| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
8,291 |
7,696 |
$3.20M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
11,217 |
10,496 |
$1.98M |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
20,890 |
18,092 |
$1.24M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
9,152 |
8,724 |
$1.17M |
| G0378 |
Hospital observation service, per hour |
4,858 |
2,791 |
$901K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
9,160 |
8,106 |
$729K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
1,911 |
1,840 |
$228K |
| 70450 |
Computed tomography, head or brain; without contrast material |
1,980 |
1,910 |
$190K |
| 80061 |
Lipid panel |
4,382 |
4,275 |
$175K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
5,447 |
1,317 |
$129K |
| 71045 |
Radiologic examination, chest; single view |
4,261 |
4,062 |
$127K |
| 59025 |
Fetal non-stress test |
1,270 |
653 |
$110K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
4,254 |
4,128 |
$106K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
3,898 |
3,481 |
$98K |
| 71046 |
Radiologic examination, chest; 2 views |
2,896 |
2,781 |
$98K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
1,407 |
1,316 |
$94K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
4,469 |
3,827 |
$84K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
987 |
933 |
$82K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
1,129 |
1,103 |
$78K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
1,555 |
1,547 |
$72K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
666 |
648 |
$58K |
| 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 |
849 |
831 |
$47K |
| 20610 |
|
301 |
274 |
$42K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
248 |
247 |
$40K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
1,031 |
949 |
$40K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
1,248 |
1,216 |
$38K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
1,327 |
1,306 |
$37K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
2,887 |
713 |
$36K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
750 |
712 |
$36K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
568 |
526 |
$34K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
813 |
791 |
$34K |
| 76830 |
Ultrasound, transvaginal |
667 |
654 |
$34K |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
1,904 |
1,900 |
$30K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
1,979 |
1,957 |
$27K |
| 84443 |
Thyroid stimulating hormone (TSH) |
4,701 |
4,580 |
$27K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
2,419 |
2,325 |
$24K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
24,714 |
20,311 |
$24K |
| 80053 |
Comprehensive metabolic panel |
9,681 |
8,415 |
$23K |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
1,054 |
1,051 |
$20K |
| 97161 |
|
494 |
475 |
$20K |
| Q3014 |
Telehealth originating site facility fee |
1,187 |
1,115 |
$19K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
971 |
326 |
$18K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
139 |
137 |
$17K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
24 |
12 |
$16K |
| A9270 |
Non-covered item or service |
4,657 |
3,460 |
$16K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
4,358 |
3,712 |
$15K |
| 82947 |
|
497 |
453 |
$14K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
1,084 |
1,081 |
$13K |
| 86900 |
|
2,137 |
1,974 |
$13K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
928 |
908 |
$13K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
877 |
857 |
$12K |
| 76801 |
|
220 |
204 |
$12K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
2,840 |
2,589 |
$12K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
3,265 |
3,194 |
$10K |
| 20611 |
|
63 |
51 |
$10K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
81 |
81 |
$10K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
1,534 |
1,470 |
$9K |
| 90686 |
|
623 |
614 |
$8K |
| 73564 |
|
751 |
638 |
$8K |
| 36415 |
Collection of venous blood by venipuncture |
13,506 |
11,242 |
$8K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
8,135 |
7,410 |
$7K |
| 84439 |
|
1,530 |
1,500 |
$6K |
| 73562 |
|
427 |
419 |
