| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
34,932 |
30,444 |
$3.14M |
| 96361 |
Intravenous infusion, hydration; each additional hour |
5,663 |
4,270 |
$2.37M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
17,042 |
13,632 |
$2.24M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
12,694 |
10,603 |
$1.77M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
9,241 |
7,152 |
$1.39M |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
11,264 |
9,972 |
$1.25M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
15,784 |
12,980 |
$953K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
4,611 |
3,224 |
$933K |
| 90834 |
Psychotherapy, 45 minutes with patient |
13,234 |
6,218 |
$773K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
2,221 |
2,038 |
$545K |
| 70450 |
Computed tomography, head or brain; without contrast material |
2,339 |
2,107 |
$484K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
4,844 |
4,285 |
$473K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
1,366 |
765 |
$377K |
| 41899 |
Unlisted procedure, dentoalveolar structures |
220 |
195 |
$362K |
| 90832 |
Psychotherapy, 30 minutes with patient |
2,321 |
1,420 |
$323K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
1,195 |
1,046 |
$295K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
3,158 |
2,650 |
$287K |
| 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 |
4,004 |
3,643 |
$284K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
2,633 |
2,275 |
$270K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
9,748 |
3,921 |
$249K |
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
1,958 |
349 |
$226K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
2,384 |
1,427 |
$224K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
961 |
586 |
$194K |
| 96367 |
|
989 |
641 |
$191K |
| 80053 |
Comprehensive metabolic panel |
14,006 |
11,313 |
$132K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
8,204 |
6,558 |
$122K |
| C9803 |
Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
6,057 |
5,406 |
$118K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
3,425 |
3,175 |
$117K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
1,313 |
1,173 |
$117K |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
7,983 |
1,484 |
$108K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
1,422 |
1,259 |
$94K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
1,941 |
879 |
$89K |
| 92507 |
Treatment of speech, language, voice, communication, and/or auditory processing disorder |
2,508 |
775 |
$82K |
| G0378 |
Hospital observation service, per hour |
638 |
481 |
$81K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
16,718 |
13,170 |
$80K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
2,186 |
1,934 |
$76K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
980 |
285 |
$70K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
3,927 |
1,651 |
$68K |
| H0022 |
Alcohol and/or drug intervention service (planned facilitation) |
2,017 |
980 |
$61K |
| 80306 |
|
4,134 |
3,425 |
$60K |
| 97161 |
|
1,562 |
1,402 |
$58K |
| 99215 |
Prolong outpt/office vis |
742 |
614 |
$57K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,261 |
944 |
$55K |
| 99239 |
Hospital discharge day management, more than 30 minutes |
1,056 |
790 |
$52K |
| 0240U |
|
1,840 |
1,658 |
$51K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
223 |
205 |
$50K |
| 99223 |
Prolong inpt eval add15 m |
1,134 |
810 |
$48K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
251 |
237 |
$47K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
1,396 |
1,236 |
$46K |
| 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 |
2,875 |
2,619 |
$42K |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
8,061 |
6,424 |
$41K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
439 |
401 |
$39K |
| 84443 |
Thyroid stimulating hormone (TSH) |
3,868 |
3,398 |
$39K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
731 |
592 |
$38K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
5,296 |
4,229 |
$36K |
| 84484 |
|
5,589 |
4,184 |
$31K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
104 |
96 |
$25K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
5,560 |
4,515 |
