| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 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 |
627,615 |
280,579 |
$35.11M |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
895,937 |
395,023 |
$25.53M |
| 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 |
256,470 |
102,284 |
$14.40M |
| 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 |
216,003 |
103,932 |
$9.82M |
| G0483 |
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; 22 or more drug class(es), including metabolite(s) if performed |
123,968 |
57,115 |
$7.72M |
| 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 |
103,083 |
71,160 |
$4.81M |
| 86481 |
|
31,169 |
29,005 |
$1.51M |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
58,351 |
21,554 |
$1.48M |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
56,293 |
49,675 |
$1.17M |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
55,701 |
49,140 |
$1.15M |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
55,132 |
48,618 |
$1.09M |
| 87563 |
|
44,544 |
39,227 |
$864K |
| 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 |
51,756 |
36,154 |
$781K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
62,254 |
55,535 |
$772K |
| 86480 |
|
18,484 |
16,667 |
$607K |
| 87631 |
|
13,568 |
10,207 |
$579K |
| 87633 |
Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets |
7,441 |
6,380 |
$566K |
| 87522 |
Neg quan hep c or qual rna |
25,674 |
23,251 |
$541K |
| 86803 |
|
53,704 |
48,891 |
$450K |
| 86780 |
|
65,818 |
58,257 |
$444K |
| 87637 |
Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV |
5,109 |
4,399 |
$389K |
| 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 |
21,095 |
18,969 |
$342K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
27,909 |
25,303 |
$341K |
| 80053 |
Comprehensive metabolic panel |
57,782 |
52,725 |
$335K |
| 80050 |
General health panel |
8,208 |
7,045 |
$300K |
| 84443 |
Thyroid stimulating hormone (TSH) |
31,154 |
28,527 |
$300K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
9,905 |
8,352 |
$275K |
| 81226 |
|
4,617 |
4,058 |
$249K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
55,688 |
50,719 |
$244K |
| 80074 |
|
16,532 |
14,399 |
$236K |
| 82607 |
|
23,081 |
20,882 |
$188K |
| 80061 |
Lipid panel |
23,049 |
20,755 |
$174K |
| 87340 |
|
30,311 |
27,850 |
$167K |
| 87529 |
|
8,935 |
8,025 |
$163K |
| 87581 |
|
16,101 |
12,576 |
$158K |
| 87486 |
|
15,866 |
12,349 |
$155K |
| 81225 |
|
4,305 |
3,773 |
$155K |
| 87541 |
|
15,482 |
12,007 |
$149K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
13,346 |
10,207 |
$148K |
| 86705 |
|
19,307 |
17,714 |
$143K |
| 87511 |
|
8,076 |
7,211 |
$119K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
26,274 |
23,800 |
$114K |
| 87640 |
|
11,783 |
8,906 |
$105K |
| 86706 |
|
16,039 |
14,656 |
$87K |
| 81227 |
|
3,365 |
2,947 |
$71K |
| 86704 |
|
11,486 |
10,608 |
$71K |
| 36415 |
Collection of venous blood by venipuncture |
13,936 |
12,012 |
$68K |
| 82248 |
|
20,662 |
19,344 |
$64K |
| 83735 |
|
11,575 |
10,530 |
$60K |
| 81025 |
|
14,243 |
6,665 |
$60K |
| 81230 |
|
2,313 |
1,983 |
$55K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
13,722 |
12,725 |
$53K |
| 81231 |
|
2,145 |
1,839 |
$52K |
| 84481 |
|
5,802 |
5,208 |
$49K |
| 81328 |
|
1,547 |
1,305 |
$44K |
| 87641 |
|
3,838 |
3,212 |
$39K |
| 84439 |
|
10,136 |
9,087 |
$39K |
| 80373 |
|
15,188 |
11,297 |
$32K |
| 80364 |
|
9,892 |
7,662 |
$31K |
| 80372 |
|
14,216 |
