| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
Emergency department visit for the evaluation and management, high severity |
76,562 |
68,358 |
$19.10M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
84,133 |
78,057 |
$14.42M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
37,180 |
33,372 |
$11.94M |
| A0429 |
Ambulance service, basic life support, emergency transport (bls-emergency) |
26,364 |
20,697 |
$7.53M |
| A0427 |
Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) |
20,727 |
18,652 |
$5.86M |
| A0430 |
Ambulance service, conventional air services, transport, one way (fixed wing) |
2,666 |
2,541 |
$5.16M |
| A0435 |
Fixed wing air mileage, per statute mile |
2,575 |
2,497 |
$3.94M |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
8,801 |
8,357 |
$3.17M |
| G0378 |
Hospital observation service, per hour |
5,100 |
4,812 |
$2.89M |
| 96361 |
Intravenous infusion, hydration; each additional hour |
49,149 |
41,902 |
$2.83M |
| 70450 |
Computed tomography, head or brain; without contrast material |
13,386 |
12,292 |
$2.78M |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
50,886 |
44,504 |
$2.50M |
| A0431 |
Ambulance service, conventional air services, transport, one way (rotary wing) |
1,203 |
1,121 |
$2.30M |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
33,716 |
28,902 |
$2.20M |
| 87631 |
|
16,865 |
16,051 |
$2.20M |
| 96375 |
Therapeutic injection; each additional sequential IV push |
36,273 |
31,006 |
$2.08M |
| 71045 |
Radiologic examination, chest; single view |
32,924 |
30,034 |
$1.95M |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
16,542 |
10,186 |
$1.82M |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
7,061 |
6,618 |
$1.69M |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
5,088 |
4,835 |
$1.59M |
| 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 |
19,397 |
16,903 |
$1.53M |
| A0436 |
Rotary wing air mileage, per statute mile |
1,139 |
1,071 |
$1.46M |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
12,816 |
12,172 |
$1.30M |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
22,447 |
6,867 |
$1.20M |
| 80053 |
Comprehensive metabolic panel |
103,530 |
89,451 |
$1.16M |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
123,923 |
103,140 |
$996K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
13,081 |
11,608 |
$958K |
| D2930 |
Prefabricated stainless steel crown - primary tooth |
6,578 |
937 |
$880K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
2,431 |
2,301 |
$868K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
5,273 |
3,769 |
$865K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
3,816 |
3,589 |
$859K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
10,663 |
6,890 |
$848K |
| 92507 |
Treatment of speech, language, voice, communication, and/or auditory processing disorder |
11,898 |
4,040 |
$841K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
11,226 |
4,502 |
$776K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
1,600 |
1,554 |
$747K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
2,549 |
2,457 |
$652K |
| 36415 |
Collection of venous blood by venipuncture |
123,588 |
101,815 |
$587K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
1,065 |
1,037 |
$543K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
4,856 |
4,657 |
$528K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
12,219 |
11,891 |
$527K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
980 |
918 |
$518K |
| 70486 |
|
2,353 |
2,236 |
$498K |
| 47563 |
