| Code | Description | Claims | Beneficiaries | Total Paid |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
68,593 |
62,023 |
$3.84M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
25,307 |
22,772 |
$2.05M |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
10,581 |
4,477 |
$1.75M |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
42,866 |
19,663 |
$1.70M |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
18,049 |
16,164 |
$1.51M |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
29,463 |
26,555 |
$1.29M |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
12,346 |
11,366 |
$1.13M |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
11,194 |
10,109 |
$1.12M |
| 76818 |
|
7,355 |
4,358 |
$782K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
4,734 |
4,504 |
$564K |
| 99233 |
Prolong inpt eval add15 m |
9,724 |
4,769 |
$536K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
3,724 |
3,481 |
$469K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
5,781 |
5,301 |
$466K |
| 59025 |
Fetal non-stress test |
18,102 |
14,306 |
$395K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
1,698 |
1,574 |
$265K |
| 99231 |
Subsequent hospital care, per day, straightforward or low complexity |
10,625 |
5,067 |
$241K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
4,369 |
4,018 |
$207K |
| 99222 |
Initial hospital care, per day, moderate complexity |
2,389 |
2,110 |
$205K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
2,162 |
2,038 |
$204K |
| 99460 |
|
2,798 |
2,389 |
$198K |
| 99244 |
Office or other outpatient consultation, moderate to high complexity |
1,212 |
1,132 |
$193K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
3,962 |
3,437 |
$188K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
1,635 |
1,405 |
$144K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
4,013 |
3,604 |
$142K |
| 99223 |
Prolong inpt eval add15 m |
1,032 |
946 |
$142K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
1,885 |
1,635 |
$137K |
| 76813 |
|
1,256 |
1,188 |
$133K |
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
201 |
170 |
$133K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
1,452 |
921 |
$118K |
| 0012A |
|
3,431 |
3,225 |
$109K |
| 0011A |
|
3,836 |
3,542 |
$107K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
6,457 |
5,412 |
$96K |
| 99201 |
|
2,188 |
2,052 |
$75K |
| 99462 |
|
2,470 |
1,503 |
$68K |
| 99205 |
Prolong outpt/office vis |
446 |
404 |
$68K |
| 99385 |
|
683 |
557 |
$65K |
| 99381 |
|
754 |
653 |
$62K |
| 76820 |
|
1,383 |
740 |
$55K |
| 99215 |
Prolong outpt/office vis |
512 |
481 |
$55K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
466 |
437 |
$47K |
| 91122 |
|
293 |
150 |
$46K |
| 92557 |
|
1,481 |
1,397 |
$43K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
2,143 |
1,928 |
$38K |
| 99221 |
|
519 |
481 |
$37K |
| 3074F |
|
33,816 |
30,992 |
$33K |
| 90461 |
|
892 |
871 |
$32K |
| 92567 |
|
2,787 |
2,577 |
$30K |
