| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
27,509 |
25,692 |
$4.49M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
23,152 |
20,974 |
$3.53M |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
13,392 |
12,254 |
$2.41M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
14,411 |
13,843 |
$2.39M |
| 96361 |
Intravenous infusion, hydration; each additional hour |
8,502 |
6,889 |
$2.18M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
9,916 |
9,021 |
$1.55M |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
13,341 |
3,737 |
$1.52M |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
8,114 |
7,712 |
$1.35M |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
5,431 |
3,601 |
$1.28M |
| 80053 |
Comprehensive metabolic panel |
70,009 |
63,252 |
$1.20M |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
27,231 |
24,959 |
$1.11M |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
1,678 |
1,665 |
$1.08M |
| 87633 |
Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets |
2,411 |
2,351 |
$1.05M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
5,801 |
5,717 |
$980K |
| 70450 |
Computed tomography, head or brain; without contrast material |
3,880 |
3,712 |
$952K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
4,186 |
4,086 |
$944K |
| 45378 |
Colonoscopy, flexible; diagnostic, including collection of specimen(s) |
1,107 |
1,104 |
$918K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
1,095 |
1,086 |
$876K |
| C1713 |
Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) |
466 |
463 |
$632K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
2,655 |
2,627 |
$627K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
1,934 |
1,903 |
$587K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
2,575 |
1,962 |
$450K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
13,868 |
13,723 |
$395K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
1,662 |
1,633 |
$373K |
| 36415 |
Collection of venous blood by venipuncture |
74,580 |
45,886 |
$363K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
6,130 |
6,017 |
$335K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
5,821 |
5,667 |
$332K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
2,267 |
2,256 |
$332K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
1,143 |
1,134 |
$323K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
5,116 |
5,076 |
$321K |
| 86850 |
|
8,417 |
7,907 |
$299K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
1,876 |
1,136 |
$294K |
| 99215 |
Prolong outpt/office vis |
1,815 |
1,717 |
$289K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
9,223 |
2,884 |
$288K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
11,682 |
11,410 |
$283K |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
2,531 |
2,471 |
$276K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
1,087 |
1,080 |
$265K |
| 93970 |
|
697 |
689 |
$262K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
1,055 |
1,049 |
$245K |
| 80061 |
Lipid panel |
27,529 |
27,249 |
$245K |
| 45385 |
Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) |
425 |
421 |
$243K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
