| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
Emergency department visit for the evaluation and management, high severity |
84,594 |
77,988 |
$33.71M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
107,058 |
99,499 |
$31.24M |
| G0378 |
Hospital observation service, per hour |
19,271 |
16,536 |
$19.28M |
| J9271 |
Injection, pembrolizumab, 1 mg |
1,681 |
1,185 |
$17.05M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
31,445 |
29,425 |
$12.28M |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
30,602 |
17,185 |
$11.66M |
| J1745 |
Injection, infliximab, excludes biosimilar, 10 mg |
1,184 |
1,101 |
$10.67M |
| J9312 |
Injection, rituximab, 10 mg |
1,113 |
603 |
$7.06M |
| 96375 |
Therapeutic injection; each additional sequential IV push |
46,520 |
32,620 |
$6.71M |
| J9306 |
Injection, pertuzumab, 1 mg |
831 |
609 |
$5.74M |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
24,881 |
23,240 |
$5.69M |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
2,738 |
2,644 |
$5.04M |
| J9299 |
Injection, nivolumab, 1 mg |
773 |
424 |
$4.99M |
| A0429 |
Ambulance service, basic life support, emergency transport (bls-emergency) |
19,775 |
16,839 |
$4.87M |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
30,434 |
24,069 |
$4.73M |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
18,468 |
17,582 |
$3.85M |
| J0897 |
Injection, denosumab, 1 mg |
1,867 |
1,747 |
$3.76M |
| 96361 |
Intravenous infusion, hydration; each additional hour |
33,561 |
28,065 |
$3.61M |
| J1561 |
Injection, immune globulin, (gamunex-c/gammaked), non-lyophilized (e.g., liquid), 500 mg |
2,015 |
1,003 |
$3.50M |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
7,010 |
6,679 |
$3.49M |
| A0427 |
Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) |
10,854 |
10,039 |
$3.42M |
| 78815 |
Positron emission tomography (PET) for limited area imaging |
3,100 |
3,031 |
$3.06M |
| 93458 |
|
933 |
882 |
$2.90M |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
4,947 |
4,814 |
$2.87M |
| 36430 |
|
6,572 |
3,787 |
$2.83M |
| J9310 |
Injection, rituximab, 100 mg |
338 |
239 |
$2.66M |
| J9355 |
Injection, trastuzumab, excludes biosimilar, 10 mg |
458 |
318 |
$2.62M |
| J9144 |
Injection, daratumumab, 10 mg and hyaluronidase-fihj |
680 |
396 |
$2.26M |
| J1439 |
Injection, ferric carboxymaltose, 1 mg |
1,955 |
1,369 |
$2.26M |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
1,964 |
1,886 |
$2.16M |
| 96367 |
|
13,362 |
9,330 |
$2.11M |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
46,358 |
10,822 |
$1.88M |
| 41899 |
Unlisted procedure, dentoalveolar structures |
824 |
802 |
$1.87M |
| 92587 |
|
9,330 |
9,168 |
$1.86M |
| 0202U |
Oncology (prostate), multianalyte, gene expression profiling |
15,673 |
14,849 |
$1.85M |
| 94060 |
|
3,365 |
3,267 |
$1.72M |
| 70450 |
Computed tomography, head or brain; without contrast material |
16,440 |
15,233 |
$1.70M |
| 94010 |
|
4,890 |
4,771 |
$1.67M |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
9,712 |
7,586 |
$1.66M |
| J9035 |
Injection, bevacizumab, 10 mg |
293 |
188 |
$1.63M |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
31,803 |
28,051 |
$1.62M |
| 96409 |
|
3,205 |
1,932 |
$1.60M |
| Q5107 |
Injection, bevacizumab-awwb, biosimilar, (mvasi), 10 mg |
715 |
258 |
$1.55M |
| J0485 |
Injection, belatacept, 1 mg |
1,345 |
857 |
$1.53M |
| 96411 |
|
3,408 |
2,214 |
$1.46M |
| J0185 |
Injection, aprepitant, 1 mg |
4,358 |
2,574 |
$1.45M |
| 80053 |
Comprehensive metabolic panel |
127,284 |
102,078 |
$1.35M |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
79,896 |
20,159 |
$1.34M |
| 42820 |
Tonsillectomy and adenoidectomy; younger than age 12 |
501 |
493 |
$1.33M |
| OP710 |
|
16,544 |
15,472 |
$1.30M |
| A0425 |
Ground mileage, per statute mile |
34,108 |
28,640 |
$1.28M |
| 95810 |
Polysomnography; sleep staging with 4 or more additional parameters |
931 |
903 |
$1.26M |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
53,490 |
47,129 |
$1.26M |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
3,642 |
3,531 |
$1.25M |
| C1713 |
Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) |
1,387 |
1,252 |
$1.15M |
| 71046 |
Radiologic examination, chest; 2 views |
39,527 |
37,528 |
$1.15M |
| OP278 |
|
1,615 |
1,476 |
$1.13M |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
12,360 |
11,306 |
$1.12M |
| 96401 |
|
4,017 |
2,900 |
$1.09M |
| P9040 |
