| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
Emergency department visit for the evaluation and management, high severity |
56,317 |
51,595 |
$7.80M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
35,313 |
31,559 |
$5.24M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
40,541 |
37,759 |
$4.74M |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
10,989 |
10,015 |
$3.88M |
| J3490 |
Unclassified drugs |
97,860 |
49,199 |
$1.82M |
| 70450 |
Computed tomography, head or brain; without contrast material |
10,918 |
10,026 |
$1.52M |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
19,981 |
17,621 |
$1.02M |
| 96361 |
Intravenous infusion, hydration; each additional hour |
23,343 |
20,207 |
$787K |
| 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 |
9,358 |
8,611 |
$761K |
| 71045 |
Radiologic examination, chest; single view |
34,749 |
31,361 |
$746K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
22,217 |
18,799 |
$734K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
11,465 |
10,151 |
$708K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
26,045 |
23,171 |
$665K |
| 80053 |
Comprehensive metabolic panel |
30,421 |
25,840 |
$587K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
9,803 |
9,407 |
$575K |
| 36415 |
Collection of venous blood by venipuncture |
24,196 |
19,650 |
$558K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
70,899 |
59,891 |
$470K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
37,052 |
32,349 |
$444K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
13,057 |
11,163 |
$359K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
26,171 |
22,687 |
$322K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
4,349 |
3,999 |
$314K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
7,805 |
7,176 |
$267K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
1,290 |
1,180 |
$258K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
5,171 |
4,760 |
$211K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
7,972 |
7,246 |
$206K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
15,769 |
13,511 |
$195K |
| 81025 |
|
28,599 |
25,843 |
$193K |
| 80076 |
|
28,257 |
25,308 |
$190K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
17,064 |
15,554 |
$170K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
719 |
670 |
$162K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
1,275 |
1,197 |
$156K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
8,375 |
6,778 |
$154K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
2,727 |
2,573 |
$149K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
906 |
491 |
$143K |
| 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 |
2,868 |
2,459 |
$140K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
5,398 |
5,006 |
$135K |
| 87428 |
|
2,262 |
2,051 |
$132K |
| 84484 |
|
17,532 |
14,466 |
$130K |
| 83690 |
|
21,984 |
19,808 |
$126K |
| 81001 |
|
25,897 |
23,874 |
$115K |
| 87070 |
|
4,250 |
3,996 |
$115K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
5,012 |
4,648 |
$114K |
| 87400 |
|
3,604 |
3,323 |
$101K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
1,439 |
1,301 |
$95K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
4,326 |
3,102 |
$92K |
| 81003 |
|
17,959 |
16,125 |
$84K |
| G0378 |
Hospital observation service, per hour |
2,383 |
1,761 |
$83K |
| 83735 |
|
16,705 |
14,358 |
$77K |
| 82150 |
|
14,804 |
13,338 |
$77K |
| 42820 |
Tonsillectomy and adenoidectomy; younger than age 12 |
83 |
82 |
$70K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
2,231 |
2,030 |
$61K |
| 87040 |
|
4,519 |
3,923 |
$56K |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
428 |
361 |
$55K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
4,491 |
4,259 |
$53K |
| 0202U |
Oncology (prostate), multianalyte, gene expression profiling |
559 |
536 |
$53K |
| 69436 |
Tympanostomy (requiring insertion of ventilating tube), general anesthesia |
116 |
115 |
$46K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
275 |
258 |
$39K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
20,847 |
18,448 |
$38K |
| 81015 |
|
10,739 |
9,506 |
$35K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
267 |
239 |
$34K |
| 87081 |
|
900 |
864 |
$30K |
| 87077 |
|
2,349 |
2,138 |
$29K |
| 84443 |
Thyroid stimulating hormone (TSH) |
2,835 |
2,512 |
$29K |
| 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 |
1,411 |
1,344 |
$28K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
1,015 |
913 |
$26K |
| 71046 |
Radiologic examination, chest; 2 views |
769 |
715 |
$25K |
| 95810 |
Polysomnography; sleep staging with 4 or more additional parameters |
58 |
48 |
$25K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
692 |
642 |
$25K |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
9,278 |
7,925 |
$22K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
10,370 |
9,420 |
$22K |
| 96376 |
|
1,370 |
852 |
$22K |
| 87220 |
|
2,886 |
2,665 |
$22K |
| 45378 |
Colonoscopy, flexible; diagnostic, including collection of specimen(s) |
81 |
77 |
$20K |
| G0379 |
Direct admission of patient for hospital observation care |
185 |
139 |
$20K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
4,512 |
3,994 |
$19K |
| 73630 |
|
296 |
269 |
$19K |
| J2704 |
Injection, propofol, 10 mg |
4,416 |
3,995 |
$18K |
| 96367 |
|
55 |
41 |
$18K |
| 83880 |
|
1,292 |
1,140 |
$17K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
2,986 |
2,693 |