$6K |
| 73610 |
|
733 |
689 |
$6K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
15,337 |
12,724 |
$6K |
| 82607 |
|
1,185 |
1,155 |
$6K |
| A4402 |
Lubricant, per ounce |
254 |
247 |
$6K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
91 |
91 |
$5K |
| 73630 |
|
793 |
742 |
$5K |
| 96160 |
|
400 |
397 |
$5K |
| 88304 |
|
93 |
91 |
$4K |
| 87088 |
|
2,668 |
2,493 |
$4K |
| 76818 |
|
60 |
36 |
$4K |
| 76770 |
|
78 |
76 |
$4K |
| 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 |
196 |
189 |
$3K |
| 84460 |
|
3,983 |
3,674 |
$3K |
| 86850 |
|
2,062 |
1,910 |
$3K |
| 84702 |
|
2,403 |
2,197 |
$3K |
| 73030 |
|
360 |
341 |
$3K |
| 93971 |
|
55 |
55 |
$3K |
| 84484 |
|
5,273 |
4,195 |
$2K |
| 90674 |
|
81 |
79 |
$2K |
| 73502 |
|
203 |
187 |
$2K |
| 99385 |
|
70 |
70 |
$2K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
2,248 |
2,195 |
$2K |
| 87070 |
|
729 |
689 |
$2K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
26 |
25 |
$2K |
| 80076 |
|
895 |
852 |
$2K |
| 96127 |
|
535 |
513 |
$2K |
| 76642 |
|
46 |
39 |
$2K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
37 |
26 |
$2K |
| 87186 |
|
770 |
722 |
$2K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
128 |
126 |
$1K |
| 87077 |
|
774 |
726 |
$1K |
| 81001 |
|
7,106 |
6,646 |
$1K |
| 92507 |
Treatment of speech, language, voice, communication, and/or auditory processing disorder |
30 |
12 |
$1K |
| 82728 |
|
310 |
305 |
$1K |
| 84146 |
|
124 |
121 |
$1K |
| 72100 |
|
94 |
92 |
$1K |
| 83735 |
|
4,047 |
3,402 |
$1K |
| 86803 |
|
158 |
158 |
$1K |
| 85610 |
|
2,797 |
2,422 |
$1K |
| 87390 |
|
104 |
104 |
$1K |
| 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 |
3,208 |
2,703 |
$1K |
| 90656 |
|
66 |
62 |
$1K |
| 83550 |
|
277 |
275 |
$997.75 |
| 86901 |
|
2,346 |
2,175 |
$972.74 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
96 |
96 |
$959.00 |
| C1713 |
Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) |
426 |
398 |
$937.76 |
| 81025 |
|
4,864 |
4,599 |
$799.60 |
| 84550 |
|
339 |
328 |
$799.58 |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
12 |
12 |
$737.32 |
| 90661 |
|
42 |
42 |
$704.61 |
| 86702 |
|
104 |
104 |
$659.06 |
| 76536 |
|
13 |
12 |
$656.04 |
| 85730 |
|
2,352 |
2,048 |
$653.22 |
| 85027 |
|
1,670 |
1,331 |
$635.09 |
| 83690 |
|
6,003 |
5,429 |
$627.91 |
| 83615 |
|
186 |
182 |
$601.06 |
| 85651 |
|
445 |
405 |
$597.92 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
848 |
825 |
$587.08 |
| 82550 |
|
241 |
219 |
$525.41 |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
39 |
39 |
$520.38 |
| 83880 |
|
597 |
568 |
$492.49 |
| 82570 |
|
327 |
299 |
$483.27 |
| 84450 |
|
3,982 |
3,674 |
$476.49 |
| G0103 |
Prostate cancer screening; prostate specific antigen test (psa) |
68 |
67 |
$472.23 |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
789 |
723 |
$433.29 |
| 86701 |
|
104 |
104 |
$432.99 |
| 81003 |
|
2,124 |
1,960 |
$418.69 |
| 85379 |
|
1,394 |
1,336 |
$406.51 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
41 |
40 |
$398.54 |
| 74022 |
|
363 |
354 |
$362.40 |
| 86140 |
|
195 |
167 |
$350.75 |
| 83525 |
|
48 |
48 |
$340.17 |
| 99406 |
|
24 |
24 |
$339.60 |
| 97165 |
|
14 |
14 |
$338.64 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
676 |
454 |
$316.30 |
| 82565 |
|
606 |
554 |
$305.19 |
| 87899 |
|
90 |
88 |
$300.84 |
| 82150 |
|
3,075 |
2,809 |
$292.64 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
53 |
52 |
$287.00 |
| 97014 |
|
40 |
13 |
$273.74 |
| 93017 |
|
28 |
26 |
$255.84 |
| 84100 |
|
823 |
603 |
$245.90 |
| 73130 |
|
74 |
71 |
$242.25 |
| 82043 |
|
152 |
146 |
$236.83 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
3,412 |
3,225 |
$218.11 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
13 |
13 |
$209.00 |
| 87040 |
|
870 |
816 |
$195.84 |
| 87480 |
|
39 |
38 |
$194.24 |
| 87510 |
|
39 |
38 |
$194.24 |
| 87660 |
|
39 |
38 |
$194.24 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
7,670 |
6,725 |
$189.95 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
29 |
28 |
$180.36 |
| 86592 |
|
84 |
82 |
$178.23 |
| 86703 |
|
64 |
63 |
$174.66 |
| 87428 |
|
14 |
14 |
$171.60 |
| 83605 |
|
2,258 |
2,030 |