Red blood cells, leukocytes reduced, irradiated, each unit |
2,989 |
1,733 |
$1.06M |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
5,219 |
4,931 |
$1.05M |
| 96402 |
|
2,668 |
2,382 |
$974K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
7,345 |
7,023 |
$971K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
19,930 |
7,457 |
$969K |
| 44970 |
|
408 |
381 |
$949K |
| 92567 |
|
10,579 |
10,349 |
$922K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
10,863 |
10,662 |
$920K |
| Q5117 |
Injection, trastuzumab-anns, biosimilar, (kanjinti), 10 mg |
356 |
225 |
$895K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
20,367 |
18,885 |
$891K |
| 95117 |
|
9,351 |
4,003 |
$881K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
144,070 |
111,772 |
$856K |
| 92557 |
|
3,607 |
3,545 |
$842K |
| 74183 |
|
1,475 |
1,447 |
$813K |
| 92652 |
|
1,109 |
1,071 |
$785K |
| G0108 |
Diabetes outpatient self-management training services, individual, per 30 minutes |
2,217 |
1,946 |
$784K |
| 93970 |
|
3,237 |
3,086 |
$781K |
| 95782 |
|
556 |
534 |
$774K |
| P9037 |
Platelets, pheresis, leukocytes reduced, irradiated, each unit |
492 |
264 |
$769K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
4,946 |
4,721 |
$763K |
| A0434 |
Specialty care transport (sct) |
1,895 |
1,790 |
$745K |
| 92579 |
|
3,814 |
3,716 |
$730K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
11,184 |
10,634 |
$723K |
| 93976 |
|
2,503 |
2,412 |
$723K |
| P9016 |
Red blood cells, leukocytes reduced, each unit |
2,105 |
1,621 |
$690K |
| 77412 |
|
7,946 |
846 |
$678K |
| 92585 |
|
681 |
675 |
$662K |
| 94729 |
|
2,512 |
2,420 |
$660K |
| J9202 |
Goserelin acetate implant, per 3.6 mg |
657 |
589 |
$660K |
| OP250 |
|
248,938 |
169,091 |
$628K |
| 92582 |
|
2,929 |
2,873 |
$627K |
| 94727 |
|
2,497 |
2,413 |
$626K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
21,160 |
16,167 |
$623K |
| 77334 |
|
1,559 |
1,094 |
$617K |
| OP272 |
|
34,901 |
32,109 |
$586K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
3,371 |
3,212 |
$584K |
| OP370 |
|
8,127 |
7,179 |
$564K |
| 76830 |
Ultrasound, transvaginal |
6,015 |
5,817 |
$516K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
950 |
869 |
$507K |
| 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 |
7,122 |
6,805 |
$497K |
| 72197 |
|
1,032 |
1,010 |
$487K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
4,553 |
2,827 |
$484K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
1,335 |
703 |
$480K |
| 69436 |
Tympanostomy (requiring insertion of ventilating tube), general anesthesia |
374 |
367 |
$475K |
| 93971 |
|
2,658 |
2,545 |
$459K |
| 99215 |
Prolong outpt/office vis |
4,239 |
4,095 |
$453K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
5,914 |
5,062 |
$453K |
| 87633 |
Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets |
3,575 |
3,527 |
$452K |
| 95165 |
Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy, multiple dose vials |
1,863 |
820 |
$452K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
4,900 |
4,066 |
$443K |
| 76770 |
|
5,122 |
4,987 |
$442K |
| 96376 |
|
7,797 |
6,196 |
$430K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
1,609 |
1,588 |
$424K |
| 19083 |
|
238 |
213 |
$419K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
5,012 |
4,855 |
$418K |
| 71250 |
|
3,658 |
3,505 |
$412K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
4,529 |
4,105 |
$411K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
10,820 |
10,616 |
$394K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
5,304 |
4,825 |
$386K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
11,434 |
10,495 |
$376K |
| 97161 |
|
8,354 |
7,959 |
$344K |
| 0002A |
|
10,426 |
10,414 |
$338K |
| J9395 |
Injection, fulvestrant, 25 mg |
490 |
396 |
$325K |
| 76801 |
|
2,881 |
2,748 |
$309K |
| 77066 |
Tomosynthesis, mammo |
2,872 |
2,794 |
$308K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
1,116 |
1,073 |
$304K |
| 0001A |
|
10,575 |
10,564 |
$303K |
| 59025 |
Fetal non-stress test |
2,571 |
2,363 |
$294K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
13,868 |
12,402 |
$293K |
| 95819 |
|
585 |
577 |
$288K |
| 71045 |
Radiologic examination, chest; single view |
12,319 |
11,259 |
$288K |
| 93017 |
|
1,688 |
1,570 |
$287K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
1,332 |
1,242 |
$284K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,598 |
2,539 |
$282K |
| C1776 |