$24K |
| 83880 |
|
2,142 |
1,876 |
$24K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
3,646 |
2,775 |
$24K |
| 86140 |
|
7,807 |
6,571 |
$23K |
| 84703 |
|
3,142 |
2,756 |
$22K |
| 83605 |
|
4,046 |
3,496 |
$22K |
| 81001 |
|
6,690 |
5,769 |
$21K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
50 |
48 |
$19K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,292 |
1,149 |
$19K |
| 83735 |
|
5,384 |
4,476 |
$19K |
| 97597 |
|
1,602 |
585 |
$18K |
| 82077 |
|
2,117 |
1,799 |
$17K |
| 83690 |
|
3,620 |
3,065 |
$17K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
459 |
368 |
$16K |
| 87081 |
|
1,189 |
1,052 |
$16K |
| 87400 |
|
1,863 |
861 |
$16K |
| 71046 |
Radiologic examination, chest; 2 views |
3,164 |
2,858 |
$15K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
208 |
194 |
$15K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
3,442 |
3,038 |
$15K |
| 81003 |
|
4,541 |
4,012 |
$15K |
| 99205 |
Prolong outpt/office vis |
191 |
159 |
$15K |
| 90847 |
Family psychotherapy with the patient present, 50 minutes |
63 |
51 |
$14K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
497 |
457 |
$13K |
| 80329 |
|
790 |
428 |
$13K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
477 |
201 |
$12K |
| 43235 |
|
19 |
13 |
$11K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
46 |
38 |
$11K |
| 86710 |
|
638 |
288 |
$10K |
| 87077 |
|
2,587 |
1,857 |
$10K |
| 85379 |
|
1,729 |
1,589 |
$10K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
489 |
455 |
$10K |
| 92015 |
Determination of refractive state |
1,995 |
1,900 |
$9K |
| 99443 |
|
649 |
374 |
$9K |
| 80143 |
|
963 |
826 |
$9K |
| 80179 |
|
943 |
817 |
$9K |
| 87040 |
|
2,040 |
1,063 |
$8K |
| 87186 |
|
2,121 |
1,610 |
$8K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
29 |
27 |
$8K |
| 99222 |
Initial hospital care, per day, moderate complexity |
169 |
134 |
$8K |
| 82962 |
|
4,572 |
1,683 |
$8K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
7,391 |
6,144 |
$7K |
| 99233 |
Prolong inpt eval add15 m |
346 |
170 |
$7K |
| 76801 |
|
47 |
42 |
$7K |
| 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 |
125 |
89 |
$7K |
| 87631 |
|
56 |
54 |
$7K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
41 |
38 |
$7K |
| 85027 |
|
1,581 |
1,330 |
$7K |
| 71045 |
Radiologic examination, chest; single view |
4,298 |
3,812 |
$6K |
| 94664 |
|
19 |
18 |
$6K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
185 |
168 |
$6K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
185 |
168 |
$6K |
| 73030 |
|
651 |
572 |
$5K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
5,143 |
4,051 |
$4K |
| 85610 |
|
2,123 |
1,782 |
$4K |
| 73562 |
|
503 |
438 |
$4K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
145 |
100 |
$4K |
| 92134 |
|
1,277 |
828 |
$4K |
| 81002 |
|
682 |
587 |
$4K |
| 81025 |
|
464 |
398 |
$4K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
37 |
37 |
$4K |
| 73630 |
|
627 |
516 |
$3K |
| 73610 |
|
579 |
506 |
$3K |
| 87070 |
|
375 |
318 |
$3K |
| 99442 |
|
208 |
130 |
$2K |
| 97162 |
|
83 |
70 |
$2K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
16 |
16 |
$2K |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
12,934 |
6,538 |
$2K |
| 71271 |
|
12 |
12 |
$2K |
| 93017 |
|
13 |
12 |
$2K |
| 36415 |
Collection of venous blood by venipuncture |
17,593 |
13,588 |
$2K |
| 85730 |
|
590 |
533 |
$2K |
| 93971 |
|
26 |
24 |
$2K |
| 51798 |
|
201 |
183 |
$2K |
| 97165 |
|
33 |
32 |
$2K |
| 82150 |
|
275 |
240 |
$2K |
| 87420 |
|
104 |
95 |
$1K |
| 97116 |
|
165 |
77 |
$1K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
841 |
424 |
$1K |
| 73110 |
|
198 |
162 |
$1K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
4,113 |
3,745 |
$1K |
| 36591 |
|
96 |
50 |
$1K |
| 73502 |
|
69 |
61 |
$1K |
| 73130 |
|
100 |
88 |
$975.32 |
| 98968 |
|
147 |
114 |
$907.59 |
| 67028 |
Intravitreal injection of a pharmacologic agent |
42 |
24 |
$868.43 |
| 99238 |
Hospital discharge day management, 30 minutes or less |
28 |
25 |
$769.81 |
| 84145 |
|
95 |
90 |
$765.69 |
| 74019 |
|
175 |
160 |
$716.03 |
| 11721 |
|
67 |
39 |
$564.27 |
| 92133 |
|
65 |
40 |
$562.08 |
| Q3014 |
Telehealth originating site facility fee |
102 |
77 |
$538.42 |