$152.43 |
| 84075 |
|
3,632 |
3,361 |
$148.60 |
| 90715 |
|
375 |
368 |
$148.00 |
| 84520 |
|
518 |
480 |
$130.31 |
| 84703 |
|
301 |
297 |
$109.84 |
| J7030 |
Infusion, normal saline solution , 1000 cc |
10,764 |
8,640 |
$101.59 |
| 82247 |
|
3,655 |
3,383 |
$98.97 |
| 81000 |
|
53 |
53 |
$95.20 |
| 87634 |
|
136 |
135 |
$91.97 |
| 82948 |
|
1,951 |
1,368 |
$81.04 |
| 82962 |
|
2,934 |
2,145 |
$72.31 |
| 86765 |
|
16 |
16 |
$66.44 |
| G0008 |
Administration of influenza virus vaccine |
29 |
27 |
$63.28 |
| 82746 |
|
30 |
26 |
$62.30 |
| 59050 |
|
31 |
25 |
$60.98 |
| 87420 |
|
90 |
89 |
$60.00 |
| 74018 |
|
12 |
12 |
$48.33 |
| 83090 |
|
13 |
13 |
$47.50 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
8,205 |
7,002 |
$44.52 |
| 84466 |
|
47 |
45 |
$40.59 |
| 84132 |
|
611 |
573 |
$40.01 |
| 73110 |
|
13 |
12 |
$31.62 |
| 82310 |
|
254 |
232 |
$23.64 |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
172 |
170 |
$19.58 |
| 96376 |
|
1,422 |
950 |
$18.85 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
4,190 |
3,950 |
$18.74 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
4,071 |
3,056 |
$17.65 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
2,917 |
2,790 |
$11.13 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
4,190 |
3,957 |
$5.18 |
| 84295 |
|
297 |
274 |
$3.02 |
| A9585 |
Injection, gadobutrol, 0.1 ml |
29 |
28 |
$0.00 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
2,678 |
2,442 |
$0.00 |
| J2060 |
Injection, lorazepam, 2 mg |
1,422 |
1,137 |
$0.00 |
| C1769 |
Guide wire |
707 |
536 |
$0.00 |
| 82435 |
|
295 |
273 |
$0.00 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
1,499 |
1,371 |
$0.00 |
| 94760 |
|
590 |
422 |
$0.00 |
| J7050 |
Infusion, normal saline solution, 250 cc |
380 |
284 |
$0.00 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
1,353 |
1,026 |
$0.00 |
| G0283 |
Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care |
200 |
51 |
$0.00 |
| J2795 |
Injection, ropivacaine hydrochloride, 1 mg |
283 |
276 |
$0.00 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
87 |
59 |
$0.00 |
| 73560 |
|
12 |
12 |
$0.00 |
| J2370 |
Injection, phenylephrine hcl, up to 1 ml |
40 |
40 |
$0.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
17 |
16 |
$0.00 |
| 74019 |
|
13 |
12 |
$0.00 |
| J7620 |
Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme |
84 |
58 |
$0.00 |
| J3360 |
Injection, diazepam, up to 5 mg |
13 |
12 |
$0.00 |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
29 |
29 |
$0.00 |
| J1630 |
Injection, haloperidol, up to 5 mg |
17 |
14 |
$0.00 |
| J2371 |
Injection, phenylephrine hydrochloride, 20 micrograms |
12 |
12 |
$0.00 |
| J1644 |
Injection, heparin sodium, per 1000 units |
2,063 |
1,262 |
$0.00 |
| 82374 |
|
297 |
275 |
$0.00 |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
533 |
503 |
$0.00 |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
4,031 |
3,432 |
$0.00 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
530 |
444 |
$0.00 |
| C1894 |
Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser |
88 |
82 |
$0.00 |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
294 |
251 |
$0.00 |
| 76942 |
|
191 |
187 |
$0.00 |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
814 |
485 |
$0.00 |
| C9113 |
Injection, pantoprazole sodium, per vial |
99 |
67 |
$0.00 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
2,111 |
1,598 |
$0.00 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
1,815 |
1,622 |
$0.00 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
281 |
277 |
$0.00 |
| J2710 |
Injection, neostigmine methylsulfate, up to 0.5 mg |
146 |
111 |
$0.00 |
| J0171 |
Injection, adrenalin, epinephrine, 0.1 mg |
12 |
12 |
$0.00 |
| J1171 |
Injection, hydromorphone, 0.1 mg |
50 |
45 |
$0.00 |
| A9575 |
Injection, gadoterate meglumine, 0.1 ml |
28 |
28 |
$0.00 |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
15 |
13 |
$0.00 |
| J3370 |
Injection, vancomycin hcl, 500 mg |
55 |
48 |
$0.00 |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
12 |
12 |
$0.00 |
| 72114 |
|
14 |
14 |
$0.00 |
| A6212 |
Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing |
12 |
12 |
$0.00 |