| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
Emergency department visit for the evaluation and management, high severity |
62,724 |
57,448 |
$24.64M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
50,264 |
46,109 |
$10.97M |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
20,908 |
19,434 |
$3.27M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
5,084 |
4,439 |
$2.40M |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
77,034 |
68,181 |
$2.30M |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
15,809 |
14,374 |
$693K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
5,577 |
5,193 |
$682K |
| 71045 |
Radiologic examination, chest; single view |
12,930 |
11,950 |
$668K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
14,603 |
12,839 |
$615K |
| 41899 |
Unlisted procedure, dentoalveolar structures |
786 |
725 |
$508K |
| G0378 |
Hospital observation service, per hour |
6,132 |
4,444 |
$504K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
851 |
760 |
$485K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
54,249 |
46,656 |
$449K |
| 59025 |
Fetal non-stress test |
3,457 |
2,796 |
$441K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
4,989 |
4,456 |
$363K |
| 93303 |
Transthoracic echocardiography for congenital cardiac anomalies, follow-up or limited study |
916 |
771 |
$335K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
14,440 |
12,516 |
$314K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
36,911 |
33,476 |
$310K |
| J1745 |
Injection, infliximab, excludes biosimilar, 10 mg |
54 |
50 |
$300K |
| G0379 |
Direct admission of patient for hospital observation care |
4,379 |
3,728 |
$292K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
386 |
358 |
$283K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
5,667 |
5,027 |
$241K |
| 80053 |
Comprehensive metabolic panel |
25,413 |
21,110 |
$237K |
| J3490 |
Unclassified drugs |
133,957 |
58,222 |
$227K |
| 84443 |
Thyroid stimulating hormone (TSH) |
10,448 |
9,317 |
$224K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
5,008 |
4,597 |
$201K |
| 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 |
2,271 |
1,902 |
$182K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
958 |
821 |
$181K |
| 70450 |
Computed tomography, head or brain; without contrast material |
667 |
613 |
$181K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
5,803 |
4,951 |
$179K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
5,803 |
4,951 |
$176K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
622 |
583 |
$175K |
| 99215 |
Prolong outpt/office vis |
4,796 |
4,393 |
$162K |
| 93325 |
|
1,065 |
911 |
$151K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
4,817 |
4,076 |
$143K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
10,137 |
8,992 |
$139K |
| 36415 |
Collection of venous blood by venipuncture |
43,388 |
37,347 |
$131K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
10,047 |
8,994 |
$128K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
1,658 |
1,062 |
$127K |
| 97803 |
|
1,410 |
1,278 |
$114K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
2,593 |
2,327 |
$111K |
| 93320 |
|
903 |
758 |
$104K |
| 94760 |
|
6,329 |
5,620 |
$103K |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
2,506 |
2,337 |
$92K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
1,312 |
1,121 |
$90K |
| 84439 |
|
6,796 |
6,251 |
$88K |
| 97802 |
|
829 |
758 |
$87K |
| 85027 |
|
11,543 |
10,114 |
$84K |
| 80076 |
|
9,393 |
8,537 |
$83K |
| 81025 |
|
8,802 |
7,875 |
$74K |
| 80061 |
Lipid panel |
3,922 |
3,589 |
$72K |
| 81001 |
|
18,302 |
16,437 |
$71K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
1,790 |
1,677 |
$68K |
| 87536 |
|
1,558 |
1,450 |
$64K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
3,379 |
3,040 |
$62K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
5,844 |
5,153 |
$58K |
| 94060 |
|
306 |
278 |
$55K |
| 83690 |
|
6,801 |
6,239 |
$52K |
| 88184 |
|
1,308 |
1,213 |
$51K |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
1,459 |
1,308 |
$50K |
| 87631 |
|
425 |
370 |