|
135 |
135 |
$488K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
1,551 |
1,495 |
$475K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
15,203 |
12,847 |
$452K |
| 71046 |
Radiologic examination, chest; 2 views |
7,651 |
7,286 |
$438K |
| 59025 |
Fetal non-stress test |
3,296 |
2,375 |
$426K |
| A0428 |
Ambulance service, basic life support, non-emergency transport, (bls) |
3,900 |
3,644 |
$415K |
| 87590 |
|
16,323 |
15,581 |
$403K |
| 49083 |
|
1,241 |
518 |
$401K |
| A0425 |
Ground mileage, per statute mile |
15,276 |
12,519 |
$367K |
| 87490 |
|
16,328 |
15,585 |
$365K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
1,168 |
1,118 |
$353K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
3,113 |
3,017 |
$350K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
10,320 |
3,628 |
$339K |
| C9803 |
Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
14,193 |
13,524 |
$336K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
4,168 |
2,956 |
$332K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
39,257 |
35,606 |
$326K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
725 |
677 |
$299K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
7,328 |
6,061 |
$286K |
| 83690 |
|
42,064 |
37,461 |
$283K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
502 |
488 |
$279K |
| 73610 |
|
2,898 |
2,731 |
$279K |
| 76830 |
Ultrasound, transvaginal |
2,431 |
2,373 |
$277K |
| J3490 |
Unclassified drugs |
29,383 |
13,085 |
$275K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
8,790 |
8,578 |
$274K |
| 73030 |
|
2,929 |
2,726 |
$255K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
40,265 |
32,901 |
$247K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
1,684 |
1,670 |
$247K |
| 92588 |
|
1,284 |
1,267 |
$232K |
| 84443 |
Thyroid stimulating hormone (TSH) |
14,657 |
14,027 |
$226K |
| 93971 |
|
2,341 |
2,201 |
$217K |
| 45378 |
Colonoscopy, flexible; diagnostic, including collection of specimen(s) |
421 |
411 |
$209K |
| 81001 |
|
44,966 |
41,393 |
$206K |
| D3220 |
Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction |
1,713 |
484 |
$204K |
| 73562 |
|
2,029 |
1,949 |
$202K |
| 93017 |
|
1,506 |
1,421 |
$200K |
| G0481 |
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; 8-14 drug class(es), including metabolite(s) if performed |
1,151 |
1,117 |
$198K |
| 84484 |
|
18,406 |
14,637 |
$195K |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
11,990 |
10,962 |
$191K |
| 74018 |
|
2,917 |
2,577 |
$189K |
| G0390 |
Trauma response team associated with hospital critical care service |
600 |
572 |
$183K |
| 80306 |
|
9,951 |
9,351 |
$179K |
| 83880 |
|
7,147 |
6,426 |
$177K |
| 72100 |
|
1,908 |
1,810 |
$173K |
| 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 |
2,631 |
2,524 |
$170K |
| 73630 |
|
2,588 |
2,475 |
$168K |
| D7140 |
Extraction, erupted tooth or exposed root |
1,435 |
396 |
$167K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
13,457 |
12,582 |
$163K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
2,902 |
1,145 |
$162K |
| 73130 |
|
2,422 |
2,290 |
$162K |
| 82803 |
|
9,752 |
7,455 |
$160K |
| 76801 |
|
1,387 |
1,202 |
$158K |
| J1644 |
Injection, heparin sodium, per 1000 units |
6,375 |
3,497 |
$156K |
| 45385 |
Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) |
255 |
248 |
$155K |
| 43235 |
|
425 |
417 |
$153K |
| D2932 |
|
1,320 |
383 |
$145K |
| G0475 |
Hiv antigen/antibody, combination assay, screening |
5,982 |
5,879 |
$145K |
| 73560 |
|
2,643 |
2,498 |
$142K |
| 80061 |