Joint device (implantable) |
123 |
107 |
$282K |
| 99245 |
|
2,342 |
2,297 |
$279K |
| 88185 |
|
2,308 |
1,617 |
$277K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
3,134 |
3,068 |
$274K |
| 92555 |
|
2,572 |
2,530 |
$269K |
| 76641 |
|
2,980 |
2,807 |
$266K |
| 96416 |
|
2,530 |
1,419 |
$266K |
| C1889 |
Implantable/insertable device, not otherwise classified |
320 |
276 |
$265K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
25,815 |
23,501 |
$263K |
| 96415 |
|
8,982 |
5,839 |
$249K |
| 77065 |
Tomosynthesis, mammo |
2,970 |
2,723 |
$237K |
| 70491 |
|
1,511 |
1,449 |
$231K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
498 |
483 |
$228K |
| J0585 |
Injection, onabotulinumtoxina, 1 unit |
150 |
126 |
$221K |
| J9358 |
Injection, fam-trastuzumab deruxtecan-nxki, 1 mg |
32 |
24 |
$212K |
| 70486 |
|
1,545 |
1,465 |
$210K |
| OP270 |
|
63,778 |
59,272 |
$210K |
| 84484 |
|
30,780 |
25,547 |
$206K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
10,219 |
8,869 |
$206K |
| 76642 |
|
3,577 |
3,422 |
$203K |
| 96368 |
|
3,187 |
2,082 |
$202K |
| 95800 |
|
491 |
475 |
$199K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
8,924 |
8,078 |
$196K |
| 47562 |
|
100 |
91 |
$189K |
| 92507 |
Treatment of speech, language, voice, communication, and/or auditory processing disorder |
3,427 |
1,253 |
$186K |
| 36591 |
|
2,209 |
1,787 |
$185K |
| 73564 |
|
5,272 |
4,993 |
$184K |
| 36561 |
|
98 |
87 |
$178K |
| G0279 |
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) |
5,050 |
4,784 |
$176K |
| 86900 |
|
30,811 |
22,052 |
$173K |
| 77080 |
|
2,452 |
2,376 |
$171K |
| J1453 |
Injection, fosaprepitant, 1 mg |
996 |
580 |
$168K |
| 77336 |
|
2,109 |
1,003 |
$167K |
| 76813 |
|
1,316 |
1,300 |
$166K |
| 70496 |
|
1,259 |
1,166 |
$164K |
| 86850 |
|
27,268 |
18,562 |
$164K |
| 93356 |
|
938 |
815 |
$152K |
| A0428 |
Ambulance service, basic life support, non-emergency transport, (bls) |
3,177 |
2,998 |
$152K |
| 83735 |
|
41,832 |
27,890 |
$149K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
17,479 |
6,621 |
$147K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
21,125 |
17,490 |
$147K |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
20,392 |
17,106 |
$145K |
| 76536 |
|
2,273 |
2,213 |
$141K |
| 73030 |
|
4,405 |
4,179 |
$140K |
| 70498 |
|
1,097 |
1,021 |
$138K |
| C9463 |
Injection, aprepitant, 1 mg |
323 |
209 |
$137K |
| 96417 |
|
7,397 |
4,536 |
$137K |
| 45385 |
Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) |
391 |
356 |
$134K |
| 81001 |
|
41,472 |
37,447 |
$133K |
| 73130 |
|
4,750 |
4,524 |
$131K |
| 95714 |
|
513 |
326 |
$131K |
| 72141 |
|
532 |
506 |
$130K |
| 86803 |
|
15,449 |
14,107 |
$126K |
| J9070 |
Cyclophosphamide, 100 mg |
477 |
298 |
$125K |
| C9062 |
Injection, daratumumab 10 mg and hyaluronidase-fihj |
20 |
12 |
$124K |
| 92526 |
|
2,371 |
1,121 |
$123K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
1,217 |
1,199 |
$119K |
| 73630 |
|
4,395 |
4,200 |
$118K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
41,200 |
29,932 |
$117K |
| OP258 |
|
130,447 |
85,312 |
$117K |
| 86901 |
|
31,625 |
22,177 |
$115K |
| 93880 |
|
551 |
540 |
$114K |
| 87507 |
|
1,537 |
1,377 |
$112K |
| C1769 |
Guide wire |
4,226 |
3,493 |
$112K |
| 73562 |
|
3,005 |
2,874 |
$111K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
5,139 |
4,822 |
$111K |
| 81268 |
|
1,008 |
835 |
$110K |
| 36592 |
|
945 |
547 |
$110K |
| 73610 |
|
4,535 |
4,346 |
$109K |
| 76870 |
|
1,840 |
1,751 |
$109K |
| 97162 |
|
1,960 |
1,920 |
$108K |
| 84702 |
|
12,397 |
10,619 |
$106K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
20,972 |
18,864 |
$104K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
4,275 |
4,246 |
$102K |
| 74018 |
|
4,326 |
4,091 |
$102K |
| 54161 |
|
40 |
40 |
$100K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
9,831 |
9,456 |
$100K |
| J2785 |
Injection, regadenoson, 0.1 mg |
659 |
590 |
$99K |
| 83605 |
|
15,219 |
13,126 |
$99K |
| 36415 |
Collection of venous blood by venipuncture |
97,017 |
74,459 |
$98K |
| 97010 |
|
23,893 |
6,734 |
$96K |
| 84443 |
Thyroid stimulating hormone (TSH) |
13,602 |
12,077 |
$94K |
| J1720 |
Injection, hydrocortisone sodium succinate, up to 100 mg |
3,158 |
2,139 |
$91K |
| J3490 |
Unclassified drugs |
9,181 |
7,748 |
$90K |
| 88341 |
|
2,048 |
1,735 |
$89K |
| 77290 |
|
381 |
347 |
$89K |
| 74174 |
|
494 |
469 |
$87K |
| 83690 |
|
