| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
Emergency department visit for the evaluation and management, high severity |
48,483 |
42,832 |
$12.91M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
41,700 |
34,922 |
$11.70M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
47,275 |
42,342 |
$9.54M |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
9,821 |
9,075 |
$5.02M |
| 96361 |
Intravenous infusion, hydration; each additional hour |
34,088 |
19,412 |
$3.90M |
| 0202U |
Oncology (prostate), multianalyte, gene expression profiling |
14,831 |
14,040 |
$3.70M |
| G0378 |
Hospital observation service, per hour |
37,511 |
14,089 |
$2.64M |
| A0427 |
Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) |
21,567 |
15,285 |
$2.55M |
| 69436 |
Tympanostomy (requiring insertion of ventilating tube), general anesthesia |
1,952 |
1,916 |
$2.49M |
| A0429 |
Ambulance service, basic life support, emergency transport (bls-emergency) |
18,586 |
13,497 |
$2.08M |
| 70450 |
Computed tomography, head or brain; without contrast material |
11,358 |
10,215 |
$1.92M |
| 71046 |
Radiologic examination, chest; 2 views |
19,963 |
18,221 |
$1.86M |
| D9420 |
|
1,126 |
1,101 |
$1.81M |
| 80053 |
Comprehensive metabolic panel |
100,827 |
79,315 |
$1.71M |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
2,900 |
2,712 |
$1.28M |
| 42820 |
Tonsillectomy and adenoidectomy; younger than age 12 |
665 |
655 |
$1.23M |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
109,665 |
76,357 |
$1.18M |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
26,046 |
18,590 |
$1.04M |
| 71045 |
Radiologic examination, chest; single view |
24,604 |
20,063 |
$946K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
32,913 |
25,253 |
$944K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
16,587 |
13,661 |
$807K |
| A0425 |
Ground mileage, per statute mile |
46,121 |
29,648 |
$794K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
38,466 |
23,583 |
$777K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
27,248 |
19,257 |
$676K |
| 0240U |
|
6,275 |
5,818 |
$651K |
| 59025 |
Fetal non-stress test |
10,513 |
6,885 |
$627K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
5,099 |
4,894 |
$614K |
| 83880 |
|
26,709 |
21,022 |
$606K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
12,165 |
8,811 |
$600K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
16,776 |
8,228 |
$586K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
34,517 |
25,727 |
$565K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
3,570 |
3,294 |
$559K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
34,984 |
7,938 |
$531K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
3,348 |
2,764 |
$516K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
7,989 |
3,644 |
$504K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
3,024 |
2,715 |
$481K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
5,405 |
5,115 |
$436K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
7,099 |
5,667 |
$430K |
| 87081 |
|
36,232 |
33,199 |
$378K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
24,667 |
11,011 |
$362K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
7,139 |
6,445 |
$344K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
2,338 |
2,009 |
$340K |
| 76801 |
|
2,716 |
