| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
383,897 |
339,839 |
$50.09M |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
82,210 |
75,291 |
$13.15M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
60,514 |
56,901 |
$9.86M |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
62,202 |
60,936 |
$8.13M |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
44,843 |
42,014 |
$6.95M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
38,011 |
35,438 |
$5.98M |
| J1745 |
Injection, infliximab, excludes biosimilar, 10 mg |
2,767 |
2,536 |
$5.78M |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
11,511 |
11,182 |
$4.93M |
| 42820 |
Tonsillectomy and adenoidectomy; younger than age 12 |
2,890 |
2,862 |
$4.90M |
| J1569 |
Injection, immune globulin, (gammagard liquid), non-lyophilized, (e.g., liquid), 500 mg |
2,150 |
1,376 |
$4.41M |
| G0378 |
Hospital observation service, per hour |
18,456 |
17,357 |
$3.83M |
| 95810 |
Polysomnography; sleep staging with 4 or more additional parameters |
4,617 |
4,582 |
$3.49M |
| 93303 |
Transthoracic echocardiography for congenital cardiac anomalies, follow-up or limited study |
7,766 |
7,569 |
$3.33M |
| 69436 |
Tympanostomy (requiring insertion of ventilating tube), general anesthesia |
2,710 |
2,680 |
$3.30M |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
10,186 |
9,935 |
$3.25M |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
20,015 |
19,292 |
$3.01M |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
49,737 |
23,117 |
$2.78M |
| 96361 |
Intravenous infusion, hydration; each additional hour |
5,437 |
3,670 |
$2.62M |
| 93304 |
|
5,136 |
4,959 |
$2.24M |
| 95812 |
|
4,794 |
4,698 |
$2.23M |
| 95782 |
|
2,900 |
2,882 |
$2.22M |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
3,570 |
3,527 |
$2.20M |
| 99215 |
Prolong outpt/office vis |
17,453 |
16,992 |
$2.09M |
| 96415 |
|
4,230 |
3,606 |
$2.00M |
| D7140 |
Extraction, erupted tooth or exposed root |
2,107 |
2,002 |
$1.95M |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
4,015 |
2,817 |
$1.82M |
| 54161 |
|
1,722 |
1,680 |
$1.78M |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
9,361 |
7,073 |
$1.76M |
| 76770 |
|
11,510 |
11,336 |
$1.72M |
| 93308 |
|
3,663 |
3,588 |
$1.52M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
14,161 |
13,649 |
$1.51M |
| Q5103 |
Injection, infliximab-dyyb, biosimilar, (inflectra), 10 mg |
877 |
767 |
$1.32M |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
3,198 |
3,127 |
$1.23M |
| 70450 |
Computed tomography, head or brain; without contrast material |
4,774 |
4,526 |
$1.20M |
| 93325 |
|
19,613 |
18,873 |
$1.18M |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
9,813 |
9,210 |
$1.18M |
| Q3014 |
Telehealth originating site facility fee |
47,043 |
44,009 |
$1.16M |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
29,869 |
14,753 |
$1.12M |
| 29075 |
|
3,585 |
3,309 |
$1.12M |
| 49452 |
|
1,866 |
1,688 |
$1.11M |
| 96450 |
|
2,627 |
2,093 |
$1.09M |
| D2930 |
Prefabricated stainless steel crown - primary tooth |
672 |
646 |
$1.03M |
| 29450 |
|
2,787 |
1,242 |
$1.03M |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
7,976 |
5,448 |
$922K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
7,441 |
7,110 |
$902K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
20,694 |
19,734 |
$887K |
| 92555 |
|
17,373 |
17,120 |
$849K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
3,166 |
2,953 |
$817K |
| 92587 |
|
5,708 |
5,598 |
$814K |
| 29065 |
|
2,612 |
2,379 |
$811K |
| P9040 |