10,692 |
$31K |
| 80355 |
|
13,845 |
10,166 |
$31K |
| 80354 |
|
15,076 |
11,295 |
$31K |
| 80366 |
|
12,216 |
8,914 |
$29K |
| 84460 |
|
12,001 |
11,761 |
$28K |
| 82247 |
|
11,877 |
11,670 |
$27K |
| 84450 |
|
11,997 |
11,760 |
$27K |
| 83992 |
|
12,045 |
9,090 |
$25K |
| 81479 |
Unlisted molecular pathology procedure |
19,518 |
3,490 |
$23K |
| 87521 |
Neg quan hep c or qual rna |
1,508 |
1,368 |
$23K |
| 82746 |
|
5,484 |
4,997 |
$21K |
| 80368 |
|
11,052 |
8,235 |
$21K |
| 81291 |
|
2,315 |
2,001 |
$20K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
4,633 |
4,212 |
$20K |
| 85027 |
|
7,083 |
6,036 |
$20K |
| 80348 |
|
10,646 |
7,578 |
$20K |
| 84155 |
|
11,883 |
11,670 |
$19K |
| 80357 |
|
10,064 |
7,298 |
$19K |
| 84403 |
|
1,696 |
1,521 |
$19K |
| 80367 |
|
9,218 |
6,643 |
$17K |
| 81355 |
|
1,376 |
1,152 |
$17K |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
189 |
182 |
$17K |
| 82670 |
|
1,258 |
1,137 |
$17K |
| 80361 |
|
5,643 |
4,581 |
$17K |
| 80360 |
|
10,115 |
7,296 |
$16K |
| 84075 |
|
6,977 |
6,913 |
$16K |
| 80346 |
|
5,686 |
3,894 |
$15K |
| 84702 |
|
2,340 |
2,018 |
$14K |
| 81241 |
|
1,223 |
1,010 |
$14K |
| 83540 |
|
4,322 |
3,911 |
$14K |
| 84146 |
|
1,557 |
1,398 |
$13K |
| 84466 |
|
2,153 |
1,976 |
$13K |
| 81240 |
|
1,224 |
1,011 |
$12K |
| 80365 |
|
5,349 |
4,525 |
$12K |
| 84144 |
|
1,183 |
1,066 |
$12K |
| 82627 |
|
1,065 |
961 |
$11K |
| 80370 |
|
5,749 |
4,069 |
$11K |
| 87632 |
|
139 |
124 |
$10K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
308 |
262 |
$10K |
| 84270 |
|
892 |
796 |
$9K |
| 80349 |
|
4,400 |
3,389 |
$9K |
| 80338 |
|
5,193 |
3,645 |
$9K |
| 80324 |
|
5,533 |
4,213 |
$9K |
| 82040 |
|
4,894 |
4,757 |
$9K |
| 80333 |
|
3,457 |
2,416 |
$9K |
| 80353 |
|
4,227 |
3,227 |
$9K |
| 80076 |
|
2,574 |
2,288 |
$9K |
| 80337 |
|
3,452 |
2,412 |
$9K |
| 86709 |
|
1,732 |
1,576 |
$8K |
| 80356 |
|
3,473 |
2,707 |
$7K |
| 80359 |
|
3,307 |
2,353 |
$7K |
| 87186 |
|
1,274 |
1,177 |
$6K |
| 83001 |
|
791 |
704 |
$6K |
| 83002 |
|
789 |
702 |
$6K |
| 82728 |
|
953 |
848 |
$6K |
| 80369 |
|
3,936 |
2,974 |
$6K |
| 81401 |
|
287 |
130 |
$6K |
| 87077 |
|
1,304 |
1,205 |
$6K |
| 80358 |
|
3,120 |
2,496 |
$6K |
| 86592 |
|
2,347 |
2,087 |
$5K |
| 80164 |
|
857 |
735 |
$5K |
| 84153 |
|
628 |
554 |
$5K |
| 80375 |
|
1,863 |
1,176 |
$3K |
| 80323 |
|
1,794 |
1,122 |
$3K |
| 87341 |
|
633 |
585 |
$3K |
| 80342 |
|
2,115 |
1,316 |
$3K |
| 80371 |
|
1,596 |
980 |
$3K |
| 84100 |
|
1,073 |
1,013 |
$3K |
| 80362 |
|
3,053 |
2,246 |
$3K |
| 86593 |
|
1,050 |
922 |
$2K |
| G2023 |
Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
162 |
145 |
$2K |
| 80178 |
|
598 |
511 |
$2K |
| 83550 |
|
512 |
446 |
$2K |
| 81003 |
|
1,654 |
1,433 |
$2K |
| 84436 |
|
579 |
535 |
$2K |
| 82533 |
|
204 |
168 |
$1K |
| 84480 |
|
283 |
257 |
$1K |
| 83690 |
|
710 |
626 |
$1K |
| 87481 |
|
153 |
145 |
$1K |
| 86376 |
|
184 |
163 |
$1K |
| 82150 |
|
678 |
598 |
$1K |
| 83525 |
|
249 |
210 |
$1K |
| 86140 |
|
375 |
331 |
$913.24 |
| 85610 |
|
179 |
157 |
$367.76 |
| 84681 |
|
54 |
40 |
$353.51 |
| 87801 |
Infectious agent detection by nucleic acid; amplified probe, multiple organisms |
16 |
15 |
$168.48 |
| 82977 |
|
32 |
29 |
$102.77 |
| 80069 |
|
12 |
12 |
$53.21 |
| 87501 |
|
28 |
28 |
$18.47 |
| 81418 |
|
148 |
133 |
$0.35 |
| 80363 |
|
2,571 |
1,951 |
$0.00 |
| 80321 |
|
163 |
137 |
$0.00 |
| 80326 |
|
41 |
31 |
$0.00 |
| 80325 |
|
420 |
259 |
$0.00 |