| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
258,588 |
221,277 |
$22.45M |
| 96361 |
Intravenous infusion, hydration; each additional hour |
62,162 |
47,623 |
$17.89M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
129,913 |
113,164 |
$17.84M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
147,752 |
135,068 |
$17.45M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
73,480 |
60,186 |
$11.70M |
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
82,003 |
8,590 |
$5.03M |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
14,073 |
10,711 |
$3.82M |
| 70450 |
Computed tomography, head or brain; without contrast material |
13,062 |
10,343 |
$3.35M |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
7,332 |
6,181 |
$3.02M |
| G0378 |
Hospital observation service, per hour |
35,709 |
12,404 |
$2.92M |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
37,111 |
12,328 |
$2.68M |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
14,453 |
7,705 |
$2.48M |
| J9271 |
Injection, pembrolizumab, 1 mg |
228 |
133 |
$2.24M |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
10,238 |
8,318 |
$1.93M |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
6,894 |
5,113 |
$1.90M |
| 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 |
10,497 |
8,181 |
$1.39M |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
6,477 |
2,926 |
$1.35M |
| 90791 |
Psychiatric diagnostic evaluation |
6,530 |
5,858 |
$1.35M |
| 80053 |
Comprehensive metabolic panel |
131,471 |
104,731 |
$1.18M |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
2,926 |
2,460 |
$1.07M |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
10,720 |
10,073 |
$1.04M |
| 47562 |
|
462 |
338 |
$989K |
| 45385 |
Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) |
1,806 |
1,478 |
$930K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
44,961 |
30,108 |
$927K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
3,105 |
2,295 |
$865K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
7,523 |
4,042 |
$853K |
| 95810 |
Polysomnography; sleep staging with 4 or more additional parameters |
1,218 |
1,054 |
$786K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
15,577 |
7,242 |
$711K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
5,993 |
5,035 |
$699K |
| 58571 |
|
330 |
207 |
$698K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
2,853 |
2,427 |
$698K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
95,516 |
76,861 |
$695K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
20,732 |
17,513 |
$693K |
| 95886 |
|
1,908 |
1,661 |
$688K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
5,119 |
4,248 |
$682K |
| 77386 |
|
1,942 |
174 |
$667K |
| 95811 |
|
1,045 |
922 |
$632K |
| 58661 |
|
386 |
228 |
$615K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
5,221 |
2,575 |
$548K |
| 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 |
3,425 |
3,257 |
$530K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
74,646 |
60,745 |
$522K |
| 90834 |
Psychotherapy, 45 minutes with patient |
6,708 |
2,768 |
$518K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
1,971 |
1,675 |
$508K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
2,881 |
2,627 |
$502K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
93,510 |
74,732 |
$483K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
7,220 |
5,988 |
$481K |
| 76830 |
Ultrasound, transvaginal |
4,996 |
4,090 |
$463K |
| 87633 |
Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets |
3,057 |
2,211 |
$431K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
52,059 |
38,249 |
$424K |
| 64488 |
|
2,565 |
1,791 |
$415K |
| 29848 |
|
334 |
230 |
$415K |
| 96367 |
|
4,389 |
2,245 |
$397K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
10,181 |
4,305 |
$396K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
20,787 |
17,531 |
$372K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
169,887 |
133,656 |
$370K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
1,737 |
1,421 |
$361K |
| 59025 |
Fetal non-stress test |
2,459 |
1,193 |
$359K |
| 76642 |
|
3,005 |
2,604 |
$351K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
3,049 |
2,916 |
$351K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
4,865 |
2,456 |
$350K |
| 71045 |
Radiologic examination, chest; single view |
46,359 |