Red blood cells, leukocytes reduced, irradiated, each unit |
1,701 |
1,289 |
$803K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
1,217 |
1,201 |
$745K |
| 36430 |
|
3,983 |
2,602 |
$740K |
| 55175 |
|
457 |
445 |
$712K |
| 92507 |
Treatment of speech, language, voice, communication, and/or auditory processing disorder |
13,772 |
6,437 |
$652K |
| 97162 |
|
10,499 |
10,287 |
$591K |
| 42830 |
|
333 |
332 |
$578K |
| P9016 |
Red blood cells, leukocytes reduced, each unit |
1,022 |
833 |
$564K |
| H2020 |
Therapeutic behavioral services, per diem |
1,032 |
98 |
$547K |
| 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 |
6,528 |
6,217 |
$533K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
3,764 |
3,681 |
$530K |
| 92567 |
|
24,377 |
23,924 |
$469K |
| 44970 |
|
121 |
117 |
$461K |
| 92523 |
|
3,726 |
3,643 |
$460K |
| 96112 |
|
739 |
732 |
$459K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
1,704 |
1,655 |
$433K |
| 12011 |
|
1,598 |
1,546 |
$416K |
| 97763 |
|
1,741 |
1,618 |
$412K |
| 95716 |
|
854 |
795 |
$383K |
| 31575 |
|
1,304 |
1,272 |
$378K |
| Q5111 |
Injection, pegfilgrastim-cbqv (udenyca), biosimilar, 0.5 mg |
128 |
99 |
$372K |
| 76536 |
|
2,866 |
2,778 |
$360K |
| 54360 |
|
418 |
409 |
$346K |
| 72141 |
|
2,315 |
2,284 |
$326K |
| 17110 |
|
1,072 |
1,062 |
$322K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
2,801 |
2,697 |
$310K |
| 87497 |
|
8,905 |
5,816 |
$297K |
| 54640 |
|
208 |
203 |
$286K |
| 97166 |
|
4,894 |
4,787 |
$283K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
3,604 |
3,526 |
$276K |
| 36415 |
Collection of venous blood by venipuncture |
117,185 |
103,945 |
$272K |
| 92552 |
|
3,368 |
3,322 |
$271K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
1,174 |
1,140 |
$271K |
| 97535 |
Self-care/home management training, each 15 minutes |
5,079 |
3,720 |
$269K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
103,566 |
78,132 |
$269K |
| 81415 |
|
891 |
881 |
$268K |
| 92553 |
|
3,143 |
3,097 |
$266K |
| 76885 |
|
2,077 |
1,975 |
$261K |
| 62252 |
|
2,249 |
2,121 |
$259K |
| 92611 |
|
4,081 |
4,037 |
$258K |
| 31622 |
|
242 |
233 |
$237K |
| 87799 |
|
10,039 |
5,877 |
$228K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
6,869 |
3,830 |
$226K |
| 93975 |
|
3,532 |
3,388 |
$226K |
| 92585 |
|
784 |
754 |
$223K |
| 76870 |
|
1,846 |
1,785 |
$220K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
434 |
415 |
$217K |
| 11900 |
|
660 |
651 |
$209K |
| J9217 |
Leuprolide acetate (for depot suspension), 7.5 mg |
374 |
369 |
$209K |
| D2330 |
|
215 |
207 |
$209K |
| 92060 |
|
7,398 |
7,306 |
$208K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
27,927 |
27,358 |
$206K |
| 97161 |
|
3,754 |
3,693 |
$205K |
| 95700 |
|
1,395 |
1,347 |
$192K |
| 29105 |
|
890 |
842 |
$191K |
| 24538 |
|
43 |
41 |
$190K |
| 92557 |
|
1,993 |
1,971 |
$189K |
| 12001 |
|
709 |
682 |
$189K |
| 43762 |
|
819 |
793 |
$186K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
22,612 |
20,934 |
$186K |
| 76882 |
|
1,613 |
1,437 |
$183K |
| 87507 |
|
2,792 |
2,711 |
$171K |
| 71046 |
Radiologic examination, chest; 2 views |
21,141 |
19,983 |
$165K |
| 80069 |
|
22,857 |
18,814 |
$159K |
| 87631 |
|
7,410 |
7,151 |
$157K |
| 71250 |
|
1,088 |
1,069 |
$157K |
| 29405 |
|
465 |
354 |
$155K |
| 90686 |
|
16,268 |
16,013 |
$145K |
| 96367 |
|
1,975 |
1,673 |
$143K |
| 82784 |
|
15,965 |
13,468 |
$142K |
| 87637 |
Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV |
21,290 |
20,365 |
$141K |
| 92522 |
|
2,331 |
2,283 |
$136K |
| 81416 |