Lipid panel |
10,325 |
10,004 |
$141K |
| 92523 |
|
979 |
947 |
$141K |
| 12002 |
|
1,240 |
1,191 |
$139K |
| 93303 |
Transthoracic echocardiography for congenital cardiac anomalies, follow-up or limited study |
141 |
140 |
$136K |
| 80074 |
|
2,760 |
2,701 |
$135K |
| 81025 |
|
15,326 |
14,154 |
$134K |
| 73110 |
|
2,031 |
1,924 |
$132K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
12,884 |
12,457 |
$131K |
| 82077 |
|
6,566 |
5,650 |
$126K |
| 71250 |
|
806 |
767 |
$126K |
| 12001 |
|
1,116 |
1,076 |
$126K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
2,524 |
2,422 |
$120K |
| 92567 |
|
2,687 |
2,626 |
$120K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
1,075 |
1,055 |
$119K |
| 94726 |
|
817 |
785 |
$116K |
| 87633 |
Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets |
267 |
259 |
$98K |
| G0123 |
Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, screening by cytotechnologist under physician supervision |
3,862 |
3,815 |
$98K |
| 92557 |
|
833 |
814 |
$95K |
| 87186 |
|
10,438 |
9,834 |
$93K |
| J8501 |
Aprepitant, oral, 5 mg |
1,560 |
1,520 |
$93K |
| 84439 |
|
9,306 |
9,043 |
$92K |
| 83605 |
|
8,986 |
7,127 |
$92K |
| 96376 |
|
6,950 |
5,460 |
$92K |
| J0561 |
Injection, penicillin g benzathine, 100,000 units |
865 |
828 |
$92K |
| 76770 |
|
906 |
873 |
$89K |
| P9047 |
Infusion, albumin (human), 25%, 50 ml |
476 |
167 |
$88K |
| 97161 |
|
2,897 |
2,748 |
$87K |
| 84702 |
|
5,260 |
3,827 |
$86K |
| 85610 |
|
23,934 |
20,586 |
$84K |
| 83735 |
|
13,651 |
10,490 |
$84K |
| 73140 |
|
1,200 |
1,131 |
$84K |
| 73080 |
|
1,284 |
1,200 |
$84K |
| 76536 |
|
752 |
729 |
$83K |
| 88304 |
|
2,797 |
2,715 |
$81K |
| 10060 |
|
709 |
675 |
$80K |
| A6260 |
Wound cleansers, any type, any size |
6,308 |
3,145 |
$78K |
| 88342 |
|
1,540 |
1,487 |
$76K |
| A9270 |
Non-covered item or service |
34,499 |
14,424 |
$76K |
| 72141 |
|
238 |
230 |
$74K |
| 82962 |
|
22,193 |
10,938 |
$72K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
9,772 |
8,301 |
$70K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
2,834 |
2,739 |
$70K |
| J8499 |
Prescription drug, oral, non chemotherapeutic, nos |
47,659 |
30,718 |
$70K |
| 87081 |
|
8,393 |
8,115 |
$70K |
| 73502 |
|
1,441 |
1,332 |
$70K |
| 12011 |
|
644 |
625 |
$70K |
| 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 |
1,798 |
1,778 |
$70K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
1,316 |
1,297 |
$69K |
| 87480 |
|
3,007 |
2,875 |
$69K |
| P9016 |
Red blood cells, leukocytes reduced, each unit |
252 |
199 |
$69K |
| 86920 |
|
342 |
281 |
$68K |
| 87510 |
|
3,007 |
2,875 |
$68K |
| 87660 |
|
3,008 |
2,876 |
$68K |
| 81220 |
CFTR (cystic fibrosis transmembrane conductance regulator) gene analysis; common variants |
121 |
118 |
$67K |
| 85730 |
|
11,779 |
10,727 |
$67K |
| 36430 |
|
279 |
210 |
$67K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
1,065 |
1,012 |
$66K |
| J2785 |
Injection, regadenoson, 0.1 mg |
694 |
649 |
$64K |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
3,622 |
3,114 |
$62K |
| 87040 |
|
8,233 |
4,311 |
$62K |
| 86003 |
|
369 |
240 |
$62K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
804 |
696 |
$61K |
| C1713 |
Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) |
475 |
465 |
$60K |
| 78815 |
Positron emission tomography (PET) for limited area imaging |
103 |
99 |
$60K |
| 82728 |
|
4,849 |
4,668 |
$59K |
| 29125 |
|
481 |
454 |
$58K |
| 87077 |
|
7,305 |
6,890 |
$58K |
| 86850 |
|
7,225 |
6,319 |
$58K |
| A9500 |