| 31575 |
|
563 |
501 |
$30K |
| 94010 |
|
1,041 |
962 |
$28K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
4,424 |
3,935 |
$28K |
| 31231 |
|
478 |
459 |
$27K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
2,233 |
1,978 |
$27K |
| 42820 |
Tonsillectomy and adenoidectomy; younger than age 12 |
96 |
88 |
$23K |
| 0002A |
|
1,021 |
946 |
$21K |
| 90833 |
Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) |
642 |
428 |
$20K |
| 81025 |
|
4,797 |
4,273 |
$18K |
| 76830 |
Ultrasound, transvaginal |
142 |
138 |
$17K |
| 99243 |
|
168 |
150 |
$17K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
189 |
172 |
$16K |
| G0101 |
Cervical or vaginal cancer screening; pelvic and clinical breast examination |
518 |
473 |
$15K |
| 96161 |
|
4,908 |
4,304 |
$14K |
| 83655 |
|
1,858 |
1,707 |
$14K |
| 0001A |
|
1,177 |
1,026 |
$14K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
253 |
212 |
$14K |
| 99177 |
|
1,265 |
1,128 |
$13K |
| 92579 |
|
443 |
425 |
$13K |
| 69436 |
Tympanostomy (requiring insertion of ventilating tube), general anesthesia |
56 |
53 |
$13K |
| 31237 |
|
86 |
65 |
$12K |
| 99239 |
Hospital discharge day management, more than 30 minutes |
161 |
144 |
$12K |
| 99242 |
|
187 |
179 |
$12K |
| 99384 |
|
120 |
112 |
$12K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
390 |
339 |
$11K |
| 15002 |
|
104 |
53 |
$11K |
| 99219 |
|
164 |
111 |
$9K |
| 99442 |
|
639 |
552 |
$9K |
| 94664 |
|
652 |
625 |
$9K |
| 92504 |
|
407 |
370 |
$8K |
| 44970 |
|
15 |
12 |
$8K |
| 99254 |
|
61 |
53 |
$7K |
| 15003 |
|
36 |
14 |
$7K |
| 97802 |
|
149 |
124 |
$6K |
| 85018 |
|
4,162 |
3,730 |
$6K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
201 |
183 |
$6K |
| 99225 |
|
173 |
107 |
$6K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
302 |
280 |
$5K |
| 92552 |
|
214 |
204 |
$5K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
1,301 |
1,078 |
$5K |
| 92550 |
|
331 |
307 |
$5K |
| 51792 |
|
27 |
25 |
$5K |
| 42900 |
|
15 |
13 |
$4K |
| 94016 |
|
276 |
229 |
$4K |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
220 |
206 |
$4K |
| 99383 |
|
45 |
43 |
$3K |
| 76825 |
|
20 |
13 |
$3K |
| 94060 |
|
213 |
185 |
$3K |
| 76801 |
|
28 |
28 |
$3K |
| 99382 |
|
85 |
55 |
$3K |
| 88720 |
|
1,207 |
985 |
$3K |
| 92555 |
|
155 |
143 |
$3K |
| 99217 |
|
88 |
67 |
$3K |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
26 |
25 |
$3K |
| 0500F |
|
770 |
743 |
$2K |
| 81002 |
|
15,136 |
12,475 |
$2K |
| 99253 |
|
35 |
29 |
$2K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
70 |
57 |
$2K |
| 90686 |
|
10,417 |
9,196 |
$2K |
| 96127 |
|
439 |
389 |
$2K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
276 |
217 |
$2K |
| 51784 |
|
21 |
12 |
$2K |
| 3044F |
|
1,943 |
1,681 |
$1K |
| 99220 |
|
14 |
13 |
$1K |
| 97803 |
|
46 |
38 |
$1K |
| 69210 |
|
43 |
40 |
$1K |
| 54150 |
|
12 |
12 |
$1K |
| 31622 |
|
18 |
16 |
$1K |
| 0031A |
|
78 |
76 |
$1K |
| 31579 |
|
15 |
14 |
$1K |
