| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
74,864 |
68,469 |
$6.29M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
41,529 |
36,507 |
$2.77M |
| 80053 |
Comprehensive metabolic panel |
29,689 |
24,272 |
$1.26M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
12,343 |
8,000 |
$950K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
11,895 |
11,190 |
$823K |
| 70450 |
Computed tomography, head or brain; without contrast material |
7,092 |
6,151 |
$699K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
4,706 |
4,338 |
$668K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
12,632 |
8,712 |
$654K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
4,713 |
4,388 |
$469K |
| G0257 |
Unscheduled or emergency dialysis treatment for an esrd patient in a hospital outpatient department that is not certified as an esrd facility |
1,846 |
251 |
$382K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
1,877 |
1,708 |
$358K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
2,603 |
2,348 |
$328K |
| 81003 |
|
33,585 |
29,631 |
$237K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
2,231 |
825 |
$172K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
3,585 |
3,025 |
$162K |
| 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 |
2,941 |
2,828 |
$146K |
| G0378 |
Hospital observation service, per hour |
8,134 |
4,308 |
$138K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
8,416 |
7,246 |
$135K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
1,061 |
973 |
$130K |
| G0382 |
Level 3 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room or emergency department; (2) it is held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment; or (3) during the calendar year immediately preceding the calendar year in which a determination under 42 cfr 489.24 is being made, based on a representative sample of patient visits that occurred during that calendar year, it provides at least one-third of all of its outpatient visits for the treatment of emergency medical conditions on an urgent basis without requiring a previously scheduled appointment) |
1,623 |
1,542 |
$126K |
| 87070 |
|
7,818 |
7,410 |
$121K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
2,508 |
2,092 |
$119K |
| 80305 |
|
5,341 |
4,645 |
$107K |
| 71045 |
Radiologic examination, chest; single view |
16,402 |
14,143 |
$96K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
2,046 |
1,945 |
$85K |
| 84702 |
|
4,256 |
3,304 |
$85K |
| 10060 |
|
904 |
832 |
$78K |
| 85027 |
|
43,561 |
32,383 |
$72K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
6,158 |
5,821 |
$65K |
| 87169 |
|
3,242 |
3,049 |
$63K |
| 86850 |
|
1,492 |
1,236 |
$60K |
| 71046 |
Radiologic examination, chest; 2 views |
4,578 |
4,120 |
$60K |
| A9270 |
Non-covered item or service |
11,104 |
2,840 |
$58K |
| 81025 |
|
15,579 |
14,147 |
$53K |
| 12001 |
|
570 |
534 |
$51K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
1,228 |
1,099 |
$50K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
1,418 |
1,309 |
$44K |
| 87088 |
|
5,121 |
4,598 |
$44K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
7,475 |
6,732 |
$40K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
204 |
179 |
$39K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
295 |
279 |
$35K |
| 73610 |
|
995 |
919 |
$35K |
| 87077 |
|
2,255 |
1,994 |
$33K |
| 76801 |
|
3,109 |
2,537 |
$31K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
1,111 |
928 |
$29K |
| 76830 |
Ultrasound, transvaginal |
1,240 |
1,181 |
$29K |
| 85610 |
|
6,758 |
5,486 |
$27K |
| 73630 |
|
959 |
876 |
$26K |
| 72131 |
|
808 |
697 |
$26K |
| J1644 |
Injection, heparin sodium, per 1000 units |
4,982 |
2,210 |
$25K |
| 70486 |
|
504 |
444 |
$24K |
| 12011 |
|
261 |
242 |
$24K |
| 73030 |
|
1,214 |
1,046 |
$23K |
| 82565 |
|
310 |
267 |
$23K |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
1,832 |
1,339 |
$23K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
998 |
578 |
$22K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
2,563 |
1,913 |
$22K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
16,117 |
12,460 |
$21K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
2,470 |
2,283 |
$21K |