$48K |
| 94010 |
|
962 |
886 |
$47K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
77 |
64 |
$47K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
1,082 |
442 |
$45K |
| 0002A |
|
1,001 |
927 |
$45K |
| 86800 |
|
1,874 |
1,729 |
$45K |
| 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 |
1,737 |
1,450 |
$45K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
1,343 |
1,205 |
$43K |
| 86850 |
|
3,043 |
2,471 |
$43K |
| 0001A |
|
981 |
917 |
$42K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
3,884 |
3,268 |
$40K |
| 95819 |
|
169 |
158 |
$40K |
| 84403 |
|
1,049 |
960 |
$39K |
| 86376 |
|
1,868 |
1,728 |
$39K |
| 86780 |
|
1,997 |
1,767 |
$36K |
| 83002 |
|
1,280 |
1,172 |
$34K |
| D0272 |
Bitewings - two radiographic images |
132 |
124 |
$34K |
| 83001 |
|
1,264 |
1,155 |
$33K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
6,852 |
6,242 |
$31K |
| D2930 |
Prefabricated stainless steel crown - primary tooth |
111 |
104 |
$30K |
| 88185 |
|
1,308 |
1,213 |
$30K |
| 82670 |
|
885 |
787 |
$30K |
| D0220 |
Intraoral - periapical first radiographic image |
118 |
110 |
$30K |
| 86762 |
|
1,727 |
1,392 |
$29K |
| 86803 |
|
1,777 |
1,434 |
$29K |
| 86787 |
|
1,797 |
1,476 |
$27K |
| D3220 |
Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction |
91 |
87 |
$27K |
| G0481 |
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; 8-14 drug class(es), including metabolite(s) if performed |
299 |
257 |
$26K |
| D1206 |
Topical application of fluoride varnish |
125 |
117 |
$26K |
| 76801 |
|
497 |
368 |
$25K |
| 95012 |
|
743 |
675 |
$25K |
| D0230 |
Intraoral - periapical each additional radiographic image |
130 |
108 |
$25K |
| 82784 |
|
1,831 |
1,690 |
$24K |
| 97161 |
|
350 |
316 |
$23K |
| 83655 |
|
1,617 |
1,314 |
$23K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
923 |
836 |
$22K |
| 82533 |
|
822 |
748 |
$21K |
| 83525 |
|
1,169 |
1,072 |
$20K |
| 80306 |
|
1,293 |
1,067 |
$19K |
| 76770 |
|
129 |
96 |
$19K |
| 86592 |
|
3,727 |
3,124 |
$19K |
| 87340 |
|
1,661 |
1,341 |
$17K |
| 83735 |
|
2,602 |
2,354 |
$17K |
| 82728 |
|
1,040 |
940 |
$16K |
| J1439 |
Injection, ferric carboxymaltose, 1 mg |
28 |
25 |
$15K |
| 99205 |
Prolong outpt/office vis |
414 |
373 |
$15K |
| J2704 |
Injection, propofol, 10 mg |
2,173 |
2,005 |
$15K |
| 81220 |
CFTR (cystic fibrosis transmembrane conductance regulator) gene analysis; common variants |
32 |
28 |
$15K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
240 |
221 |
$15K |
| G0108 |
Diabetes outpatient self-management training services, individual, per 30 minutes |
303 |
273 |
$14K |
| 95018 |
|
29 |
28 |
$14K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
89 |
69 |
$13K |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
886 |
795 |
$12K |
| 85045 |
|
853 |
777 |
$12K |
| 83520 |
|
626 |
584 |
$12K |
| 84305 |
|
581 |
542 |
$11K |
| 84484 |
|
1,077 |
890 |
$11K |
| 83021 |
|
554 |
422 |
$11K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
898 |
786 |
$11K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
2,909 |
2,663 |
$11K |
| 82657 |
|
377 |
356 |
$11K |
| 71046 |
Radiologic examination, chest; 2 views |
104 |
97 |
$11K |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
367 |
327 |
$10K |
| 84445 |
|
128 |
122 |
$10K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
56 |
43 |
$10K |
| 87081 |
|
1,249 |
1,090 |
$10K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
147 |
142 |
$10K |
| 83516 |
|
585 |
516 |
$10K |
| 76830 |
Ultrasound, transvaginal |
88 |
67 |
$9K |
| 86255 |
|
568 |
505 |
$9K |
| J7050 |
Infusion, normal saline solution, 250 cc |
1,570 |
663 |
$9K |
| 82950 |
|
1,434 |
1,271 |
$9K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
20 |
12 |
$9K |
| 81003 |
|
3,018 |
2,703 |
$8K |
| 83540 |
|
809 |
740 |
$8K |
| 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 |
289 |
180 |
$8K |
| 86361 |
|
157 |
152 |
$7K |
| 86140 |
|
834 |
772 |
$7K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
1,070 |
937 |
$6K |
| 83020 |
|
398 |
340 |
$6K |
| 86003 |
|
45 |
43 |
$6K |
| 90715 |
|