| 96118 |
|
31 |
12 |
$1K |
| 93000 |
|
101 |
85 |
$1K |
| 95117 |
|
151 |
105 |
$1K |
| G0108 |
Diabetes outpatient self-management training services, individual, per 30 minutes |
35 |
29 |
$934.75 |
| 76827 |
|
20 |
13 |
$918.62 |
| 94729 |
|
167 |
144 |
$908.76 |
| 31526 |
|
16 |
14 |
$866.00 |
| 94726 |
|
101 |
95 |
$815.18 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
113 |
89 |
$698.45 |
| 3046F |
|
226 |
219 |
$680.00 |
| 90834 |
Psychotherapy, 45 minutes with patient |
83 |
48 |
$665.37 |
| 99188 |
|
84 |
55 |
$565.80 |
| 90715 |
|
134 |
125 |
$531.59 |
| 36416 |
|
144 |
132 |
$463.42 |
| 94760 |
|
304 |
262 |
$459.47 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
14 |
13 |
$406.31 |
| G2211 |
Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established) |
1,382 |
1,296 |
$320.41 |
| 3075F |
|
817 |
756 |
$315.00 |
| 90670 |
|
10,797 |
9,809 |
$300.99 |
| 90677 |
|
839 |
827 |
$298.04 |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
19 |
15 |
$244.80 |
| 93325 |
|
18 |
12 |
$226.21 |
| 99443 |
|
15 |
13 |
$207.35 |
| 3077F |
|
645 |
598 |
$190.01 |
| 1160F |
|
45,474 |
41,853 |
$162.51 |
| 1159F |
|
13,948 |
13,122 |
$162.51 |
| 3008F |
|
42,998 |
39,461 |
$162.51 |
| 90697 |
|
1,820 |
1,742 |
$148.76 |
| 83037 |
|
55 |
32 |
$129.72 |
| 99406 |
|
23 |
15 |
$108.50 |
| 3725F |
|
13,197 |
11,950 |
$105.48 |
| 84030 |
|
59 |
39 |
$77.77 |
| 90716 |
|
266 |
239 |
$68.77 |
| 3078F |
|
24,040 |
22,091 |
$25.00 |
| 90723 |
|
1,274 |
1,135 |
$11.02 |
| 90633 |
|
3,557 |
3,250 |
$8.26 |
| 91301 |
|
6,647 |
5,910 |
$7.18 |
| 90698 |
|
3,642 |
3,341 |
$4.25 |
| 90680 |
|
7,251 |
6,712 |
$4.10 |
| 91300 |
|
1,966 |
1,629 |
$1.30 |
| 91307 |
|
67 |
32 |
$0.18 |
| 90651 |
|
178 |
162 |
$0.09 |
| 91303 |
|
91 |
73 |
$0.05 |
| 90648 |
|
2,309 |
2,070 |
$0.01 |
| 0502F |
|
17,224 |
14,240 |
$0.00 |
| 90685 |
|
694 |
562 |
$0.00 |
| 3288F |
|
6,007 |
5,439 |
$0.00 |
| 90710 |
|
256 |
240 |
$0.00 |
| 4005F |
|
172 |
157 |
$0.00 |
| 90707 |
|
288 |
261 |
$0.00 |
| 90734 |
|
195 |
193 |
$0.00 |
| 4187F |
|
137 |
131 |
$0.00 |
| 90700 |
|
43 |
39 |
$0.00 |
| 90713 |
|
22 |
15 |
$0.00 |
| 3050F |
|
140 |
124 |
$0.00 |
| 90671 |
|
246 |
236 |
$0.00 |
| 0368T |
|
43 |
15 |
$0.00 |
| T1017 |
Targeted case management, each 15 minutes |
523 |
225 |
$0.00 |
| 99358 |
Prolong nursin fac eval 15m |
29 |
28 |
$0.00 |
| 99173 |
|
12 |
12 |
$0.00 |
| 99024 |
|
8,562 |
5,380 |
$0.00 |
| 90619 |
|
29 |
28 |
$0.00 |
| 1126F |
|
5,740 |
5,231 |
$0.00 |
| 1157F |
|
6,414 |
5,789 |
$0.00 |
| 1111F |
|
8,295 |
7,485 |
$0.00 |
| 1125F |
|
1,268 |
1,129 |
$0.00 |
| 3079F |
|
5,560 |
5,091 |
$0.00 |
| 3080F |
|
246 |
233 |
$0.00 |
| 4010F |
|
1,823 |
1,648 |
$0.00 |
| 3048F |
|
1,042 |
935 |
$0.00 |
| 3049F |
|
400 |
363 |
$0.00 |
| 90656 |
|
454 |
448 |
$0.00 |
| 1170F |
|
132 |
127 |
$0.00 |
| 90744 |
|
329 |
299 |
$0.00 |
| 90696 |
|
56 |
54 |
$0.00 |
| 92558 |
|
13 |
12 |
$0.00 |
| 90688 |
|
16 |
12 |
$0.00 |