| Code | Description | Claims | Beneficiaries | Total Paid |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
268,474 |
261,078 |
$44.56M |
| X4011 |
State-specific procedure code |
32,889 |
32,129 |
$29.67M |
| X4003 |
|
154,516 |
149,483 |
$24.31M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
65,810 |
64,426 |
$20.10M |
| X4014 |
|
13,063 |
12,996 |
$17.88M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
18,728 |
18,521 |
$7.35M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
99,588 |
95,213 |
$4.61M |
| 87400 |
|
5,916 |
2,951 |
$4.37M |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
11,531 |
11,057 |
$4.09M |
| 87430 |
|
7,069 |
7,007 |
$3.96M |
| 80048 |
Basic metabolic panel (calcium, ionized) |
26,017 |
23,538 |
$3.96M |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
21,595 |
19,043 |
$3.30M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
5,229 |
5,145 |
$3.12M |
| 93325 |
|
4,492 |
4,141 |
$2.95M |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
9,838 |
9,742 |
$2.73M |
| 80076 |
|
19,957 |
18,117 |
$2.62M |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
12,729 |
12,580 |
$2.56M |
| 87081 |
|
11,011 |
10,903 |
$2.49M |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
7,688 |
7,665 |
$1.56M |
| J3490 |
Unclassified drugs |
2,343 |
1,088 |
$1.36M |
| 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 |
44,987 |
43,678 |
$1.30M |
| 42820 |
Tonsillectomy and adenoidectomy; younger than age 12 |
256 |
256 |
$1.27M |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
3,249 |
3,131 |
$1.14M |
| 71046 |
Radiologic examination, chest; 2 views |
3,115 |
3,049 |
$1.13M |
| 85027 |
|
12,268 |
11,914 |
$1.08M |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
1,376 |
1,309 |
$1.02M |
| 93303 |
Transthoracic echocardiography for congenital cardiac anomalies, follow-up or limited study |
1,027 |
970 |
$987K |
| 86140 |
|
6,575 |
6,164 |
$985K |
| X4006 |
|
296 |
281 |
$943K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
2,711 |
1,215 |
$914K |
| 93320 |
|
781 |
731 |
$877K |
| 76770 |
|
3,503 |
3,391 |
$845K |
| 84443 |
Thyroid stimulating hormone (TSH) |
12,618 |
12,362 |
$845K |
| 85652 |
|
5,603 |
5,236 |
$834K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
10,579 |
10,312 |
$769K |
| 93304 |
|
1,665 |
1,540 |
$743K |
| 80061 |
Lipid panel |
9,203 |
8,981 |
$728K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
916 |
881 |
$720K |
| 83655 |
|
5,802 |
5,682 |
$705K |
| 72082 |
|
2,927 |
2,764 |
$662K |
| 29075 |
|
2,097 |
1,983 |
$649K |
| 86003 |
|
1,517 |
789 |
$648K |
| 95819 |
|
1,720 |
1,691 |
$615K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
2,012 |
1,901 |
$614K |
| 93321 |
|
2,065 |
1,884 |
$567K |
| 81003 |
|
2,958 |
2,856 |
$553K |
| 94010 |
|
2,987 |
2,900 |
$476K |
| 73620 |
|
587 |
482 |
$464K |
| 73140 |
|
1,503 |
1,295 |
$462K |
| 69436 |
Tympanostomy (requiring insertion of ventilating tube), general anesthesia |
258 |
255 |
$453K |
| 82977 |
|
3,224 |
2,821 |
$447K |
| 73100 |
|
3,083 |
2,745 |
$391K |
| 85046 |
|
2,680 |
2,274 |
$358K |
| 81001 |
|
923 |
845 |
