| Code | Description | Claims | Beneficiaries | Total Paid |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
59,558 |
55,016 |
$4.30M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
26,510 |
23,961 |
$3.14M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
17,618 |
15,816 |
$2.53M |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
21,579 |
18,853 |
$1.36M |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
26,923 |
24,532 |
$891K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
26,915 |
24,528 |
$873K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
125,252 |
104,065 |
$813K |
| 80053 |
Comprehensive metabolic panel |
100,435 |
87,095 |
$793K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
17,504 |
15,480 |
$733K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
17,713 |
14,616 |
$683K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
1,039 |
946 |
$677K |
| 70450 |
Computed tomography, head or brain; without contrast material |
4,538 |
4,108 |
$667K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
14,665 |
11,812 |
$662K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
9,420 |
8,875 |
$525K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
3,586 |
3,257 |
$520K |
| G0378 |
Hospital observation service, per hour |
16,066 |
6,617 |
$505K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
12,557 |
11,776 |
$407K |
| 71046 |
Radiologic examination, chest; 2 views |
11,817 |
10,915 |
$407K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
25,262 |
22,255 |
$404K |
| 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 |
7,005 |
5,936 |
$399K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
6,386 |
3,450 |
$373K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
20,290 |
16,777 |
$354K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
24,063 |
18,186 |
$335K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
12,983 |
10,581 |
$324K |
| 36415 |
Collection of venous blood by venipuncture |
134,831 |
107,449 |
$278K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
5,426 |
4,629 |
$245K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
3,370 |
3,060 |
$243K |
| 84443 |
Thyroid stimulating hormone (TSH) |
12,285 |
10,972 |
$219K |
| J3490 |
Unclassified drugs |
54,101 |
19,767 |
$214K |
| 59025 |
Fetal non-stress test |
4,337 |
3,503 |
$207K |
| 71045 |
Radiologic examination, chest; single view |
10,382 |
9,222 |
$197K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
2,368 |
2,107 |
$192K |
| 80061 |
Lipid panel |
12,122 |
11,112 |
$189K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
4,748 |
1,385 |
$187K |
| 84484 |
|
33,100 |
17,467 |
$176K |
| 69436 |
Tympanostomy (requiring insertion of ventilating tube), general anesthesia |
196 |
193 |
$171K |
| 87077 |
|
17,669 |
16,436 |
$157K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
2,208 |
1,272 |
$154K |
| 86780 |
|
9,098 |
8,074 |
$149K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
4,605 |
4,043 |
$132K |
| 81025 |
|
16,957 |
15,449 |
$130K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
3,515 |
3,197 |
$129K |
| 87400 |
|
5,432 |
5,195 |
$121K |
| 81001 |
|
39,335 |
35,440 |
$116K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
3,532 |
3,044 |
$111K |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
4,120 |
3,855 |
$109K |
| 83690 |
|
15,719 |
14,431 |
$97K |
| 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 |
1,002 |
917 |
$83K |
| 88142 |
|
3,938 |
3,516 |
$82K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
12,251 |
9,129 |
$78K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
8,517 |
7,711 |