| 90715 |
|
16 |
15 |
$534.58 |
| 80061 |
Lipid panel |
56 |
52 |
$509.88 |
| 82803 |
|
35 |
28 |
$484.92 |
| 82948 |
|
206 |
161 |
$476.28 |
| 86850 |
|
144 |
126 |
$470.36 |
| 87205 |
|
183 |
150 |
$464.80 |
| 86618 |
|
35 |
27 |
$457.60 |
| J7030 |
Infusion, normal saline solution , 1000 cc |
6,079 |
4,245 |
$454.48 |
| 96523 |
|
32 |
14 |
$400.84 |
| 86900 |
|
211 |
169 |
$353.59 |
| 86901 |
|
211 |
169 |
$350.27 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
6,284 |
5,224 |
$337.01 |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
15 |
14 |
$336.49 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
56 |
52 |
$315.50 |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
16 |
12 |
$285.78 |
| 80320 |
|
1,093 |
898 |
$255.51 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
964 |
729 |
$232.48 |
| 84702 |
|
18 |
14 |
$217.70 |
| 87210 |
|
44 |
38 |
$210.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
98 |
85 |
$174.39 |
| 97035 |
|
26 |
12 |
$147.62 |
| 72100 |
|
15 |
13 |
$134.78 |
| 94761 |
|
991 |
839 |
$113.04 |
| 80051 |
|
21 |
14 |
$105.25 |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
2,665 |
2,028 |
$91.16 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
5,258 |
4,221 |
$90.09 |
| 82248 |
|
31 |
27 |
$79.90 |
| J2704 |
Injection, propofol, 10 mg |
3,405 |
2,849 |
$74.79 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
143 |
107 |
$66.21 |
| 82565 |
|
24 |
17 |
$60.78 |
| J1642 |
Injection, heparin sodium, (heparin lock flush), per 10 units |
1,559 |
743 |
$59.14 |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
500 |
348 |
$53.44 |
| 51702 |
|
13 |
12 |
$45.82 |
| 84520 |
|
21 |
14 |
$41.86 |
| 82947 |
|
21 |
14 |
$41.66 |
| J7060 |
5% dextrose/water (500 ml = 1 unit) |
855 |
449 |
$40.50 |
| J3490 |
Unclassified drugs |
577 |
483 |
$31.38 |
| A9585 |
Injection, gadobutrol, 0.1 ml |
263 |
234 |
$29.16 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
815 |
608 |
$23.88 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
961 |
684 |
$21.63 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
3,283 |
2,537 |
$11.97 |
| J2060 |
Injection, lorazepam, 2 mg |
440 |
366 |
$11.07 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
611 |
506 |
$6.51 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
1,580 |
1,285 |
$6.38 |
| 94760 |
|
372 |
279 |
$5.64 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
844 |
659 |
$4.15 |
| 96376 |
|
1,132 |
720 |
$3.20 |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
359 |
315 |
$2.03 |
| A9270 |
Non-covered item or service |
11,091 |
3,109 |
$1.66 |
| C9113 |
Injection, pantoprazole sodium, per vial |
17 |
12 |
$1.32 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
77 |
63 |
$0.04 |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
484 |
346 |
$0.02 |
| S0119 |
Ondansetron, oral, 4 mg (for circumstances falling under the medicare statute, use hcpcs q code) |
533 |
466 |
$0.00 |
| J0702 |
Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg |
12 |
12 |
$0.00 |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
94 |
87 |
$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 |
17 |
12 |
$0.00 |
| J0136 |
Injection, acetaminophen (b braun), not therapeutically equivalent to j0131, 10 mg |
45 |
40 |
$0.00 |
| 74018 |
|
13 |
12 |
$0.00 |
| G8978 |
Mobility: walking & moving around functional limitation, current status, at therapy episode outset and at reporting intervals |
15 |
12 |
$0.00 |
| 76942 |
|
15 |
14 |
$0.00 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
407 |
317 |
$0.00 |
| J2249 |
Injection, remimazolam, 1 mg |
21 |
19 |
$0.00 |
| 73564 |
|
32 |
24 |
$0.00 |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
146 |
134 |
$0.00 |
| C9290 |
Injection, bupivacaine liposome, 1 mg |
118 |
108 |
$0.00 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
24 |
19 |
$0.00 |
| G8991 |
Other physical or occupational therapy primary functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting |
13 |
12 |
$0.00 |
| A9579 |
Injection, gadolinium-based magnetic resonance contrast agent, not otherwise specified (nos), per ml |
12 |
12 |
$0.00 |
| J2003 |
Injection, lidocaine hydrochloride, 1 mg |
16 |
14 |
$0.00 |