38,931 |
$346K |
| 70491 |
|
1,051 |
792 |
$327K |
| 74240 |
|
2,112 |
1,953 |
$318K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
28,232 |
15,488 |
$312K |
| 70496 |
|
1,282 |
980 |
$309K |
| 94060 |
|
2,423 |
2,107 |
$307K |
| 96415 |
|
1,059 |
618 |
$307K |
| 84484 |
|
62,401 |
41,300 |
$304K |
| 36415 |
Collection of venous blood by venipuncture |
306,232 |
242,890 |
$302K |
| 87637 |
Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV |
16,867 |
12,979 |
$300K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
6,594 |
5,702 |
$300K |
| 11045 |
|
968 |
494 |
$296K |
| 97161 |
|
4,819 |
4,036 |
$291K |
| 71046 |
Radiologic examination, chest; 2 views |
13,252 |
11,535 |
$290K |
| 45378 |
Colonoscopy, flexible; diagnostic, including collection of specimen(s) |
569 |
381 |
$288K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
11,879 |
10,279 |
$273K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
3,176 |
2,463 |
$270K |
| 58558 |
|
225 |
151 |
$269K |
| 76801 |
|
2,149 |
2,008 |
$258K |
| 94760 |
|
73,301 |
67,913 |
$251K |
| 49083 |
|
656 |
274 |
$247K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
2,491 |
1,211 |
$245K |
| 52356 |
|
119 |
88 |
$242K |
| 71271 |
|
1,515 |
1,353 |
$235K |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
5,686 |
4,977 |
$235K |
| C8929 |
Transthoracic echocardiography with contrast, or without contrast followed by with contrast, real-time with image documentation (2d), includes m-mode recording, when performed, complete, with spectral doppler echocardiography, and with color flow doppler echocardiography |
1,061 |
909 |
$231K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
569 |
445 |
$230K |
| 71250 |
|
2,575 |
2,284 |
$230K |
| 78815 |
Positron emission tomography (PET) for limited area imaging |
358 |
321 |
$224K |
| G0121 |
Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk |
386 |
269 |
$221K |
| 97162 |
|
4,198 |
3,452 |
$218K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
42,573 |
28,226 |
$210K |
| 96146 |
|
1,648 |
1,487 |
$208K |
| 90832 |
Psychotherapy, 30 minutes with patient |
2,307 |
1,843 |
$205K |
| 76770 |
|
1,363 |
1,163 |
$203K |
| 95813 |
|
253 |
215 |
$199K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
1,467 |
1,367 |
$197K |
| 80061 |
Lipid panel |
22,274 |
20,059 |
$197K |
| 86850 |
|
8,655 |
6,751 |
$188K |
| 76813 |
|
1,698 |
1,592 |
$186K |
| 93971 |
|
2,342 |
1,912 |
$185K |
| 85027 |
|
51,751 |
42,013 |
$184K |
| 84443 |
Thyroid stimulating hormone (TSH) |
18,180 |
15,937 |
$182K |
| 93970 |
|
1,271 |
1,048 |
$182K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
1,055 |
950 |
$174K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
1,009 |
876 |
$173K |
| 88142 |
|
9,131 |
7,923 |
$171K |
| 81514 |
|
758 |
439 |
$168K |
| 0202U |
Oncology (prostate), multianalyte, gene expression profiling |
1,418 |
1,119 |
$168K |
| 70498 |
|
1,231 |
944 |
$168K |
| P9016 |
Red blood cells, leukocytes reduced, each unit |
705 |
403 |
$167K |
| J1439 |
Injection, ferric carboxymaltose, 1 mg |
236 |
85 |
$165K |
| 94727 |
|
2,499 |
2,162 |
$160K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
684 |
614 |
$153K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
865 |
749 |
$150K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
17,930 |
14,791 |
$150K |
| 76536 |
|
1,485 |
1,356 |
$148K |
| 82607 |
|
8,585 |
7,767 |
$148K |
| 77336 |
|
1,569 |
720 |
$145K |
| 88307 |
|
1,856 |
981 |
$142K |
| 94729 |
|
2,693 |
2,333 |
$140K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
26,110 |
23,354 |
$140K |
| 95806 |
|
425 |
408 |
$137K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
8,289 |
7,519 |
$135K |
| J7307 |
Etonogestrel (contraceptive) implant system, including implant and supplies |
155 |
77 |
$135K |
| 90677 |
|
940 |
809 |
$133K |
| 87631 |
|
896 |
878 |
$132K |
| 12001 |
|
880 |
751 |
$130K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
1,072 |
824 |
$129K |
| 74183 |
|
498 |
445 |
$125K |
| 19083 |
|
169 |
144 |
$125K |
| 72141 |
|
737 |
641 |
$125K |
| 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 |
14,331 |
10,566 |
$123K |
| 87102 |
|
6,150 |
5,346 |
$122K |
| 77300 |
|
424 |
183 |
$119K |
| 86900 |
|
9,599 |
7,447 |
$116K |
| 86592 |
|
5,456 |
4,739 |
$110K |
| 80320 |
|
5,397 |
4,586 |
$108K |