Technetium tc-99m sestamibi, diagnostic, per study dose |
939 |
879 |
$58K |
| 87070 |
|
6,477 |
6,129 |
$58K |
| 73590 |
|
920 |
877 |
$57K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
3,629 |
3,461 |
$56K |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
6,549 |
5,510 |
$52K |
| 76642 |
|
506 |
490 |
$52K |
| 84703 |
|
5,628 |
5,364 |
$52K |
| 86900 |
|
7,640 |
6,863 |
$51K |
| 82607 |
|
3,595 |
3,481 |
$50K |
| 94729 |
|
843 |
810 |
$50K |
| J2704 |
Injection, propofol, 10 mg |
6,848 |
6,525 |
$50K |
| G0482 |
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; 15-21 drug class(es), including metabolite(s) if performed |
262 |
251 |
$50K |
| 97597 |
|
482 |
357 |
$49K |
| 86140 |
|
7,931 |
7,103 |
$48K |
| 86803 |
|
3,001 |
2,940 |
$47K |
| 97162 |
|
1,088 |
1,016 |
$47K |
| J7050 |
Infusion, normal saline solution, 250 cc |
4,302 |
2,593 |
$47K |
| 83550 |
|
5,181 |
5,000 |
$46K |
| 73090 |
|
676 |
643 |
$46K |
| 80055 |
|
829 |
806 |
$46K |
| 70491 |
|
131 |
130 |
$45K |
| C1769 |
Guide wire |
1,952 |
1,627 |
$45K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
7,548 |
4,287 |
$42K |
| 86235 |
|
679 |
333 |
$40K |
| 96367 |
|
1,118 |
942 |
$39K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
930 |
908 |
$36K |
| 86901 |
|
7,636 |
6,860 |
$36K |
| 85379 |
|
3,389 |
3,194 |
$35K |
| 73120 |
|
313 |
304 |
$35K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
917 |
895 |
$35K |
| 88307 |
|
207 |
201 |
$35K |
| 86592 |
|
6,054 |
5,900 |
$34K |
| 82746 |
|
2,250 |
2,182 |
$34K |
| 80050 |
General health panel |
2,644 |
2,492 |
$34K |
| M0243 |
Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring |
83 |
81 |
$34K |
| 86038 |
|
2,328 |
2,262 |
$33K |
| 70498 |
|
78 |
76 |
$32K |
| 82330 |
|
2,706 |
2,490 |
$32K |
| D2929 |
|
111 |
29 |
$30K |
| 76942 |
|
476 |
461 |
$29K |
| 72170 |
|
395 |
381 |
$29K |
| 83970 |
|
901 |
850 |
$29K |
| 82075 |
|
1,339 |
1,093 |
$29K |
| 93458 |
|
26 |
25 |
$29K |
| 11750 |
|
102 |
99 |
$28K |
| 94010 |
|
206 |
197 |
$27K |
| 90715 |
|
2,083 |
2,007 |
$26K |
| 95812 |
|
153 |
150 |
$26K |
| 92552 |
|
224 |
221 |
$26K |
| 83540 |
|
3,803 |
3,659 |
$25K |
| 84146 |
|
1,151 |
1,113 |
$25K |
| 81003 |
|
7,908 |
6,709 |
$24K |
| 80076 |
|
2,285 |
2,045 |
$24K |
| 84100 |
|
5,294 |
4,424 |
$24K |
| 97165 |
|
755 |
719 |
$24K |
| 84403 |
|
851 |
809 |
$24K |
| A9577 |
Injection, gadobenate dimeglumine (multihance), per ml |
1,852 |
1,775 |
$23K |
| 74183 |
|
37 |
36 |
$23K |
| 92579 |
|
194 |
190 |
$23K |
| 93970 |
|
145 |
142 |
$22K |
| C1725 |
Catheter, transluminal angioplasty, non-laser (may include guidance, infusion/perfusion capability) |
969 |
751 |
$22K |
| 84145 |
|
1,478 |
1,244 |
$22K |
| 41899 |
Unlisted procedure, dentoalveolar structures |
12 |
12 |
$22K |
| 94060 |
|
266 |
257 |
$22K |
| 84481 |
|
1,091 |
1,059 |
$21K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
18,886 |
17,007 |
$21K |
| 87641 |
|
1,029 |
954 |
$20K |
| 76981 |
|
157 |
157 |
$20K |
| 85652 |
|
5,467 |
5,001 |
$20K |
| 87340 |
|
1,814 |
1,777 |
$20K |
| 92610 |
|
215 |
209 |
$19K |
| 10061 |
|
168 |
157 |
$19K |
| 72070 |
|
230 |
225 |
$19K |
| 82140 |
|
1,465 |
1,281 |
$19K |
| 83516 |
|
1,180 |
1,072 |
$18K |
| J0690 |
Injection, cefazolin sodium, 500 mg |
5,582 |
4,089 |
$18K |
| S0119 |
Ondansetron, oral, 4 mg (for circumstances falling under the medicare statute, use hcpcs q code) |
9,802 |
8,349 |
$18K |
| 71101 |
|
203 |
193 |
$18K |
| 92555 |
|
183 |
183 |
$17K |
| 87205 |
|
3,880 |
2,990 |
$17K |