2,295 |
$329K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
2,236 |
2,048 |
$324K |
| 84484 |
|
28,845 |
20,666 |
$313K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
1,143 |
867 |
$307K |
| 76642 |
|
2,482 |
2,277 |
$281K |
| 81001 |
|
37,012 |
31,756 |
$273K |
| 93458 |
|
800 |
591 |
$257K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
26,876 |
23,904 |
$251K |
| 84443 |
Thyroid stimulating hormone (TSH) |
19,525 |
17,667 |
$250K |
| 74018 |
|
3,982 |
3,644 |
$246K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
5,068 |
4,643 |
$229K |
| 96376 |
|
15,477 |
7,456 |
$222K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
30,236 |
24,995 |
$219K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
569 |
557 |
$210K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
31,063 |
18,147 |
$210K |
| 81025 |
|
16,658 |
14,753 |
$208K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
834 |
754 |
$206K |
| 47562 |
|
84 |
79 |
$200K |
| 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 |
4,380 |
3,933 |
$195K |
| 83690 |
|
17,882 |
15,204 |
$192K |
| 87040 |
|
10,958 |
9,196 |
$183K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
2,492 |
2,103 |
$182K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
12,199 |
10,056 |
$177K |
| 93971 |
|
2,024 |
1,880 |
$174K |
| 73630 |
|
2,520 |
2,342 |
$165K |
| C9803 |
Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
13,763 |
12,660 |
$163K |
| 93041 |
|
16,353 |
4,213 |
$162K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
2,468 |
1,828 |
$156K |
| 72110 |
|
1,537 |
1,446 |
$155K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,699 |
4,469 |
$154K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
405 |
351 |
$153K |
| 73610 |
|
2,291 |
2,166 |
$152K |
| 73030 |
|
2,539 |
2,371 |
$148K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
3,284 |
3,104 |
$147K |
| 74019 |
|
1,672 |
1,572 |
$145K |
| 80061 |
Lipid panel |
22,589 |
19,769 |
$140K |
| 87430 |
|
7,364 |
7,103 |
$140K |
| 86140 |
|
14,149 |
12,074 |
$139K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
3,056 |
2,717 |
$136K |
| 90791 |
Psychiatric diagnostic evaluation |
3,027 |
2,624 |
$130K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
621 |
578 |
$129K |
| 73564 |
|
1,844 |
1,735 |
$128K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
8,241 |
7,651 |
$126K |
| 36592 |
|
10,496 |
6,891 |
$122K |
| 87633 |
Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets |
615 |
591 |
$121K |
| 85730 |
|
24,728 |
18,318 |
$121K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
5,050 |
4,676 |
$117K |
| 70486 |
|
814 |
763 |
$116K |
| 93017 |
|
1,442 |
1,163 |
$114K |
| 85610 |
|
34,829 |
26,041 |
$113K |
| D1208 |
Topical application of fluoride, excluding varnish |
270 |
269 |
$111K |
| D1120 |
Prophylaxis - child |
495 |
490 |
$110K |
| 73130 |
|
1,736 |
1,612 |
$108K |
| 73110 |
|
1,611 |
1,528 |
$105K |
| 88304 |
|
2,609 |
2,488 |
$104K |
| 84702 |
|
6,570 |
5,013 |
$102K |
| D2930 |
Prefabricated stainless steel crown - primary tooth |
429 |
424 |
$100K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
888 |
804 |
$98K |
| 85027 |
|
15,340 |
12,032 |
$96K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
3,936 |
3,623 |
$95K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
202 |