$343K |
| 81025 |
|
2,511 |
2,409 |
$322K |
| 82728 |
|
3,640 |
3,446 |
$317K |
| 84439 |
|
7,140 |
6,984 |
$311K |
| 96415 |
|
662 |
622 |
$243K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,448 |
2,338 |
$243K |
| 92523 |
|
624 |
607 |
$234K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
11,207 |
11,108 |
$228K |
| 72170 |
|
1,855 |
1,789 |
$226K |
| 81415 |
|
51 |
51 |
$225K |
| 83615 |
|
1,543 |
1,218 |
$207K |
| 92507 |
Treatment of speech, language, voice, communication, and/or auditory processing disorder |
1,795 |
695 |
$200K |
| 16020 |
|
754 |
571 |
$194K |
| 83021 |
|
365 |
327 |
$189K |
| 81443 |
|
94 |
88 |
$182K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
600 |
587 |
$169K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
3,208 |
3,161 |
$167K |
| 73090 |
|
1,014 |
836 |
$166K |
| 92567 |
|
3,290 |
3,238 |
$162K |
| 95812 |
|
237 |
231 |
$161K |
| 86703 |
|
338 |
332 |
$150K |
| 74018 |
|
1,229 |
1,149 |
$145K |
| 83880 |
|
309 |
281 |
$144K |
| 86803 |
|
194 |
191 |
$137K |
| 87631 |
|
150 |
147 |
$132K |
| 87340 |
|
184 |
181 |
$130K |
| 86706 |
|
183 |
180 |
$130K |
| 86704 |
|
183 |
180 |
$130K |
| 94664 |
|
568 |
564 |
$112K |
| 87077 |
|
481 |
461 |
$97K |
| 82550 |
|
1,025 |
985 |
$93K |
| 86900 |
|
626 |
583 |
$92K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
2,897 |
2,829 |
$88K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
710 |
696 |
$81K |
| G0378 |
Hospital observation service, per hour |
149 |
146 |
$79K |
| 86901 |
|
612 |
571 |
$79K |
| 82570 |
|
1,330 |
1,245 |
$73K |
| 86885 |
|
426 |
394 |
$69K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
429 |
410 |
$68K |
| 87634 |
|
1,440 |
1,355 |
$65K |
| 81407 |
|
29 |
28 |
$63K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
3,225 |
3,195 |
$62K |
| 97161 |
|
313 |
301 |
$56K |
| 29065 |
|
192 |
187 |
$56K |
| 84100 |
|
1,490 |
1,062 |
$50K |
| 83970 |
|
461 |
376 |
$50K |
| 87040 |
|
45 |
42 |
$47K |
| J1745 |
Injection, infliximab, excludes biosimilar, 10 mg |
13 |
12 |
$47K |
| 87186 |
|
263 |
258 |
$44K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
1,027 |
989 |
$43K |
| 83735 |
|
1,054 |
735 |
$42K |
| 16025 |
|
158 |
139 |
$42K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
974 |
937 |
$41K |
| 85610 |
|
208 |
203 |
$39K |
| 73070 |
|
213 |
181 |
$38K |
| 83540 |
|
171 |
167 |
$35K |
| 81229 |
|
64 |
64 |
$33K |
| 41899 |
Unlisted procedure, dentoalveolar structures |
27 |
27 |
$33K |
| 92133 |
|
190 |
188 |
$33K |
| 93786 |
|
365 |
356 |
$33K |
| 86923 |
|
24 |
13 |
$32K |
| 99215 |
Prolong outpt/office vis |
191 |
191 |
$32K |
| 92504 |
|
350 |
330 |
$31K |
| 84156 |
|
691 |
651 |
$28K |
| 95117 |
|
1,185 |
713 |
$28K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
169 |
164 |
$28K |
| 85240 |
|
101 |
97 |
$27K |
| 82784 |
|
684 |
579 |
$27K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
290 |
283 |
$26K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
204 |
123 |
$25K |
| 87210 |
|
76 |
70 |
$24K |
| 0202U |
Oncology (prostate), multianalyte, gene expression profiling |
51 |
51 |
$24K |
| 92526 |