| 76870 |
|
142 |
138 |
$17K |
| 77066 |
Tomosynthesis, mammo |
100 |
100 |
$17K |
| 76000 |
|
127 |
118 |
$17K |
| 87400 |
|
1,264 |
613 |
$17K |
| 81005 |
|
6,921 |
6,483 |
$16K |
| 84550 |
|
3,418 |
2,982 |
$15K |
| A0433 |
Advanced life support, level 2 (als 2) |
43 |
43 |
$15K |
| 82248 |
|
2,884 |
2,305 |
$15K |
| 73660 |
|
249 |
235 |
$15K |
| 86762 |
|
974 |
946 |
$15K |
| 80069 |
|
2,580 |
1,699 |
$15K |
| 82105 |
|
813 |
797 |
$15K |
| G0257 |
Unscheduled or emergency dialysis treatment for an esrd patient in a hospital outpatient department that is not certified as an esrd facility |
241 |
144 |
$14K |
| 86780 |
|
957 |
937 |
$14K |
| 82950 |
|
2,677 |
2,407 |
$14K |
| A6213 |
Foam dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing |
1,215 |
864 |
$14K |
| 97113 |
|
218 |
84 |
$14K |
| 83615 |
|
2,525 |
2,037 |
$14K |
| 82565 |
|
3,575 |
3,163 |
$14K |
| A9150 |
Non-prescription drugs |
10,709 |
8,529 |
$13K |
| 82570 |
|
2,840 |
2,551 |
$13K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
641 |
622 |
$13K |
| A6021 |
Collagen dressing, sterile, size 16 sq. in. or less, each |
407 |
223 |
$13K |
| 86160 |
|
942 |
461 |
$13K |
| 97166 |
|
206 |
206 |
$13K |
| 87147 |
|
2,850 |
2,751 |
$13K |
| 83001 |
|
557 |
550 |
$13K |
| 36416 |
|
14,145 |
9,961 |
$12K |
| 84425 |
|
582 |
563 |
$12K |
| C1887 |
Catheter, guiding (may include infusion/perfusion capability) |
865 |
649 |
$12K |
| 92526 |
|
140 |
81 |
$11K |
| 97163 |
|
201 |
193 |
$11K |
| 12013 |
|
140 |
133 |
$11K |
| C1776 |
Joint device (implantable) |
54 |
51 |
$11K |
| 86431 |
|
1,359 |
1,317 |
$11K |
| 84156 |
|
2,980 |
2,630 |
$11K |
| 74022 |
|
133 |
130 |
$10K |
| 86376 |
|
604 |
594 |
$10K |
| 82951 |
|
661 |
585 |
$10K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
158 |
145 |
$10K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
62 |
48 |
$10K |
| 84600 |
|
683 |
624 |
$9K |
| C9113 |
Injection, pantoprazole sodium, per vial |
3,848 |
2,981 |
$9K |
| 97167 |
|
134 |
123 |
$9K |
| 72040 |
|
95 |
90 |
$9K |
| 82550 |
|
1,284 |
1,082 |
$9K |
| 82784 |
|
871 |
773 |
$8K |
| 78227 |
|
27 |
27 |
$8K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
134 |
121 |
$8K |
| A0998 |
Ambulance response and treatment, no transport |
465 |
448 |
$8K |
| 83655 |
|
547 |
540 |
$8K |
| J0330 |
Injection, succinylcholine chloride, up to 20 mg |
1,337 |
1,277 |
$8K |
| 85027 |
|
1,016 |
991 |
$8K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
30 |
27 |
$8K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
16,501 |
13,766 |
$7K |
| 84402 |
|
277 |
265 |
$7K |
| 81511 |
|
148 |
146 |
$7K |
| 87899 |
|
377 |
181 |
$7K |
| 82670 |
|
225 |
218 |
$7K |
| 99156 |
|
835 |
770 |
$7K |
| C9290 |
Injection, bupivacaine liposome, 1 mg |
150 |
148 |
$7K |
| 85014 |
|
2,700 |
2,374 |
$7K |
| J1170 |
Injection, hydromorphone, up to 4 mg |
7,936 |
5,933 |
$7K |
| 86225 |
|
265 |
231 |
$6K |
| 88142 |
|
333 |
321 |
$6K |
| 77080 |
|
82 |
81 |
$6K |
| 29515 |
|
80 |
80 |
$6K |
| 93270 |
|
157 |
149 |
$6K |
| 91200 |
|
41 |
41 |
$6K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
9,673 |
9,088 |
$6K |
| G0279 |
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) |
160 |
157 |
$6K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
53 |
12 |
$6K |
| J1953 |
Injection, levetiracetam, 10 mg |
418 |
364 |
$5K |
| 80047 |
|
408 |
391 |
$5K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
28,436 |
24,383 |
$5K |
| A4649 |
Surgical supply; miscellaneous |
615 |
417 |
$5K |