| 82728 |
|
8,621 |
7,740 |
$107K |
| 93017 |
|
1,108 |
912 |
$107K |
| 10060 |
|
697 |
574 |
$103K |
| 73630 |
|
4,217 |
3,539 |
$103K |
| 36430 |
|
827 |
439 |
$103K |
| 29580 |
|
954 |
397 |
$101K |
| 93798 |
|
1,980 |
443 |
$96K |
| 84630 |
|
5,211 |
4,875 |
$96K |
| 97113 |
|
1,234 |
422 |
$92K |
| 70486 |
|
1,411 |
1,141 |
$92K |
| 93270 |
|
869 |
757 |
$89K |
| 90837 |
Psychotherapy, 53 minutes with patient |
796 |
381 |
$88K |
| 86803 |
|
7,183 |
6,204 |
$87K |
| 74174 |
|
513 |
410 |
$87K |
| Q3014 |
Telehealth originating site facility fee |
7,797 |
7,461 |
$85K |
| 93458 |
|
75 |
51 |
$85K |
| 73221 |
|
416 |
385 |
$82K |
| 73030 |
|
3,653 |
2,888 |
$81K |
| 88341 |
|
1,217 |
932 |
$81K |
| 87205 |
|
8,563 |
7,139 |
$81K |
| 72100 |
|
2,510 |
2,068 |
$79K |
| C8930 |
Transthoracic echocardiography, with contrast, or without contrast followed by with contrast, real-time with image documentation (2d), includes m-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or pharmacologically induced stress, with interpretation and report; including performance of continuous electrocardiographic monitoring, with physician supervision |
308 |
238 |
$77K |
| J2315 |
Injection, naltrexone, depot form, 1 mg |
66 |
62 |
$77K |
| 43235 |
|
186 |
132 |
$77K |
| 86361 |
|
1,837 |
1,708 |
$76K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
8,542 |
7,352 |
$76K |
| 73560 |
|
2,071 |
1,623 |
$75K |
| 12002 |
|
538 |
454 |
$75K |
| 90670 |
|
414 |
291 |
$72K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
6,599 |
5,706 |
$72K |
| G0239 |
Therapeutic procedures to improve respiratory function or increase strength or endurance of respiratory muscles, two or more individuals (includes monitoring) |
2,247 |
509 |
$71K |
| 84702 |
|
12,710 |
8,706 |
$69K |
| 87536 |
|
1,633 |
1,547 |
$66K |
| 90686 |
|
4,538 |
4,350 |
$66K |
| 76870 |
|
815 |
634 |
$66K |
| 97166 |
|
1,354 |
1,011 |
$65K |
| 72158 |
|
300 |
239 |
$64K |
| 83690 |
|
38,957 |
31,026 |
$64K |
| 83735 |
|
22,797 |
16,780 |
$63K |
| 73130 |
|
3,951 |
3,161 |
$62K |
| 83540 |
|
8,576 |
7,667 |
$61K |
| 77066 |
Tomosynthesis, mammo |
1,806 |
1,564 |
$61K |
| 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 |
10,971 |
8,640 |
$60K |
| 95912 |
|
651 |
587 |
$60K |
| 90636 |
|
227 |
165 |
$60K |
| 90715 |
|
3,855 |
3,115 |
$59K |
| 84439 |
|
4,019 |
3,432 |
$59K |
| 72110 |
|
1,055 |
925 |
$59K |
| 90674 |
|
3,248 |
2,695 |
$58K |
| 77334 |
|
255 |
133 |
$57K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
973 |
613 |
$56K |
| J9299 |
Injection, nivolumab, 1 mg |
20 |
12 |
$56K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
531 |
448 |
$55K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
530 |
455 |
$55K |
| 81001 |
|
65,190 |
54,078 |
$54K |
| 97165 |
|
902 |
689 |
$53K |
| 87340 |
|
3,942 |
3,463 |
$52K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
3,948 |
3,062 |
$51K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
1,165 |
522 |
$51K |
| 74018 |
|
1,780 |
1,397 |
$50K |
| 80076 |
|
7,495 |
7,017 |
$50K |
| 75574 |
|
172 |
146 |
$50K |
| 81025 |
|
30,905 |
24,854 |
$50K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
640 |
244 |
$49K |
| 87507 |
|
495 |
391 |
$49K |
| 90651 |
|
556 |
468 |
$48K |
| 82746 |
|
6,209 |
5,716 |
$47K |
| 77049 |
|
138 |
124 |
$47K |
| 86762 |
|
2,463 |
2,181 |
$47K |
| 86593 |
|
4,568 |
3,874 |
$47K |
| 96376 |
|
11,198 |
5,158 |
$47K |
| 77080 |
|
731 |
649 |
$46K |
| 74178 |
|
194 |
173 |
$46K |
| 73502 |
|
1,944 |
1,570 |
$45K |
| C1713 |
Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) |
1,328 |
872 |
$44K |
| 77065 |
Tomosynthesis, mammo |
1,209 |
996 |
$44K |
| G0257 |
Unscheduled or emergency dialysis treatment for an esrd patient in a hospital outpatient department that is not certified as an esrd facility |
230 |
91 |
$43K |
| 97116 |
|
1,591 |
832 |
$43K |
| 72050 |
|
735 |
636 |
$43K |
| 64418 |
|
278 |
187 |
$43K |
| 94625 |
|
1,071 |
250 |
$42K |
| 86140 |
|
4,778 |
3,562 |
$40K |
| J1756 |
Injection, iron sucrose, 1 mg |
2,320 |
863 |
$40K |
| 93880 |
|
537 |
480 |
$40K |
| C9803 |
Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
1,183 |
1,127 |
$40K |
| 72040 |
|
1,132 |
923 |
$39K |
| 87077 |
|
5,954 |
4,771 |
$38K |
| 11043 |
|
187 |
107 |
$38K |
| 87653 |
|
1,367 |
1,136 |
$38K |
| 86901 |