12,560 |
11,172 |
$236K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
833 |
823 |
$233K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
1,161 |
1,013 |
$229K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
11,678 |
11,406 |
$225K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
5,537 |
4,875 |
$213K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
1,290 |
1,181 |
$210K |
| 59025 |
Fetal non-stress test |
1,069 |
874 |
$204K |
| 87637 |
Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV |
3,622 |
3,557 |
$196K |
| 76641 |
|
5,171 |
5,118 |
$189K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
630 |
628 |
$175K |
| 86900 |
|
8,401 |
8,016 |
$164K |
| 86901 |
|
8,399 |
8,013 |
$153K |
| 84443 |
Thyroid stimulating hormone (TSH) |
22,238 |
21,830 |
$144K |
| 77065 |
Tomosynthesis, mammo |
1,828 |
1,709 |
$141K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
7,056 |
6,934 |
$140K |
| J9271 |
Injection, pembrolizumab, 1 mg |
14 |
12 |
$138K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
19,035 |
18,800 |
$136K |
| 88142 |
|
6,540 |
6,518 |
$134K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
3,689 |
3,628 |
$131K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
56,641 |
50,481 |
$129K |
| 78815 |
Positron emission tomography (PET) for limited area imaging |
205 |
204 |
$124K |
| G0378 |
Hospital observation service, per hour |
230 |
220 |
$119K |
| 77066 |
Tomosynthesis, mammo |
1,504 |
1,481 |
$115K |
| 86480 |
|
2,147 |
2,130 |
$114K |
| 73221 |
|
451 |
449 |
$111K |
| 93976 |
|
255 |
252 |
$106K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
2,186 |
1,547 |
$104K |
| 72141 |
|
461 |
459 |
$101K |
| 76830 |
Ultrasound, transvaginal |
1,967 |
1,910 |
$101K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
1,823 |
1,677 |
$101K |
| 97162 |
|
635 |
631 |
$100K |
| 96415 |
|
185 |
133 |
$97K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
10,355 |
9,397 |
$97K |
| 84439 |
|
13,126 |
12,854 |
$97K |
| 71250 |
|
1,152 |
1,145 |
$94K |
| 82607 |
|
8,405 |
8,299 |
$90K |
| 88304 |
|
3,703 |
3,677 |
$89K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
5,937 |
4,960 |
$89K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
5,838 |
5,774 |
$87K |
| 82728 |
|
7,430 |
7,225 |
$85K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
2,186 |
1,922 |
$76K |
| 87486 |
|
2,547 |
2,483 |
$75K |
| J3490 |
Unclassified drugs |
6,930 |
4,496 |
$75K |
| 84270 |
|
1,270 |
1,257 |
$70K |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
2,547 |
2,542 |
$69K |
| 86769 |
|
2,063 |
2,033 |
$69K |
| 95810 |
Polysomnography; sleep staging with 4 or more additional parameters |
82 |
82 |
$64K |
| 74183 |
|
257 |
256 |
$62K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
10,848 |
10,204 |
$62K |
| 76770 |
|
389 |
387 |
$61K |
| 82746 |
|
5,531 |
5,467 |
$58K |
| 90686 |
|
2,565 |
2,550 |
$58K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
849 |
839 |
$56K |
| 87581 |
|
2,549 |
2,485 |
$56K |
| 86803 |
|
6,496 |
6,426 |
$55K |
| 84403 |
|
2,068 |
2,043 |
$52K |
| A9585 |
Injection, gadobutrol, 0.1 ml |
