| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
Emergency department visit for the evaluation and management, high severity |
24,369 |
21,243 |
$4.55M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
25,372 |
21,991 |
$3.46M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
15,075 |
13,274 |
$3.40M |
| 0202U |
Oncology (prostate), multianalyte, gene expression profiling |
3,141 |
2,222 |
$406K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
2,313 |
2,218 |
$378K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
11,064 |
9,757 |
$331K |
| 0240U |
|
1,931 |
1,822 |
$276K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
37,491 |
31,288 |
$240K |
| 71045 |
Radiologic examination, chest; single view |
8,466 |
7,602 |
$228K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
15,506 |
11,203 |
$205K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
5,045 |
1,888 |
$196K |
| 80053 |
Comprehensive metabolic panel |
27,469 |
23,116 |
$192K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
304 |
291 |
$186K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
6,519 |
4,761 |
$184K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
5,550 |
4,749 |
$177K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
3,404 |
2,890 |
$160K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
2,576 |
2,309 |
$151K |
| J3490 |
Unclassified drugs |
40,696 |
17,069 |
$149K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
3,960 |
3,243 |
$135K |
| 70450 |
Computed tomography, head or brain; without contrast material |
1,366 |
1,240 |
$134K |
| 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 |
1,747 |
1,323 |
$125K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
5,825 |
5,089 |
$121K |
| 36415 |
Collection of venous blood by venipuncture |
47,983 |
40,013 |
$109K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
1,854 |
1,559 |
$99K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
5,514 |
4,429 |
$81K |
| 71046 |
Radiologic examination, chest; 2 views |
2,808 |
2,314 |
$79K |
| 80061 |
Lipid panel |
4,094 |
3,787 |
$70K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
3,029 |
2,680 |
$68K |
| 84443 |
Thyroid stimulating hormone (TSH) |
3,516 |
3,222 |
$58K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
1,468 |
1,247 |
$47K |
| 81003 |
|
22,500 |
19,749 |
$46K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
1,466 |
1,244 |
$45K |
| 87801 |
Infectious agent detection by nucleic acid; amplified probe, multiple organisms |
676 |
589 |
$45K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
83 |
77 |
$44K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
4,265 |
3,871 |
$44K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
5,642 |
5,008 |
$42K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
969 |
441 |
$40K |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
1,190 |
1,016 |
$37K |
| 81025 |
|
4,645 |
4,072 |
$34K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,451 |
1,298 |
$32K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
1,198 |
1,019 |
$32K |
| 84484 |
|
4,490 |
3,844 |
$31K |
| 83605 |
|
3,210 |
2,865 |
$31K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
2,092 |
1,887 |
$28K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
841 |
739 |
$28K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
513 |
453 |
$28K |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
771 |
669 |
$26K |
| 87070 |
|
2,609 |
2,333 |
$25K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
603 |
570 |
$25K |
| 83690 |
|
3,757 |
3,359 |
$23K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
135 |
128 |
$22K |
| 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 |
925 |
711 |
$22K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
745 |
696 |
$18K |
| 83704 |
|
612 |
561 |
$18K |
| J8499 |
Prescription drug, oral, non chemotherapeutic, nos |
9,528 |
5,072 |
$17K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
288 |
271 |
$16K |
| 87633 |
Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets |
86 |
68 |
$16K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
431 |
411 |
$15K |
| 80076 |
|
1,758 |
1,633 |
$15K |
| 83735 |
|
2,966 |
2,644 |
$15K |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
4,687 |
3,813 |
$15K |
| 82607 |
|
747 |
643 |
$14K |
| 83880 |
|
774 |
701 |
$14K |
| 82728 |
|
1,761 |
1,539 |
$13K |
| 99215 |
Prolong outpt/office vis |
611 |
540 |
$13K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
277 |
241 |
$12K |
| 84466 |
|
1,805 |
1,553 |
$12K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
462 |
379 |
$11K |
| 36591 |
|
2,135 |
1,157 |
$11K |
| J2704 |
Injection, propofol, 10 mg |
3,697 |
3,135 |
$11K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
3,772 |
3,249 |
$11K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
227 |
173 |
$11K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
1,427 |
1,222 |
$10K |
| 87806 |
|
351 |
307 |
$10K |