192 |
$93K |
| 95810 |
Polysomnography; sleep staging with 4 or more additional parameters |
117 |
115 |
$91K |
| 96367 |
|
2,857 |
1,723 |
$90K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
916 |
877 |
$89K |
| A0428 |
Ambulance service, basic life support, non-emergency transport, (bls) |
4,237 |
2,362 |
$87K |
| 72100 |
|
1,373 |
1,297 |
$85K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
13,570 |
11,736 |
$84K |
| 87807 |
|
4,526 |
4,115 |
$83K |
| 76830 |
Ultrasound, transvaginal |
440 |
422 |
$82K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
3,934 |
3,619 |
$82K |
| 93975 |
|
329 |
313 |
$82K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,713 |
1,751 |
$79K |
| 76942 |
|
900 |
812 |
$78K |
| 87077 |
|
7,773 |
6,953 |
$76K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
8,720 |
6,533 |
$74K |
| APT17 |
|
5,105 |
4,921 |
$73K |
| 80320 |
|
6,286 |
5,127 |
$71K |
| 87186 |
|
8,011 |
7,230 |
$70K |
| 97597 |
|
2,409 |
1,444 |
$70K |
| 73502 |
|
1,746 |
1,623 |
$70K |
| 83605 |
|
8,318 |
5,845 |
$68K |
| 86901 |
|
9,370 |
7,666 |
$68K |
| 84703 |
|
5,301 |
4,878 |
$66K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
1,372 |
760 |
$66K |
| 76770 |
|
612 |
527 |
$64K |
| 81003 |
|
17,224 |
14,905 |
$63K |
| 82607 |
|
5,825 |
5,275 |
$61K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
10,246 |
3,299 |
$61K |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
10,891 |
9,417 |
$60K |
| 83735 |
|
14,146 |
8,055 |
$59K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
2,104 |
1,606 |
$59K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
9,020 |
2,920 |
$58K |
| 86850 |
|
6,381 |
5,129 |
$58K |
| 73590 |
|
978 |
895 |
$56K |
| 93320 |
|
789 |
641 |
$55K |
| 93325 |
|
918 |
755 |
$54K |
| 72170 |
|
943 |
884 |
$54K |
| 77066 |
Tomosynthesis, mammo |
1,394 |
1,314 |
$54K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
2,773 |
2,493 |
$53K |
| 82553 |
|
5,538 |
4,176 |
$53K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
15,157 |
10,724 |
$50K |
| 80074 |
|
1,404 |
1,188 |
$50K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
578 |
495 |
$47K |
| 97161 |
|
3,674 |
3,341 |
$47K |
| G0379 |
Direct admission of patient for hospital observation care |
1,264 |
1,029 |
$46K |
| 82728 |
|
4,587 |
3,995 |
$46K |
| 73090 |
|
653 |
632 |
$46K |
| APT15 |
|
3,918 |
3,222 |
$45K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
18,084 |
16,700 |
$45K |
| 85379 |
|
4,427 |
3,796 |
$43K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
5,676 |
2,017 |
$43K |
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
1,054 |
98 |
$42K |
| J2357 |
Injection, omalizumab, 5 mg |
45 |
24 |
$41K |
| 93351 |
|
213 |
182 |
$40K |
| 74021 |
|
637 |
553 |
$39K |
| G0390 |
Trauma response team associated with hospital critical care service |
38 |
37 |
$39K |
| D3220 |
Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction |
155 |
154 |
$37K |
| 84439 |
|
4,984 |
4,600 |
$37K |
| 82803 |
|
3,057 |
2,018 |
$37K |
| 82550 |
|
12,075 |
9,640 |
$36K |
| 12001 |
|
343 |
333 |
$34K |
| S9443 |
Lactation classes, non-physician provider, per session |
895 |
687 |
$34K |
| 42830 |
|
24 |
24 |
$33K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
2,925 |
2,790 |
$33K |
| 73080 |
|
556 |
526 |
$32K |
| APT16 |
|
2,223 |