21,950 |
19,770 |
$87K |
| 93798 |
|
874 |
131 |
$87K |
| J2704 |
Injection, propofol, 10 mg |
24,007 |
20,497 |
$86K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
8,891 |
8,227 |
$86K |
| 72110 |
|
2,073 |
2,007 |
$83K |
| J9047 |
Injection, carfilzomib, 1 mg |
74 |
13 |
$83K |
| 83880 |
|
8,024 |
6,800 |
$82K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
30,614 |
21,618 |
$79K |
| 72082 |
|
1,433 |
1,412 |
$79K |
| J1170 |
Injection, hydromorphone, up to 4 mg |
10,764 |
6,791 |
$78K |
| 87040 |
|
5,109 |
4,418 |
$78K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
906 |
750 |
$77K |
| 73110 |
|
2,688 |
2,526 |
$76K |
| 85610 |
|
19,739 |
17,329 |
$75K |
| 74019 |
|
2,493 |
2,363 |
$74K |
| J0640 |
Injection, leucovorin calcium, per 50 mg |
2,561 |
1,394 |
$74K |
| 12011 |
|
1,692 |
1,623 |
$71K |
| C9290 |
Injection, bupivacaine liposome, 1 mg |
1,384 |
1,261 |
$69K |
| 96040 |
|
723 |
699 |
$67K |
| 88342 |
|
4,914 |
4,472 |
$67K |
| 95700 |
|
412 |
361 |
$67K |
| 97116 |
|
4,805 |
3,009 |
$67K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
4,171 |
3,846 |
$66K |
| J3590 |
Unclassified biologics |
280 |
273 |
$66K |
| J9267 |
Injection, paclitaxel, 1 mg |
2,421 |
1,041 |
$65K |
| 12001 |
|
1,537 |
1,479 |
$65K |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
3,590 |
3,534 |
$64K |
| 73590 |
|
2,367 |
2,219 |
$63K |
| 87799 |
|
5,052 |
2,928 |
$63K |
| 85730 |
|
16,847 |
15,067 |
$62K |
| 97802 |
|
251 |
249 |
$61K |
| 86923 |
|
4,210 |
2,971 |
$61K |
| 73080 |
|
1,974 |
1,873 |
$60K |
| 82962 |
|
28,256 |
20,441 |
$60K |
| 97113 |
|
1,732 |
442 |
$59K |
| 81003 |
|
23,671 |
22,135 |
$59K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
4,173 |
3,847 |
$59K |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
10,286 |
6,408 |
$58K |
| 88184 |
|
2,494 |
1,885 |
$57K |
| 78816 |
|
54 |
51 |
$54K |
| 87486 |
|
3,563 |
3,513 |
$52K |
| 72131 |
|
796 |
733 |
$52K |
| 87581 |
|
3,564 |
3,515 |
$52K |
| 87070 |
|
8,490 |
7,853 |
$51K |
| 73502 |
|
2,199 |
2,097 |
$51K |
| 96523 |
|
358 |
338 |
$50K |
| 84100 |
|
25,005 |
14,972 |
$50K |
| J1644 |
Injection, heparin sodium, per 1000 units |
9,332 |
3,818 |
$49K |
| C1874 |
Stent, coated/covered, with delivery system |
96 |
93 |
$49K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
804 |
721 |
$48K |
| 85027 |
|
12,202 |
10,276 |
$48K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
12,201 |
11,242 |
$48K |
| 92604 |
|
141 |
129 |
$48K |
| J9217 |
Leuprolide acetate (for depot suspension), 7.5 mg |
30 |
26 |
$47K |
| 77072 |
|
1,606 |
1,578 |
$47K |
| 64483 |
|
25 |
25 |
$46K |
| 72158 |
|
134 |
126 |
$46K |
| 78306 |
|
486 |
467 |
$45K |
| 90715 |
|
2,841 |
2,728 |
$45K |
| 96450 |
|
91 |
61 |
$44K |
| 93296 |
|
1,787 |
1,686 |
$43K |
| G0379 |
Direct admission of patient for hospital observation care |
120 |
108 |
$43K |
| 97597 |
|
310 |
171 |
$42K |
| 88304 |
|
2,887 |
2,775 |
$42K |
| C8929 |
Transthoracic echocardiography with contrast, or without contrast followed by with contrast, real-time with image documentation (2d), includes m-mode recording, when performed, complete, with spectral doppler echocardiography, and with color flow doppler echocardiography |
37 |
37 |
$41K |
| 80061 |
Lipid panel |
6,739 |
5,861 |
$41K |
| 99354 |
|
361 |
358 |
$41K |
| 10060 |
|
499 |
475 |
$41K |
| 74178 |
|
166 |
161 |
$40K |
| 87186 |
|
5,986 |
5,376 |
$40K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
504 |
432 |
$39K |
| 77300 |
|
195 |
186 |
$38K |
| A9552 |
Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries |
3,528 |
3,426 |
$38K |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
12,607 |
11,614 |
$36K |
| 73090 |
|
1,443 |
1,311 |
$36K |
| J9045 |
Injection, carboplatin, 50 mg |
1,368 |
766 |
$36K |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
8,249 |
6,507 |
$36K |
| 86140 |
|
13,017 |
11,483 |
$36K |
| J2469 |
Injection, palonosetron hcl, 25 mcg |
503 |
266 |
$35K |
| 88307 |
|
1,020 |
926 |
$35K |
| 82805 |
|
2,053 |
1,875 |
$35K |
| 87340 |
|
9,363 |
8,276 |
$34K |
| 82077 |
|
4,671 |
4,137 |
$32K |
| 97165 |
|
956 |
877 |
$32K |
| C1894 |
Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser |
2,895 |
2,591 |
$32K |
| 73560 |
|
1,338 |
1,241 |
$32K |
| 92550 |
|
278 |
272 |
$31K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
4,067 |
3,324 |
$31K |
| 90677 |
|
131 |
116 |
$31K |
| 73552 |
|
1,300 |