|
911 |
813 |
$132K |
| J0475 |
Injection, baclofen, 10 mg |
263 |
259 |
$130K |
| 49500 |
|
56 |
51 |
$129K |
| 92610 |
|
2,596 |
2,551 |
$126K |
| 92579 |
|
8,019 |
7,881 |
$123K |
| 36592 |
|
5,220 |
2,839 |
$123K |
| 67311 |
|
43 |
41 |
$123K |
| 92582 |
|
7,503 |
7,382 |
$121K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
2,446 |
2,417 |
$121K |
| 81229 |
|
1,169 |
1,136 |
$121K |
| 84443 |
Thyroid stimulating hormone (TSH) |
36,759 |
35,678 |
$116K |
| 73718 |
|
487 |
481 |
$115K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
13,191 |
11,363 |
$113K |
| J0585 |
Injection, onabotulinumtoxina, 1 unit |
325 |
258 |
$113K |
| 80197 |
|
10,650 |
6,224 |
$112K |
| 80053 |
Comprehensive metabolic panel |
17,277 |
14,652 |
$112K |
| 99205 |
Prolong outpt/office vis |
1,026 |
1,014 |
$110K |
| 87633 |
Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets |
4,223 |
4,008 |
$108K |
| J1439 |
Injection, ferric carboxymaltose, 1 mg |
315 |
290 |
$106K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
946 |
925 |
$105K |
| 76825 |
|
2,561 |
2,373 |
$103K |
| 80061 |
Lipid panel |
14,077 |
13,692 |
$98K |
| 70486 |
|
924 |
905 |
$97K |
| 81479 |
Unlisted molecular pathology procedure |
2,694 |
2,553 |
$96K |
| 69210 |
|
2,301 |
2,264 |
$96K |
| 96409 |
|
6,674 |
3,383 |
$95K |
| 97164 |
|
2,456 |
2,403 |
$94K |
| 99001 |
|
27,959 |
26,427 |
$93K |
| 84439 |
|
20,939 |
20,337 |
$93K |
| 97760 |
|
2,237 |
2,143 |
$92K |
| 82248 |
|
34,187 |
23,419 |
$91K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
20,049 |
19,662 |
$90K |
| 95816 |
|
366 |
360 |
$89K |
| 83735 |
|
40,577 |
30,021 |
$88K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
33,382 |
31,765 |
$88K |
| 97165 |
|
1,535 |
1,506 |
$88K |
| 80051 |
|
24,233 |
20,611 |
$87K |
| 82728 |
|
22,322 |
21,106 |
$86K |
| 83880 |
|
5,524 |
4,697 |
$83K |
| D2331 |
|
168 |
162 |
$83K |
| 72170 |
|
8,063 |
7,815 |
$83K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
9,441 |
8,887 |
$83K |
| 38220 |
|
98 |
92 |
$82K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
5,119 |
4,583 |
$81K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
10,870 |
8,614 |
$81K |
| 93226 |
|
1,885 |
1,851 |
$80K |
| 93271 |
|
558 |
556 |
$80K |
| 77080 |
|
1,072 |
1,063 |
$80K |
| 87040 |
|
5,351 |
4,519 |
$79K |
| 86834 |
|
3,063 |
2,804 |
$79K |
| 72146 |
|
2,396 |
2,367 |
$79K |
| 70544 |
|
316 |
313 |
$79K |
| 83970 |
|
3,909 |
3,730 |
$78K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
386 |
376 |
$78K |
| 20680 |
|
88 |
76 |
$76K |
| 95951 |
|
176 |
146 |
$75K |
| 86923 |
|
4,094 |
2,764 |
$74K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
6,560 |
4,820 |
$74K |
| 24640 |
|
151 |
145 |
$72K |
| 74240 |
|
713 |
703 |
$72K |
| 74018 |
|
5,891 |
5,372 |
$70K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
1,633 |
1,495 |
$68K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
3,403 |
1,911 |
$64K |
| 82565 |
|
42,058 |
34,437 |
$64K |
| 88185 |
|
1,047 |
919 |
$64K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
6,702 |
5,361 |
$63K |
| 51741 |
|
263 |
259 |
$62K |
| 94010 |
|
4,884 |
4,798 |
$61K |
| 72082 |
|
5,836 |
5,765 |
$60K |
| 38222 |
|
80 |
78 |
$60K |
| 84311 |
|
31,509 |
21,687 |
$57K |
| 84460 |
|
69,525 |
58,225 |
$57K |
| 86835 |
|
3,068 |
2,808 |
$56K |
| 82670 |
|
3,588 |
3,526 |
$56K |
| Q5120 |
Injection, pegfilgrastim-bmez (ziextenzo), biosimilar, 0.5 mg |
16 |
12 |
$56K |
| 76827 |
|
2,531 |
2,358 |
$55K |
| 51600 |
|
245 |
244 |
$55K |
| 84305 |
|
4,019 |
3,962 |
$54K |