2,110 |
$31K |
| 99215 |
Prolong outpt/office vis |
1,110 |
755 |
$31K |
| 83718 |
|
2,595 |
2,494 |
$29K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
11,760 |
10,210 |
$29K |
| 87070 |
|
3,465 |
2,993 |
$29K |
| 97010 |
|
7,217 |
2,050 |
$29K |
| 82948 |
|
7,701 |
4,026 |
$28K |
| 84145 |
|
1,647 |
1,266 |
$28K |
| 86900 |
|
7,559 |
6,110 |
$28K |
| 73562 |
|
803 |
751 |
$27K |
| 80143 |
|
1,567 |
1,409 |
$26K |
| J2704 |
Injection, propofol, 10 mg |
9,990 |
9,244 |
$26K |
| 87631 |
|
335 |
323 |
$25K |
| 97016 |
|
1,966 |
614 |
$24K |
| 83550 |
|
3,715 |
3,315 |
$24K |
| 80179 |
|
1,500 |
1,362 |
$24K |
| 90715 |
|
1,328 |
1,167 |
$23K |
| J2785 |
Injection, regadenoson, 0.1 mg |
388 |
347 |
$23K |
| 36415 |
Collection of venous blood by venipuncture |
72,617 |
45,578 |
$22K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
12,767 |
11,850 |
$22K |
| J0690 |
Injection, cefazolin sodium, 500 mg |
5,607 |
4,733 |
$21K |
| 88307 |
|
270 |
246 |
$21K |
| 36600 |
|
3,573 |
2,505 |
$21K |
| 84146 |
|
1,040 |
916 |
$21K |
| 83540 |
|
4,086 |
3,637 |
$20K |
| 87088 |
|
2,587 |
2,427 |
$19K |
| 76870 |
|
83 |
76 |
$19K |
| 93880 |
|
264 |
209 |
$18K |
| 12002 |
|
160 |
152 |
$18K |
| 84112 |
|
379 |
342 |
$18K |
| 85007 |
|
4,694 |
3,968 |
$17K |
| 72050 |
|
212 |
192 |
$17K |
| 84153 |
|
1,014 |
977 |
$16K |
| 85652 |
|
4,011 |
3,584 |
$16K |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
734 |
702 |
$15K |
| A0426 |
Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) |
352 |
273 |
$15K |
| 82805 |
|
889 |
650 |
$15K |
| 87205 |
|
3,552 |
3,063 |
$15K |
| J1170 |
Injection, hydromorphone, up to 4 mg |
7,052 |
5,089 |
$15K |
| 71101 |
|
227 |
219 |
$15K |
| 82043 |
|
4,005 |
3,303 |
$15K |
| 82746 |
|
1,862 |
1,594 |
$14K |
| 80076 |
|
1,040 |
840 |
$14K |
| 82150 |
|
1,698 |
1,489 |
$14K |
| 51701 |
|
1,051 |
858 |
$14K |
| 83970 |
|
575 |
497 |
$13K |
| 80329 |
|
441 |
312 |
$13K |
| 97014 |
|
2,009 |
572 |
$13K |
| 76818 |
|
185 |
146 |
$13K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
4,060 |
3,390 |
$13K |
| 12011 |
|
150 |
147 |
$13K |
| 76536 |
|
81 |
80 |
$12K |
| 72141 |
|
89 |
85 |
$12K |
| 93970 |
|
108 |
98 |
$12K |
| A9577 |
Injection, gadobenate dimeglumine (multihance), per ml |
615 |
588 |
$12K |
| P9016 |
Red blood cells, leukocytes reduced, each unit |
219 |
118 |
$12K |
| 10061 |
|
107 |
94 |
$12K |
| 82010 |
|
1,478 |
1,269 |
$12K |
| 86920 |
|
413 |
239 |
$12K |
| 90686 |
|
1,272 |
1,143 |
$11K |
| 72040 |
|
246 |
234 |
$11K |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
3,181 |
2,880 |
$11K |
| J3480 |
Injection, potassium chloride, per 2 meq |
3,288 |
1,783 |
$11K |
| 82247 |
|
1,842 |
1,125 |
$11K |
| 86803 |
|
1,312 |
1,219 |
$11K |
| J7050 |
Infusion, normal saline solution, 250 cc |
4,168 |
2,864 |
$11K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
96 |
80 |
$10K |
| 73140 |
|
179 |
168 |
$9K |
| 87507 |
|
44 |
43 |
$9K |
| J0595 |
Injection, butorphanol tartrate, 1 mg |
1,228 |
959 |
$9K |
| J1980 |
Injection, hyoscyamine sulfate, up to 0.25 mg |
343 |
326 |
$9K |
| 29581 |
|
497 |
150 |
$9K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
644 |
587 |
$8K |
| A0433 |
Advanced life support, level 2 (als 2) |
104 |
68 |
$8K |
| 97162 |
|
1,065 |
973 |
$8K |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
