| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
165,699 |
149,740 |
$16.52M |
| X4011 |
State-specific procedure code |
12,825 |
12,055 |
$9.19M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
16,993 |
16,281 |
$5.96M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
19,250 |
18,519 |
$4.56M |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
50,903 |
44,914 |
$3.99M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
62,117 |
55,299 |
$3.67M |
| X4003 |
|
69,468 |
60,464 |
$3.20M |
| 80048 |
Basic metabolic panel (calcium, ionized) |
30,198 |
25,629 |
$2.72M |
| X4006 |
|
2,720 |
2,178 |
$2.66M |
| 81025 |
|
9,534 |
9,124 |
$1.67M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
3,564 |
3,341 |
$1.48M |
| 81001 |
|
9,225 |
8,735 |
$1.43M |
| Y7506 |
|
1,097 |
810 |
$1.14M |
| Y7507 |
|
3,509 |
3,198 |
$1.14M |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
6,328 |
5,894 |
$1.06M |
| J3490 |
Unclassified drugs |
12,510 |
9,008 |
$973K |
| 81003 |
|
21,341 |
17,485 |
$923K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
5,852 |
5,269 |
$777K |
| 71046 |
Radiologic examination, chest; 2 views |
3,473 |
3,272 |
$728K |
| 80076 |
|
7,723 |
7,187 |
$557K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
5,363 |
5,000 |
$539K |
| 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 |
13,464 |
9,170 |
$489K |
| 87631 |
|
716 |
691 |
$479K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
677 |
635 |
$421K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
2,816 |
2,663 |
$419K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
7,285 |
974 |
$341K |
| 73630 |
|
2,589 |
2,100 |
$269K |
| 83690 |
|
3,396 |
3,206 |
$262K |
| 94060 |
|
1,194 |
1,127 |
$245K |
| D7999 |
|
56 |
56 |
$244K |
| 86780 |
|
4,879 |
4,649 |
$232K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
626 |
361 |
$205K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
5,298 |
812 |
$199K |
| G0378 |
Hospital observation service, per hour |
299 |
244 |
$196K |
| 94726 |
|
1,021 |
966 |
$182K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
162 |
158 |
$163K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
2,861 |
2,543 |
$145K |
| 87088 |
|
2,813 |
2,627 |
$128K |
| 95810 |
Polysomnography; sleep staging with 4 or more additional parameters |
193 |
175 |
$121K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
974 |
953 |
$120K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
2,633 |
2,511 |
$120K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
2,237 |
2,082 |
$116K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
9,354 |
8,833 |
$115K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,547 |
1,524 |
$114K |
| 88342 |
|
667 |
624 |
$95K |
| 82948 |
|
32,853 |
1,924 |
$90K |
| 20610 |
|
708 |
604 |
$89K |
| 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 |
9,343 |
6,265 |
$88K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,156 |
1,137 |
$83K |
| 80053 |
Comprehensive metabolic panel |
5,837 |
5,528 |
$81K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
883 |
845 |
$77K |
| 90834 |
Psychotherapy, 45 minutes with patient |
749 |
413 |
$76K |
| C9803 |
Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
6,207 |
5,833 |
$75K |
| 86850 |
|
1,110 |
1,049 |
$74K |
| 80061 |
Lipid panel |
5,129 |
4,860 |
$74K |
| 86900 |
|
983 |
933 |
$68K |
| 11102 |
|
517 |
469 |
$66K |
| 86901 |
|
966 |
918 |
$62K |
| 84484 |
|
1,160 |
1,073 |
$57K |
| 71045 |
Radiologic examination, chest; single view |
1,052 |
1,002 |
$54K |
| 84443 |
Thyroid stimulating hormone (TSH) |
2,894 |
2,717 |
$52K |
| 86803 |
|
1,103 |
1,050 |
$51K |
| 87340 |
|
949 |
895 |
$46K |
| 87801 |
Infectious agent detection by nucleic acid; amplified probe, multiple organisms |
848 |
812 |
$45K |
| 95811 |
|
42 |
41 |
$41K |
| 45385 |
Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) |
37 |
36 |
$41K |
| 86762 |
|
683 |
647 |
$40K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
709 |
640 |
$36K |
| 17000 |
|
328 |
306 |
$34K |
| 0001A |
|
1,056 |
944 |
$34K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
1,268 |
1,168 |
$31K |
| 94729 |
|
773 |
721 |
$31K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
364 |
329 |
$29K |
| 17110 |
|
198 |
189 |
$29K |
| 0002A |
|
847 |
771 |
$28K |
| 87081 |
|
171 |
168 |
$27K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
76 |
74 |
$27K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
8,692 |
7,709 |
$26K |
| 20611 |
|
117 |
97 |
$26K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
234 |
220 |
$24K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
233 |
219 |