|
9,604 |
7,449 |
$37K |
| 73562 |
|
2,830 |
2,263 |
$37K |
| J0574 |
Buprenorphine/naloxone, oral, greater than 6 mg, but less than or equal to 10 mg buprenorphine |
737 |
304 |
$37K |
| 88342 |
|
2,891 |
2,238 |
$36K |
| 93923 |
|
541 |
475 |
$36K |
| 70544 |
|
239 |
167 |
$36K |
| 82947 |
|
18,157 |
6,115 |
$36K |
| 12011 |
|
242 |
206 |
$36K |
| 73610 |
|
2,677 |
2,202 |
$36K |
| 93225 |
|
329 |
297 |
$33K |
| 76820 |
|
530 |
187 |
$33K |
| 72156 |
|
171 |
134 |
$33K |
| 00731 |
|
5,360 |
4,376 |
$30K |
| J3490 |
Unclassified drugs |
17,231 |
8,950 |
$30K |
| J2791 |
Injection, rho(d) immune globulin (human), (rhophylac), intramuscular or intravenous, 100 iu |
431 |
294 |
$30K |
| 95909 |
|
337 |
296 |
$29K |
| G0008 |
Administration of influenza virus vaccine |
9,969 |
9,204 |
$29K |
| 73565 |
|
884 |
808 |
$29K |
| 82950 |
|
2,261 |
1,982 |
$29K |
| 73564 |
|
746 |
640 |
$29K |
| 84425 |
|
3,004 |
2,785 |
$28K |
| 0352U |
|
4,189 |
3,667 |
$27K |
| 72131 |
|
383 |
304 |
$27K |
| 90734 |
|
369 |
323 |
$27K |
| 73700 |
|
237 |
193 |
$27K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
28,271 |
22,330 |
$27K |
| 87522 |
Neg quan hep c or qual rna |
836 |
744 |
$27K |
| 94660 |
|
258 |
107 |
$26K |
| 73110 |
|
1,859 |
1,481 |
$26K |
| P9047 |
Infusion, albumin (human), 25%, 50 ml |
153 |
85 |
$26K |
| G0279 |
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) |
2,701 |
2,335 |
$26K |
| 85610 |
|
23,568 |
14,644 |
$25K |
| 97535 |
Self-care/home management training, each 15 minutes |
1,240 |
659 |
$25K |
| 83880 |
|
6,507 |
4,968 |
$25K |
| 70487 |
|
75 |
52 |
$25K |
| 95911 |
|
435 |
370 |
$24K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
276 |
263 |
$24K |
| 37799 |
|
26 |
16 |
$24K |
| 88304 |
|
1,864 |
1,288 |
$24K |
| 93356 |
|
1,309 |
1,145 |
$24K |
| 77301 |
|
38 |
34 |
$23K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
242 |
212 |
$23K |
| 72072 |
|
786 |
629 |
$23K |
| 82570 |
|
4,605 |
3,872 |
$22K |
| 92134 |
|
412 |
381 |
$21K |
| 83605 |
|
8,733 |
6,153 |
$21K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
5,292 |
3,885 |
$20K |
| 78227 |
|
79 |
44 |
$19K |
| 78264 |
|
83 |
73 |
$19K |
| 67028 |
Intravitreal injection of a pharmacologic agent |
85 |
76 |
$19K |
| 85055 |
|
1,960 |
1,542 |
$19K |
| 87338 |
|
972 |
886 |
$19K |
| 97035 |
|
264 |
123 |
$18K |
| 87902 |
|
128 |
110 |
$18K |
| J7297 |
Levonorgestrel-releasing intrauterine contraceptive system (liletta), 52 mg |
38 |
14 |
$18K |
| 83020 |
|
925 |
844 |
$17K |
| 84403 |
|
973 |
875 |
$17K |
| 82105 |
|
887 |
763 |
$17K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
190 |
175 |
$17K |
| 86480 |
|
507 |
450 |
$17K |
| 80069 |
|
984 |
811 |
$17K |
| 93226 |
|
320 |
290 |
$17K |
| J2469 |
Injection, palonosetron hcl, 25 mcg |
1,666 |
760 |
$17K |
| 97163 |
|
338 |
293 |
$17K |
| S9472 |
Cardiac rehabilitation program, non-physician provider, per diem |
281 |
58 |
$17K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
170 |
159 |
$16K |
| 81003 |
|
13,370 |
11,654 |
$16K |
| J1453 |
Injection, fosaprepitant, 1 mg |
987 |
452 |
$15K |
| 95012 |
|
377 |
326 |
$15K |
| 86923 |
|
738 |
452 |
$15K |
| 84146 |
|
1,086 |
853 |
$15K |
| 36591 |
|
994 |
540 |
$14K |
| 88312 |
|
784 |
645 |
$14K |
| 99152 |
|
892 |
667 |
$14K |
| 73080 |
|
692 |
587 |
$13K |
| 93922 |
|
157 |
141 |
$13K |
| 87070 |
|
2,634 |
2,065 |
$13K |
| 72197 |
|
47 |
40 |
$13K |
| 87106 |
|
1,017 |
819 |
$13K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
4,149 |
3,265 |
$13K |
| 87186 |
|
4,548 |
3,578 |
$12K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
6,236 |
4,474 |
$12K |
| 74230 |
|
108 |
98 |
$12K |
| 73620 |
|
695 |
549 |
$12K |
| 86706 |
|
1,390 |
1,174 |
$12K |
| 83516 |
|
598 |
541 |
$12K |
| C9290 |
Injection, bupivacaine liposome, 1 mg |
147 |
97 |
$11K |
| 83550 |
|
3,144 |
2,599 |
$11K |
| 95819 |
|
82 |
54 |
$11K |
| 45381 |
|
17 |
12 |
$11K |
| 73120 |
|
300 |
224 |
$11K |
| 86704 |
|
727 |
653 |
$11K |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
10,613 |
3,757 |
$11K |
| 82550 |
|
6,185 |
4,221 |
$11K |
| 82670 |
|
335 |
325 |
$10K |
| 82248 |
|
8,091 |
5,483 |
$10K |
| D0330 |
Panoramic radiographic image |
366 |
358 |
$10K |
| 83021 |
|
397 |
354 |
$10K |
| 83615 |
|
2,418 |
1,579 |
$10K |
| 00811 |
|
1,454 |
1,160 |
$10K |
