| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
49,260 |
43,178 |
$9.32M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
36,815 |
31,156 |
$6.46M |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
10,615 |
9,681 |
$1.95M |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
6,848 |
6,134 |
$1.49M |
| 70450 |
Computed tomography, head or brain; without contrast material |
6,373 |
5,718 |
$1.29M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
6,718 |
5,834 |
$1.17M |
| G0378 |
Hospital observation service, per hour |
6,259 |
3,540 |
$829K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
3,371 |
2,992 |
$707K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
2,361 |
2,144 |
$661K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
2,843 |
2,491 |
$644K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
1,044 |
994 |
$605K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
3,238 |
3,003 |
$593K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
8,112 |
2,166 |
$401K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
1,002 |
913 |
$357K |
| G0383 |
Level 4 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room or emergency department; (2) it is held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment; or (3) during the calendar year immediately preceding the calendar year in which a determination under 42 cfr 489.24 is being made, based on a representative sample of patient visits that occurred during that calendar year, it provides at least one-third of all of its outpatient visits for the treatment of emergency medical conditions on an urgent basis without requiring a previously scheduled appointment) |
1,530 |
1,196 |
$257K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
5,064 |
4,463 |
$231K |
| 76830 |
Ultrasound, transvaginal |
2,273 |
2,101 |
$221K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
2,022 |
1,795 |
$217K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
2,446 |
2,229 |
$216K |
| 76818 |
|
2,502 |
1,214 |
$216K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
2,658 |
2,436 |
$177K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
282 |
276 |
$175K |
| 59025 |
Fetal non-stress test |
910 |
755 |
$175K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
3,620 |
2,831 |
$161K |
| 80053 |
Comprehensive metabolic panel |
39,567 |
32,503 |
$160K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
884 |
806 |
$141K |
| 93971 |
|
1,455 |
1,308 |
$135K |
| 76801 |
|
2,245 |
1,968 |
$118K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
1,028 |
1,002 |
$111K |
| 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 |
4,779 |
4,305 |
$106K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
913 |
888 |
$102K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
1,385 |
1,257 |
$86K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
540 |
523 |
$79K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
1,591 |
1,440 |
$73K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
1,755 |
1,700 |
$72K |
| 97162 |
|
448 |
430 |
$72K |
| 71046 |
Radiologic examination, chest; 2 views |
12,781 |
11,436 |
$70K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
24,962 |
20,762 |
$59K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
1,987 |
1,725 |
$55K |
| 97164 |
|
243 |
224 |
$54K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
225 |
203 |
$53K |
| 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 |
3,151 |
2,761 |
$52K |
| 45385 |
Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) |
54 |
54 |
$46K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
8,686 |
6,710 |
$39K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
20,957 |
17,015 |
$38K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
3,632 |
1,223 |
$35K |
| 85027 |
|
50,124 |
38,506 |
$34K |
| 71045 |
Radiologic examination, chest; single view |
12,387 |
10,672 |
$32K |
| 87040 |
|
4,206 |
3,265 |
$32K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
1,743 |
1,689 |
$31K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
1,002 |
572 |
$30K |
| 83880 |
|
3,996 |
3,276 |
$26K |
| 84484 |
|
14,996 |
11,262 |
$25K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
12,265 |
9,961 |
$22K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
6,616 |
5,796 |
$21K |
| 71250 |
|
305 |
283 |
$20K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
263 |
243 |
$20K |