2,941 |
2,667 |
$52K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
443 |
439 |
$50K |
| 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 |
710 |
700 |
$50K |
| C1889 |
Implantable/insertable device, not otherwise classified |
907 |
903 |
$49K |
| 71046 |
Radiologic examination, chest; 2 views |
6,074 |
5,903 |
$48K |
| 76536 |
|
1,391 |
1,384 |
$46K |
| 83516 |
|
1,349 |
1,301 |
$45K |
| 97161 |
|
336 |
330 |
$44K |
| 83880 |
|
1,501 |
1,441 |
$44K |
| 84153 |
|
2,748 |
2,713 |
$42K |
| 83001 |
|
2,189 |
2,162 |
$41K |
| 87340 |
|
5,115 |
5,070 |
$41K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
4,012 |
3,992 |
$40K |
| 86885 |
|
1,043 |
984 |
$39K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
9,317 |
7,542 |
$37K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
665 |
601 |
$36K |
| 88342 |
|
711 |
696 |
$36K |
| 83002 |
|
2,033 |
2,003 |
$36K |
| 82784 |
|
2,244 |
2,162 |
$36K |
| 93971 |
|
647 |
637 |
$35K |
| 87077 |
|
4,377 |
4,232 |
$35K |
| 76642 |
|
1,311 |
1,295 |
$34K |
| 85610 |
|
11,365 |
10,789 |
$34K |
| 83655 |
|
2,429 |
2,420 |
$34K |
| 77049 |
|
123 |
123 |
$33K |
| C9803 |
Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
16,610 |
15,069 |
$33K |
| 12001 |
|
69 |
69 |
$33K |
| 84702 |
|
3,765 |
2,993 |
$33K |
| 84146 |
|
1,670 |
1,646 |
$32K |
| 70496 |
|
139 |
139 |
$32K |
| 90715 |
|
1,234 |
1,227 |
$32K |
| A9552 |
Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries |
231 |
230 |
$32K |
| 80076 |
|
3,615 |
3,280 |
$32K |
| 83540 |
|
7,413 |
7,225 |
$32K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
855 |
846 |
$32K |
| 86706 |
|
3,667 |
3,633 |
$32K |
| 82670 |
|
1,109 |
1,077 |
$31K |
| 87081 |
|
6,247 |
6,119 |
$30K |
| 96402 |
|
438 |
407 |
$30K |
| 82378 |
|
2,123 |
1,976 |
$30K |
| 83550 |
|
6,693 |
6,540 |
$29K |
| 86300 |
|
1,720 |
1,621 |
$28K |
| 87070 |
|
3,937 |
3,845 |
$28K |
| 76801 |
|
516 |
505 |
$28K |
| 96367 |
|
290 |
170 |
$27K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
4,631 |
4,461 |
$26K |
| 86762 |
|
1,884 |
1,873 |
$25K |
| 86704 |
|
2,829 |
2,808 |
$24K |
| 86320 |
|
1,011 |
979 |
$24K |
| 83970 |
|
661 |
650 |
$24K |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
190 |
189 |
$23K |
| 29580 |
|
73 |
27 |
$23K |
| 83520 |
|
328 |
317 |
$22K |
| 12011 |
|
41 |
41 |
$22K |
| 93303 |
Transthoracic echocardiography for congenital cardiac anomalies, follow-up or limited study |
177 |
177 |
$21K |
| 93320 |
|
439 |
439 |
$21K |
| 77062 |
|
417 |
416 |
$21K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
232 |
199 |
$21K |
| 86765 |
|
1,786 |
1,776 |
$21K |
| 72197 |
|
83 |
83 |
$20K |
| 81003 |
|
17,255 |
16,662 |
$20K |
| 86140 |
|
5,664 |
5,436 |
$20K |
| 81001 |
|
10,635 |
10,095 |
$19K |
| Q3014 |
Telehealth originating site facility fee |
717 |
567 |
$18K |
| 86708 |
|
2,344 |
2,325 |
$18K |
| 86200 |
|
664 |
659 |
$18K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
113 |
112 |
$18K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
918 |
858 |
$18K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
11,819 |
10,505 |
$18K |
| 86618 |
|
1,226 |
1,212 |
$17K |