| 31624 |
|
67 |
66 |
$53K |
| 73560 |
|
4,675 |
4,394 |
$53K |
| J3490 |
Unclassified drugs |
5,870 |
2,342 |
$53K |
| 0001A |
|
1,838 |
1,781 |
$53K |
| 97750 |
|
1,462 |
1,366 |
$52K |
| 82947 |
|
8,315 |
7,516 |
$52K |
| 97803 |
|
2,103 |
1,874 |
$51K |
| 43760 |
|
186 |
179 |
$51K |
| 97116 |
|
2,003 |
1,340 |
$51K |
| 93321 |
|
8,630 |
8,387 |
$50K |
| 11100 |
|
84 |
83 |
$50K |
| 77072 |
|
4,245 |
4,187 |
$49K |
| 92652 |
|
1,192 |
1,163 |
$49K |
| 73070 |
|
5,572 |
4,562 |
$48K |
| 95819 |
|
207 |
204 |
$48K |
| 86140 |
|
30,431 |
27,699 |
$47K |
| 85027 |
|
23,778 |
22,696 |
$46K |
| 0002A |
|
1,239 |
1,225 |
$46K |
| 93320 |
|
7,739 |
7,542 |
$46K |
| 86850 |
|
8,367 |
6,399 |
$45K |
| 92556 |
|
1,010 |
1,001 |
$44K |
| 74241 |
|
360 |
356 |
$44K |
| 82533 |
|
2,661 |
2,490 |
$43K |
| 84403 |
|
3,982 |
3,920 |
$43K |
| 83001 |
|
3,699 |
3,601 |
$42K |
| 83550 |
|
16,636 |
16,096 |
$42K |
| 92526 |
|
803 |
625 |
$41K |
| 83002 |
|
4,073 |
3,960 |
$40K |
| J3262 |
Injection, tocilizumab, 1 mg |
126 |
85 |
$39K |
| 88313 |
|
3,506 |
2,333 |
$38K |
| 83498 |
|
3,239 |
3,079 |
$37K |
| 86376 |
|
2,400 |
2,364 |
$37K |
| 82157 |
|
1,111 |
1,076 |
$37K |
| 83540 |
|
17,293 |
16,724 |
$37K |
| J3380 |
Injection, vedolizumab, intravenous, 1 mg |
13 |
13 |
$36K |
| G0379 |
Direct admission of patient for hospital observation care |
231 |
224 |
$36K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
2,857 |
2,667 |
$36K |
| 86356 |
|
2,269 |
1,556 |
$36K |
| 86481 |
|
2,501 |
2,447 |
$36K |
| 88307 |
|
1,344 |
1,243 |
$35K |
| 83655 |
|
3,103 |
3,011 |
$34K |
| 92524 |
|
618 |
592 |
$34K |
| 97168 |
|
841 |
820 |
$34K |
| 70480 |
|
254 |
254 |
$33K |
| 94060 |
|
2,056 |
2,030 |
$33K |
| 86359 |
|
3,565 |
2,677 |
$33K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
22,766 |
22,302 |
$33K |
| 86355 |
|
3,059 |
2,477 |
$32K |
| C1713 |
Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) |
2,222 |
2,164 |
$32K |
| J2704 |
Injection, propofol, 10 mg |
65,557 |
27,031 |
$31K |
| 29345 |
|
101 |
91 |
$30K |
| 84450 |
|
27,133 |
23,376 |
$30K |
| 73610 |
|
5,128 |
4,697 |
$30K |
| 84520 |
|
30,296 |
24,192 |
$30K |
| 83520 |
|
5,485 |
5,085 |
$29K |
| 84075 |
|
32,070 |
25,823 |
$29K |
| 92609 |
|
439 |
305 |
$29K |
| 62370 |
|
234 |
231 |
$29K |
| 99460 |
|
340 |
331 |
$29K |
| 94726 |
|
939 |
921 |
$28K |
| 20670 |
|
12 |
12 |
$28K |
| 82139 |
|
2,731 |
2,517 |
$28K |
| 84100 |
|
19,716 |
14,355 |
$28K |
| 82785 |
|
2,846 |
2,805 |
$28K |
| 73552 |
|
2,074 |
1,836 |
$27K |
| 74019 |
|
5,209 |
4,861 |
$27K |
| 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 |
2,577 |
2,386 |
$27K |
| 86360 |
|
2,050 |
1,986 |
$26K |
| 29125 |
|
86 |
84 |
$26K |
| 86003 |
|
4,841 |
3,407 |
$26K |
| 97542 |
|
449 |
419 |
$26K |
| 83615 |
|
10,983 |
7,518 |
$25K |
| 80169 |
|
1,986 |
1,450 |
$24K |
| 82570 |
|
12,461 |
11,300 |
$24K |
| 73620 |
|
2,389 |
2,264 |
$24K |
| 72081 |
|
2,621 |
2,560 |
$24K |
| 82627 |
|
1,654 |
1,633 |
$24K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
2,440 |
1,660 |
$23K |
| 84146 |
|
2,082 |
2,001 |
$23K |
| 70543 |
|
52 |
52 |
$23K |
| 10060 |
|
117 |
106 |
$23K |
| 73090 |
|
6,396 |
5,104 |
$23K |
| G0268 |
Removal of impacted cerumen (one or both ears) by physician on same date of service as audiologic function testing |
506 |
496 |
$23K |
| 92607 |
|
294 |
292 |
$23K |
| 97163 |
|
431 |
424 |
$23K |
| 73590 |
|
4,242 |
3,606 |
$23K |
| 87103 |
|
2,887 |
2,341 |
$22K |
| 82977 |
|
23,259 |
20,363 |
$22K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