|
383 |
344 |
$22K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,674 |
1,670 |
$22K |
| 86902 |
|
78 |
66 |
$21K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
106 |
67 |
$21K |
| 72081 |
|
121 |
108 |
$21K |
| 77072 |
|
161 |
160 |
$20K |
| 85730 |
|
68 |
67 |
$20K |
| 84460 |
|
1,033 |
918 |
$20K |
| 86160 |
|
116 |
110 |
$20K |
| 62370 |
|
194 |
188 |
$19K |
| P9040 |
Red blood cells, leukocytes reduced, irradiated, each unit |
69 |
53 |
$19K |
| 74019 |
|
53 |
52 |
$18K |
| 84450 |
|
700 |
683 |
$17K |
| 86592 |
|
13 |
13 |
$16K |
| 84550 |
|
618 |
379 |
$16K |
| 76825 |
|
25 |
24 |
$14K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
101 |
95 |
$14K |
| 73590 |
|
322 |
302 |
$13K |
| 83516 |
|
410 |
386 |
$13K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
44 |
41 |
$13K |
| 84305 |
|
231 |
226 |
$13K |
| 95816 |
|
52 |
51 |
$12K |
| 96040 |
|
443 |
389 |
$12K |
| 17110 |
|
31 |
29 |
$11K |
| 96409 |
|
79 |
51 |
$10K |
| 82785 |
|
372 |
369 |
$8K |
| 86038 |
|
42 |
36 |
$8K |
| 86800 |
|
310 |
298 |
$7K |
| 93308 |
|
38 |
36 |
$7K |
| 86376 |
|
319 |
309 |
$6K |
| 90686 |
|
1,099 |
1,098 |
$6K |
| 43762 |
|
26 |
26 |
$6K |
| 80197 |
|
474 |
315 |
$6K |
| 62369 |
|
28 |
28 |
$5K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
382 |
380 |
$5K |
| 87070 |
|
74 |
74 |
$5K |
| 87205 |
|
64 |
64 |
$5K |
| 31575 |
|
27 |
27 |
$5K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
39 |
25 |
$5K |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
791 |
672 |
$5K |
| 97165 |
|
59 |
55 |
$4K |
| 80069 |
|
424 |
289 |
$4K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
26 |
26 |
$4K |
| 87101 |
|
41 |
37 |
$4K |
| 43760 |
|
13 |
12 |
$4K |
| S0119 |
Ondansetron, oral, 4 mg (for circumstances falling under the medicare statute, use hcpcs q code) |
130 |
123 |
$4K |
| 92610 |
|
38 |
38 |
$3K |
| 92579 |
|
25 |
25 |
$3K |
| 86364 |
|
280 |
276 |
$3K |
| J3535 |
Drug administered through a metered dose inhaler |
79 |
77 |
$3K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
106 |
75 |
$3K |
| 80180 |
|
203 |
165 |
$3K |
| 16000 |
|
14 |
14 |
$2K |
| 70450 |
Computed tomography, head or brain; without contrast material |
24 |
24 |
$2K |
| 92524 |
|
37 |
37 |
$2K |
| 71045 |
Radiologic examination, chest; single view |
43 |
28 |
$2K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
187 |
159 |
$2K |
| 73552 |
|
58 |
49 |
$2K |
| 86780 |
|
116 |
113 |
$2K |
| 83550 |
|
169 |
166 |
$2K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
22 |
19 |
$2K |
| 76827 |
|
13 |
12 |
$2K |
| 73610 |
|
14 |
14 |
$2K |
| 87799 |
|
54 |
39 |
$2K |
| 85397 |
|
49 |
45 |
$1K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
14 |
14 |
$1K |
| 92015 |
Determination of refractive state |
245 |
243 |
$1K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
14 |
12 |
$1K |
| 85246 |
|
57 |
57 |
$1K |
| 83002 |
|
43 |
43 |
$1K |
| 83001 |
|
42 |
42 |
$1K |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
33 |
26 |
$936.64 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
13 |
13 |
$887.62 |
| 84478 |
|
108 |
99 |