| 73564 |
|
951 |
854 |
$21K |
| J2704 |
Injection, propofol, 10 mg |
1,284 |
1,017 |
$20K |
| 73130 |
|
699 |
638 |
$19K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
17,469 |
15,092 |
$19K |
| 74018 |
|
1,135 |
1,056 |
$17K |
| 93971 |
|
1,117 |
1,004 |
$17K |
| 86900 |
|
3,016 |
2,576 |
$16K |
| 84484 |
|
10,238 |
7,023 |
$16K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
1,108 |
1,000 |
$16K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
9,812 |
9,395 |
$16K |
| 73560 |
|
673 |
572 |
$16K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
1,747 |
1,610 |
$15K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
11,884 |
9,290 |
$14K |
| C1894 |
Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser |
790 |
656 |
$14K |
| 80047 |
|
350 |
299 |
$13K |
| 84703 |
|
2,441 |
2,253 |
$12K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
1,831 |
1,484 |
$12K |
| 73620 |
|
400 |
370 |
$12K |
| 93458 |
|
43 |
38 |
$11K |
| 76818 |
|
196 |
91 |
$11K |
| 85730 |
|
5,390 |
4,403 |
$11K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
80 |
73 |
$11K |
| J3490 |
Unclassified drugs |
413 |
284 |
$11K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
7,560 |
5,998 |
$10K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
5,739 |
4,548 |
$10K |
| 73140 |
|
205 |
194 |
$9K |
| 72040 |
|
285 |
247 |
$9K |
| 80076 |
|
465 |
425 |
$9K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
606 |
563 |
$8K |
| 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 |
1,133 |
912 |
$8K |
| 84132 |
|
377 |
298 |
$8K |
| 12002 |
|
111 |
102 |
$8K |
| C1713 |
Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) |
13 |
12 |
$8K |
| J0690 |
Injection, cefazolin sodium, 500 mg |
376 |
266 |
$7K |
| 84112 |
|
55 |
48 |
$7K |
| C1769 |
Guide wire |
554 |
459 |
$7K |
| 71250 |
|
212 |
177 |
$7K |
| 80061 |
Lipid panel |
1,094 |
957 |
$6K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
100 |
85 |
$6K |
| 87807 |
|
1,818 |
1,747 |
$6K |
| J0360 |
Injection, hydralazine hcl, up to 20 mg |
1,024 |
704 |
$6K |
| 73110 |
|
241 |
221 |
$6K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
473 |
442 |
$6K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
1,654 |
1,520 |
$5K |
| 83880 |
|
2,769 |
2,303 |
$5K |
| G0381 |
Level 2 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room or emergency department; (2) it is held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment; or (3) during the calendar year immediately preceding the calendar year in which a determination under 42 cfr 489.24 is being made, based on a representative sample of patient visits that occurred during that calendar year, it provides at least one-third of all of its outpatient visits for the treatment of emergency medical conditions on an urgent basis without requiring a previously scheduled appointment) |
113 |
109 |
$5K |
| 83735 |
|
3,523 |
2,834 |
$5K |
| 73090 |
|
141 |
129 |
$5K |
| 72100 |
|
260 |
246 |
$5K |
| 93017 |
|
262 |
226 |
$5K |
| 84443 |
Thyroid stimulating hormone (TSH) |
2,941 |
2,507 |
$4K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
3,160 |
2,322 |
$4K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
29 |
24 |
$4K |
| 85379 |
|
1,728 |
1,537 |
$4K |
| 72128 |
|
146 |
125 |
$4K |
| 93798 |
|
103 |
12 |
$4K |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
4,816 |
3,478 |
$4K |
| 83690 |
|
9,681 |
8,511 |
$4K |
| 93970 |
|
204 |
188 |
$4K |
| G0383 |
Level 4 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room or emergency department; (2) it is held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment; or (3) during the calendar year immediately preceding the calendar year in which a determination under 42 cfr 489.24 is being made, based on a representative sample of patient visits that occurred during that calendar year, it provides at least one-third of all of its outpatient visits for the treatment of emergency medical conditions on an urgent basis without requiring a previously scheduled appointment) |
102 |
96 |
$4K |
| 76642 |
|
55 |
50 |
$4K |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
3,464 |
2,659 |
$4K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
1,755 |
1,491 |