3,524 |
2,626 |
$8K |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
2,178 |
1,681 |
$8K |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
2,808 |
2,421 |
$8K |
| 76000 |
|
453 |
386 |
$8K |
| 86592 |
|
1,997 |
1,777 |
$8K |
| J7042 |
5% dextrose/normal saline (500 ml = 1 unit) |
1,853 |
935 |
$8K |
| 95811 |
|
13 |
12 |
$7K |
| 72072 |
|
143 |
132 |
$7K |
| 82570 |
|
1,631 |
1,477 |
$7K |
| 82248 |
|
1,533 |
1,030 |
$7K |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
8,837 |
8,209 |
$7K |
| 94644 |
|
686 |
545 |
$6K |
| 84550 |
|
1,418 |
1,266 |
$6K |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
5,274 |
2,032 |
$6K |
| 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 |
72 |
67 |
$6K |
| 84481 |
|
369 |
350 |
$6K |
| 97116 |
|
1,307 |
578 |
$5K |
| G0279 |
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) |
769 |
735 |
$5K |
| M0243 |
Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring |
67 |
64 |
$5K |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
139 |
118 |
$5K |
| 86038 |
|
496 |
435 |
$5K |
| G0410 |
Group psychotherapy other than of a multiple-family group, in a partial hospitalization or intensive outpatient setting, approximately 45 to 50 minutes |
122 |
12 |
$5K |
| 97535 |
Self-care/home management training, each 15 minutes |
1,484 |
986 |
$5K |
| J2795 |
Injection, ropivacaine hydrochloride, 1 mg |
648 |
602 |
$5K |
| M0222 |
Intravenous injection, bebtelovimab, includes injection and post administration monitoring |
51 |
49 |
$5K |
| G0283 |
Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care |
1,255 |
415 |
$5K |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
5,189 |
3,996 |
$5K |
| 87340 |
|
603 |
547 |
$5K |
| J2060 |
Injection, lorazepam, 2 mg |
1,971 |
1,574 |
$5K |
| 84156 |
|
852 |
637 |
$5K |
| J2550 |
Injection, promethazine hcl, up to 50 mg |
3,153 |
2,090 |
$5K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
685 |
623 |
$5K |
| 36430 |
|
338 |
194 |
$5K |
| J1815 |
Injection, insulin, per 5 units |
4,472 |
1,707 |
$4K |
| C1713 |
Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) |
362 |
342 |
$4K |
| 90688 |
|
412 |
365 |
$4K |
| 73560 |
|
142 |
130 |
$4K |
| J1644 |
Injection, heparin sodium, per 1000 units |
6,456 |
2,520 |
$4K |
| 73552 |
|
96 |
92 |
$4K |
| J0461 |
Injection, atropine sulfate, 0.01 mg |
626 |
581 |
$4K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
359 |
309 |
$4K |
| 80164 |
|
376 |
310 |
$4K |
| J1741 |
Injection, ibuprofen, 100 mg |
1,844 |
1,584 |
$4K |
| 82272 |
|
1,091 |
951 |
$4K |
| 86308 |
|
314 |
300 |
$4K |
| 84403 |
|
143 |
135 |
$4K |
| 87641 |
|
415 |
402 |
$4K |
| S0077 |
Injection, clindamycin phosphate, 300 mg |
317 |
239 |
$3K |
| 71250 |
|
29 |
17 |
$3K |
| 84100 |
|
3,088 |
2,065 |
$3K |
| J1756 |
Injection, iron sucrose, 1 mg |
111 |
43 |
$3K |
| 70498 |
|
41 |
39 |
$3K |
| 70496 |
|
28 |
26 |
$3K |
| 82565 |
|
1,274 |
887 |
$3K |
| 95816 |
|
26 |
25 |
$3K |
| J0171 |
Injection, adrenalin, epinephrine, 0.1 mg |
558 |
530 |
$3K |
| J1940 |
Injection, furosemide, up to 20 mg |
4,040 |
1,815 |
$3K |
| J0360 |
Injection, hydralazine hcl, up to 20 mg |
940 |
692 |
$3K |
| 94668 |
|
159 |
43 |
$3K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
20 |
16 |
$2K |
| 72081 |
|
28 |
28 |