| 86003 |
|
294 |
285 |
$17K |
| 83883 |
|
460 |
365 |
$17K |
| J1756 |
Injection, iron sucrose, 1 mg |
393 |
142 |
$17K |
| 82627 |
|
701 |
693 |
$17K |
| 86694 |
|
497 |
493 |
$16K |
| 85730 |
|
7,519 |
7,186 |
$16K |
| 81025 |
|
4,310 |
4,112 |
$15K |
| 76813 |
|
388 |
385 |
$15K |
| 77080 |
|
242 |
242 |
$14K |
| 86787 |
|
1,654 |
1,623 |
$14K |
| 86735 |
|
1,741 |
1,729 |
$14K |
| 86376 |
|
990 |
978 |
$14K |
| 87507 |
|
31 |
31 |
$14K |
| 70486 |
|
173 |
171 |
$14K |
| 83735 |
|
5,431 |
4,804 |
$13K |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
1,783 |
1,678 |
$13K |
| 82533 |
|
917 |
869 |
$13K |
| 86747 |
|
758 |
667 |
$13K |
| 71045 |
Radiologic examination, chest; single view |
2,611 |
2,462 |
$13K |
| 86780 |
|
1,163 |
1,123 |
$13K |
| 82550 |
|
3,181 |
3,060 |
$13K |
| 83020 |
|
930 |
927 |
$12K |
| 29125 |
|
54 |
54 |
$12K |
| 85027 |
|
6,995 |
6,532 |
$12K |
| 87088 |
|
2,137 |
2,063 |
$12K |
| 86161 |
|
1,117 |
1,102 |
$12K |
| 86709 |
|
1,626 |
1,612 |
$12K |
| 87186 |
|
2,661 |
2,556 |
$12K |
| 86235 |
|
776 |
743 |
$12K |
| 90834 |
Psychotherapy, 45 minutes with patient |
186 |
105 |
$12K |
| 84144 |
|
555 |
484 |
$11K |
| 86593 |
|
3,368 |
3,327 |
$11K |
| 86160 |
|
1,135 |
1,119 |
$11K |
| 94060 |
|
358 |
355 |
$11K |
| 88307 |
|
139 |
137 |
$11K |
| 86304 |
|
537 |
508 |
$10K |
| 73562 |
|
944 |
935 |
$10K |
| 85652 |
|
7,291 |
6,996 |
$10K |
| 77061 |
|
196 |
194 |
$10K |
| 82947 |
|
5,590 |
4,899 |
$10K |
| 84481 |
|
1,477 |
1,452 |
$10K |
| 62323 |
|
27 |
27 |
$10K |
| 82105 |
|
1,509 |
1,477 |
$10K |
| 83615 |
|
2,478 |
2,226 |
$10K |
| 90750 |
|
66 |
66 |
$10K |
| 83525 |
|
737 |
733 |
$9K |
| 86800 |
|
744 |
735 |
$9K |
| 73700 |
|
94 |
94 |
$9K |
| 93325 |
|
474 |
474 |
$9K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
7,125 |
6,975 |
$9K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
164 |
162 |
$9K |
| J2704 |
Injection, propofol, 10 mg |
4,909 |
4,722 |
$9K |
| 90677 |
|
122 |
122 |
$9K |
| 83690 |
|
7,005 |
6,557 |
$9K |
| 85380 |
|
1,332 |
1,299 |
$9K |
| 82043 |
|
2,254 |
2,237 |
$8K |
| 87634 |
|
468 |
459 |
$8K |
| 86812 |
|
126 |
126 |
$8K |
| 87641 |
|
261 |
243 |
$8K |
| A4648 |
Tissue marker, implantable, any type, each |
317 |
307 |
$8K |
| 86141 |
|
875 |
866 |
$8K |
| 86334 |
|
463 |
437 |
$8K |
| 86778 |
|
588 |
581 |
$8K |
| 72195 |
|
25 |
24 |
$8K |
| 77085 |
|
53 |
53 |
$8K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
110 |
109 |
$8K |
| 93017 |
|
262 |
261 |
$8K |
| 81050 |
|
1,059 |
1,003 |
$8K |
| 80050 |
General health panel |
258 |
256 |
$7K |
| 87510 |
|
565 |
547 |
$7K |
| 87480 |
|
565 |
547 |
$7K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
6,248 |
5,260 |
$7K |
| 84703 |
|
5,943 |
5,607 |
$7K |
| 84550 |
|
1,937 |
1,792 |
$7K |
| 82570 |
|
1,517 |
1,450 |
$7K |
| 87660 |
|
638 |
617 |
$7K |
| 85045 |
|
2,282 |
2,230 |
$7K |
| 73130 |
|
697 |
678 |
$7K |
| 94729 |
|
382 |
379 |
$7K |
| 86431 |
|
1,465 |
1,454 |
$7K |
| 93975 |
|
17 |
17 |
$6K |
| 84480 |
|
1,291 |
1,269 |
$6K |
| 82977 |
|
1,254 |
1,227 |
$6K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
1,020 |
937 |
$6K |
| 10060 |