1,214 |
$31K |
| J0690 |
Injection, cefazolin sodium, 500 mg |
10,798 |
8,671 |
$31K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
7,966 |
6,971 |
$31K |
| 87077 |
|
4,636 |
4,370 |
$31K |
| 85045 |
|
8,726 |
5,259 |
$31K |
| 87634 |
|
1,769 |
1,761 |
$30K |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
3,732 |
2,929 |
$30K |
| C1887 |
Catheter, guiding (may include infusion/perfusion capability) |
1,548 |
1,348 |
$30K |
| 76821 |
|
431 |
229 |
$30K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
9,084 |
6,990 |
$29K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
27,547 |
23,167 |
$29K |
| 99417 |
Prolong home eval add 15m |
1,756 |
1,649 |
$29K |
| J1642 |
Injection, heparin sodium, (heparin lock flush), per 10 units |
7,865 |
4,817 |
$29K |
| 81025 |
|
6,706 |
6,364 |
$28K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
4,204 |
3,742 |
$26K |
| 76820 |
|
501 |
281 |
$25K |
| 87497 |
|
2,646 |
1,286 |
$25K |
| A9585 |
Injection, gadobutrol, 0.1 ml |
4,780 |
4,652 |
$25K |
| J9370 |
Vincristine sulfate, 1 mg |
1,911 |
1,342 |
$25K |
| 80197 |
|
4,406 |
2,091 |
$24K |
| 92610 |
|
103 |
100 |
$23K |
| 80143 |
|
2,798 |
2,517 |
$21K |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
4,588 |
3,269 |
$21K |
| 83615 |
|
9,225 |
5,192 |
$21K |
| 73523 |
|
524 |
503 |
$21K |
| 80179 |
|
2,653 |
2,404 |
$21K |
| OP682 |
|
40 |
39 |
$20K |
| 72156 |
|
48 |
48 |
$20K |
| J9263 |
Injection, oxaliplatin, 0.5 mg |
871 |
494 |
$20K |
| 29125 |
|
699 |
670 |
$20K |
| 92523 |
|
299 |
292 |
$20K |
| 70544 |
|
85 |
80 |
$19K |
| 72157 |
|
40 |
38 |
$19K |
| 97803 |
|
185 |
183 |
$18K |
| 82728 |
|
3,661 |
2,902 |
$18K |
| J3480 |
Injection, potassium chloride, per 2 meq |
4,040 |
2,394 |
$18K |
| 84550 |
|
8,919 |
5,059 |
$17K |
| A9575 |
Injection, gadoterate meglumine, 0.1 ml |
5,173 |
4,764 |
$17K |
| 72100 |
|
600 |
574 |
$17K |
| 90670 |
|
120 |
118 |
$17K |
| 73700 |
|
158 |
150 |
$16K |
| 85652 |
|
8,052 |
7,058 |
$16K |
| 82550 |
|
3,996 |
3,407 |
$16K |
| 95957 |
|
218 |
83 |
$15K |
| 36600 |
|
800 |
734 |
$15K |
| OP229 |
|
291 |
275 |
$15K |
| 73521 |
|
416 |
405 |
$14K |
| 77295 |
|
24 |
24 |
$14K |
| 81267 |
|
856 |
667 |
$14K |
| J9206 |
Injection, irinotecan, 20 mg |
514 |
221 |
$14K |
| 73060 |
|
633 |
582 |
$14K |
| 0003A |
|
438 |
436 |
$14K |
| 93351 |
|
66 |
57 |
$14K |
| 0031A |
|
423 |
423 |
$14K |
| 85379 |
|
3,752 |
3,521 |
$13K |
| 76000 |
|
279 |
274 |
$13K |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
9,008 |
8,032 |
$13K |
| 77280 |
|
92 |
81 |
$13K |
| J2997 |
Injection, alteplase recombinant, 1 mg |
91 |
61 |
$13K |
| 76604 |
|
360 |
330 |
$12K |
| 82248 |
|
2,295 |
1,869 |
$12K |
| Q9957 |
Injection, perflutren lipid microspheres, per ml |
119 |
113 |
$12K |
| 70543 |
|
31 |
26 |
$12K |
| P9073 |
Platelets, pheresis, pathogen-reduced, each unit |
163 |
82 |
$11K |
| 76882 |
|
357 |
337 |
$11K |
| J0136 |
Injection, acetaminophen (b braun), not therapeutically equivalent to j0131, 10 mg |
3,946 |
3,373 |
$11K |
| 71101 |
|
307 |
300 |
$11K |
| 97166 |
|
187 |
179 |
$10K |
| 84439 |
|
4,327 |
3,526 |
$10K |
| C1760 |
Closure device, vascular (implantable/insertable) |
410 |
361 |
$10K |
| 86704 |
|
2,270 |
1,730 |
$10K |
| 77417 |
|
227 |
130 |
$10K |
| 82784 |
|
2,313 |
1,497 |
$9K |
| J9201 |
Injection, gemcitabine hydrochloride, not otherwise specified, 200 mg |
505 |
198 |
$9K |
| 80076 |
|
1,966 |
1,655 |
$9K |
| J3370 |
Injection, vancomycin hcl, 500 mg |
1,373 |
933 |
$9K |
| 82607 |
|
1,999 |
1,739 |
$9K |
| G0257 |
Unscheduled or emergency dialysis treatment for an esrd patient in a hospital outpatient department that is not certified as an esrd facility |
73 |
32 |
$9K |
| 73100 |
|
314 |
291 |
$9K |
| 81002 |
|
7,232 |
7,061 |
$9K |
| 87205 |
|
2,964 |
2,660 |
$9K |
| J0330 |
Injection, succinylcholine chloride, up to 20 mg |
2,558 |
2,419 |
$8K |
| J9000 |
Injection, doxorubicin hydrochloride, 10 mg |
405 |
247 |
$8K |
| 88313 |
|
954 |
741 |
$8K |
| A9502 |
Technetium tc-99m tetrofosmin, diagnostic, per study dose |
1,439 |
1,246 |
$8K |
| 86360 |
|
1,245 |
801 |
$8K |
| 84145 |
|
791 |
712 |
$8K |
| 0071A |
|
210 |
210 |
$8K |
| 86780 |
|
2,263 |
1,781 |
$8K |
| 86706 |
|
2,221 |
1,696 |
$8K |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
339 |
329 |
$7K |
| A4648 |
Tissue marker, implantable, any type, each |
1,011 |
752 |
$7K |
| 87522 |
Neg quan hep c or qual rna |