| 86200 |
|
384 |
379 |
$5K |
| 76376 |
|
1,008 |
956 |
$5K |
| 87522 |
Neg quan hep c or qual rna |
93 |
90 |
$5K |
| A4216 |
Sterile water, saline and/or dextrose, diluent/flush, 10 ml |
5,769 |
3,793 |
$5K |
| A6210 |
Foam dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing |
222 |
141 |
$5K |
| 73600 |
|
54 |
52 |
$5K |
| 87505 |
|
313 |
307 |
$5K |
| M0245 |
Intravenous infusion, bamlanivimab and etesevimab, includes infusion and post administration monitoring |
13 |
13 |
$5K |
| 70496 |
|
14 |
14 |
$5K |
| 80320 |
|
1,639 |
1,426 |
$5K |
| 87088 |
|
960 |
918 |
$5K |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
7,176 |
5,829 |
$5K |
| 82947 |
|
1,359 |
1,261 |
$5K |
| J3370 |
Injection, vancomycin hcl, 500 mg |
401 |
254 |
$5K |
| 83002 |
|
202 |
198 |
$5K |
| 85018 |
|
1,405 |
1,186 |
$5K |
| 73552 |
|
82 |
77 |
$4K |
| 82043 |
|
598 |
583 |
$4K |
| J2560 |
Injection, phenobarbital sodium, up to 120 mg |
484 |
434 |
$4K |
| J1790 |
Injection, droperidol, up to 5 mg |
1,457 |
1,341 |
$4K |
| 84460 |
|
766 |
660 |
$4K |
| 72114 |
|
43 |
40 |
$4K |
| J7070 |
Infusion, d5w, 1000 cc |
75 |
70 |
$4K |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
971 |
803 |
$4K |
| 86696 |
|
149 |
116 |
$4K |
| J2795 |
Injection, ropivacaine hydrochloride, 1 mg |
446 |
425 |
$4K |
| 74230 |
|
42 |
42 |
$4K |
| 82800 |
|
496 |
464 |
$4K |
| 64488 |
|
202 |
199 |
$4K |
| 87338 |
|
207 |
201 |
$3K |
| 74300 |
|
69 |
69 |
$3K |
| J1815 |
Injection, insulin, per 5 units |
2,493 |
1,354 |
$3K |
| A6196 |
Alginate or other fiber gelling dressing, wound cover, sterile, pad size 16 sq. in. or less, each dressing |
227 |
127 |
$3K |
| 93226 |
|
54 |
52 |
$3K |
| 97116 |
|
162 |
98 |
$3K |
| 64450 |
|
14 |
13 |
$3K |
| 93225 |
|
52 |
50 |
$3K |
| M0222 |
Intravenous injection, bebtelovimab, includes injection and post administration monitoring |
13 |
13 |
$3K |
| J0295 |
Injection, ampicillin sodium/sulbactam sodium, per 1.5 gm |
353 |
197 |
$3K |
| G0008 |
Administration of influenza virus vaccine |
177 |
167 |
$3K |
| 87210 |
|
594 |
564 |
$3K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
70 |
70 |
$3K |
| 92582 |
|
25 |
25 |
$3K |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
692 |
647 |
$3K |
| 72110 |
|
38 |
38 |
$3K |
| 80143 |
|
163 |
149 |
$3K |
| J3480 |
Injection, potassium chloride, per 2 meq |
656 |
492 |
$3K |
| G0103 |
Prostate cancer screening; prostate specific antigen test (psa) |
139 |
137 |
$3K |
| 87807 |
|
191 |
184 |
$3K |
| 82977 |
|
335 |
304 |
$3K |
| S0166 |
Injection, olanzapine, 2.5 mg |
55 |
54 |
$3K |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
7,455 |
6,882 |
$3K |
| A6212 |
Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing |
168 |
110 |
$3K |
| J2060 |
Injection, lorazepam, 2 mg |
6,575 |
5,543 |
$3K |
| 83021 |
|
111 |
109 |
$2K |
| 84520 |
|
790 |
730 |
$2K |
| 72131 |
|
16 |
15 |
$2K |
| 99157 |
|
584 |
546 |
$2K |
| 84478 |
|
419 |
406 |
$2K |
| 86800 |
|
144 |
142 |
$2K |
| 80179 |
|
140 |
130 |
$2K |
| 97035 |
|
107 |
50 |
$2K |
| 82310 |
|
465 |
436 |
$2K |
| 73060 |
|
39 |
39 |
$2K |
| 93307 |
|
15 |
13 |
$2K |
| 92611 |
|
30 |
30 |
$2K |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
51 |
35 |
$2K |
| 84450 |
|
428 |
347 |
$2K |
| 82010 |
|
249 |
225 |
$2K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
13 |
12 |
$2K |
| 94799 |
|
24 |
24 |
$2K |
| 36901 |
|
27 |
24 |
$2K |
| 87634 |
|
177 |
169 |
$2K |
| 97763 |
|
34 |
24 |
$2K |
| A9552 |
Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries |
