
$27K |
| J1756 |
Injection, iron sucrose, 1 mg |
691 |
289 |
$26K |
| 99221 |
|
322 |
251 |
$22K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
1,448 |
734 |
$19K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,707 |
1,435 |
$19K |
| 76820 |
|
1,228 |
557 |
$19K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
576 |
440 |
$18K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
203 |
160 |
$17K |
| 93295 |
|
632 |
549 |
$14K |
| 93296 |
|
1,302 |
1,149 |
$14K |
| 96127 |
|
3,903 |
3,451 |
$14K |
| 93000 |
|
1,484 |
1,376 |
$14K |
| 87428 |
|
233 |
232 |
$13K |
| 99217 |
|
244 |
193 |
$13K |
| 99441 |
|
450 |
367 |
$10K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
1,978 |
1,745 |
$9K |
| 90686 |
|
773 |
634 |
$9K |
| 98968 |
|
333 |
215 |
$8K |
| 90715 |
|
244 |
206 |
$8K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
60 |
58 |
$8K |
| 76818 |
|
124 |
81 |
$8K |
| 81003 |
|
3,441 |
2,596 |
$6K |
| 93298 |
|
564 |
521 |
$5K |
| 99459 |
|
522 |
457 |
$5K |
| 96156 |
|
69 |
55 |
$5K |
| 99417 |
Prolong home eval add 15m |
69 |
45 |
$5K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
25 |
15 |
$4K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
461 |
354 |
$4K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
325 |
302 |
$4K |
| 00170 |
Anesthesia for intraoral procedures, including biopsy |
44 |
38 |
$4K |
| 01961 |
|
32 |
24 |
$4K |
| 71046 |
Radiologic examination, chest; 2 views |
264 |
218 |
$3K |
| 99244 |
Office or other outpatient consultation, moderate to high complexity |
32 |
31 |
$3K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
57 |
39 |
$3K |
| 99253 |
|
34 |
24 |
$3K |
| 90656 |
|
171 |
165 |
$3K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
44 |
43 |
$2K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
74 |
36 |
$2K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
107 |
56 |
$2K |
| 99218 |
|
23 |
17 |
$2K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
27 |
24 |
$2K |
| 99401 |
|
68 |
47 |
$2K |
| 59430 |
|
18 |
16 |
$2K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
152 |
51 |
$2K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
109 |
105 |
$1K |
| 93294 |
|
143 |
125 |
$1K |
| G2211 |
Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established) |
523 |
484 |
$1K |
| 81002 |
|
770 |
482 |
$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 |
236 |
189 |
$1K |
| 90847 |
Family psychotherapy with the patient present, 50 minutes |
14 |
12 |
$936.92 |
| 36415 |
Collection of venous blood by venipuncture |
362 |
307 |
$713.14 |
| 93303 |
Transthoracic echocardiography for congenital cardiac anomalies, follow-up or limited study |
15 |
12 |
$630.44 |
| 82962 |
|
338 |
316 |
$547.23 |
| 00731 |
|
14 |
12 |
$509.48 |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
85 |
76 |
$325.18 |
| 82948 |
|
1,387 |
937 |
$247.89 |
| 20553 |
|
14 |
12 |
$181.61 |
| S9442 |
Birthing classes, non-physician provider, per session |
38 |
13 |
$157.68 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
17 |
17 |
$143.32 |
| 51798 |
|
12 |
12 |
$143.24 |
| 82947 |
|
133 |
98 |
$138.24 |
| 87210 |
|
31 |
28 |
$131.98 |
| 93356 |
|
77 |
71 |
$124.78 |
| 94726 |
|
31 |
27 |
$103.12 |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
45 |
20 |
$100.98 |
| 82270 |
|
32 |
26 |
$72.58 |
| 76376 |
|
12 |
12 |
$66.64 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
36 |
36 |
$51.29 |
| 85610 |
|
33 |
14 |
$41.73 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
78 |
66 |
$32.58 |
| 93793 |
|
41 |
24 |
$13.10 |
| 0503F |
|
107 |
95 |
$3.33 |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
16 |
14 |
$1.25 |
| J2426 |
Injection, paliperidone palmitate extended release (invega sustenna), 1 mg |
29 |
25 |
$0.02 |
| J0401 |
Injection, aripiprazole (abilify maintena), 1 mg |
69 |
60 |
$0.01 |
| 1036F |
|
412 |
388 |
$0.00 |
| 0500F |
|
126 |
120 |
$0.00 |
| 3044F |
|
161 |
160 |
$0.00 |
| J3490 |
Unclassified drugs |
60 |
60 |
$0.00 |
| 3074F |
|
1,298 |
1,221 |
$0.00 |
| 0501F |
|
135 |
112 |
$0.00 |
| 36416 |
|
187 |
162 |
$0.00 |
| 3079F |
|
150 |
146 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
26 |
26 |
$0.00 |
| 96150 |
|
21 |
12 |
$0.00 |
| 3078F |
|
940 |
881 |
$0.00 |
| 1159F |
|
354 |
340 |
$0.00 |
| 3077F |
|
42 |
39 |
$0.00 |
| Q0163 |
Diphenhydramine hydrochloride, 50 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at time of chemotherapy treatment not to exceed a 48 hour dosage regimen |
22 |
15 |
$0.00 |