| 83655 |
|
489 |
403 |
$9K |
| A9150 |
Non-prescription drugs |
11,784 |
8,157 |
$9K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,085 |
546 |
$8K |
| 86592 |
|
1,552 |
1,381 |
$8K |
| 86140 |
|
2,070 |
1,869 |
$7K |
| J7050 |
Infusion, normal saline solution, 250 cc |
3,119 |
1,190 |
$7K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
308 |
78 |
$6K |
| 83540 |
|
1,809 |
1,560 |
$6K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
2,050 |
1,720 |
$6K |
| 86850 |
|
474 |
402 |
$5K |
| 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 |
129 |
115 |
$5K |
| 29581 |
|
222 |
105 |
$5K |
| 85610 |
|
1,866 |
1,640 |
$5K |
| 84703 |
|
465 |
413 |
$4K |
| 85379 |
|
673 |
627 |
$4K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
16 |
13 |
$3K |
| 88112 |
|
72 |
69 |
$3K |
| 82378 |
|
266 |
203 |
$3K |
| 85027 |
|
390 |
324 |
$3K |
| J0690 |
Injection, cefazolin sodium, 500 mg |
395 |
309 |
$3K |
| 74018 |
|
68 |
67 |
$3K |
| 87807 |
|
248 |
240 |
$3K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
700 |
605 |
$3K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
63 |
50 |
$3K |
| 86762 |
|
167 |
148 |
$2K |
| 87340 |
|
245 |
215 |
$2K |
| 95810 |
Polysomnography; sleep staging with 4 or more additional parameters |
30 |
12 |
$2K |
| Q0138 |
Injection, ferumoxytol, for treatment of iron deficiency anemia, 1 mg (non-esrd use) |
15 |
14 |
$2K |
| 74022 |
|
69 |
64 |
$2K |
| 85651 |
|
1,124 |
1,010 |
$2K |
| 83615 |
|
627 |
514 |
$2K |
| 87581 |
|
84 |
68 |
$2K |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
612 |
500 |
$2K |
| A4216 |
Sterile water, saline and/or dextrose, diluent/flush, 10 ml |
505 |
252 |
$2K |
| 86900 |
|
459 |
378 |
$2K |
| 80329 |
|
32 |
27 |
$1K |
| 88108 |
|
143 |
93 |
$1K |
| 87486 |
|
57 |
44 |
$1K |
| 82962 |
|
543 |
393 |
$1K |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
212 |
167 |
$1K |
| 86901 |
|
350 |
297 |
$1K |
| 80305 |
|
140 |
130 |
$1K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
15 |
13 |
$1K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
205 |
190 |
$1K |
| 85730 |
|
277 |
233 |
$1K |
| 83021 |
|
62 |
49 |
$1K |
| 95816 |
|
68 |
27 |
$1K |
| 72110 |
|
40 |
15 |
$924.87 |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
31 |
26 |
$862.10 |
| J2919 |
Injection, methylprednisolone sodium succinate, 5 mg |
73 |
71 |
$821.56 |
| 99238 |
Hospital discharge day management, 30 minutes or less |
17 |
13 |
$811.93 |
| 80320 |
|
51 |
41 |
$795.60 |
| 82947 |
|
185 |
170 |
$769.85 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
216 |
146 |
$746.16 |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
124 |
31 |
$698.67 |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
39 |
13 |
$667.10 |
| A9270 |
Non-covered item or service |
2,427 |
1,133 |
$605.38 |
| 73630 |
|
25 |
12 |
$599.48 |
| Q0144 |
Azithromycin dihydrate, oral, capsules/powder, 1 gram |
149 |
121 |
$551.89 |
| 95909 |
|
28 |
13 |
$504.11 |
| 87653 |
|
13 |
13 |
$495.60 |
| 84480 |
|
19 |
15 |
$442.59 |
| 82009 |
|
134 |
123 |
$442.18 |
| J1040 |
Injection, methylprednisolone acetate, 80 mg |
48 |
41 |
$405.48 |
| 82150 |
|
86 |
79 |
$396.69 |
| 82077 |
|
70 |
64 |
$390.03 |
| 97161 |
|
18 |
13 |
$374.54 |
| 84436 |
|
57 |
54 |
$352.90 |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
25 |
25 |
$324.25 |
| 85660 |
|
62 |
49 |
$316.48 |
| 87040 |
|
39 |
28 |
$316.08 |
| 82043 |
|
55 |
52 |
$293.52 |
| 95886 |
|
29 |
14 |
$290.67 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
53 |
26 |
$263.85 |
| 87077 |
|
46 |
41 |
$262.65 |
| 86735 |
|
13 |
12 |
$254.98 |
| 86765 |
|
13 |
12 |
$251.64 |
| 86787 |
|
13 |
12 |
$251.64 |
| 84479 |
|
41 |
41 |
$229.99 |
| J1642 |
Injection, heparin sodium, (heparin lock flush), per 10 units |
646 |
312 |
$207.90 |
| 84702 |
|
15 |
12 |
$207.48 |
| 97803 |
|
34 |
25 |
$194.80 |
| 87186 |
|
29 |
25 |
$187.09 |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
194 |
91 |
$186.16 |
| J7030 |
Infusion, normal saline solution , 1000 cc |
63 |
60 |
$165.24 |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
55 |
50 |
$163.82 |
| J2003 |
Injection, lidocaine hydrochloride, 1 mg |
57 |
46 |
$134.50 |
| 82140 |
|
16 |
15 |
$120.44 |
| 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 |
409 |
358 |
$119.02 |
| 94760 |
|
45 |
23 |
$106.43 |
| 85007 |
|
34 |
26 |
$95.37 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
45 |
40 |
$84.72 |
| 82570 |
|
14 |
13 |
$79.03 |
| S0020 |
Injection, bupivicaine hydrochloride, 30 ml |
16 |
16 |
$56.97 |
| J2550 |
Injection, promethazine hcl, up to 50 mg |
13 |
12 |
$48.18 |
| J0330 |
Injection, succinylcholine chloride, up to 20 mg |
19 |
14 |
$46.52 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
14 |
12 |
$34.19 |
| 94664 |
|
12 |
12 |
$28.04 |
| J0585 |
Injection, onabotulinumtoxina, 1 unit |
15 |
13 |
$5.52 |
| G1004 |
Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program |
361 |
332 |
$0.04 |