|
16 |
15 |
$6K |
| 86695 |
|
171 |
169 |
$6K |
| 73030 |
|
639 |
623 |
$5K |
| 86039 |
|
1,054 |
1,046 |
$5K |
| 84512 |
|
3,855 |
3,330 |
$5K |
| 86038 |
|
1,081 |
1,000 |
$5K |
| 94727 |
|
381 |
378 |
$5K |
| 99441 |
|
97 |
81 |
$5K |
| 86710 |
|
1,024 |
1,014 |
$5K |
| 84100 |
|
2,142 |
1,895 |
$5K |
| 87040 |
|
1,097 |
953 |
$4K |
| C1769 |
Guide wire |
157 |
155 |
$4K |
| 82950 |
|
899 |
893 |
$4K |
| 86225 |
|
845 |
830 |
$4K |
| 72100 |
|
355 |
354 |
$4K |
| 76000 |
|
80 |
77 |
$4K |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
2,924 |
2,662 |
$4K |
| 73630 |
|
732 |
720 |
$4K |
| 86317 |
|
62 |
62 |
$4K |
| 74181 |
|
13 |
13 |
$4K |
| 86920 |
|
44 |
40 |
$4K |
| 99442 |
|
44 |
39 |
$4K |
| 90656 |
|
217 |
217 |
$4K |
| 84305 |
|
176 |
175 |
$3K |
| 84156 |
|
1,087 |
1,030 |
$3K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
14 |
13 |
$3K |
| J0134 |
Injection, acetaminophen (fresenius kabi), not therapeutically equivalent to j0131, 10 mg |
1,099 |
1,011 |
$3K |
| 73110 |
|
312 |
299 |
$3K |
| 84445 |
|
25 |
25 |
$3K |
| 82565 |
|
474 |
468 |
$3K |
| J7050 |
Infusion, normal saline solution, 250 cc |
5,754 |
3,316 |
$3K |
| M0239 |
Intravenous infusion, bamlanivimab-xxxx, includes infusion and post administration monitoring |
13 |
13 |
$3K |
| 82948 |
|
1,942 |
1,537 |
$3K |
| J2469 |
Injection, palonosetron hcl, 25 mcg |
345 |
206 |
$3K |
| 84436 |
|
677 |
660 |
$2K |
| 86696 |
|
186 |
184 |
$2K |
| 88112 |
|
77 |
76 |
$2K |
| 93351 |
|
28 |
28 |
$2K |
| J0690 |
Injection, cefazolin sodium, 500 mg |
1,935 |
1,776 |
$2K |
| J1170 |
Injection, hydromorphone, up to 4 mg |
1,205 |
941 |
$2K |
| 85007 |
|
1,958 |
1,773 |
$2K |
| 90698 |
|
210 |
210 |
$2K |
| 80159 |
|
234 |
220 |
$2K |
| 86146 |
|
108 |
107 |
$2K |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
4,167 |
3,967 |
$2K |
| 82652 |
|
20 |
19 |
$2K |
| 82150 |
|
892 |
836 |
$2K |
| 82465 |
|
499 |
499 |
$2K |
| 70491 |
|
12 |
12 |
$2K |
| 83695 |
|
112 |
111 |
$2K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
1,649 |
1,644 |
$2K |
| 83010 |
|
174 |
164 |
$2K |
| 82248 |
|
454 |
353 |
$2K |
| 73610 |
|
395 |
394 |
$2K |
| 97116 |
|
62 |
37 |
$2K |
| 0031A |
|
51 |
49 |
$2K |
| 86147 |
|
128 |
127 |
$2K |
| J0136 |
Injection, acetaminophen (b braun), not therapeutically equivalent to j0131, 10 mg |
782 |
755 |
$2K |
| 87205 |
|
717 |
678 |
$2K |
| 87338 |
|
228 |
227 |
$2K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
4,657 |
4,355 |
$2K |
| 76870 |
|
55 |
53 |
$2K |
| 77336 |
|
28 |
12 |
$2K |
| 83605 |
|
1,600 |
1,468 |
$2K |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
1,261 |
1,114 |
$2K |
| 86301 |
|
114 |
104 |
$2K |
| 84165 |
|
229 |
208 |
$2K |
| 83921 |
|
83 |
83 |
$2K |
| 86777 |
|
113 |
112 |
$2K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
3,001 |
2,814 |
$1K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
3,128 |
2,724 |
$1K |
| 82247 |
|
304 |
209 |
$1K |
| 90732 |
|
13 |
13 |
$1K |
| 86592 |
|
677 |
672 |
$1K |
| 88300 |
|
163 |
162 |
$1K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
25 |
23 |
$1K |
| 0012A |
|
47 |
47 |
$1K |
| 0011A |
|