$71K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
6,586 |
6,018 |
$70K |
| 11045 |
|
735 |
449 |
$69K |
| 96376 |
|
2,324 |
1,277 |
$66K |
| 86701 |
|
5,509 |
5,026 |
$57K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
2,114 |
1,689 |
$55K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
4,093 |
3,868 |
$55K |
| 86803 |
|
3,051 |
2,609 |
$53K |
| 0202U |
Oncology (prostate), multianalyte, gene expression profiling |
533 |
465 |
$48K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
10,492 |
7,898 |
$46K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
94 |
91 |
$44K |
| 94060 |
|
1,107 |
1,019 |
$43K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
187 |
167 |
$42K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
2,432 |
1,587 |
$40K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
652 |
612 |
$39K |
| 87428 |
|
620 |
577 |
$38K |
| 94727 |
|
1,117 |
1,033 |
$38K |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
3,660 |
2,916 |
$38K |
| 82728 |
|
5,174 |
4,642 |
$36K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
11,135 |
10,147 |
$35K |
| 81220 |
CFTR (cystic fibrosis transmembrane conductance regulator) gene analysis; common variants |
134 |
125 |
$34K |
| 87070 |
|
3,485 |
3,310 |
$33K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
119 |
117 |
$32K |
| 87340 |
|
2,785 |
2,390 |
$30K |
| 83735 |
|
6,900 |
5,270 |
$30K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
2,208 |
2,049 |
$26K |
| 83605 |
|
3,726 |
2,819 |
$25K |
| 86850 |
|
2,124 |
1,814 |
$25K |
| 83880 |
|
1,835 |
1,568 |
$25K |
| 95810 |
Polysomnography; sleep staging with 4 or more additional parameters |
105 |
103 |
$25K |
| 83550 |
|
5,268 |
4,732 |
$24K |
| 85027 |
|
3,835 |
3,156 |
$23K |
| 95819 |
|
235 |
231 |
$22K |
| 86003 |
|
159 |
93 |
$20K |
| 94729 |
|
454 |
388 |
$20K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
575 |
538 |
$19K |
| 77336 |
|
377 |
145 |
$19K |
| 83540 |
|
5,486 |
4,910 |
$19K |
| 81003 |
|
7,892 |
7,135 |
$18K |
| 86787 |
|
1,186 |
1,019 |
$18K |
| 86762 |
|
1,030 |
872 |
$18K |
| J7050 |
Infusion, normal saline solution, 250 cc |
5,236 |
2,326 |
$17K |
| 88342 |
|
186 |
171 |
$16K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
1,317 |
798 |
$16K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
5,165 |
4,397 |
$15K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
129 |
123 |
$15K |
| 93017 |
|
203 |
182 |
$15K |
| J1815 |
Injection, insulin, per 5 units |
1,823 |
1,027 |
$14K |
| 81513 |
|
1,658 |
1,477 |
$14K |
| J1756 |
Injection, iron sucrose, 1 mg |
460 |
206 |
$13K |
| C1713 |
Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) |
14 |
14 |
$13K |
| 82105 |
|
512 |
467 |
$11K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
1,812 |
1,530 |
$11K |
| J2704 |
Injection, propofol, 10 mg |
2,342 |
2,188 |
$11K |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
377 |
334 |
$11K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
111 |
99 |
$11K |
| J2785 |
Injection, regadenoson, 0.1 mg |
133 |
116 |
$11K |
| 87536 |
|
229 |
219 |
$11K |
| 84702 |
|
1,030 |
884 |
$10K |
| 95813 |
|
47 |
43 |
$10K |
| 94618 |
|
1,027 |
971 |
$10K |
| A9500 |
Technetium tc-99m sestamibi, diagnostic, per study dose |
208 |
174 |
$10K |
| 82950 |
|
1,517 |
1,376 |
$10K |
| 80305 |
|
1,138 |
1,072 |
$10K |
| J1439 |
Injection, ferric carboxymaltose, 1 mg |
17 |
12 |
$10K |
| 94761 |
|
4,625 |
2,285 |
$9K |
| 83021 |
|
364 |
304 |
$8K |
| 82962 |
|
11,899 |
3,211 |
$8K |
| 17250 |
|
298 |
201 |
$8K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
329 |
302 |
$8K |
| 82607 |
|
550 |
491 |