516 |
495 |
$22K |
| 73630 |
|
4,243 |
4,051 |
$22K |
| 70360 |
|
3,393 |
3,327 |
$21K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
10,246 |
6,362 |
$21K |
| 85610 |
|
14,039 |
12,041 |
$21K |
| 84630 |
|
2,246 |
2,211 |
$21K |
| 76942 |
|
244 |
238 |
$20K |
| 86357 |
|
2,382 |
1,567 |
$20K |
| 85045 |
|
8,982 |
7,525 |
$20K |
| 93786 |
|
1,612 |
1,596 |
$20K |
| 94729 |
|
859 |
838 |
$20K |
| 72156 |
|
132 |
127 |
$20K |
| 86900 |
|
8,748 |
6,718 |
$20K |
| 81001 |
|
28,841 |
26,280 |
$19K |
| 86812 |
|
1,054 |
1,032 |
$19K |
| 83883 |
|
1,755 |
1,702 |
$19K |
| 82040 |
|
12,798 |
11,801 |
$19K |
| 0071A |
|
507 |
473 |
$19K |
| 82610 |
|
2,817 |
2,660 |
$19K |
| 83993 |
|
1,516 |
1,496 |
$18K |
| 81425 |
|
58 |
58 |
$18K |
| 83918 |
|
1,603 |
1,482 |
$18K |
| 82657 |
|
2,168 |
1,806 |
$18K |
| 85652 |
|
25,869 |
24,017 |
$18K |
| 14040 |
|
55 |
55 |
$17K |
| 72020 |
|
773 |
751 |
$17K |
| 96411 |
|
2,450 |
1,446 |
$17K |
| 84446 |
|
2,762 |
2,689 |
$17K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
124 |
114 |
$17K |
| 72195 |
|
381 |
377 |
$17K |
| 84590 |
|
2,823 |
2,755 |
$17K |
| 88342 |
|
2,170 |
2,039 |
$16K |
| 86800 |
|
1,699 |
1,673 |
$16K |
| 74455 |
|
90 |
89 |
$16K |
| 88108 |
|
3,342 |
2,675 |
$16K |
| 92604 |
|
308 |
289 |
$16K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
41 |
41 |
$16K |
| 73080 |
|
2,225 |
1,912 |
$16K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
31,602 |
28,724 |
$16K |
| 87077 |
|
13,192 |
10,746 |
$15K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
14,134 |
13,226 |
$15K |
| 73140 |
|
3,089 |
2,799 |
$15K |
| 70491 |
|
92 |
92 |
$15K |
| D1351 |
Sealant - per tooth |
962 |
930 |
$15K |
| 82247 |
|
16,364 |
13,619 |
$15K |
| 82105 |
|
1,421 |
1,355 |
$15K |
| 36591 |
|
262 |
190 |
$15K |
| 93225 |
|
1,441 |
1,417 |
$15K |
| 82310 |
|
12,062 |
9,927 |
$14K |
| 93296 |
|
392 |
388 |
$14K |
| 73100 |
|
5,138 |
4,246 |
$14K |
| 82607 |
|
2,378 |
2,324 |
$14K |
| P9037 |
Platelets, pheresis, leukocytes reduced, irradiated, each unit |
19 |
12 |
$14K |
| 85378 |
|
2,042 |
1,800 |
$14K |
| 86901 |
|
8,698 |
6,681 |
$14K |
| 77073 |
|
2,444 |
2,397 |
$13K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
13,856 |
10,171 |
$13K |
| 0072A |
|
343 |
331 |
$13K |
| G0108 |
Diabetes outpatient self-management training services, individual, per 30 minutes |
543 |
483 |
$13K |
| 86665 |
|
2,642 |
1,558 |
$13K |
| 73130 |
|
3,659 |
3,353 |
$13K |
| 69209 |
|
118 |
116 |
$13K |
| 90685 |
|
774 |
760 |
$13K |
| 86160 |
|
4,189 |
2,627 |
$13K |
| 76377 |
|
3,284 |
3,181 |
$13K |
| 74181 |
|
63 |
57 |
$13K |
| 86663 |
|
1,588 |
1,544 |
$12K |
| 73720 |
|
38 |
38 |
$12K |
| 86317 |
|
1,947 |
731 |
$12K |
| 83605 |
|
1,390 |
1,273 |
$12K |
| 82542 |
|
1,470 |
1,337 |
$12K |
| 84402 |
|
1,407 |
1,387 |
$12K |
| 84436 |
|
1,741 |
1,706 |
$12K |
| 82017 |
|
978 |
952 |
$12K |
| 86341 |
|
1,523 |
837 |
$11K |
| 0202U |
Oncology (prostate), multianalyte, gene expression profiling |
11,320 |
10,636 |
$11K |
| 86337 |
|
713 |
690 |
$11K |
| 83021 |
|
1,152 |
922 |
$11K |
| 0004A |
|
299 |
282 |
$11K |
| 70250 |
|
1,967 |
1,862 |
$11K |
| 86364 |
|
5,445 |
5,365 |
$11K |
| 81403 |
|
140 |
129 |
$11K |
| 86235 |
|
1,036 |
707 |
$10K |
| 72197 |
|
41 |
38 |
$10K |
| 84703 |
|
12,668 |
11,900 |
$10K |
| 71045 |
Radiologic examination, chest; single view |
1,352 |
1,241 |
$10K |
| 82962 |
|
15,515 |
11,935 |
$10K |
| 83020 |
|
1,552 |
1,429 |
$10K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
346 |
316 |
$10K |
| 87070 |