86 |
86 |
$1K |
| 97035 |
|
56 |
24 |
$1K |
| 82785 |
|
94 |
94 |
$1K |
| 90746 |
|
37 |
37 |
$1K |
| 90670 |
|
25 |
25 |
$1K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
5,746 |
5,102 |
$1K |
| A9502 |
Technetium tc-99m tetrofosmin, diagnostic, per study dose |
12 |
12 |
$1K |
| 99235 |
|
24 |
24 |
$1K |
| P9604 |
Travel allowance one way in connection with medically necessary laboratory specimen collection drawn from home bound or nursing home bound patient; prorated trip charge |
570 |
387 |
$988.57 |
| 72110 |
|
39 |
39 |
$969.65 |
| 86255 |
|
111 |
110 |
$951.50 |
| 82164 |
|
27 |
26 |
$927.42 |
| J7060 |
5% dextrose/water (500 ml = 1 unit) |
675 |
333 |
$922.53 |
| 88360 |
|
13 |
13 |
$914.65 |
| 83718 |
|
186 |
186 |
$880.81 |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
1,354 |
1,071 |
$871.09 |
| C1894 |
Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser |
85 |
54 |
$845.20 |
| 86021 |
|
25 |
25 |
$842.44 |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
18 |
18 |
$836.35 |
| 73502 |
|
94 |
94 |
$823.90 |
| 83993 |
|
70 |
69 |
$774.46 |
| 90681 |
|
73 |
73 |
$716.79 |
| Q9965 |
Low osmolar contrast material, 100-199 mg/ml iodine concentration, per ml |
85 |
84 |
$680.53 |
| 91301 |
|
95 |
78 |
$653.30 |
| G0475 |
Hiv antigen/antibody, combination assay, screening |
29 |
28 |
$648.71 |
| J0171 |
Injection, adrenalin, epinephrine, 0.1 mg |
42 |
41 |
$635.18 |
| 86325 |
|
36 |
32 |
$634.30 |
| 96376 |
|
1,092 |
897 |
$620.12 |
| 90744 |
|
55 |
55 |
$580.67 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
159 |
150 |
$580.66 |
| 80051 |
|
99 |
96 |
$564.60 |
| 82024 |
|
13 |
13 |
$559.32 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
1,430 |
1,369 |
$540.31 |
| 76820 |
|
37 |
25 |
$515.81 |
| 82397 |
|
16 |
15 |
$500.94 |
| 77072 |
|
54 |
54 |
$495.11 |
| 86580 |
|
99 |
96 |
$490.01 |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
522 |
501 |
$476.13 |
| 82172 |
|
29 |
29 |
$475.51 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
1,375 |
1,097 |
$474.81 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
101 |
86 |
$466.78 |
| 90832 |
Psychotherapy, 30 minutes with patient |
16 |
13 |
$442.00 |
| 80164 |
|
44 |
39 |
$424.55 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
671 |
507 |
$424.01 |
| 85613 |
|
57 |
57 |
$421.98 |
| 84425 |
|
25 |
25 |
$378.00 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
2,576 |
2,513 |
$357.03 |
| 83498 |
|
12 |
12 |
$353.21 |
| 83721 |
|
64 |
64 |
$341.07 |
| 87177 |
|
76 |
74 |
$340.20 |
| 84207 |
|
12 |
12 |
$336.64 |
| G0103 |
Prostate cancer screening; prostate specific antigen test (psa) |
12 |
12 |
$312.33 |
| 70498 |
|
13 |
13 |
$307.84 |
| 87420 |
|
84 |
82 |
$300.32 |
| 87430 |
|
151 |
150 |
$299.40 |
| 90734 |
|
16 |
16 |
$285.24 |
| 90620 |
|
13 |
13 |
$273.34 |
| J1453 |
Injection, fosaprepitant, 1 mg |
19 |
12 |
$263.59 |
| 90633 |
|
29 |
29 |
$250.00 |
| 72040 |
|
26 |
26 |
$218.18 |
| 82955 |
|
25 |
25 |
$213.94 |
| 73521 |
|
12 |
12 |
$210.68 |
| 84132 |
|
132 |
128 |
$208.78 |
| J8540 |
Dexamethasone, oral, 0.25 mg |
112 |
99 |
$169.82 |
| J1644 |