$8K |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
2,258 |
1,352 |
$8K |
| 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 |
242 |
222 |
$8K |
| 86706 |
|
576 |
467 |
$8K |
| 87081 |
|
912 |
827 |
$8K |
| 95811 |
|
25 |
24 |
$7K |
| 84439 |
|
628 |
593 |
$7K |
| 0240U |
|
53 |
46 |
$7K |
| 36600 |
|
585 |
536 |
$7K |
| 86705 |
|
486 |
384 |
$7K |
| 97597 |
|
417 |
324 |
$7K |
| 96523 |
|
156 |
137 |
$6K |
| 86360 |
|
102 |
99 |
$6K |
| 82803 |
|
703 |
619 |
$6K |
| 66984 |
Extracapsular cataract removal with insertion of intraocular lens prosthesis |
36 |
36 |
$6K |
| 73630 |
|
155 |
129 |
$6K |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
1,975 |
1,461 |
$6K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
80 |
79 |
$5K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
984 |
764 |
$5K |
| 86359 |
|
102 |
99 |
$5K |
| 94664 |
|
597 |
510 |
$5K |
| 86140 |
|
656 |
610 |
$4K |
| 82043 |
|
560 |
510 |
$4K |
| 83020 |
|
260 |
230 |
$4K |
| 96367 |
|
220 |
171 |
$4K |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
1,021 |
837 |
$4K |
| 97162 |
|
85 |
82 |
$4K |
| 87420 |
|
192 |
189 |
$3K |
| 86696 |
|
197 |
140 |
$3K |
| 85610 |
|
1,881 |
1,499 |
$3K |
| 82570 |
|
450 |
413 |
$3K |
| 93797 |
|
349 |
48 |
$3K |
| 77334 |
|
31 |
12 |
$3K |
| 86592 |
|
540 |
520 |
$3K |
| 86900 |
|
855 |
711 |
$3K |
| 86901 |
|
855 |
711 |
$3K |
| 80074 |
|
44 |
42 |
$3K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
28 |
28 |
$3K |
| 87481 |
|
131 |
123 |
$3K |
| 85652 |
|
753 |
716 |
$3K |
| 87511 |
|
133 |
125 |
$3K |
| 83525 |
|
170 |
153 |
$3K |
| 80076 |
|
293 |
279 |
$3K |
| 85730 |
|
1,050 |
893 |
$2K |
| 36591 |
|
113 |
86 |
$2K |
| 45385 |
Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) |
40 |
40 |
$2K |
| 84550 |
|
437 |
411 |
$2K |
| 84481 |
|
93 |
86 |
$2K |
| 87186 |
|
325 |
261 |
$2K |
| 86695 |
|
197 |
140 |
$2K |
| 82677 |
|
80 |
72 |
$2K |
| 87040 |
|
977 |
428 |
$2K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
269 |
251 |
$2K |
| 96417 |
|
29 |
16 |
$2K |
| 84403 |
|
41 |
39 |
$2K |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
363 |
209 |
$2K |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
339 |
318 |
$2K |
| 84402 |
|
39 |
37 |
$2K |
| 94799 |
|
106 |
72 |
$2K |
| J1644 |
Injection, heparin sodium, per 1000 units |
1,285 |
481 |
$2K |
| 87625 |
|
54 |
49 |
$1K |
| 73130 |
|
25 |
25 |
$1K |
| 86336 |
|
80 |
72 |
$1K |
| J8540 |
Dexamethasone, oral, 0.25 mg |
239 |
213 |
$1K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
14 |
12 |
$1K |
| 80143 |
|
124 |
105 |
$1K |
| 73562 |
|
12 |
12 |
$1K |
| 73030 |
|
14 |
14 |
$1K |
| 72100 |
|
14 |
13 |
$1K |
| A4216 |
Sterile water, saline and/or dextrose, diluent/flush, 10 ml |
933 |
685 |
$997.59 |
| 86361 |
|
39 |
39 |
$995.56 |
| J8597 |
Antiemetic drug, oral, not otherwise specified |
348 |
331 |
$966.41 |
| G0008 |
Administration of influenza virus vaccine |
143 |
139 |
$963.32 |
| 0296T |
|
26 |
24 |
$947.12 |
| 84100 |
|
491 |
369 |
$868.20 |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
71 |
25 |
$835.17 |
| 85055 |
|
110 |
77 |
$831.58 |
| 74022 |
|
12 |
12 |
$825.84 |
| G0239 |
Therapeutic procedures to improve respiratory function or increase strength or endurance of respiratory muscles, two or more individuals (includes monitoring) |
153 |
28 |
$822.84 |
| 82948 |
|
400 |
181 |
$815.18 |
| 45378 |
Colonoscopy, flexible; diagnostic, including collection of specimen(s) |
15 |
15 |
$785.57 |
| 85046 |
|
347 |
320 |
$777.23 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
36 |
32 |
$750.20 |
| 90686 |
|
113 |
111 |
$725.16 |
| 85379 |
|