$24K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
262 |
246 |
$24K |
| 73030 |
|
375 |
325 |
$22K |
| 85610 |
|
3,547 |
1,724 |
$21K |
| 88142 |
|
468 |
454 |
$21K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
154 |
151 |
$21K |
| 83516 |
|
780 |
503 |
$20K |
| 72110 |
|
247 |
227 |
$20K |
| 84439 |
|
949 |
896 |
$20K |
| 97116 |
|
333 |
54 |
$18K |
| 11900 |
|
155 |
143 |
$18K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
118 |
113 |
$15K |
| 85730 |
|
152 |
147 |
$15K |
| 82950 |
|
486 |
467 |
$13K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
130 |
127 |
$13K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
174 |
172 |
$12K |
| 59025 |
Fetal non-stress test |
81 |
67 |
$11K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
56 |
55 |
$10K |
| 83880 |
|
298 |
275 |
$10K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
31 |
27 |
$9K |
| 90832 |
Psychotherapy, 30 minutes with patient |
105 |
48 |
$9K |
| 64483 |
|
13 |
12 |
$9K |
| 82607 |
|
275 |
240 |
$8K |
| 0004A |
|
254 |
162 |
$8K |
| 72050 |
|
89 |
86 |
$7K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
46 |
30 |
$7K |
| 45378 |
Colonoscopy, flexible; diagnostic, including collection of specimen(s) |
12 |
12 |
$7K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
183 |
121 |
$7K |
| 73564 |
|
83 |
63 |
$7K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
37 |
37 |
$6K |
| 87070 |
|
527 |
499 |
$6K |
| 92002 |
|
86 |
82 |
$5K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
46 |
45 |
$5K |
| 87205 |
|
639 |
609 |
$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 |
67 |
63 |
$5K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
64 |
63 |
$4K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
60 |
53 |
$4K |
| 82784 |
|
352 |
331 |
$4K |
| 73502 |
|
43 |
38 |
$4K |
| 86481 |
|
39 |
39 |
$4K |
| 80050 |
General health panel |
38 |
38 |
$4K |
| 76801 |
|
40 |
40 |
$4K |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
106 |
104 |
$4K |
| 0011A |
|
128 |
116 |
$4K |
| 83735 |
|
644 |
519 |
$3K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
61 |
60 |
$3K |
| 97535 |
Self-care/home management training, each 15 minutes |
277 |
89 |
$3K |
| 0013A |
|
66 |
64 |
$3K |
| 70450 |
Computed tomography, head or brain; without contrast material |
28 |
27 |
$3K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
40 |
36 |
$3K |
| 11721 |
|
931 |
823 |
$3K |
| 83655 |
|
309 |
299 |
$2K |
| 73610 |
|
43 |
36 |
$2K |
| 82550 |
|
734 |
628 |
$2K |
| 11056 |
|
22 |
15 |
$2K |
| 97165 |
|
55 |
41 |
$2K |
| 0012A |
|
75 |
71 |
$2K |
| 86787 |
|
44 |
42 |
$2K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
52 |
12 |
$2K |
| 98928 |
|
208 |
189 |
$2K |
| 76830 |
Ultrasound, transvaginal |
27 |
25 |
$2K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
19 |
19 |
$2K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
21 |
12 |
$2K |
| 0054A |
|
45 |
44 |
$2K |
| 86140 |
|
428 |
372 |
$2K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
13 |
12 |
$2K |
| 82728 |
|
108 |
101 |
$1K |
| 0003A |
|
32 |
32 |
$1K |
| 84466 |
|
103 |
97 |
$1K |
| 0071A |
|
65 |
46 |
$1K |
| 71250 |
|
29 |
27 |
$1K |
| 85651 |
|
378 |
327 |
$1K |
| 11055 |
|
13 |
12 |
$1K |
| 99460 |
|
13 |
13 |
$1K |
| 87210 |
|
202 |
195 |
$1K |
| 90480 |
|
28 |
27 |
$962.06 |
| 83020 |
|
24 |
24 |
$875.14 |
| 86704 |
|
56 |
54 |
$766.32 |
| 99238 |
Hospital discharge day management, 30 minutes or less |
13 |
13 |
$718.90 |
| 86706 |
|
68 |
66 |
$695.48 |
| 86708 |
|
54 |
52 |
$693.37 |
| 83540 |
|
102 |
96 |
$659.90 |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
12 |
12 |
$550.00 |
| 82247 |
|
16 |
13 |
$511.27 |
| 41899 |
Unlisted procedure, dentoalveolar structures |
82 |
68 |
$443.13 |
| 93296 |
|
15 |
15 |
$416.87 |
| 87641 |
|
12 |
12 |
$373.05 |
| 84702 |
|
28 |
27 |
$353.87 |
| 36415 |
Collection of venous blood by venipuncture |
2,587 |
1,593 |
$318.05 |
| 90837 |
Psychotherapy, 53 minutes with patient |
15 |
13 |
$276.21 |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
30 |
29 |
$257.59 |
| 84100 |
|
37 |
28 |
$237.56 |
| 85018 |
|
179 |
176 |
$236.91 |
| 86376 |
|
12 |
12 |
$193.24 |
| 82103 |
|
13 |
12 |
$163.37 |
| 82390 |
|
12 |
12 |
$142.62 |
| 82570 |
|
25 |
24 |
$102.14 |
| 85379 |
|
57 |
34 |
$99.47 |
| 82977 |
|
12 |
12 |
$97.75 |
| Q3014 |
Telehealth originating site facility fee |
19 |
16 |
$69.81 |
| 98927 |
|
12 |
12 |
$38.65 |
| 87186 |
|
14 |
12 |
$34.12 |
| 84156 |
|
12 |
12 |
$8.75 |
| G0008 |
Administration of influenza virus vaccine |
234 |
214 |
$5.64 |
| 17003 |
|
114 |
75 |
$0.00 |
| XXXXX |
|
69 |
55 |
$0.00 |
| 0250 |
|
54 |
40 |
$0.00 |