| 73590 |
|
1,231 |
965 |
$10K |
| J1815 |
Injection, insulin, per 5 units |
9,023 |
2,071 |
$10K |
| J0500 |
Injection, dicyclomine hcl, up to 20 mg |
720 |
475 |
$10K |
| 83970 |
|
489 |
423 |
$10K |
| J1170 |
Injection, hydromorphone, up to 4 mg |
9,870 |
4,986 |
$10K |
| 98926 |
|
233 |
206 |
$10K |
| J0561 |
Injection, penicillin g benzathine, 100,000 units |
25 |
12 |
$9K |
| 90661 |
|
1,041 |
1,037 |
$9K |
| 26055 |
|
14 |
12 |
$9K |
| J2805 |
Injection, sincalide, 5 micrograms |
77 |
42 |
$9K |
| 85652 |
|
4,376 |
3,405 |
$9K |
| 92083 |
|
246 |
225 |
$9K |
| J2543 |
Injection, piperacillin sodium/tazobactam sodium, 1 gram/0.125 grams (1.125 grams) |
2,334 |
893 |
$9K |
| 80074 |
|
836 |
680 |
$9K |
| C1776 |
Joint device (implantable) |
347 |
232 |
$8K |
| J2704 |
Injection, propofol, 10 mg |
28,870 |
22,096 |
$8K |
| 72170 |
|
1,383 |
1,067 |
$8K |
| 86038 |
|
523 |
432 |
$8K |
| 96368 |
|
1,062 |
371 |
$8K |
| 88112 |
|
610 |
479 |
$8K |
| 82043 |
|
3,095 |
2,684 |
$8K |
| 93242 |
|
97 |
97 |
$8K |
| 90750 |
|
48 |
40 |
$8K |
| 84153 |
|
717 |
631 |
$7K |
| 00812 |
|
1,663 |
1,220 |
$7K |
| G0009 |
Administration of pneumococcal vaccine |
1,354 |
1,106 |
$7K |
| 82784 |
|
830 |
647 |
$7K |
| 93924 |
|
69 |
61 |
$7K |
| 64486 |
|
63 |
39 |
$7K |
| 10061 |
|
42 |
38 |
$7K |
| 74246 |
|
43 |
38 |
$7K |
| 77338 |
|
42 |
34 |
$7K |
| 73070 |
|
526 |
398 |
$7K |
| 73552 |
|
530 |
424 |
$7K |
| 71101 |
|
801 |
650 |
$6K |
| 36592 |
|
977 |
498 |
$6K |
| D1110 |
Prophylaxis - adult |
196 |
186 |
$6K |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
12,501 |
8,894 |
$6K |
| 73090 |
|
762 |
628 |
$6K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
41,171 |
29,362 |
$6K |
| 93246 |
|
75 |
75 |
$6K |
| 84156 |
|
1,562 |
1,219 |
$6K |
| 84481 |
|
799 |
671 |
$6K |
| 85014 |
|
2,532 |
1,653 |
$6K |
| 31624 |
|
50 |
40 |
$6K |
| 84100 |
|
3,344 |
1,891 |
$6K |
| 84703 |
|
3,582 |
2,850 |
$6K |
| 95913 |
|
63 |
54 |
$5K |
| 73600 |
|
367 |
293 |
$5K |
| G0424 |
Pulmonary rehabilitation, including exercise (includes monitoring), one hour, per session, up to two sessions per day |
188 |
50 |
$5K |
| 86334 |
|
311 |
254 |
$5K |
| 84145 |
|
1,378 |
927 |
$5K |
| 90849 |
|
112 |
51 |
$5K |
| D0140 |
Limited oral evaluation - problem focused |
224 |
220 |
$5K |
| 98927 |
|
165 |
152 |
$5K |
| 87040 |
|
4,602 |
1,700 |
$5K |
| Q9957 |
Injection, perflutren lipid microspheres, per ml |
879 |
729 |
$5K |
| 92611 |
|
95 |
86 |
$5K |
| 85379 |
|
4,636 |
3,477 |
$5K |
| J1805 |
Injection, esmolol hydrochloride, 10 mg |
5,189 |
3,863 |
$5K |
| Q2039 |
Influenza virus vaccine, not otherwise specified |
974 |
926 |
$5K |
| 76775 |
|
68 |
60 |
$5K |
| 82565 |
|
660 |
548 |
$5K |
| 87075 |
|
1,651 |
1,310 |
$4K |
| 86431 |
|
415 |
344 |
$4K |
| J0640 |
Injection, leucovorin calcium, per 50 mg |
125 |
25 |
$4K |
| 73140 |
|
196 |
176 |
$4K |
| 99153 |
Mod sedat endo service >5yrs |
458 |
341 |
$4K |
| 00940 |
|
354 |
268 |
$4K |
| 83001 |
|
234 |
210 |
$4K |
| 73060 |
|
426 |
345 |
$4K |
| 01810 |
|
940 |
699 |
$4K |
| 29125 |
|
523 |
416 |
$4K |
| 86708 |
|
358 |
332 |
$3K |
| 82803 |
|
2,500 |
1,765 |
$3K |
| 97014 |
|
73 |
31 |
$3K |
| G0105 |
Colorectal cancer screening; colonoscopy on individual at high risk |
14 |
13 |
$3K |
| 80202 |
|
516 |
292 |
$3K |
| D7140 |
Extraction, erupted tooth or exposed root |
55 |
38 |
$3K |
| 85730 |
|
3,605 |
2,602 |
$3K |
| 93976 |
|
17 |
12 |
$3K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
315 |
308 |
$3K |
| 96523 |
|
60 |
36 |
$3K |
| J2272 |
Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg |
4,182 |
2,107 |
$3K |
| 90746 |
|
252 |
233 |
$3K |
| 64445 |
|
14 |
12 |
$3K |
| 85018 |
|
2,560 |
1,659 |
$3K |
| D0120 |
Periodic oral evaluation - established patient |
158 |
157 |
$3K |
| 20610 |
|
17 |
13 |
$3K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
54,582 |
37,984 |
$3K |
| 95816 |
|
25 |
16 |
$3K |
| Q2038 |
Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (fluzone) |
859 |
785 |
$3K |
| 00790 |
|
600 |
448 |
$3K |
| 00910 |
|
211 |
156 |
$3K |
| D0274 |
Bitewings - four radiographic images |
217 |
212 |
$3K |
| J9045 |
Injection, carboplatin, 50 mg |
201 |
92 |
$3K |
| 84550 |
|
685 |
572 |
$3K |
| 87529 |
|
215 |
172 |
$3K |
| 84165 |
|
443 |
360 |
$3K |
| 90732 |
|
92 |
89 |
$3K |