$756.65 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
42 |
42 |
$722.24 |
| 95012 |
|
27 |
26 |
$702.55 |
| 90723 |
|
24 |
24 |
$642.00 |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
12 |
12 |
$590.28 |
| 80074 |
|
12 |
12 |
$536.25 |
| 82610 |
|
41 |
39 |
$523.02 |
| 92587 |
|
70 |
70 |
$521.67 |
| 93296 |
|
13 |
13 |
$515.08 |
| 97803 |
|
185 |
164 |
$503.84 |
| 82040 |
|
89 |
71 |
$463.43 |
| J8540 |
Dexamethasone, oral, 0.25 mg |
182 |
174 |
$452.78 |
| 90670 |
|
80 |
80 |
$430.68 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
26 |
26 |
$417.30 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
25 |
25 |
$401.25 |
| 92134 |
|
14 |
13 |
$395.90 |
| 84403 |
|
12 |
12 |
$388.83 |
| 82670 |
|
12 |
12 |
$377.73 |
| 36415 |
Collection of venous blood by venipuncture |
501 |
479 |
$375.70 |
| 83498 |
|
14 |
12 |
$333.34 |
| 85660 |
|
51 |
27 |
$332.14 |
| 51701 |
|
13 |
13 |
$310.52 |
| 74022 |
|
13 |
13 |
$309.50 |
| J8499 |
Prescription drug, oral, non chemotherapeutic, nos |
465 |
301 |
$307.55 |
| 82627 |
|
17 |
15 |
$306.45 |
| 82565 |
|
38 |
37 |
$300.61 |
| 87147 |
|
33 |
32 |
$297.37 |
| 83020 |
|
14 |
13 |
$297.12 |
| 87420 |
|
27 |
26 |
$288.70 |
| 84630 |
|
14 |
12 |
$283.27 |
| 76536 |
|
12 |
12 |
$282.74 |
| 96361 |
Intravenous infusion, hydration; each additional hour |
15 |
15 |
$277.70 |
| L3908 |
Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf |
57 |
54 |
$239.08 |
| 83690 |
|
30 |
28 |
$239.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
12 |
12 |
$196.61 |
| J7030 |
Infusion, normal saline solution , 1000 cc |
88 |
68 |
$193.46 |
| 82310 |
|
32 |
31 |
$191.55 |
| J9370 |
Vincristine sulfate, 1 mg |
19 |
14 |
$177.59 |
| 85007 |
|
64 |
54 |
$174.42 |
| 82043 |
|
29 |
29 |
$170.72 |
| 82104 |
|
12 |
12 |
$168.66 |
| 97802 |
|
27 |
27 |
$163.95 |
| 82103 |
|
12 |
12 |
$160.09 |
| 95004 |
Percutaneous tests with allergenic extracts, immediate type reaction |
13 |
13 |
$147.27 |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
46 |
43 |
$139.64 |
| 73130 |
|
41 |
40 |
$131.53 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
155 |
149 |
$126.80 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
209 |
201 |
$124.66 |
| 86015 |
|
12 |
12 |
$123.75 |
| 82390 |
|
12 |
12 |
$122.99 |
| 84030 |
|
30 |
25 |
$120.13 |
| 86431 |
|
13 |
12 |
$109.69 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
159 |
148 |
$106.38 |
| 82150 |
|
13 |
13 |
$100.74 |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
93 |
59 |
$90.11 |
| J2704 |
Injection, propofol, 10 mg |
193 |
189 |
$83.83 |
| J7050 |
Infusion, normal saline solution, 250 cc |
72 |
63 |
$63.49 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
90 |
81 |
$56.64 |
| 81015 |
|
12 |
12 |
$51.15 |
| Y7506 |
|
108 |
102 |
$50.84 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
31 |
25 |
$20.35 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
33 |
30 |
$14.81 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
19 |
19 |
$11.89 |
| S0020 |
Injection, bupivicaine hydrochloride, 30 ml |
33 |
33 |
$1.53 |
| Y7507 |
|
26 |
26 |
$0.00 |
| 84436 |
|
55 |
55 |
$0.00 |