|
5,918 |
5,576 |
$10K |
| 87486 |
|
444 |
425 |
$9K |
| 76800 |
|
71 |
69 |
$9K |
| 72040 |
|
1,079 |
1,039 |
$9K |
| 83516 |
|
5,964 |
5,658 |
$9K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
2,876 |
2,681 |
$9K |
| 88237 |
|
134 |
127 |
$9K |
| 11104 |
|
28 |
28 |
$9K |
| 92504 |
|
92 |
89 |
$9K |
| 80158 |
|
625 |
224 |
$9K |
| 95811 |
|
12 |
12 |
$9K |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
750 |
699 |
$9K |
| 88184 |
|
1,200 |
1,099 |
$9K |
| J0690 |
Injection, cefazolin sodium, 500 mg |
14,129 |
11,441 |
$9K |
| J9370 |
Vincristine sulfate, 1 mg |
4,501 |
2,932 |
$9K |
| 84255 |
|
1,381 |
1,356 |
$9K |
| 80076 |
|
2,203 |
2,042 |
$9K |
| 80195 |
|
783 |
500 |
$9K |
| 81426 |
|
56 |
56 |
$9K |
| 87081 |
|
9,136 |
8,859 |
$9K |
| 97802 |
|
161 |
159 |
$9K |
| 73110 |
|
2,056 |
1,948 |
$9K |
| 84156 |
|
6,120 |
5,263 |
$8K |
| 73600 |
|
1,325 |
1,243 |
$8K |
| 73562 |
|
1,341 |
1,313 |
$8K |
| 99243 |
|
135 |
133 |
$8K |
| 86664 |
|
1,589 |
1,545 |
$8K |
| 93788 |
|
310 |
307 |
$8K |
| 80164 |
|
632 |
611 |
$8K |
| 82525 |
|
947 |
929 |
$8K |
| C1769 |
Guide wire |
1,725 |
1,588 |
$8K |
| 85520 |
|
700 |
481 |
$8K |
| 88264 |
|
134 |
127 |
$8K |
| 85730 |
|
7,207 |
6,572 |
$8K |
| 85246 |
|
1,579 |
1,503 |
$7K |
| 83690 |
|
13,738 |
12,753 |
$7K |
| 82550 |
|
5,406 |
4,977 |
$7K |
| 72100 |
|
925 |
906 |
$7K |
| 82010 |
|
4,085 |
2,710 |
$7K |
| P9073 |
Platelets, pheresis, pathogen-reduced, each unit |
20 |
12 |
$7K |
| 31231 |
|
43 |
43 |
$7K |
| 80299 |
|
552 |
412 |
$7K |
| A9575 |
Injection, gadoterate meglumine, 0.1 ml |
6,072 |
4,343 |
$7K |
| 73060 |
|
1,335 |
1,162 |
$7K |
| 86480 |
|
366 |
358 |
$7K |
| 86902 |
|
1,578 |
962 |
$7K |
| 92133 |
|
1,067 |
1,059 |
$7K |
| 83789 |
|
1,306 |
1,193 |
$7K |
| 73030 |
|
1,198 |
1,141 |
$7K |
| 93971 |
|
57 |
54 |
$6K |
| 81321 |
|
27 |
27 |
$6K |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
3,209 |
2,327 |
$6K |
| 73218 |
|
28 |
28 |
$6K |
| 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 |
3,701 |
3,033 |
$6K |
| 85240 |
|
1,081 |
1,044 |
$6K |
| 82465 |
|
3,094 |
2,957 |
$6K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
23,360 |
20,887 |
$6K |
| 85044 |
|
2,636 |
2,142 |
$6K |
| 82803 |
|
2,584 |
2,314 |
$6K |
| 82379 |
|
726 |
703 |
$6K |
| 86038 |
|
3,114 |
3,057 |
$6K |
| 81003 |
|
15,327 |
14,628 |
$6K |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
3,778 |
3,088 |
$6K |
| 82140 |
|
1,323 |
1,131 |
$6K |
| 85245 |
|
1,308 |
1,167 |
$6K |
| 62270 |
|
17 |
13 |
$6K |
| 82043 |
|
5,492 |
5,310 |
$5K |
| 95813 |
|
12 |
12 |
$5K |
| 84134 |
|
2,023 |
1,963 |
$5K |
| 73000 |
|
1,386 |
1,273 |
$5K |
| 73120 |
|
982 |
924 |
$5K |
| 87581 |
|
465 |
446 |
$5K |
| 87340 |
|
1,888 |
1,835 |
$5K |
| 84480 |
|
1,495 |
1,421 |
$5K |
| 87184 |
|
7,739 |
7,214 |
$5K |
| 85384 |
|
3,395 |
2,965 |
$5K |
| J9250 |
Methotrexate sodium, 5 mg |
2,863 |
2,149 |
$5K |
| 99233 |
Prolong inpt eval add15 m |
102 |
41 |
$5K |
| 86803 |
|
1,625 |
1,582 |
$5K |
| 84244 |
|
478 |
461 |
$5K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
15,694 |
14,600 |
$5K |
| 82103 |
|
546 |
529 |
$5K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
148 |
139 |
$5K |
| 82261 |
|
942 |
852 |
$5K |
| J2795 |
Injection, ropivacaine hydrochloride, 1 mg |
5,094 |
4,357 |
$5K |
| 87205 |
|
6,249 |
5,865 |
$5K |
| 77074 |
|
809 |
768 |
$5K |
| 82390 |
|
784 |
769 |
$5K |
| 86780 |
|
723 |
704 |
$5K |
| 88304 |
|
2,513 |
2,409 |
$4K |
| 74021 |
|
493 |
464 |
$4K |
| 84681 |
|
753 |
730 |
$4K |
| 17250 |
|