1,401 |
1,009 |
$7K |
| G0008 |
Administration of influenza virus vaccine |
734 |
713 |
$7K |
| J3489 |
Injection, zoledronic acid, 1 mg |
186 |
170 |
$7K |
| 92540 |
|
14 |
14 |
$7K |
| 0072A |
|
195 |
195 |
$7K |
| 72040 |
|
245 |
235 |
$7K |
| 86480 |
|
1,253 |
884 |
$7K |
| 86922 |
|
477 |
285 |
$7K |
| 86921 |
|
492 |
298 |
$7K |
| J9075 |
Injection, cyclophosphamide, not otherwise specified, 5 mg |
20 |
14 |
$7K |
| 84480 |
|
866 |
811 |
$7K |
| 90686 |
|
625 |
607 |
$7K |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
2,868 |
1,254 |
$6K |
| 29581 |
|
51 |
13 |
$6K |
| 72146 |
|
25 |
25 |
$6K |
| J7042 |
5% dextrose/normal saline (500 ml = 1 unit) |
4,516 |
3,344 |
$6K |
| J2060 |
Injection, lorazepam, 2 mg |
2,448 |
1,815 |
$6K |
| 76981 |
|
112 |
111 |
$6K |
| 83550 |
|
2,415 |
2,037 |
$6K |
| J2710 |
Injection, neostigmine methylsulfate, up to 0.5 mg |
1,745 |
1,650 |
$6K |
| J0171 |
Injection, adrenalin, epinephrine, 0.1 mg |
362 |
303 |
$6K |
| 86359 |
|
1,265 |
818 |
$6K |
| 83540 |
|
2,673 |
2,265 |
$6K |
| 0004A |
|
171 |
169 |
$6K |
| 82948 |
|
3,196 |
3,128 |
$6K |
| 12002 |
|
134 |
124 |
$6K |
| 90837 |
Psychotherapy, 53 minutes with patient |
90 |
38 |
$5K |
| 97535 |
Self-care/home management training, each 15 minutes |
410 |
322 |
$5K |
| C1725 |
Catheter, transluminal angioplasty, non-laser (may include guidance, infusion/perfusion capability) |
96 |
88 |
$5K |
| 82150 |
|
1,368 |
1,166 |
$5K |
| 88360 |
|
350 |
259 |
$5K |
| 84156 |
|
2,007 |
1,497 |
$5K |
| 72170 |
|
358 |
318 |
$5K |
| 86902 |
|
466 |
278 |
$5K |
| 95951 |
|
20 |
13 |
$5K |
| J2543 |
Injection, piperacillin sodium/tazobactam sodium, 1 gram/0.125 grams (1.125 grams) |
1,315 |
735 |
$5K |
| 83970 |
|
569 |
445 |
$5K |
| 15853 |
|
77 |
66 |
$5K |
| 84153 |
|
671 |
542 |
$5K |
| 0064A |
|
155 |
151 |
$5K |
| 82570 |
|
2,900 |
2,266 |
$5K |
| 86665 |
|
1,183 |
804 |
$5K |
| J2919 |
Injection, methylprednisolone sodium succinate, 5 mg |
676 |
470 |
$5K |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
4,901 |
3,616 |
$5K |
| C1781 |
Mesh (implantable) |
12 |
12 |
$4K |
| 64642 |
|
14 |
14 |
$4K |
| 93298 |
|
231 |
202 |
$4K |
| 82746 |
|
900 |
766 |
$4K |
| 86357 |
|
1,053 |
641 |
$4K |
| J1940 |
Injection, furosemide, up to 20 mg |
305 |
199 |
$4K |
| J0295 |
Injection, ampicillin sodium/sulbactam sodium, per 1.5 gm |
1,501 |
860 |
$4K |
| 87536 |
|
154 |
121 |
$4K |
| 86870 |
|
116 |
71 |
$4K |
| 86769 |
|
253 |
244 |
$4K |
| 87088 |
|
2,905 |
2,586 |
$4K |
| J2920 |
Injection, methylprednisolone sodium succinate, up to 40 mg |
1,134 |
787 |
$4K |
| 36593 |
|
19 |
16 |
$4K |
| 82977 |
|
1,981 |
1,382 |
$4K |
| 80074 |
|
229 |
204 |
$4K |
| 97168 |
|
64 |
63 |
$4K |
| 72052 |
|
74 |
73 |
$3K |
| 73000 |
|
119 |
110 |
$3K |
| 86355 |
|
1,062 |
645 |
$3K |
| 85384 |
|
879 |
638 |
$3K |
| 76942 |
|
77 |
66 |
$3K |
| 84436 |
|
690 |
682 |
$3K |
| J8540 |
Dexamethasone, oral, 0.25 mg |
6,709 |
5,716 |
$3K |
| 73070 |
|
126 |
112 |
$3K |
| 89051 |
|
1,375 |
1,005 |
$3K |
| 75574 |
|
15 |
15 |
$3K |
| J1580 |
Injection, garamycin, gentamicin, up to 80 mg |
189 |
163 |
$3K |
| 93293 |
|
182 |
182 |
$3K |
| 97016 |
|
1,984 |
513 |
$3K |
| 87075 |
|
740 |
611 |
$3K |
| G2066 |
Interrogation device evaluation(s), (remote) up to 30 days; implantable cardiovascular physiologic monitor system, implantable loop recorder system, or subcutaneous cardiac rhythm monitor system, remote data acquisition(s), receipt of transmissions and technician review, technical support and distribution of results |
146 |
123 |
$3K |
| 73120 |
|
89 |
87 |
$3K |
| J3360 |
Injection, diazepam, up to 5 mg |
334 |
271 |
$3K |
| 86787 |
|
1,021 |
688 |
$3K |
| 87400 |
|
210 |
209 |
$3K |
| 88311 |
|
1,040 |
850 |
$3K |
| G0009 |
Administration of pneumococcal vaccine |
432 |
376 |
$3K |
| 70487 |
|
15 |
12 |
$2K |
| 80047 |
|
667 |
666 |
$2K |
| 64643 |
|
15 |
15 |
$2K |
| 82010 |
|
708 |
595 |
$2K |
| 0053A |
|
69 |
69 |
$2K |
| 83655 |
|
641 |
584 |
$2K |
| 29105 |
|
39 |
39 |
$2K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
81 |
60 |
$2K |
| 77332 |
|
37 |
31 |
$2K |
| C1751 |
Catheter, infusion, inserted peripherally, centrally or midline (other than hemodialysis) |
115 |
108 |
$2K |
| 72072 |
|
82 |
80 |
$2K |
| 86644 |
|
1,044 |
679 |
$2K |
| J1836 |
Injection, metronidazole, 10 mg |
733 |
440 |
$2K |
| 84703 |
|
2,082 |
1,934 |
$2K |
| 70480 |
