| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| X4011 |
State-specific procedure code |
13,959 |
13,215 |
$4.14M |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
42,347 |
36,409 |
$2.56M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
10,828 |
9,997 |
$2.10M |
| 80053 |
Comprehensive metabolic panel |
36,321 |
31,755 |
$2.05M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
16,684 |
15,765 |
$2.01M |
| Y7506 |
|
11,533 |
9,406 |
$1.53M |
| 81001 |
|
11,506 |
10,901 |
$1.41M |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
8,396 |
7,719 |
$560K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
2,092 |
1,901 |
$549K |
| X4006 |
|
850 |
417 |
$526K |
| 71045 |
Radiologic examination, chest; single view |
7,031 |
6,518 |
$522K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
4,646 |
4,317 |
$483K |
| 36415 |
Collection of venous blood by venipuncture |
6,549 |
5,698 |
$289K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
11,928 |
11,113 |
$287K |
| 83690 |
|
4,214 |
4,004 |
$276K |
| 71046 |
Radiologic examination, chest; 2 views |
1,377 |
1,267 |
$223K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
1,005 |
768 |
$201K |
| X4003 |
|
2,037 |
739 |
$198K |
| 82150 |
|
2,673 |
2,561 |
$186K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
1,147 |
1,018 |
$177K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
611 |
506 |
$172K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
2,039 |
1,669 |
$162K |
| 87400 |
|
1,376 |
1,352 |
$155K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
5,983 |
5,630 |
$143K |
| 84484 |
|
4,019 |
3,397 |
$135K |
| 82550 |
|
3,396 |
3,178 |
$127K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
718 |
685 |
$114K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
2,300 |
1,750 |
$112K |
| Y7507 |
|
410 |
346 |
$110K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
7,517 |
7,231 |
$110K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
1,553 |
1,492 |
$110K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
801 |
327 |
$108K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
2,212 |
1,929 |
$103K |
| 93017 |
|
757 |
693 |
$102K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
1,384 |
1,268 |
$97K |
| 87081 |
|
401 |
381 |
$93K |
| 85610 |
|
2,247 |
2,074 |
$83K |
| 92507 |
Treatment of speech, language, voice, communication, and/or auditory processing disorder |
506 |
144 |
$78K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
542 |
268 |
$67K |
| 88312 |
|
908 |
727 |
$64K |
| 87581 |
|
76 |
74 |
$60K |
| 87486 |
|
76 |
74 |
$60K |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
75 |
73 |
$59K |
| 59025 |
Fetal non-stress test |
616 |
483 |
$57K |
| 87633 |
Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets |
59 |
59 |
$54K |
| 94726 |
|
416 |
388 |
$51K |
| 83735 |
|
3,386 |
2,289 |
$50K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
4,672 |
4,261 |
$49K |
| 94060 |
|
436 |
391 |
$49K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
1,371 |
1,246 |
$40K |
| 86141 |
|
768 |
711 |
$39K |
| 36591 |
|
1,989 |
902 |
$39K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
625 |
177 |
$36K |
| 85730 |
|
1,495 |
1,395 |
$35K |
| 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 |
547 |
504 |
$34K |
| 70450 |
Computed tomography, head or brain; without contrast material |
534 |
479 |
$27K |
| A9502 |
Technetium tc-99m tetrofosmin, diagnostic, per study dose |
376 |
282 |
$23K |
| U0004 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc, making use of high throughput technologies as described by cms-2020-01-r |
2,036 |
1,832 |
$20K |
| 84443 |
Thyroid stimulating hormone (TSH) |
2,292 |
1,920 |
$18K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
511 |
480 |
$17K |
| 94729 |
|
260 |
230 |
$17K |
| 95811 |
|
38 |
37 |
$16K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
118 |
39 |
$15K |
| 45385 |
Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) |
31 |
28 |
$14K |
| G0378 |
Hospital observation service, per hour |
26 |
25 |
$14K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