| 29581 |
|
40 |
24 |
$2K |
| 84155 |
|
360 |
308 |
$2K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
90 |
84 |
$2K |
| 97150 |
Therapeutic procedure(s), group (2 or more individuals) |
58 |
40 |
$2K |
| D0220 |
Intraoral - periapical first radiographic image |
481 |
461 |
$2K |
| 11721 |
|
52 |
52 |
$2K |
| C9113 |
Injection, pantoprazole sodium, per vial |
1,473 |
635 |
$2K |
| 88360 |
|
29 |
26 |
$2K |
| 86304 |
|
147 |
116 |
$2K |
| J1642 |
Injection, heparin sodium, (heparin lock flush), per 10 units |
5,191 |
1,760 |
$2K |
| 80164 |
|
527 |
396 |
$2K |
| M0243 |
Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring |
14 |
12 |
$2K |
| 82330 |
|
451 |
340 |
$2K |
| 72083 |
|
28 |
23 |
$2K |
| J3370 |
Injection, vancomycin hcl, 500 mg |
2,679 |
1,269 |
$2K |
| 88172 |
|
41 |
28 |
$2K |
| 82040 |
|
719 |
604 |
$2K |
| 76818 |
|
28 |
15 |
$2K |
| C1781 |
Mesh (implantable) |
216 |
147 |
$2K |
| 94664 |
|
442 |
277 |
$2K |
| 84163 |
|
75 |
71 |
$2K |
| J0690 |
Injection, cefazolin sodium, 500 mg |
4,045 |
2,597 |
$2K |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
2,262 |
1,436 |
$2K |
| 92610 |
|
48 |
38 |
$2K |
| 82010 |
|
1,683 |
1,118 |
$2K |
| J1953 |
Injection, levetiracetam, 10 mg |
186 |
99 |
$2K |
| G0390 |
Trauma response team associated with hospital critical care service |
222 |
167 |
$2K |
| 93926 |
|
16 |
12 |
$2K |
| 86160 |
|
89 |
70 |
$2K |
| 94010 |
|
13 |
13 |
$2K |
| 00840 |
|
1,695 |
1,119 |
$1K |
| 86200 |
|
87 |
81 |
$1K |
| 96103 |
|
14 |
13 |
$1K |
| D0210 |
Intraoral - complete series of radiographic images |
24 |
24 |
$1K |
| G0297 |
Low dose ct scan (ldct) for lung cancer screening |
14 |
12 |
$1K |
| 64413 |
|
14 |
14 |
$1K |
| 51701 |
|
396 |
304 |
$1K |
| 73100 |
|
52 |
36 |
$1K |
| 64999 |
|
12 |
12 |
$1K |
| 92133 |
|
58 |
58 |
$1K |
| 82533 |
|
103 |
71 |
$1K |
| C1769 |
Guide wire |
475 |
370 |
$1K |
| 80177 |
|
352 |
256 |
$1K |
| 86225 |
|
80 |
68 |
$1K |
| 78306 |
|
14 |
12 |
$1K |
| 90648 |
|
115 |
102 |
$1K |
| 84132 |
|
479 |
355 |
$1K |
| J7050 |
Infusion, normal saline solution, 250 cc |
6,284 |
2,916 |
$1K |
| 87493 |
|
76 |
62 |
$1K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
19,606 |
12,530 |
$1K |
| 84270 |
|
70 |
63 |
$1K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
569 |
491 |
$967.49 |
| 94762 |
|
964 |
748 |
$958.54 |
| 86308 |
|
439 |
302 |
$945.52 |
| 89051 |
|
243 |
157 |
$932.33 |
| 86870 |
|
70 |
34 |
$929.09 |
| 00400 |
|
381 |
271 |
$924.37 |
| 90694 |
|
77 |
65 |
$912.99 |
| 88173 |
|
450 |
360 |
$880.81 |
| 86364 |
|
86 |
77 |
$880.13 |
| 86235 |
|
51 |
39 |
$878.86 |
| 84402 |
|
70 |
63 |
$872.20 |
| J1644 |
Injection, heparin sodium, per 1000 units |
3,359 |
1,421 |
$866.09 |
| 82140 |
|
294 |
216 |
$863.57 |
| 97010 |
|
21 |
13 |
$834.47 |
| 51702 |
|
229 |
183 |
$831.57 |
| 72202 |
|
12 |
12 |
$806.44 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
8,319 |
4,986 |
$804.45 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
6,033 |
3,368 |
$801.23 |
| J2360 |
Injection, orphenadrine citrate, up to 60 mg |
2,030 |
1,380 |
$783.82 |
| 97597 |
|
24 |
13 |
$757.95 |
| 0054A |
|
27 |
27 |
$744.30 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
1,705 |
974 |
$743.76 |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
15 |
12 |
$737.10 |
| J2795 |
Injection, ropivacaine hydrochloride, 1 mg |
1,033 |
499 |
$730.47 |
| J0360 |
Injection, hydralazine hcl, up to 20 mg |
794 |
470 |
$726.85 |
| 90656 |
|
84 |
83 |
$713.05 |
| J2550 |
Injection, promethazine hcl, up to 50 mg |
2,056 |
1,173 |
$700.35 |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
2,236 |
1,394 |
$658.16 |
| A9552 |
Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries |
373 |
337 |
$625.90 |
| J0295 |
Injection, ampicillin sodium/sulbactam sodium, per 1.5 gm |
978 |
358 |
$605.76 |
| 76942 |
|
126 |
100 |
$604.93 |
| 76098 |
|
27 |
15 |
$604.24 |
| A9270 |
Non-covered item or service |
25,173 |
2,523 |
$600.87 |
| 82378 |
|
76 |
62 |
$586.98 |
| J2060 |
Injection, lorazepam, 2 mg |
4,686 |
2,884 |
$584.46 |
| 90632 |
|
19 |
19 |
$573.90 |
| J2310 |
Injection, naloxone hydrochloride, per 1 mg |
43 |
24 |
$536.82 |
| 90723 |
|
104 |
83 |
$530.12 |
| 76937 |
|
78 |
58 |
$510.30 |
| 84480 |
|
144 |
131 |
$496.96 |
| 80323 |
|
24 |
24 |
$495.14 |
| 01965 |
|