68 |
66 |
$2K |
| 70360 |
|
26 |
26 |
$2K |
| 84132 |
|
668 |
598 |
$2K |
| 86039 |
|
137 |
134 |
$2K |
| 76881 |
|
12 |
12 |
$2K |
| 85046 |
|
273 |
265 |
$2K |
| 87045 |
|
189 |
181 |
$2K |
| 86695 |
|
113 |
110 |
$2K |
| 84295 |
|
543 |
507 |
$2K |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
4,845 |
4,393 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
255 |
184 |
$2K |
| 82465 |
|
392 |
379 |
$2K |
| 74220 |
|
14 |
14 |
$2K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
548 |
374 |
$2K |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
2,269 |
1,794 |
$2K |
| 86318 |
|
109 |
106 |
$2K |
| 84075 |
|
326 |
267 |
$2K |
| 90686 |
|
111 |
103 |
$2K |
| 87046 |
|
150 |
143 |
$1K |
| 82553 |
|
151 |
96 |
$1K |
| 16020 |
|
17 |
16 |
$1K |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
350 |
321 |
$1K |
| 82533 |
|
70 |
66 |
$1K |
| 73100 |
|
14 |
12 |
$1K |
| 82435 |
|
428 |
399 |
$1K |
| J2550 |
Injection, promethazine hcl, up to 50 mg |
3,305 |
2,862 |
$1K |
| 92556 |
|
29 |
29 |
$1K |
| 87536 |
|
15 |
14 |
$1K |
| 80329 |
|
188 |
129 |
$1K |
| 82247 |
|
206 |
189 |
$1K |
| J3360 |
Injection, diazepam, up to 5 mg |
311 |
295 |
$1K |
| 80164 |
|
85 |
80 |
$1K |
| 87075 |
|
118 |
111 |
$1K |
| 86481 |
|
16 |
16 |
$1K |
| 87625 |
|
39 |
38 |
$1K |
| 82378 |
|
59 |
50 |
$1K |
| 93880 |
|
14 |
14 |
$999.95 |
| A6457 |
Tubular dressing with or without elastic, any width, per linear yard |
238 |
143 |
$991.16 |
| 29105 |
|
13 |
13 |
$949.10 |
| 80051 |
|
111 |
107 |
$927.38 |
| S0028 |
Injection, famotidine, 20 mg |
2,392 |
2,212 |
$920.50 |
| J8540 |
Dexamethasone, oral, 0.25 mg |
1,784 |
1,704 |
$910.05 |
| 11730 |
|
12 |
12 |
$894.28 |
| C1750 |
Catheter, hemodialysis/peritoneal, long-term |
31 |
27 |
$872.56 |
| 87109 |
|
43 |
43 |
$867.51 |
| 89051 |
|
158 |
124 |
$816.33 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
1,787 |
1,633 |
$737.19 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
1,548 |
1,439 |
$715.81 |
| 87324 |
|
59 |
57 |
$708.87 |
| 87449 |
|
62 |
60 |
$690.95 |
| 87339 |
|
53 |
52 |
$676.30 |
| Q9950 |
Injection, sulfur hexafluoride lipid microspheres, per ml |
18 |
18 |
$657.77 |
| 94761 |
|
147 |
101 |
$631.33 |
| J2370 |
Injection, phenylephrine hcl, up to 1 ml |
732 |
667 |
$627.52 |
| 83930 |
|
84 |
76 |
$614.86 |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
32 |
32 |
$600.11 |
| J7620 |
Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme |
624 |
546 |
$596.94 |
| J1740 |
Injection, ibandronate sodium, 1 mg |
48 |
47 |
$545.95 |
| 96368 |
|
79 |
76 |
$539.25 |
| 83883 |
|
32 |
24 |
$512.33 |
| J0280 |
Injection, aminophyllin, up to 250 mg |
245 |
233 |
$482.10 |
| A6197 |
Alginate or other fiber gelling dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., each dressing |
16 |
13 |
$463.77 |
| 87328 |
|
26 |
26 |
$442.45 |
| 86255 |
|
37 |
37 |
$418.51 |
| 86361 |
|
14 |
14 |
$409.30 |
| 87329 |
|
24 |
24 |
$375.23 |
| J2919 |
Injection, methylprednisolone sodium succinate, 5 mg |
103 |
69 |
$369.40 |
| J1642 |
Injection, heparin sodium, (heparin lock flush), per 10 units |
367 |
50 |
$348.01 |
| 82374 |
|
116 |
107 |
$340.06 |
| G2023 |
Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
22 |
20 |
$339.08 |
| 86430 |
|
39 |
39 |
$331.86 |
| J1030 |
Injection, methylprednisolone acetate, 40 mg |
50 |
46 |
$299.26 |
| Q0222 |
Injection, bebtelovimab, 175 mg |
13 |
13 |
$280.00 |
| J7644 |
Ipratropium bromide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per milligram |