|
12 |
12 |
$2K |
| C2617 |
Stent, non-coronary, temporary, without delivery system |
190 |
168 |
$2K |
| 73620 |
|
78 |
70 |
$2K |
| 88112 |
|
396 |
300 |
$2K |
| 83520 |
|
391 |
300 |
$2K |
| C9113 |
Injection, pantoprazole sodium, per vial |
1,427 |
878 |
$2K |
| J0134 |
Injection, acetaminophen (fresenius kabi), not therapeutically equivalent to j0131, 10 mg |
611 |
509 |
$2K |
| 86038 |
|
496 |
374 |
$2K |
| 83020 |
|
853 |
535 |
$2K |
| 87449 |
|
567 |
220 |
$2K |
| Q9961 |
High osmolar contrast material, 250-299 mg/ml iodine concentration, per ml |
43 |
42 |
$2K |
| 88108 |
|
345 |
222 |
$2K |
| OP637 |
|
9,038 |
4,359 |
$2K |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
2,424 |
2,137 |
$2K |
| G1004 |
Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program |
2,436 |
1,590 |
$1K |
| 82247 |
|
340 |
239 |
$1K |
| 86160 |
|
171 |
120 |
$1K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
190 |
164 |
$1K |
| 87641 |
|
161 |
148 |
$1K |
| G8978 |
Mobility: walking & moving around functional limitation, current status, at therapy episode outset and at reporting intervals |
267 |
258 |
$1K |
| G8979 |
Mobility: walking & moving around functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting |
296 |
278 |
$1K |
| 87305 |
|
467 |
190 |
$1K |
| 87420 |
|
110 |
109 |
$1K |
| 90656 |
|
86 |
86 |
$1K |
| 86645 |
|
871 |
576 |
$1K |
| 87081 |
|
380 |
355 |
$1K |
| 85014 |
|
691 |
689 |
$1K |
| L8699 |
Prosthetic implant, not otherwise specified |
139 |
133 |
$1K |
| J0744 |
Injection, ciprofloxacin for intravenous infusion, 200 mg |
56 |
45 |
$1K |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
287 |
274 |
$1K |
| 94644 |
|
43 |
42 |
$1K |
| J0702 |
Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg |
181 |
151 |
$1K |
| 84132 |
|
962 |
830 |
$1K |
| 0054A |
|
31 |
30 |
$940.74 |
| 82533 |
|
377 |
257 |
$927.66 |
| 94760 |
|
226 |
159 |
$906.47 |
| 0052A |
|
26 |
25 |
$904.34 |
| M0220 |
Injection, tixagevimab and cilgavimab, for the pre-exposure prophylaxis only, for certain adults and pediatric individuals (12 years of age and older weighing at least 40kg) with no known sars-cov-2 exposure, who either have moderate to severely compromised immune systems or for whom vaccination with any available covid-19 vaccine is not recommended due to a history of severe adverse reaction to a covid-19 vaccine(s) and/or covid-19 vaccine component(s), includes injection and post administration monitoring |
14 |
13 |
$903.00 |
| 90723 |
|
15 |
12 |
$900.65 |
| 84157 |
|
753 |
548 |
$899.55 |
| 73600 |
|
31 |
27 |
$825.65 |
| 74241 |
|
12 |
12 |
$811.80 |
| 76776 |
|
31 |
26 |
$799.53 |
| 92593 |
|
12 |
12 |
$794.64 |
| C1788 |
Port, indwelling (implantable) |
42 |
37 |
$786.94 |
| 85660 |
|
1,034 |
539 |
$771.47 |
| 76010 |
|
44 |
40 |
$768.62 |
| 88300 |
|
248 |
217 |
$767.20 |
| 82945 |
|
747 |
546 |
$738.16 |
| 84403 |
|
124 |
83 |
$727.06 |
| 84146 |
|
144 |
109 |
$679.99 |
| 77001 |
|
15 |
14 |
$638.30 |
| 90648 |
|
28 |
27 |
$635.34 |
| J1596 |
Injection, glycopyrrolate, 0.1 mg |
687 |
566 |
$627.10 |
| 87496 |
|
15 |
12 |
$625.55 |
| 93280 |
|
26 |
26 |
$607.79 |
| 74240 |
|
13 |
12 |
$569.44 |
| 86788 |
|
478 |
334 |
$566.11 |
| 87147 |
|
229 |
204 |
$555.71 |
| 83002 |
|
133 |
100 |
$542.73 |
| 70160 |
|
13 |
13 |
$539.58 |
| 86703 |
|
41 |
41 |
$532.56 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
187 |
174 |
$528.22 |
| 76937 |
|
12 |
12 |
$521.02 |
| 0051A |
|
15 |
14 |
$520.00 |
| J9260 |
Injection, methotrexate sodium, 50 mg |
206 |
138 |
$518.21 |
| J7510 |
Prednisolone oral, per 5 mg |
1,326 |
1,126 |
$487.90 |
| 83001 |
|
131 |
100 |
$470.91 |
| 86789 |
|
477 |
333 |
$469.27 |
| 87640 |
|
162 |
144 |
$467.36 |
| 29130 |
|
28 |
28 |
$461.08 |
| 29515 |
|
14 |
12 |
$450.87 |
| 86664 |
|
362 |
250 |
$437.79 |
| 86308 |
|
203 |
188 |
$434.30 |
| A9503 |
Technetium tc-99m medronate, diagnostic, per study dose, up to 30 millicuries |
519 |
494 |
$431.79 |
| J0456 |
Injection, azithromycin, 500 mg |
219 |
176 |
$420.78 |
| 29505 |
|
13 |
12 |
$420.34 |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
86 |
56 |
$418.41 |
| 88312 |
|
31 |
26 |
$417.46 |
| 82043 |
|
522 |
429 |
$403.81 |
| J2370 |
Injection, phenylephrine hcl, up to 1 ml |
521 |
444 |
$402.21 |
| 86364 |
|
305 |
229 |
$393.27 |
| 82610 |
|
305 |
171 |
$391.43 |
| J2272 |
Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg |
61 |