110 |
79 |
$495.04 |
| 74022 |
|
38 |
27 |
$493.92 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
4,399 |
2,600 |
$483.27 |
| 00813 |
|
870 |
635 |
$482.46 |
| 86705 |
|
27 |
27 |
$481.48 |
| 93325 |
|
14 |
12 |
$476.17 |
| 85045 |
|
359 |
211 |
$475.30 |
| 80178 |
|
60 |
54 |
$469.97 |
| 72220 |
|
26 |
15 |
$448.44 |
| C1894 |
Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser |
652 |
507 |
$440.45 |
| J0134 |
Injection, acetaminophen (fresenius kabi), not therapeutically equivalent to j0131, 10 mg |
734 |
472 |
$431.22 |
| 87081 |
|
39 |
39 |
$424.08 |
| J0689 |
Injection, cefazolin sodium (baxter), not therapeutically equivalent to j0690, 500 mg |
4,449 |
2,937 |
$420.46 |
| J7030 |
Infusion, normal saline solution , 1000 cc |
1,766 |
921 |
$418.38 |
| C1760 |
Closure device, vascular (implantable/insertable) |
445 |
329 |
$417.10 |
| 87449 |
|
220 |
160 |
$413.09 |
| 80051 |
|
119 |
108 |
$409.26 |
| J0736 |
Injection, clindamycin phosphate, 300 mg |
121 |
66 |
$408.00 |
| 82272 |
|
343 |
254 |
$392.16 |
| 87641 |
|
329 |
290 |
$389.51 |
| 94618 |
|
14 |
13 |
$388.15 |
| J0702 |
Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg |
18 |
12 |
$381.15 |
| 83520 |
|
13 |
12 |
$368.04 |
| J1940 |
Injection, furosemide, up to 20 mg |
1,225 |
598 |
$363.51 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
6,707 |
4,629 |
$358.53 |
| 90633 |
|
41 |
29 |
$354.60 |
| J3411 |
Injection, thiamine hcl, 100 mg |
578 |
254 |
$353.13 |
| 92015 |
Determination of refractive state |
136 |
131 |
$346.85 |
| J1250 |
Injection, dobutamine hydrochloride, per 250 mg |
49 |
37 |
$346.32 |
| A9585 |
Injection, gadobutrol, 0.1 ml |
3,881 |
3,251 |
$334.35 |
| 88302 |
|
383 |
244 |
$330.99 |
| J2920 |
Injection, methylprednisolone sodium succinate, up to 40 mg |
621 |
296 |
$328.74 |
| J8540 |
Dexamethasone, oral, 0.25 mg |
846 |
440 |
$318.40 |
| 84450 |
|
52 |
51 |
$311.95 |
| 87517 |
|
14 |
14 |
$309.52 |
| 83525 |
|
36 |
29 |
$301.16 |
| 90653 |
|
90 |
87 |
$292.91 |
| 96402 |
|
13 |
12 |
$282.84 |
| J1630 |
Injection, haloperidol, up to 5 mg |
1,979 |
1,244 |
$280.65 |
| 87899 |
|
235 |
182 |
$269.46 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
12,945 |
9,413 |
$268.42 |
| J2919 |
Injection, methylprednisolone sodium succinate, 5 mg |
788 |
524 |
$260.49 |
| 88313 |
|
139 |
105 |
$256.98 |
| 87116 |
|
162 |
129 |
$243.89 |
| 36416 |
|
741 |
608 |
$243.87 |
| 36600 |
|
42 |
17 |
$243.20 |
| 82652 |
|
18 |
15 |
$234.47 |
| 73521 |
|
13 |
12 |
$224.86 |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
808 |
582 |
$221.16 |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
667 |
555 |
$208.78 |
| 87206 |
|
196 |
150 |
$205.91 |
| J3420 |
Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg |
535 |
307 |
$199.02 |
| 84300 |
|
194 |
146 |
$197.54 |
| A4648 |
Tissue marker, implantable, any type, each |
462 |
374 |
$196.89 |
| 84460 |
|
52 |
51 |
$187.41 |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
45 |
36 |
$185.34 |
| 00952 |
|
321 |
216 |
$178.14 |
| J0737 |
Injection, clindamycin phosphate (baxter), not therapeutically equivalent to j0736, 300 mg |
321 |
221 |
$175.85 |
| J1580 |
Injection, garamycin, gentamicin, up to 80 mg |
288 |
169 |
$169.33 |
| J7060 |
5% dextrose/water (500 ml = 1 unit) |
572 |
249 |
$168.82 |
| 87076 |
|
78 |
65 |
$158.43 |
| J0692 |
Injection, cefepime hydrochloride, 500 mg |
324 |
156 |
$157.50 |
| 86146 |
|
12 |
12 |
$152.29 |
| J3480 |
Injection, potassium chloride, per 2 meq |
1,241 |
677 |
$151.51 |
| 94761 |
|
722 |
604 |
$151.28 |
| C2617 |
Stent, non-coronary, temporary, without delivery system |
467 |
354 |
$147.30 |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
862 |
454 |
$137.45 |
| J0171 |
Injection, adrenalin, epinephrine, 0.1 mg |
1,217 |
790 |
$133.95 |
| 84520 |
|
41 |
40 |
$133.14 |
| 80175 |
|
35 |
25 |
$131.48 |
| 82088 |
|
16 |
14 |
$127.91 |
| A4565 |
Slings |
694 |
509 |
$127.02 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
45 |
45 |
$126.49 |
| 91322 |
|
33 |
33 |
$123.06 |
| 90662 |
|
12 |
12 |
$118.72 |
| 82977 |
|
15 |
14 |
$116.07 |
| 83002 |
|
12 |
12 |
$101.72 |
| 88333 |
|
106 |
78 |
$95.28 |
| 86618 |
|
19 |
13 |
$91.92 |
| 29130 |
|
17 |
12 |
$90.63 |
| D0230 |
Intraoral - periapical each additional radiographic image |
22 |
12 |
$84.00 |