405 |
370 |
$257.71 |
| 84153 |
|
14 |
14 |
$254.15 |
| J2359 |
Injection, olanzapine, 0.5 mg |
15 |
12 |
$238.67 |
| Q9965 |
Low osmolar contrast material, 100-199 mg/ml iodine concentration, per ml |
36 |
35 |
$234.72 |
| J2371 |
Injection, phenylephrine hydrochloride, 20 micrograms |
308 |
296 |
$232.70 |
| J1940 |
Injection, furosemide, up to 20 mg |
157 |
92 |
$229.44 |
| G8978 |
Mobility: walking & moving around functional limitation, current status, at therapy episode outset and at reporting intervals |
588 |
484 |
$224.15 |
| 82150 |
|
29 |
28 |
$223.69 |
| Q9957 |
Injection, perflutren lipid microspheres, per ml |
16 |
15 |
$222.35 |
| J0171 |
Injection, adrenalin, epinephrine, 0.1 mg |
15 |
12 |
$208.72 |
| 85007 |
|
56 |
55 |
$202.96 |
| 86706 |
|
19 |
19 |
$200.78 |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
374 |
363 |
$194.86 |
| 82040 |
|
37 |
37 |
$194.02 |
| 86705 |
|
15 |
15 |
$155.27 |
| 83525 |
|
12 |
12 |
$143.42 |
| A9537 |
Technetium tc-99m mebrofenin, diagnostic, per study dose, up to 15 millicuries |
14 |
14 |
$137.91 |
| 86709 |
|
15 |
15 |
$135.76 |
| C2617 |
Stent, non-coronary, temporary, without delivery system |
14 |
12 |
$132.16 |
| 82375 |
|
16 |
14 |
$128.70 |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
72 |
40 |
$100.24 |
| Q2038 |
Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (fluzone) |
15 |
13 |
$86.33 |
| Q2036 |
Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (flulaval) |
14 |
14 |
$79.75 |
| 84160 |
|
15 |
15 |
$76.80 |
| Q0243 |
Injection, casirivimab and imdevimab, 2400 mg |
163 |
80 |
$75.85 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
44 |
42 |
$68.86 |
| 85396 |
|
13 |
12 |
$49.13 |
| Q0162 |
Ondansetron 1 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen |
34 |
29 |
$46.88 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
18 |
18 |
$44.93 |
| J2305 |
Injection, nitroglycerin, 5 mg |
13 |
13 |
$42.08 |
| J1171 |
Injection, hydromorphone, 0.1 mg |
102 |
72 |
$41.30 |
| 92650 |
|
25 |
25 |
$33.09 |
| J2470 |
Injection, pantoprazole sodium, 40 mg |
169 |
133 |
$17.40 |
| J0670 |
Injection, mepivacaine hydrochloride, per 10 ml |
14 |
14 |
$11.13 |
| G8979 |
Mobility: walking & moving around functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting |
705 |
564 |
$6.12 |
| J1630 |
Injection, haloperidol, up to 5 mg |
14 |
12 |
$4.85 |
| J7614 |
Levalbuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 0.5 mg |
13 |
13 |
$3.14 |
| Q0245 |
Injection, bamlanivimab and etesevimab, 2100 mg |
12 |
12 |
$0.05 |
| G1004 |
Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program |
115 |
106 |
$0.00 |
| G8985 |
Carrying, moving and handling objects, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting |
238 |
197 |
$0.00 |
| C1894 |
Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser |
15 |
13 |
$0.00 |
| G8984 |
Carrying, moving & handling objects functional limitation, current status, at therapy episode outset and at reporting intervals |
170 |
145 |
$0.00 |
| G8980 |
Mobility: walking & moving around functional limitation, discharge status, at discharge from therapy or to end reporting |
107 |
94 |
$0.00 |
| G8988 |
Self care functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting |
16 |
13 |
$0.00 |
| J2175 |
Injection, meperidine hydrochloride, per 100 mg |
14 |
14 |
$0.00 |
| G8987 |
Self care functional limitation, current status, at therapy episode outset and at reporting intervals |
16 |
13 |
$0.00 |