| 12001 |
|
88 |
85 |
$17K |
| 85379 |
|
3,638 |
3,317 |
$16K |
| 97163 |
|
85 |
77 |
$15K |
| G0279 |
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) |
415 |
382 |
$15K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
93 |
91 |
$14K |
| 76642 |
|
90 |
89 |
$14K |
| 70496 |
|
40 |
39 |
$14K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
1,573 |
1,424 |
$13K |
| 72131 |
|
154 |
147 |
$12K |
| 74018 |
|
1,541 |
1,423 |
$12K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
19,060 |
15,204 |
$11K |
| 73030 |
|
1,496 |
1,310 |
$11K |
| 97535 |
Self-care/home management training, each 15 minutes |
343 |
290 |
$10K |
| 73564 |
|
1,767 |
1,508 |
$9K |
| 83605 |
|
4,304 |
3,579 |
$9K |
| 93970 |
|
82 |
76 |
$9K |
| 72110 |
|
642 |
588 |
$8K |
| 76770 |
|
84 |
76 |
$8K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
138 |
118 |
$8K |
| 81001 |
|
19,420 |
16,617 |
$8K |
| 84443 |
Thyroid stimulating hormone (TSH) |
4,450 |
3,955 |
$7K |
| 70486 |
|
84 |
82 |
$7K |
| 97116 |
|
311 |
167 |
$7K |
| 97032 |
|
133 |
49 |
$7K |
| 73630 |
|
2,019 |
1,785 |
$7K |
| 73610 |
|
1,902 |
1,705 |
$7K |
| 83690 |
|
14,214 |
11,962 |
$6K |
| 73130 |
|
1,670 |
1,467 |
$6K |
| 80076 |
|
1,364 |
1,125 |
$6K |
| 10060 |
|
33 |
24 |
$6K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
28 |
24 |
$6K |
| 84702 |
|
4,820 |
4,053 |
$5K |
| 76536 |
|
37 |
36 |
$5K |
| 72100 |
|
519 |
478 |
$5K |
| 83735 |
|
6,200 |
4,880 |
$5K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
2,440 |
2,285 |
$4K |
| 84703 |
|
9,721 |
8,628 |
$4K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
16,141 |
13,321 |
$4K |
| 86850 |
|
2,202 |
1,948 |
$4K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
13,226 |
9,285 |
$4K |
| 73110 |
|
770 |
700 |
$4K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
14 |
12 |
$3K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
139 |
65 |
$3K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
11,394 |
10,520 |
$3K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
4,949 |
4,309 |
$3K |
| 85610 |
|
6,421 |
5,411 |
$3K |
| 70491 |
|
16 |
15 |
$3K |
| 80061 |
Lipid panel |
1,117 |
990 |
$3K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
13,894 |
10,850 |
$3K |
| 97161 |
|
29 |
25 |
$3K |
| 80051 |
|
1,650 |
1,307 |
$3K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
1,106 |
983 |
$3K |
| 86900 |
|
3,271 |
2,920 |
$3K |
| J1170 |
Injection, hydromorphone, up to 4 mg |
3,790 |
2,114 |
$3K |
| 96376 |
|
2,370 |
1,842 |
$2K |
| 87070 |
|
4,839 |
4,403 |
$2K |
| 82565 |
|
1,891 |
1,522 |
$2K |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
5,376 |
4,507 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
10,327 |
9,508 |
$2K |
| 81025 |
|
6,882 |
6,252 |
$2K |
| 90715 |
|
77 |
75 |
$2K |
| 73502 |
|
277 |
237 |
$2K |
| 90714 |
|
78 |
74 |
$2K |
| 70498 |
|
37 |
37 |
$2K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
11,428 |
9,034 |
$2K |
| 86901 |
|
3,270 |
2,918 |
$1K |
| 94729 |
|
43 |
41 |
$1K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
998 |
853 |
$1K |
| 71271 |
|
13 |
13 |
$1K |
| 77066 |
Tomosynthesis, mammo |
67 |
65 |
$1K |
| 82947 |
|
1,638 |
1,307 |
$1K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
1,480 |
1,344 |
$1K |
| 81003 |
|
9,510 |
8,519 |
$1K |
| 36415 |
Collection of venous blood by venipuncture |
719 |
537 |
$1K |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
1,635 |
860 |
$1K |
| 84145 |
|
62 |
53 |
$1K |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
1,281 |
1,129 |
$980.55 |
| 94060 |
|
30 |
29 |
$967.61 |
| 87210 |
|
1,184 |
964 |
$930.06 |
| 87807 |
|
3,887 |
3,579 |
$927.47 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
4,332 |
3,401 |
$826.29 |
| 85730 |
|
2,939 |
2,481 |
$790.58 |
| 84520 |
|
1,649 |
1,306 |
$772.04 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
5,429 |
4,816 |
$707.30 |
| 73590 |
|
209 |
185 |
$685.70 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
6,290 |
4,444 |
$623.79 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
4,639 |
3,687 |
$530.35 |
| 94726 |
|
15 |
15 |
$511.87 |
| 82550 |
|
679 |
557 |
$474.15 |
| J2060 |
Injection, lorazepam, 2 mg |
1,725 |
1,232 |
$362.43 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
2,185 |
1,874 |
$351.90 |
| 86140 |
|
361 |
329 |
$301.20 |
| 94621 |
|
13 |
12 |
$292.50 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