| 84436 |
|
16 |
13 |
$83.08 |
| 85384 |
|
20 |
13 |
$82.85 |
| C1758 |
Catheter, ureteral |
2,458 |
1,719 |
$78.28 |
| Q9956 |
Injection, octafluoropropane microspheres, per ml |
723 |
615 |
$73.25 |
| J1030 |
Injection, methylprednisolone acetate, 40 mg |
121 |
114 |
$66.59 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
39 |
39 |
$65.34 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
44 |
38 |
$64.58 |
| J0330 |
Injection, succinylcholine chloride, up to 20 mg |
950 |
608 |
$64.55 |
| 84134 |
|
47 |
44 |
$62.72 |
| J2470 |
Injection, pantoprazole sodium, 40 mg |
328 |
197 |
$58.42 |
| J1171 |
Injection, hydromorphone, 0.1 mg |
633 |
393 |
$54.91 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
336 |
249 |
$53.55 |
| 84244 |
|
15 |
14 |
$50.68 |
| J2371 |
Injection, phenylephrine hydrochloride, 20 micrograms |
1,889 |
1,396 |
$42.70 |
| 90480 |
|
32 |
32 |
$41.54 |
| C1729 |
Catheter, drainage |
574 |
406 |
$34.10 |
| J1790 |
Injection, droperidol, up to 5 mg |
312 |
197 |
$33.82 |
| J1920 |
Injection, labetalol hydrochloride, 5 mg |
688 |
442 |
$31.74 |
| 81002 |
|
574 |
515 |
$31.46 |
| G0010 |
Administration of hepatitis b vaccine |
253 |
234 |
$28.54 |
| 82365 |
|
45 |
39 |
$20.39 |
| Q0114 |
Fern test |
12 |
12 |
$20.16 |
| J0461 |
Injection, atropine sulfate, 0.01 mg |
77 |
28 |
$19.94 |
| J1596 |
Injection, glycopyrrolate, 0.1 mg |
735 |
542 |
$13.58 |
| J1598 |
Injection, glycopyrrolate (fresenius kabi), not therapeutically equivalent to j1596, 0.1 mg |
393 |
369 |
$11.20 |
| J0456 |
Injection, azithromycin, 500 mg |
36 |
29 |
$8.66 |
| J2175 |
Injection, meperidine hydrochloride, per 100 mg |
152 |
87 |
$7.51 |
| J1836 |
Injection, metronidazole, 10 mg |
60 |
38 |
$5.76 |
| Q9966 |
Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml |
265 |
228 |
$5.62 |
| J0744 |
Injection, ciprofloxacin for intravenous infusion, 200 mg |
65 |
39 |
$3.98 |
| J2370 |
Injection, phenylephrine hcl, up to 1 ml |
80 |
55 |
$3.10 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
64 |
33 |
$2.53 |
| 91305 |
|
36 |
36 |
$0.39 |
| Q9963 |
High osmolar contrast material, 350-399 mg/ml iodine concentration, per ml |
206 |
191 |
$0.00 |
| 80050 |
General health panel |
34 |
27 |
$0.00 |
| C9250 |
Human plasma fibrin sealant, vapor-heated, solvent-detergent (artiss), 2 ml |
148 |
91 |
$0.00 |
| 96411 |
|
318 |
128 |
$0.00 |
| A9500 |
Technetium tc-99m sestamibi, diagnostic, per study dose |
638 |
499 |
$0.00 |
| 51798 |
|
59 |
42 |
$0.00 |
| 80047 |
|
78 |
54 |
$0.00 |
| 82962 |
|
192 |
171 |
$0.00 |
| J2785 |
Injection, regadenoson, 0.1 mg |
478 |
364 |
$0.00 |
| 01480 |
|
137 |
92 |
$0.00 |
| J1720 |
Injection, hydrocortisone sodium succinate, up to 100 mg |
24 |
13 |
$0.00 |
| A9698 |
Non-radioactive contrast imaging material, not otherwise classified, per study |
112 |
94 |
$0.00 |
| 00142 |
|
20 |
14 |
$0.00 |
| 84157 |
|
35 |
25 |
$0.00 |
| 95910 |
|
33 |
24 |
$0.00 |
| 77001 |
|
12 |
12 |
$0.00 |
| 00160 |
|
61 |
38 |
$0.00 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
19 |
17 |
$0.00 |
| Q9968 |
Injection, non-radioactive, non-contrast, visualization adjunct (e.g., methylene blue, isosulfan blue), 1 mg |
19 |
13 |
$0.00 |
| 31629 |
|
35 |
25 |
$0.00 |
| 95249 |
|
19 |
17 |
$0.00 |
| 00902 |
|
30 |
25 |
$0.00 |
| A9503 |
Technetium tc-99m medronate, diagnostic, per study dose, up to 30 millicuries |
14 |
12 |
$0.00 |
| J9267 |
Injection, paclitaxel, 1 mg |
31 |
12 |
$0.00 |
| A9573 |
Injection, gadopiclenol, 1 ml |
42 |
42 |
$0.00 |
| 31654 |
|
23 |
14 |
$0.00 |
| C1726 |
Catheter, balloon dilatation, non-vascular |
12 |
12 |
$0.00 |
| 69209 |
|
34 |
30 |
$0.00 |
| 00918 |
|
269 |
204 |
$0.00 |
| 00300 |
|
172 |
110 |
$0.00 |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
275 |
219 |
$0.00 |
| 96417 |
|
1,045 |
490 |
$0.00 |
| J0670 |
Injection, mepivacaine hydrochloride, per 10 ml |
111 |
68 |
$0.00 |
| A9541 |
Technetium tc-99m sulfur colloid, diagnostic, per study dose, up to 20 millicuries |
82 |
72 |
$0.00 |
| A9537 |
Technetium tc-99m mebrofenin, diagnostic, per study dose, up to 15 millicuries |
51 |
32 |
$0.00 |
| 00520 |
|
67 |
46 |
$0.00 |
| J1020 |
Injection, methylprednisolone acetate, 20 mg |
100 |
66 |
$0.00 |
| 01830 |
|
45 |
24 |
$0.00 |
| 76376 |
|
13 |
12 |
$0.00 |
| 01402 |
|
30 |
12 |
$0.00 |