Injection, heparin sodium, per 1000 units |
183 |
133 |
$169.24 |
| J2919 |
Injection, methylprednisolone sodium succinate, 5 mg |
48 |
39 |
$157.30 |
| 87184 |
|
24 |
24 |
$150.36 |
| J3535 |
Drug administered through a metered dose inhaler |
65 |
65 |
$145.76 |
| 84466 |
|
12 |
12 |
$138.55 |
| 90474 |
|
72 |
72 |
$138.54 |
| 72070 |
|
13 |
13 |
$136.98 |
| J2060 |
Injection, lorazepam, 2 mg |
320 |
271 |
$129.83 |
| 91200 |
|
13 |
13 |
$125.88 |
| 87106 |
|
13 |
13 |
$125.61 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
345 |
340 |
$108.15 |
| J1630 |
Injection, haloperidol, up to 5 mg |
244 |
224 |
$105.36 |
| J0330 |
Injection, succinylcholine chloride, up to 20 mg |
52 |
52 |
$102.17 |
| 87209 |
|
15 |
15 |
$95.51 |
| 84155 |
|
45 |
43 |
$92.64 |
| J2272 |
Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg |
52 |
44 |
$92.23 |
| 86705 |
|
12 |
12 |
$82.18 |
| 73590 |
|
12 |
12 |
$78.12 |
| 87341 |
|
14 |
12 |
$66.38 |
| 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 |
15 |
13 |
$59.85 |
| J2003 |
Injection, lidocaine hydrochloride, 1 mg |
153 |
146 |
$55.09 |
| 74018 |
|
15 |
13 |
$54.54 |
| 84484 |
|
119 |
116 |
$53.29 |
| 80178 |
|
13 |
12 |
$52.88 |
| J1596 |
Injection, glycopyrrolate, 0.1 mg |
82 |
81 |
$46.67 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
335 |
250 |
$46.08 |
| J7620 |
Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme |
322 |
270 |
$42.48 |
| 73080 |
|
13 |
13 |
$37.90 |
| 82040 |
|
12 |
12 |
$34.65 |
| 85041 |
|
24 |
24 |
$30.23 |
| G1004 |
Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program |
540 |
511 |
$26.89 |
| Q9966 |
Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml |
13 |
13 |
$23.46 |
| J1171 |
Injection, hydromorphone, 0.1 mg |
40 |
34 |
$20.25 |
| 85018 |
|
24 |
24 |
$20.12 |
| 85014 |
|
25 |
25 |
$20.12 |
| C9113 |
Injection, pantoprazole sodium, per vial |
15 |
14 |
$19.87 |
| 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 |
694 |
657 |
$16.29 |
| 81000 |
|
16 |
16 |
$15.00 |
| J2370 |
Injection, phenylephrine hcl, up to 1 ml |
94 |
92 |
$12.74 |
| J2371 |
Injection, phenylephrine hydrochloride, 20 micrograms |
179 |
168 |
$5.94 |
| A9270 |
Non-covered item or service |
159 |
83 |
$5.14 |
| J1642 |
Injection, heparin sodium, (heparin lock flush), per 10 units |
25 |
13 |
$1.60 |
| Q0163 |
Diphenhydramine hydrochloride, 50 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at time of chemotherapy treatment not to exceed a 48 hour dosage regimen |
233 |
193 |
$1.43 |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
26 |
25 |
$0.89 |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
13 |
12 |
$0.56 |
| 91303 |
|
16 |
14 |
$0.07 |
| G0499 |
Hepatitis b screening in non-pregnant, high risk individual includes hepatitis b surface antigen (hbsag), antibodies to hbsag (anti-hbs) and antibodies to hepatitis b core antigen (anti-hbc), and is followed by a neutralizing confirmatory test, when performed, only for an initially reactive hbsag result |
20 |
12 |
$0.00 |
| 99080 |
|
5,380 |
1,214 |
$0.00 |
| 80342 |
|
87 |
81 |
$0.00 |
| J2004 |
Injection, lidocaine hcl with epinephrine, 1 mg |
36 |
36 |
$0.00 |