14 |
13 |
$4K |
| 87529 |
|
616 |
411 |
$4K |
| 86706 |
|
1,842 |
1,789 |
$4K |
| 86644 |
|
547 |
529 |
$4K |
| 72158 |
|
124 |
121 |
$4K |
| 92608 |
|
131 |
131 |
$4K |
| 77001 |
|
30 |
28 |
$4K |
| 87338 |
|
813 |
792 |
$4K |
| 80143 |
|
741 |
671 |
$4K |
| 84478 |
|
4,203 |
3,948 |
$4K |
| 93976 |
|
28 |
27 |
$4K |
| 76000 |
|
895 |
869 |
$4K |
| 74183 |
|
12 |
12 |
$4K |
| L2820 |
Addition to lower extremity orthosis, soft interface for molded plastic, below knee section |
42 |
26 |
$4K |
| 84550 |
|
4,182 |
3,415 |
$4K |
| 85014 |
|
2,281 |
2,098 |
$4K |
| 81243 |
|
158 |
157 |
$4K |
| 0111A |
|
94 |
91 |
$4K |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
4,052 |
3,910 |
$4K |
| 84484 |
|
658 |
575 |
$4K |
| 82746 |
|
1,040 |
1,025 |
$4K |
| 83921 |
|
669 |
656 |
$4K |
| L2840 |
Addition to lower extremity orthosis, tibial length sock, fracture or equal, each |
69 |
39 |
$4K |
| 87449 |
|
909 |
873 |
$4K |
| 80180 |
|
335 |
293 |
$4K |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
3,564 |
2,725 |
$4K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
1,339 |
1,300 |
$3K |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
79 |
52 |
$3K |
| G0109 |
Diabetes outpatient self-management training services, group session (2 or more), per 30 minutes |
97 |
96 |
$3K |
| 83525 |
|
976 |
953 |
$3K |
| 0124A |
|
111 |
103 |
$3K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
3,467 |
3,363 |
$3K |
| 89050 |
|
2,992 |
2,479 |
$3K |
| 92602 |
|
44 |
39 |
$3K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
9,908 |
9,605 |
$3K |
| 0081A |
|
94 |
84 |
$3K |
| L4361 |
Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf |
832 |
797 |
$3K |
| 88312 |
|
420 |
362 |
$3K |
| 99462 |
|
78 |
72 |
$3K |
| 0112A |
|
72 |
72 |
$3K |
| 80175 |
|
283 |
275 |
$3K |
| 86774 |
|
534 |
527 |
$3K |
| 92700 |
|
88 |
82 |
$3K |
| 36416 |
|
5,359 |
4,739 |
$3K |
| 93242 |
|
198 |
198 |
$3K |
| D1206 |
Topical application of fluoride varnish |
1,768 |
1,705 |
$3K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
7,055 |
6,738 |
$3K |
| 0154A |
|
67 |
65 |
$3K |
| 0074A |
|
98 |
92 |
$3K |
| J9070 |
Cyclophosphamide, 100 mg |
17 |
12 |
$3K |
| A9579 |
Injection, gadolinium-based magnetic resonance contrast agent, not otherwise specified (nos), per ml |
1,901 |
1,853 |
$3K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
46 |
44 |
$3K |
| 0082A |
|
67 |
61 |
$3K |
| C1887 |
Catheter, guiding (may include infusion/perfusion capability) |
564 |
517 |
$3K |
| 97113 |
|
25 |
13 |
$2K |
| 86645 |
|
462 |
448 |
$2K |
| 73660 |
|
665 |
623 |
$2K |
| J1720 |
Injection, hydrocortisone sodium succinate, up to 100 mg |
309 |
230 |
$2K |
| 90656 |
|
1,512 |
1,500 |
$2K |
| 82330 |
|
1,689 |
1,438 |
$2K |
| 92250 |
|
512 |
503 |
$2K |
| 86225 |
|
1,955 |
1,841 |
$2K |
| 88311 |
|
744 |
627 |
$2K |
| 36000 |
|
1,635 |
1,565 |
$2K |
| 84445 |
|
143 |
140 |
$2K |
| 72157 |
|
98 |
95 |
$2K |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
360 |
290 |
$2K |
| 87102 |
|
1,048 |
984 |
$2K |
| 80183 |
|
161 |
158 |
$2K |
| 87324 |
|
487 |
470 |
$2K |
| 80179 |
|
684 |
627 |
$2K |
| 51798 |
|
829 |
820 |
$2K |
| J0295 |
Injection, ampicillin sodium/sulbactam sodium, per 1.5 gm |
1,897 |
621 |
$2K |
| 87181 |
|
3,391 |
2,540 |
$2K |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
374 |
366 |
$2K |
| 92015 |
Determination of refractive state |
252 |
240 |
$2K |
| 82150 |
|
1,196 |
1,038 |
$2K |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
8,160 |
6,262 |
$2K |
| 0083A |
|
46 |
45 |