$2K |
| 97598 |
|
16 |
12 |
$2K |
| 80069 |
|
557 |
328 |
$2K |
| D7140 |
Extraction, erupted tooth or exposed root |
13 |
13 |
$2K |
| 77062 |
|
196 |
190 |
$2K |
| APT11 |
|
223 |
184 |
$2K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
14 |
13 |
$2K |
| 74420 |
|
13 |
12 |
$2K |
| J3360 |
Injection, diazepam, up to 5 mg |
352 |
325 |
$2K |
| Q0111 |
Wet mounts, including preparations of vaginal, cervical or skin specimens |
244 |
228 |
$2K |
| 85018 |
|
1,436 |
947 |
$2K |
| 83615 |
|
1,036 |
766 |
$2K |
| 82950 |
|
414 |
400 |
$2K |
| 87486 |
|
87 |
78 |
$2K |
| 86762 |
|
245 |
208 |
$2K |
| 87581 |
|
87 |
78 |
$2K |
| D2331 |
|
15 |
15 |
$2K |
| APT10 |
|
207 |
171 |
$2K |
| 87210 |
|
265 |
250 |
$2K |
| 72131 |
|
14 |
13 |
$2K |
| 87147 |
|
311 |
297 |
$2K |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
271 |
249 |
$2K |
| 73060 |
|
39 |
39 |
$2K |
| J2370 |
Injection, phenylephrine hcl, up to 1 ml |
1,492 |
1,346 |
$2K |
| 29505 |
|
92 |
89 |
$2K |
| J2919 |
Injection, methylprednisolone sodium succinate, 5 mg |
355 |
298 |
$2K |
| G0257 |
Unscheduled or emergency dialysis treatment for an esrd patient in a hospital outpatient department that is not certified as an esrd facility |
222 |
65 |
$2K |
| A9500 |
Technetium tc-99m sestamibi, diagnostic, per study dose |
248 |
222 |
$2K |
| 29125 |
|
59 |
58 |
$2K |
| A9585 |
Injection, gadobutrol, 0.1 ml |
172 |
151 |
$2K |
| J2360 |
Injection, orphenadrine citrate, up to 60 mg |
312 |
288 |
$2K |
| 77065 |
Tomosynthesis, mammo |
95 |
87 |
$2K |
| J3490 |
Unclassified drugs |
3,536 |
1,759 |
$2K |
| 70491 |
|
12 |
12 |
$1K |
| C8930 |
Transthoracic echocardiography, with contrast, or without contrast followed by with contrast, real-time with image documentation (2d), includes m-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or pharmacologically induced stress, with interpretation and report; including performance of continuous electrocardiographic monitoring, with physician supervision |
34 |
27 |
$1K |
| 91322 |
|
12 |
12 |
$1K |
| 17250 |
|
72 |
52 |
$1K |
| D2934 |
|
13 |
13 |
$1K |
| 90656 |
|
80 |
76 |
$1K |
| 64450 |
|
26 |
26 |
$1K |
| 82140 |
|
244 |
140 |
$1K |
| 85014 |
|
880 |
540 |
$1K |
| 11721 |
|
233 |
198 |
$1K |
| 93308 |
|
19 |
14 |
$1K |
| J2543 |
Injection, piperacillin sodium/tazobactam sodium, 1 gram/0.125 grams (1.125 grams) |
294 |
133 |
$1K |
| 97165 |
|
247 |
220 |
$1K |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
934 |
814 |
$1K |
| 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 |
56 |
51 |
$989.89 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
30 |
26 |
$976.94 |
| 90732 |
|
12 |
12 |
$954.00 |
| J0736 |
Injection, clindamycin phosphate, 300 mg |
215 |
153 |
$933.55 |
| 73070 |
|
31 |
26 |
$885.14 |
| 10060 |
|
25 |
24 |
$846.33 |
| 85049 |
|
531 |
348 |
$802.81 |
| C9113 |
Injection, pantoprazole sodium, per vial |
1,277 |
652 |
$781.11 |
| 94729 |
|
13 |
13 |
$777.19 |
| Q3014 |
Telehealth originating site facility fee |
67 |
51 |
$722.31 |
| 82105 |
|
127 |
114 |
$720.13 |
| 88313 |
|
25 |
24 |
$708.97 |
| 83655 |
|
88 |
77 |
$701.20 |
| 71271 |
|
12 |
12 |
$701.03 |
| 97150 |
Therapeutic procedure(s), group (2 or more individuals) |
3,646 |
1,416 |
$684.41 |
| 11720 |
|
47 |
46 |
$672.06 |
| 87899 |
|
56 |
25 |
$644.22 |