$4K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
7,596 |
6,116 |
$3K |
| G0279 |
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) |
81 |
75 |
$3K |
| 82805 |
|
28 |
25 |
$3K |
| 85014 |
|
300 |
220 |
$3K |
| 87040 |
|
1,827 |
1,320 |
$3K |
| 93976 |
|
113 |
105 |
$2K |
| 73100 |
|
114 |
98 |
$2K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
5,961 |
5,101 |
$2K |
| 72110 |
|
168 |
153 |
$2K |
| 82553 |
|
918 |
664 |
$2K |
| 73600 |
|
71 |
67 |
$2K |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
2,540 |
1,215 |
$2K |
| 73120 |
|
70 |
66 |
$2K |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
2,036 |
1,358 |
$2K |
| 86140 |
|
940 |
865 |
$2K |
| 73502 |
|
211 |
182 |
$2K |
| 29125 |
|
47 |
42 |
$1K |
| 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 |
837 |
697 |
$1K |
| 80320 |
|
893 |
762 |
$1K |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
2,264 |
2,020 |
$1K |
| 73080 |
|
42 |
39 |
$1K |
| J2550 |
Injection, promethazine hcl, up to 50 mg |
2,151 |
1,673 |
$1K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
4,538 |
3,791 |
$1K |
| 86901 |
|
2,870 |
2,444 |
$1K |
| J1170 |
Injection, hydromorphone, up to 4 mg |
477 |
323 |
$1K |
| 87210 |
|
2,781 |
2,617 |
$1K |
| 73590 |
|
138 |
129 |
$1K |
| 84439 |
|
702 |
616 |
$1K |
| 93312 |
|
15 |
14 |
$1K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
1,917 |
1,733 |
$1K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
776 |
696 |
$1K |
| 90714 |
|
1,225 |
1,121 |
$1K |
| 80329 |
|
667 |
575 |
$862.66 |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
300 |
264 |
$802.66 |
| 83605 |
|
1,697 |
1,345 |
$800.22 |
| 84100 |
|
1,262 |
988 |
$798.88 |
| 87186 |
|
1,956 |
1,748 |
$752.18 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
488 |
372 |
$676.21 |
| 85018 |
|
271 |
191 |
$581.42 |
| 88342 |
|
121 |
106 |
$578.45 |
| J3370 |
Injection, vancomycin hcl, 500 mg |
339 |
251 |
$567.61 |
| 82550 |
|
1,444 |
1,201 |
$537.59 |
| J7999 |
Compounded drug, not otherwise classified |
287 |
231 |
$439.09 |
| 72170 |
|
13 |
13 |
$425.69 |
| P9016 |
Red blood cells, leukocytes reduced, each unit |
17 |
12 |
$405.26 |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
35 |
32 |
$389.20 |
| 93325 |
|
15 |
14 |
$386.19 |
| J7050 |
Infusion, normal saline solution, 250 cc |
1,095 |
742 |
$365.41 |
| 76775 |
|
14 |
13 |
$319.38 |
| J1815 |
Injection, insulin, per 5 units |
2,361 |
944 |
$297.69 |
| G1003 |
Clinical decision support mechanism medicalis, as defined by the medicare appropriate use criteria program |
173 |
129 |
$288.56 |
| 82010 |
|
14 |
14 |
$228.10 |
| 72070 |
|
13 |
12 |
$187.97 |
| 85651 |
|
451 |
406 |
$174.29 |
| 87400 |
|
4,233 |
4,005 |
$168.88 |
| 97163 |
|
64 |
52 |
$130.19 |
| 82607 |
|
31 |
26 |
$129.26 |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
21 |
15 |
$128.58 |
| 97162 |
|
15 |
14 |
$128.58 |
| J2060 |
Injection, lorazepam, 2 mg |
1,196 |
946 |
$126.59 |
| A9500 |
Technetium tc-99m sestamibi, diagnostic, per study dose |
111 |
94 |
$120.00 |
| J2785 |
Injection, regadenoson, 0.1 mg |
71 |
58 |
$120.00 |
| 93880 |
|
13 |
13 |
$98.16 |
| 87147 |
|
46 |
43 |
$96.40 |
| 96376 |
|
542 |
469 |
$59.99 |
| J8540 |
Dexamethasone, oral, 0.25 mg |
572 |
549 |
$25.83 |
| 82728 |
|
63 |
54 |
$15.68 |
| 90686 |
|
26 |
19 |
$14.32 |
| 83550 |
|
93 |
84 |
$7.84 |
| 82077 |
|
862 |
753 |
$7.62 |
| 83540 |
|
96 |
87 |
$6.72 |
| Q9957 |
Injection, perflutren lipid microspheres, per ml |
15 |
13 |
$5.20 |
| 86920 |
|
19 |
14 |
$4.17 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
462 |
407 |
$1.06 |
| S0119 |
Ondansetron, oral, 4 mg (for circumstances falling under the medicare statute, use hcpcs q code) |
1,316 |
1,235 |
$0.00 |
| 00731 |
|
29 |
25 |
$0.00 |
| C1887 |
Catheter, guiding (may include infusion/perfusion capability) |
17 |
12 |
$0.00 |
| J0692 |
Injection, cefepime hydrochloride, 500 mg |
54 |
40 |
$0.00 |
| 76937 |
|
14 |
13 |
$0.00 |
| J1630 |
Injection, haloperidol, up to 5 mg |
258 |
216 |
$0.00 |
| 87205 |
|
101 |
72 |
$0.00 |
| 74021 |
|
13 |
13 |
$0.00 |
| M0243 |
Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring |
14 |
13 |
$0.00 |
| 82746 |
|
31 |
26 |
$0.00 |