3,699 |
2,797 |
$274.45 |
| 87186 |
|
1,556 |
1,338 |
$256.04 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
2,224 |
1,958 |
$254.34 |
| 87077 |
|
1,558 |
1,356 |
$249.74 |
| Q9966 |
Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml |
808 |
667 |
$247.47 |
| 87081 |
|
1,482 |
1,435 |
$243.14 |
| 84439 |
|
58 |
54 |
$181.76 |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
24 |
19 |
$142.29 |
| J7050 |
Infusion, normal saline solution, 250 cc |
1,595 |
1,274 |
$140.02 |
| S0119 |
Ondansetron, oral, 4 mg (for circumstances falling under the medicare statute, use hcpcs q code) |
1,570 |
1,439 |
$119.93 |
| J2550 |
Injection, promethazine hcl, up to 50 mg |
1,100 |
834 |
$118.61 |
| J1815 |
Injection, insulin, per 5 units |
1,575 |
751 |
$111.18 |
| 73080 |
|
56 |
50 |
$108.79 |
| 73060 |
|
15 |
14 |
$95.27 |
| 73090 |
|
107 |
100 |
$95.27 |
| 84100 |
|
362 |
301 |
$87.12 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
1,054 |
845 |
$75.08 |
| J1644 |
Injection, heparin sodium, per 1000 units |
1,211 |
536 |
$74.65 |
| 72040 |
|
12 |
12 |
$67.41 |
| 73560 |
|
45 |
41 |
$67.40 |
| 84550 |
|
66 |
61 |
$44.79 |
| 85652 |
|
35 |
31 |
$44.34 |
| 84112 |
|
14 |
14 |
$42.03 |
| 82728 |
|
13 |
12 |
$37.17 |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
645 |
532 |
$31.89 |
| 88304 |
|
57 |
54 |
$29.07 |
| J7611 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, concentrated form, 1 mg |
764 |
708 |
$27.50 |
| 87147 |
|
83 |
72 |
$22.74 |
| 82803 |
|
406 |
336 |
$20.96 |
| 83550 |
|
14 |
12 |
$18.57 |
| 87205 |
|
104 |
93 |
$18.35 |
| 82272 |
|
18 |
17 |
$16.59 |
| 83540 |
|
14 |
12 |
$16.59 |
| 82570 |
|
12 |
12 |
$12.88 |
| 80047 |
|
176 |
163 |
$11.03 |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
282 |
249 |
$5.88 |
| 85384 |
|
15 |
14 |
$5.26 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
376 |
301 |
$5.03 |
| J0360 |
Injection, hydralazine hcl, up to 20 mg |
90 |
61 |
$3.60 |
| J7644 |
Ipratropium bromide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per milligram |
302 |
275 |
$3.50 |
| J2360 |
Injection, orphenadrine citrate, up to 60 mg |
13 |
12 |
$1.20 |
| J1630 |
Injection, haloperidol, up to 5 mg |
15 |
12 |
$0.96 |
| 99152 |
|
27 |
25 |
$0.00 |
| 82010 |
|
17 |
12 |
$0.00 |
| G1003 |
Clinical decision support mechanism medicalis, as defined by the medicare appropriate use criteria program |
200 |
167 |
$0.00 |
| S4991 |
Nicotine patches, non-legend |
104 |
52 |
$0.00 |
| S0028 |
Injection, famotidine, 20 mg |
311 |
285 |
$0.00 |
| C9113 |
Injection, pantoprazole sodium, per vial |
101 |
72 |
$0.00 |
| C1894 |
Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser |
50 |
42 |
$0.00 |
| 73140 |
|
60 |
56 |
$0.00 |
| J1171 |
Injection, hydromorphone, 0.1 mg |
115 |
73 |
$0.00 |
| J7510 |
Prednisolone oral, per 5 mg |
174 |
172 |
$0.00 |
| J2919 |
Injection, methylprednisolone sodium succinate, 5 mg |
137 |
102 |
$0.00 |
| 88312 |
|
59 |
56 |
$0.00 |
| 82248 |
|
16 |
12 |
$0.00 |
| A9270 |
Non-covered item or service |
3,599 |
961 |
$0.00 |
| 86308 |
|
54 |
52 |
$0.00 |
| A9579 |
Injection, gadolinium-based magnetic resonance contrast agent, not otherwise specified (nos), per ml |
325 |
170 |
$0.00 |
| J7620 |
Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme |
728 |
609 |
$0.00 |
| 82150 |
|
380 |
356 |
$0.00 |
| J3490 |
Unclassified drugs |
763 |
658 |
$0.00 |
| J2543 |
Injection, piperacillin sodium/tazobactam sodium, 1 gram/0.125 grams (1.125 grams) |
435 |
260 |
$0.00 |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
224 |
210 |
$0.00 |
| 87088 |
|
16 |
15 |
$0.00 |
| J2704 |
Injection, propofol, 10 mg |
158 |
128 |
$0.00 |
| J2003 |
Injection, lidocaine hydrochloride, 1 mg |
85 |
58 |
$0.00 |
| J0500 |
Injection, dicyclomine hcl, up to 20 mg |
20 |
16 |
$0.00 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
18 |
12 |
$0.00 |
| C1769 |
Guide wire |
65 |
56 |
$0.00 |
| A9500 |
Technetium tc-99m sestamibi, diagnostic, per study dose |
14 |
12 |
$0.00 |
| 36000 |
|
12 |
12 |
$0.00 |
| J2470 |
Injection, pantoprazole sodium, 40 mg |
67 |
48 |
$0.00 |
| 99153 |
Mod sedat endo service >5yrs |
14 |
13 |
$0.00 |
| J3480 |
Injection, potassium chloride, per 2 meq |
13 |
12 |
$0.00 |
| J8540 |
Dexamethasone, oral, 0.25 mg |
14 |
12 |
$0.00 |
| 71101 |
|
24 |
24 |
$0.00 |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
12 |
12 |
$0.00 |