$17K |
| 87186 |
|
2,313 |
2,103 |
$14K |
| 0240U |
|
97 |
95 |
$14K |
| 87210 |
|
974 |
892 |
$14K |
| 73560 |
|
265 |
231 |
$12K |
| 87807 |
|
1,042 |
1,016 |
$11K |
| 87420 |
|
284 |
270 |
$10K |
| 83605 |
|
1,343 |
1,126 |
$10K |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
5,257 |
4,310 |
$10K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
770 |
631 |
$10K |
| 73130 |
|
164 |
155 |
$9K |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
635 |
557 |
$9K |
| 84702 |
|
785 |
663 |
$7K |
| 59025 |
Fetal non-stress test |
140 |
93 |
$7K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
275 |
253 |
$7K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
502 |
359 |
$7K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
145 |
108 |
$7K |
| 42830 |
|
12 |
12 |
$6K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
213 |
63 |
$6K |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
342 |
302 |
$6K |
| J7620 |
Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme |
610 |
529 |
$6K |
| 85379 |
|
890 |
832 |
$6K |
| 87801 |
Infectious agent detection by nucleic acid; amplified probe, multiple organisms |
68 |
64 |
$5K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
15 |
12 |
$5K |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
922 |
810 |
$4K |
| 86900 |
|
2,107 |
1,923 |
$4K |
| 86901 |
|
2,108 |
1,923 |
$4K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
42 |
39 |
$4K |
| 73610 |
|
55 |
51 |
$4K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
12 |
12 |
$3K |
| J2550 |
Injection, promethazine hcl, up to 50 mg |
1,229 |
998 |
$3K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
70 |
65 |
$3K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
20 |
15 |
$3K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
137 |
70 |
$3K |
| J8597 |
Antiemetic drug, oral, not otherwise specified |
957 |
885 |
$3K |
| 87590 |
|
139 |
130 |
$3K |
| 95800 |
|
42 |
39 |
$3K |
| 82728 |
|
185 |
169 |
$2K |
| 86850 |
|
305 |
274 |
$2K |
| 82550 |
|
398 |
363 |
$2K |
| J1170 |
Injection, hydromorphone, up to 4 mg |
1,212 |
844 |
$2K |
| 93923 |
|
45 |
44 |
$2K |
| 86003 |
|
17 |
12 |
$2K |
| 72100 |
|
32 |
26 |
$2K |
| J2919 |
Injection, methylprednisolone sodium succinate, 5 mg |
239 |
213 |
$2K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
13 |
13 |
$2K |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
849 |
723 |
$1K |
| 83550 |
|
162 |
153 |
$1K |
| 71250 |
|
13 |
12 |
$1K |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
284 |
263 |
$1K |
| 82803 |
|
184 |
148 |
$1K |
| 80050 |
General health panel |
28 |
26 |
$1K |
| 83540 |
|
163 |
155 |
$1K |
| C9803 |
Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
224 |
217 |
$1K |
| 95816 |
|
15 |
15 |
$1K |
| 88342 |
|
28 |
24 |
$999.74 |
| 51701 |
|
45 |
39 |
$992.31 |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
13 |
13 |
$974.96 |
| J0500 |
Injection, dicyclomine hcl, up to 20 mg |
15 |
12 |
$779.46 |
| 85610 |
|
442 |
386 |
$734.60 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
52 |
51 |
$688.18 |
| J7510 |
Prednisolone oral, per 5 mg |
177 |
138 |
$640.02 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
96 |
90 |
$578.27 |
| J1644 |
Injection, heparin sodium, per 1000 units |
126 |
75 |
$560.15 |
| 80320 |
|
28 |
24 |
$458.55 |
| C1725 |
Catheter, transluminal angioplasty, non-laser (may include guidance, infusion/perfusion capability) |
14 |
13 |
$454.86 |
| 82607 |
|
32 |
26 |
$444.86 |
| 90715 |
|
42 |
37 |
$405.28 |
| 82746 |
|
30 |
25 |
$380.00 |
| J2272 |
Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg |
199 |
168 |
$366.45 |
| 82784 |
|
16 |
13 |
$310.29 |
| 85651 |
|
97 |
95 |
$272.07 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
139 |
126 |
$259.26 |
| J1790 |
Injection, droperidol, up to 5 mg |
42 |
40 |
$256.08 |
| J3535 |
Drug administered through a metered dose inhaler |
57 |
53 |
$232.28 |
| 85730 |
|
102 |
94 |
$220.19 |
| 86141 |
|
31 |
24 |
$212.73 |
| J2003 |
Injection, lidocaine hydrochloride, 1 mg |
168 |
158 |
$212.44 |
| 82785 |
|
15 |
12 |
$182.53 |
| C1894 |
Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser |
30 |
15 |
$178.53 |
| S0028 |
Injection, famotidine, 20 mg |
70 |
68 |
$157.35 |
| 80061 |
Lipid panel |
12 |
12 |
$140.55 |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
295 |
270 |
$134.03 |
| S0020 |
Injection, bupivicaine hydrochloride, 30 ml |
98 |
94 |
$132.20 |
| 85027 |
|
31 |
26 |
$111.72 |
| V2632 |
Posterior chamber intraocular lens |
13 |
12 |
$109.91 |
| C1769 |
Guide wire |
19 |
15 |
$93.64 |
| J1642 |
Injection, heparin sodium, (heparin lock flush), per 10 units |
81 |
49 |
$51.33 |
| Q0144 |
Azithromycin dihydrate, oral, capsules/powder, 1 gram |
377 |
360 |
$49.70 |
| 94761 |
|
51 |
27 |
$44.09 |
| 90714 |
|
38 |
37 |
$43.08 |
| 82272 |
|
12 |
12 |
$24.76 |
| 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 |
108 |
103 |
$0.59 |
| A9270 |
Non-covered item or service |
4,124 |
703 |
$0.00 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
19 |
14 |
$0.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
14 |
13 |
$0.00 |
| J7999 |
Compounded drug, not otherwise classified |
14 |
13 |
$0.00 |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
30 |
13 |
$0.00 |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
13 |
13 |
$0.00 |
| G1004 |
Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program |
867 |
620 |
$-0.01 |