| 86376 |
|
54 |
49 |
$638.98 |
| 82330 |
|
157 |
142 |
$638.82 |
| 84132 |
|
379 |
308 |
$606.76 |
| J0330 |
Injection, succinylcholine chloride, up to 20 mg |
111 |
104 |
$585.91 |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
425 |
253 |
$585.37 |
| 84402 |
|
25 |
24 |
$574.36 |
| 88342 |
|
29 |
25 |
$567.92 |
| A6210 |
Foam dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing |
1,663 |
827 |
$556.26 |
| J3370 |
Injection, vancomycin hcl, 500 mg |
145 |
84 |
$543.73 |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
15 |
13 |
$521.03 |
| J2920 |
Injection, methylprednisolone sodium succinate, up to 40 mg |
189 |
86 |
$512.83 |
| S0166 |
Injection, olanzapine, 2.5 mg |
23 |
16 |
$512.28 |
| 88312 |
|
15 |
12 |
$503.41 |
| J2371 |
Injection, phenylephrine hydrochloride, 20 micrograms |
582 |
509 |
$479.35 |
| 90670 |
|
104 |
87 |
$475.22 |
| A9502 |
Technetium tc-99m tetrofosmin, diagnostic, per study dose |
121 |
116 |
$472.50 |
| 96401 |
|
53 |
26 |
$471.20 |
| 82962 |
|
205 |
191 |
$459.96 |
| 85045 |
|
160 |
151 |
$447.83 |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
204 |
178 |
$438.34 |
| A6252 |
Specialty absorptive dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing |
1,201 |
451 |
$402.38 |
| 87046 |
|
63 |
55 |
$400.92 |
| G2023 |
Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
55 |
50 |
$396.61 |
| 87801 |
Infectious agent detection by nucleic acid; amplified probe, multiple organisms |
12 |
12 |
$386.40 |
| 83986 |
|
81 |
75 |
$367.46 |
| 84436 |
|
103 |
91 |
$362.41 |
| 86923 |
|
38 |
27 |
$361.25 |
| 90480 |
|
12 |
12 |
$358.00 |
| J2003 |
Injection, lidocaine hydrochloride, 1 mg |
413 |
383 |
$340.73 |
| P9612 |
Catheterization for collection of specimen, single patient, all places of service |
103 |
65 |
$328.78 |
| 87045 |
|
61 |
53 |
$320.29 |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
233 |
135 |
$313.78 |
| J1920 |
Injection, labetalol hydrochloride, 5 mg |
232 |
133 |
$312.97 |
| Q9957 |
Injection, perflutren lipid microspheres, per ml |
13 |
12 |
$306.51 |
| 86696 |
|
12 |
12 |
$296.00 |
| 87209 |
|
16 |
12 |
$276.08 |
| J1956 |
Injection, levofloxacin, 250 mg |
43 |
28 |
$269.02 |
| 87425 |
|
16 |
14 |
$268.13 |
| Q9969 |
Tc-99m from non-highly enriched uranium source, full cost recovery add-on, per study dose |
491 |
475 |
$257.19 |
| 86431 |
|
29 |
28 |
$250.29 |
| 92610 |
|
13 |
12 |
$245.64 |
| 83525 |
|
27 |
25 |
$240.71 |
| 80347 |
|
17 |
16 |
$227.07 |
| J1010 |
Injection, methylprednisolone acetate, 1 mg |
27 |
27 |
$226.16 |
| 29105 |
|
12 |
12 |
$212.68 |
| 11056 |
|
14 |
14 |
$209.14 |
| 86695 |
|
12 |
12 |
$208.29 |
| APT09 |
|
15 |
14 |
$178.65 |
| J1596 |
Injection, glycopyrrolate, 0.1 mg |
239 |
227 |
$177.41 |
| 90662 |
|
25 |
25 |
$164.24 |
| 81050 |
|
41 |
36 |
$155.63 |
| J1953 |
Injection, levetiracetam, 10 mg |
17 |
14 |
$152.79 |
| 99406 |
|
81 |
80 |
$145.97 |
| J2470 |
Injection, pantoprazole sodium, 40 mg |
203 |
140 |
$140.60 |
| J2710 |
Injection, neostigmine methylsulfate, up to 0.5 mg |
47 |
44 |
$135.59 |
| 87015 |
|
45 |
38 |
$133.41 |
| 87449 |
|
17 |
16 |
$133.11 |
| J1171 |
Injection, hydromorphone, 0.1 mg |
139 |
112 |
$130.65 |
| 87427 |
|
17 |
16 |
$122.45 |
| J1642 |
Injection, heparin sodium, (heparin lock flush), per 10 units |
675 |
174 |