171 |
149 |
$700.28 |
| 82785 |
|
46 |
39 |
$693.33 |
| 97164 |
|
28 |
25 |
$657.08 |
| 82746 |
|
69 |
63 |
$592.63 |
| 87210 |
|
128 |
125 |
$551.53 |
| 88304 |
|
12 |
12 |
$551.46 |
| 43235 |
|
25 |
24 |
$520.60 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
23 |
17 |
$516.78 |
| J1940 |
Injection, furosemide, up to 20 mg |
277 |
154 |
$493.73 |
| 82330 |
|
78 |
64 |
$442.52 |
| 84156 |
|
86 |
57 |
$430.86 |
| 87075 |
|
48 |
40 |
$380.17 |
| 77417 |
|
29 |
14 |
$379.60 |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
14 |
12 |
$378.68 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
120 |
106 |
$368.65 |
| G0257 |
Unscheduled or emergency dialysis treatment for an esrd patient in a hospital outpatient department that is not certified as an esrd facility |
47 |
25 |
$342.24 |
| J2003 |
Injection, lidocaine hydrochloride, 1 mg |
73 |
72 |
$330.96 |
| 86141 |
|
17 |
16 |
$320.28 |
| 90715 |
|
12 |
12 |
$316.29 |
| J3370 |
Injection, vancomycin hcl, 500 mg |
72 |
39 |
$309.98 |
| 96401 |
|
16 |
12 |
$294.61 |
| 97010 |
|
98 |
38 |
$225.84 |
| J2469 |
Injection, palonosetron hcl, 25 mcg |
57 |
39 |
$225.19 |
| 85018 |
|
117 |
97 |
$200.02 |
| G0123 |
Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, screening by cytotechnologist under physician supervision |
49 |
44 |
$198.56 |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
27 |
25 |
$193.39 |
| J8499 |
Prescription drug, oral, non chemotherapeutic, nos |
1,001 |
815 |
$187.27 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
71 |
49 |
$181.68 |
| 80179 |
|
87 |
77 |
$176.52 |
| 87205 |
|
48 |
40 |
$171.15 |
| J2360 |
Injection, orphenadrine citrate, up to 60 mg |
42 |
36 |
$169.42 |
| 82104 |
|
14 |
12 |
$159.47 |
| 83615 |
|
74 |
53 |
$158.27 |
| 85014 |
|
72 |
56 |
$152.82 |
| 82103 |
|
14 |
12 |
$148.22 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
33 |
31 |
$130.41 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
15 |
12 |
$119.43 |
| 84478 |
|
36 |
30 |
$92.89 |
| 82947 |
|
26 |
25 |
$88.78 |
| J0360 |
Injection, hydralazine hcl, up to 20 mg |
70 |
50 |
$85.25 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
24 |
12 |
$79.04 |
| 85660 |
|
12 |
12 |
$75.68 |
| A9270 |
Non-covered item or service |
14,921 |
3,060 |
$74.56 |
| J2060 |
Injection, lorazepam, 2 mg |
27 |
25 |
$73.99 |
| J0171 |
Injection, adrenalin, epinephrine, 0.1 mg |
43 |
38 |
$73.29 |
| J2004 |
Injection, lidocaine hcl with epinephrine, 1 mg |
15 |
15 |
$65.49 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
99 |
54 |
$52.12 |
| J0456 |
Injection, azithromycin, 500 mg |
19 |
13 |
$37.80 |
| 84132 |
|
42 |
39 |
$33.94 |
| C9113 |
Injection, pantoprazole sodium, per vial |
24 |
13 |
$33.60 |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
18 |
12 |
$19.63 |
| 85008 |
|
73 |
52 |
$8.58 |
| G1004 |
Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program |
1,804 |
1,236 |
$0.06 |
| G8980 |
Mobility: walking & moving around functional limitation, discharge status, at discharge from therapy or to end reporting |
16 |
14 |
$0.00 |
| J1642 |
Injection, heparin sodium, (heparin lock flush), per 10 units |
49 |
24 |
$0.00 |
| 95806 |
|
17 |
13 |
$0.00 |
| G8979 |
Mobility: walking & moving around functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting |
76 |
59 |
$0.00 |
| G8978 |
Mobility: walking & moving around functional limitation, current status, at therapy episode outset and at reporting intervals |
80 |
59 |
$0.00 |
| 81401 |
|
57 |
56 |
$0.00 |
| 84295 |
|
14 |
13 |
$0.00 |
| 80348 |
|
153 |
83 |
$0.00 |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
13 |
13 |
$0.00 |