939 |
823 |
$6K |
| 86900 |
|
1,414 |
1,143 |
$6K |
| 81420 |
Fetal chromosomal aneuploidy genomic sequence analysis panel |
14 |
13 |
$6K |
| 86901 |
|
1,415 |
1,143 |
$5K |
| 0031A |
|
139 |
137 |
$5K |
| 83550 |
|
435 |
402 |
$5K |
| J0134 |
Injection, acetaminophen (fresenius kabi), not therapeutically equivalent to j0131, 10 mg |
80 |
72 |
$4K |
| 90674 |
|
930 |
833 |
$4K |
| 85652 |
|
905 |
833 |
$4K |
| 82248 |
|
461 |
406 |
$4K |
| 83615 |
|
454 |
389 |
$4K |
| 84480 |
|
159 |
146 |
$4K |
| 85660 |
|
554 |
422 |
$3K |
| 0071A |
|
92 |
70 |
$3K |
| D1351 |
Sealant - per tooth |
13 |
12 |
$3K |
| 0072A |
|
80 |
60 |
$3K |
| J1642 |
Injection, heparin sodium, (heparin lock flush), per 10 units |
2,195 |
1,240 |
$3K |
| 82570 |
|
404 |
363 |
$3K |
| 95816 |
|
13 |
12 |
$3K |
| 93242 |
|
17 |
16 |
$3K |
| 87633 |
Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets |
35 |
34 |
$2K |
| 93798 |
|
89 |
14 |
$2K |
| 94761 |
|
57 |
53 |
$2K |
| J1170 |
Injection, hydromorphone, up to 4 mg |
342 |
297 |
$2K |
| 90686 |
|
742 |
620 |
$2K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
47 |
45 |
$2K |
| 84156 |
|
370 |
317 |
$2K |
| 81243 |
|
32 |
28 |
$2K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
38 |
14 |
$2K |
| 87486 |
|
35 |
34 |
$2K |
| 87581 |
|
35 |
34 |
$2K |
| 86364 |
|
1,224 |
1,150 |
$1K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
16 |
14 |
$1K |
| 82043 |
|
138 |
125 |
$1K |
| 96415 |
|
28 |
24 |
$1K |
| 84550 |
|
244 |
200 |
$1K |
| 86231 |
|
1,041 |
980 |
$985.78 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
51 |
40 |
$967.22 |
| 0124A |
|
29 |
26 |
$858.92 |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
13 |
13 |
$849.68 |
| 81329 |
|
16 |
14 |
$713.76 |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
43 |
37 |
$705.58 |
| 77336 |
|
28 |
12 |
$625.91 |
| 84702 |
|
49 |
39 |
$625.78 |
| 80299 |
|
60 |
52 |
$578.20 |
| 85007 |
|
105 |
73 |
$569.88 |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
15 |
13 |
$532.29 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
12 |
12 |
$340.56 |
| 81596 |
|
16 |
14 |
$320.94 |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
15 |
14 |
$318.43 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
18 |
12 |
$310.59 |
| Q0111 |
Wet mounts, including preparations of vaginal, cervical or skin specimens |
71 |
66 |
$301.68 |
| J3535 |
Drug administered through a metered dose inhaler |
67 |
61 |
$273.58 |
| 90670 |
|
234 |
200 |
$259.15 |
| J2920 |
Injection, methylprednisolone sodium succinate, up to 40 mg |
40 |
36 |
$238.50 |
| J1171 |
Injection, hydromorphone, 0.1 mg |
24 |
17 |
$237.73 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
120 |
109 |
$222.35 |
| 82947 |
|
42 |
39 |
$179.56 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
45 |
40 |
$133.08 |
| 83992 |
|
62 |
50 |
$91.94 |
| A9585 |
Injection, gadobutrol, 0.1 ml |
20 |
12 |
$88.51 |
| 90474 |
|
12 |
12 |
$86.41 |
| 82270 |
|
12 |
12 |
$65.02 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
54 |
52 |
$58.29 |
| J1644 |
Injection, heparin sodium, per 1000 units |
75 |
36 |
$56.38 |
| 85014 |
|
16 |
12 |
$41.34 |
| 85018 |
|
16 |
12 |
$41.34 |
| J8540 |
Dexamethasone, oral, 0.25 mg |
105 |
62 |
$34.95 |
| J8597 |
Antiemetic drug, oral, not otherwise specified |
532 |
428 |
$29.60 |
| J8499 |
Prescription drug, oral, non chemotherapeutic, nos |
255 |
154 |
$16.95 |
| G0008 |
Administration of influenza virus vaccine |
31 |
31 |
$9.35 |
| 84132 |
|
29 |
26 |
$6.01 |
| 91300 |
|
1,981 |
1,613 |
$5.83 |
| 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 |
14 |
14 |
$3.79 |
| 91307 |
|
174 |
132 |
$0.48 |
| 91312 |
|
28 |
26 |
$0.00 |
| 90681 |
|
24 |
24 |
$0.00 |
| 90633 |
|
15 |
12 |
$0.00 |
| A0429 |
Ambulance service, basic life support, emergency transport (bls-emergency) |
14 |
12 |
$0.00 |
| 90647 |
|
87 |
76 |
$0.00 |
| 91303 |
|
139 |
137 |
$0.00 |
| A0427 |
Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) |
68 |
57 |
$0.00 |
| 91301 |
|
18 |
16 |
$0.00 |
| 90723 |
|
115 |
100 |
$0.00 |
| 90680 |
|
12 |
12 |
$0.00 |