769 |
739 |
$14K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
740 |
715 |
$13K |
| 69436 |
Tympanostomy (requiring insertion of ventilating tube), general anesthesia |
16 |
13 |
$11K |
| 86592 |
|
451 |
409 |
$11K |
| 86900 |
|
86 |
75 |
$11K |
| 83605 |
|
167 |
153 |
$10K |
| 42820 |
Tonsillectomy and adenoidectomy; younger than age 12 |
12 |
12 |
$10K |
| 86850 |
|
100 |
88 |
$10K |
| 86901 |
|
100 |
87 |
$10K |
| 95810 |
Polysomnography; sleep staging with 4 or more additional parameters |
28 |
28 |
$10K |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
431 |
366 |
$9K |
| J3490 |
Unclassified drugs |
1,168 |
915 |
$9K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
199 |
111 |
$9K |
| J2785 |
Injection, regadenoson, 0.1 mg |
266 |
247 |
$9K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
35 |
28 |
$8K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
87 |
80 |
$7K |
| 80061 |
Lipid panel |
1,205 |
1,003 |
$7K |
| 81025 |
|
243 |
232 |
$6K |
| 85018 |
|
917 |
856 |
$6K |
| 87070 |
|
1,234 |
985 |
$6K |
| 43235 |
|
23 |
19 |
$5K |
| 84703 |
|
589 |
563 |
$5K |
| 0202U |
Oncology (prostate), multianalyte, gene expression profiling |
42 |
39 |
$5K |
| A4641 |
Radiopharmaceutical, diagnostic, not otherwise classified |
335 |
272 |
$5K |
| 83880 |
|
193 |
174 |
$5K |
| 87807 |
|
528 |
500 |
$4K |
| 87653 |
|
143 |
127 |
$4K |
| 81003 |
|
3,024 |
2,381 |
$4K |
| 66984 |
Extracapsular cataract removal with insertion of intraocular lens prosthesis |
45 |
24 |
$3K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
58 |
55 |
$3K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
43 |
41 |
$3K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
104 |
98 |
$3K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
689 |
667 |
$3K |
| 82950 |
|
179 |
162 |
$2K |
| 87634 |
|
97 |
90 |
$2K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
68 |
65 |
$2K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
325 |
297 |
$2K |
| 87905 |
|
12 |
12 |
$2K |
| 83655 |
|
235 |
221 |
$1K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
30 |
29 |
$1K |
| 87801 |
Infectious agent detection by nucleic acid; amplified probe, multiple organisms |
57 |
56 |
$1K |
| 86803 |
|
127 |
111 |
$1K |
| 84439 |
|
245 |
208 |
$993.81 |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
32 |
26 |
$969.80 |
| G0476 |
Infectious agent detection by nucleic acid (dna or rna); human papillomavirus (hpv), high-risk types (e.g., 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68) for cervical cancer screening, must be performed in addition to pap test |
66 |
57 |
$900.04 |
| C9803 |
Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
169 |
163 |
$846.16 |
| 76801 |
|
12 |
12 |
$792.12 |
| 74019 |
|
28 |
28 |
$790.16 |
| 85007 |
|
12 |
12 |
$785.88 |
| 85014 |
|
12 |
12 |
$785.88 |
| 85048 |
|
12 |
12 |
$785.88 |
| 85049 |
|
12 |
12 |
$785.88 |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
13 |
13 |
$690.69 |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
70 |
61 |
$677.95 |
| 80305 |
|
103 |
78 |
$642.53 |
| 85651 |
|
335 |
295 |
$562.09 |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
56 |
48 |
$506.79 |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
56 |
48 |
$506.79 |
| 71250 |
|
15 |
14 |
$482.74 |
| 86787 |
|
131 |
112 |
$474.23 |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
12 |
12 |
$450.34 |
| 80048 |
Basic metabolic panel (calcium, ionized) |
132 |
98 |
$392.54 |
| 36416 |
|
40 |
36 |
$333.66 |
| 88300 |
|
13 |
13 |
$189.50 |
| 87040 |
|
30 |
14 |
$163.04 |
| 86140 |
|
50 |
49 |
$117.95 |
| 83615 |
|
31 |
28 |
$103.36 |
| 82607 |
|
15 |
13 |
$86.62 |
| 82746 |
|
15 |
13 |
$84.44 |
| 82728 |
|
14 |
12 |
$66.04 |
| 84466 |
|
14 |
12 |
$61.79 |
| 83540 |
|
14 |
12 |
$31.31 |
| 82553 |
|
13 |
12 |
$20.80 |
| 82962 |
|
14 |
13 |
$17.70 |
| J7050 |
Infusion, normal saline solution, 250 cc |
14 |
12 |
$10.80 |
| A9270 |
Non-covered item or service |
168 |
153 |
$0.00 |
| 99156 |
|
108 |
58 |
$0.00 |
| 87340 |
|
13 |
13 |
$0.00 |
| 86762 |
|
12 |
12 |
$0.00 |
| 74018 |
|
14 |
12 |
$0.00 |