$113.76 |
| 3044F |
|
91 |
87 |
$113.17 |
| 87177 |
|
16 |
12 |
$109.25 |
| 84520 |
|
49 |
49 |
$94.13 |
| J8499 |
Prescription drug, oral, non chemotherapeutic, nos |
89 |
68 |
$92.86 |
| 51702 |
|
17 |
12 |
$86.23 |
| 96160 |
|
131 |
119 |
$77.16 |
| 84466 |
|
17 |
17 |
$76.11 |
| 80178 |
|
15 |
13 |
$74.47 |
| J0688 |
Injection, cefazolin sodium (hikma), not therapeutically equivalent to j0690, 500 mg |
80 |
39 |
$71.25 |
| 97166 |
|
27 |
26 |
$70.70 |
| 82465 |
|
13 |
12 |
$69.30 |
| J3105 |
Injection, terbutaline sulfate, up to 1 mg |
16 |
13 |
$53.07 |
| 82977 |
|
14 |
12 |
$52.62 |
| 84460 |
|
13 |
12 |
$49.77 |
| 97164 |
|
15 |
13 |
$47.16 |
| J2004 |
Injection, lidocaine hcl with epinephrine, 1 mg |
43 |
43 |
$45.65 |
| 87493 |
|
15 |
12 |
$42.48 |
| J2300 |
Injection, nalbuphine hydrochloride, per 10 mg |
19 |
14 |
$38.85 |
| J3420 |
Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg |
64 |
44 |
$36.58 |
| J0456 |
Injection, azithromycin, 500 mg |
38 |
25 |
$34.25 |
| 84295 |
|
18 |
13 |
$31.88 |
| 99173 |
|
79 |
65 |
$30.60 |
| 90658 |
|
16 |
15 |
$26.12 |
| J1630 |
Injection, haloperidol, up to 5 mg |
24 |
14 |
$24.35 |
| 92551 |
|
59 |
47 |
$22.07 |
| Q0247 |
Injection, sotrovimab, 500 mg |
26 |
25 |
$17.20 |
| 70544 |
|
19 |
12 |
$16.97 |
| G0008 |
Administration of influenza virus vaccine |
550 |
503 |
$11.74 |
| 96127 |
|
17 |
16 |
$8.56 |
| Q0244 |
Injection, casirivimab and imdevimab, 1200 mg |
177 |
159 |
$7.85 |
| 36416 |
|
14 |
12 |
$5.36 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
101 |
40 |
$4.74 |
| 96161 |
|
17 |
14 |
$2.86 |
| Q0222 |
Injection, bebtelovimab, 175 mg |
33 |
32 |
$1.12 |
| G8979 |
Mobility: walking & moving around functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting |
209 |
179 |
$0.00 |
| G8978 |
Mobility: walking & moving around functional limitation, current status, at therapy episode outset and at reporting intervals |
208 |
179 |
$0.00 |
| G1004 |
Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program |
1,061 |
800 |
$0.00 |
| 90633 |
|
14 |
14 |
$0.00 |
| G8985 |
Carrying, moving and handling objects, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting |
27 |
26 |
$0.00 |
| 64447 |
|
13 |
13 |
$0.00 |
| G8984 |
Carrying, moving & handling objects functional limitation, current status, at therapy episode outset and at reporting intervals |
28 |
27 |
$0.00 |
| 80354 |
|
17 |
16 |
$0.00 |
| 80348 |
|
17 |
16 |
$0.00 |
| Q0245 |
Injection, bamlanivimab and etesevimab, 2100 mg |
15 |
13 |
$0.00 |
| 90734 |
|
14 |
14 |
$0.00 |
| A9270 |
Non-covered item or service |
17,862 |
6,546 |
$0.00 |
| 90651 |
|
25 |
23 |
$0.00 |
| 90620 |
|
17 |
17 |
$0.00 |
| 99495 |
|
13 |
13 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
12 |
12 |
$0.00 |
| G8981 |
Changing & maintaining body position functional limitation, current status, at therapy episode outset and at reporting intervals |
14 |
13 |
$0.00 |
| G8982 |
Changing & maintaining body position functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting |
15 |
14 |
$0.00 |
| 90647 |
|
26 |
18 |
$0.00 |
| 80050 |
General health panel |
30 |
30 |
$0.00 |
| 90723 |
|
29 |
22 |
$0.00 |
| 41899 |
Unlisted procedure, dentoalveolar structures |
12 |
12 |
$0.00 |
| C1769 |
Guide wire |
13 |
12 |
$0.00 |
| 87640 |
|
14 |
13 |
$0.00 |