53 |
$387.46 |
| 0034A |
|
12 |
12 |
$357.22 |
| 90674 |
|
67 |
67 |
$356.36 |
| 86682 |
|
348 |
265 |
$353.07 |
| 0012A |
|
24 |
23 |
$347.23 |
| J3371 |
Injection, vancomycin hcl (mylan), not therapeutically equivalent to j3370, 500 mg |
144 |
81 |
$335.44 |
| 87324 |
|
218 |
179 |
$318.07 |
| J1171 |
Injection, hydromorphone, 0.1 mg |
222 |
144 |
$317.00 |
| 87154 |
|
13 |
13 |
$313.45 |
| J0137 |
Injection, acetaminophen (hikma), not therapeutically equivalent to j0131, 10 mg |
136 |
108 |
$310.09 |
| 86762 |
|
102 |
72 |
$298.89 |
| J0290 |
Injection, ampicillin sodium, 500 mg |
102 |
61 |
$295.20 |
| 82105 |
|
136 |
117 |
$286.14 |
| J2371 |
Injection, phenylephrine hydrochloride, 20 micrograms |
666 |
534 |
$273.65 |
| 87517 |
|
30 |
27 |
$270.17 |
| 70250 |
|
18 |
13 |
$246.84 |
| 87206 |
|
150 |
81 |
$243.72 |
| J1626 |
Injection, granisetron hydrochloride, 100 mcg |
58 |
27 |
$231.19 |
| J1630 |
Injection, haloperidol, up to 5 mg |
160 |
132 |
$225.50 |
| 80177 |
|
40 |
37 |
$223.53 |
| 86376 |
|
90 |
66 |
$221.68 |
| 88302 |
|
28 |
27 |
$219.64 |
| 80164 |
|
116 |
89 |
$219.26 |
| 86592 |
|
120 |
113 |
$212.35 |
| 85347 |
|
53 |
41 |
$197.26 |
| J0461 |
Injection, atropine sulfate, 0.01 mg |
43 |
26 |
$183.50 |
| 86833 |
|
12 |
12 |
$163.65 |
| 85007 |
|
79 |
76 |
$163.46 |
| J0736 |
Injection, clindamycin phosphate, 300 mg |
62 |
51 |
$160.28 |
| 82785 |
|
16 |
13 |
$149.67 |
| 82140 |
|
65 |
41 |
$145.08 |
| 86832 |
|
12 |
12 |
$136.80 |
| 82670 |
|
17 |
15 |
$134.14 |
| J2470 |
Injection, pantoprazole sodium, 40 mg |
209 |
129 |
$133.91 |
| J2003 |
Injection, lidocaine hydrochloride, 1 mg |
86 |
80 |
$129.81 |
| 87106 |
|
15 |
13 |
$116.83 |
| 70360 |
|
15 |
13 |
$114.58 |
| 88173 |
|
26 |
25 |
$108.95 |
| 84681 |
|
18 |
12 |
$105.63 |
| Q9966 |
Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml |
264 |
243 |
$99.43 |
| J3420 |
Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg |
117 |
86 |
$99.11 |
| OP940 |
|
165 |
90 |
$85.71 |
| 84305 |
|
50 |
41 |
$85.04 |
| 82330 |
|
38 |
24 |
$73.69 |
| J3411 |
Injection, thiamine hcl, 100 mg |
77 |
52 |
$69.35 |
| 83519 |
|
18 |
12 |
$66.80 |
| 86800 |
|
60 |
37 |
$65.96 |
| G0123 |
Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, screening by cytotechnologist under physician supervision |
44 |
39 |
$65.76 |
| 82465 |
|
25 |
24 |
$61.66 |
| 86618 |
|
13 |
12 |
$58.35 |
| J0360 |
Injection, hydralazine hcl, up to 20 mg |
20 |
13 |
$51.97 |
| J0687 |
Injection, cefazolin sodium (wg critical care), not therapeutically equivalent to j0690, 500 mg |
536 |
396 |
$50.28 |
| 82947 |
|
15 |
13 |
$45.15 |
| J0500 |
Injection, dicyclomine hcl, up to 20 mg |
14 |
12 |
$34.64 |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
14 |
12 |
$32.11 |
| J1643 |
Injection, heparin sodium (pfizer), not therapeutically equivalent to j1644, per 1000 units |
77 |
71 |
$31.59 |
| 84295 |
|
90 |
79 |
$30.87 |
| J2004 |
Injection, lidocaine hcl with epinephrine, 1 mg |
65 |
62 |
$24.67 |
| J1953 |
Injection, levetiracetam, 10 mg |
12 |
12 |
$23.09 |
| 91300 |
|
19,356 |
16,901 |
$21.01 |
| J1920 |
Injection, labetalol hydrochloride, 5 mg |
69 |
52 |
$19.44 |
| 84165 |
|
13 |
12 |
$17.18 |
| 86765 |
|
48 |
27 |
$10.00 |
| 36416 |
|
31 |
28 |
$9.44 |
| 83516 |
|
36 |
28 |
$9.00 |
| 82040 |
|
16 |
13 |
$8.69 |
| Q0220 |
Injection, tixagevimab and cilgavimab, for the pre-exposure prophylaxis only, for certain adults and pediatric individuals (12 years of age and older weighing at least 40kg) with no known sars-cov-2 exposure, who either have moderate to severely compromised immune systems or for whom vaccination with any available covid-19 vaccine is not recommended due to a history of severe adverse reaction to a covid-19 vaccine(s) and/or covid-19 vaccine component(s), 300 mg |
14 |
13 |
$6.00 |
| 91306 |
|
164 |
160 |
$0.00 |
| J2175 |
Injection, meperidine hydrochloride, per 100 mg |
16 |
12 |
$0.00 |
| 91307 |
|
361 |
319 |
$0.00 |
| 91301 |
|
29 |
29 |
$0.00 |
| 91305 |
|
154 |
148 |
$0.00 |
| C9600 |
Percutaneous transcatheter placement of drug eluting intracoronary stent(s), with coronary angioplasty when performed; single major coronary artery or branch |
14 |
14 |
$0.00 |
| 91303 |
|
360 |
360 |
$0.00 |
| 96111 |
|
12 |
12 |
$0.00 |
| A9541 |
Technetium tc-99m sulfur colloid, diagnostic, per study dose, up to 20 millicuries |
20 |
16 |
$0.00 |
| 99152 |
|
12 |
12 |
$0.00 |