$2K |
| 88291 |
|
522 |
384 |
$2K |
| D0220 |
Intraoral - periapical first radiographic image |
1,530 |
1,440 |
$2K |
| 73564 |
|
637 |
625 |
$2K |
| 91322 |
|
83 |
79 |
$2K |
| 87075 |
|
2,785 |
2,605 |
$2K |
| 86787 |
|
550 |
533 |
$2K |
| 87071 |
|
1,630 |
1,606 |
$2K |
| D1120 |
Prophylaxis - child |
1,148 |
1,106 |
$2K |
| 76010 |
|
658 |
618 |
$2K |
| 82024 |
|
197 |
192 |
$2K |
| D0230 |
Intraoral - periapical each additional radiographic image |
1,238 |
1,162 |
$2K |
| P9612 |
Catheterization for collection of specimen, single patient, all places of service |
5,732 |
5,498 |
$2K |
| 51784 |
|
12 |
12 |
$2K |
| 96999 |
|
12 |
12 |
$2K |
| 77076 |
|
84 |
72 |
$2K |
| J9075 |
Injection, cyclophosphamide, not otherwise specified, 5 mg |
33 |
13 |
$2K |
| 93243 |
|
198 |
198 |
$2K |
| D4355 |
|
14 |
14 |
$1K |
| 86431 |
|
1,243 |
1,216 |
$1K |
| 91321 |
|
53 |
52 |
$1K |
| 93356 |
|
144 |
142 |
$1K |
| 87147 |
|
2,352 |
2,147 |
$1K |
| 96040 |
|
595 |
591 |
$1K |
| 96113 |
|
596 |
589 |
$1K |
| 86039 |
|
998 |
978 |
$1K |
| 88346 |
|
286 |
209 |
$1K |
| 86147 |
|
176 |
114 |
$1K |
| 87210 |
|
1,571 |
1,513 |
$1K |
| 86200 |
|
966 |
949 |
$1K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
3,310 |
2,355 |
$1K |
| 86308 |
|
1,134 |
1,104 |
$1K |
| 82085 |
|
968 |
863 |
$1K |
| J2274 |
Injection, morphine sulfate, preservative-free for epidural or intrathecal use, 10 mg |
3,981 |
3,373 |
$1K |
| 92134 |
|
282 |
277 |
$1K |
| 84295 |
|
1,016 |
851 |
$1K |
| 92622 |
|
54 |
54 |
$1K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
22 |
22 |
$1K |
| 92083 |
|
107 |
107 |
$1K |
| 93000 |
|
104 |
103 |
$1K |
| J0834 |
Injection, cosyntropin, 0.25 mg |
14 |
13 |
$1K |
| 94644 |
|
2,687 |
2,519 |
$1K |
| 84481 |
|
261 |
254 |
$1K |
| 82272 |
|
389 |
351 |
$1K |
| 86146 |
|
177 |
115 |
$1K |
| 82104 |
|
208 |
202 |
$1K |
| 85670 |
|
1,019 |
947 |
$986.41 |
| 86258 |
|
293 |
289 |
$984.76 |
| 85018 |
|
459 |
430 |
$959.82 |
| 90480 |
|
176 |
169 |
$948.01 |
| 82180 |
|
205 |
202 |
$913.08 |
| 80306 |
|
855 |
794 |
$903.80 |
| 87088 |
|
1,581 |
1,510 |
$898.26 |
| 80177 |
|
83 |
83 |
$879.12 |
| 70370 |
|
31 |
31 |
$878.75 |
| J0171 |
Injection, adrenalin, epinephrine, 0.1 mg |
1,037 |
983 |
$878.63 |
| 85097 |
|
24 |
24 |
$869.56 |
| 87177 |
|
213 |
207 |
$838.71 |
| 81406 |
|
42 |
41 |
$837.25 |
| 85347 |
|
388 |
273 |
$833.69 |
| 86705 |
|
342 |
330 |
$814.14 |
| L3908 |
Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf |
1,563 |
1,518 |
$760.11 |
| 88300 |
|
1,251 |
1,223 |
$759.47 |
| 71550 |
|
54 |
54 |
$727.22 |
| 88341 |
|
109 |
77 |
$697.96 |
| 96152 |
|
25 |
13 |
$697.17 |
| 87045 |
|
140 |
138 |
$692.43 |
| 86008 |
|
225 |
212 |
$681.40 |
| 87101 |
|
703 |
688 |
$676.36 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
53 |
51 |
$675.09 |
| 0134A |
|
24 |
19 |
$654.00 |
| J3370 |
Injection, vancomycin hcl, 500 mg |
858 |
595 |
$653.14 |
| 86353 |
|
42 |
40 |
$643.40 |
| D0140 |
Limited oral evaluation - problem focused |
15 |
14 |
$641.38 |
| 93270 |
|
106 |
104 |
$627.04 |
| 86648 |
|
85 |
82 |
$625.68 |
| 97150 |
Therapeutic procedure(s), group (2 or more individuals) |
58 |
27 |
$605.25 |
| 84157 |
|
206 |
179 |
$588.08 |
| 82945 |
|
216 |
190 |
$568.25 |
| J8540 |
Dexamethasone, oral, 0.25 mg |
9,365 |
8,232 |
$559.67 |
| 81405 |
|
26 |
24 |
$558.60 |
| 85576 |
|
75 |
49 |
$554.20 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
2,075 |
1,777 |
$523.09 |
| J9260 |
Injection, methotrexate sodium, 50 mg |
236 |
169 |
$520.08 |
| 87046 |
|
199 |
138 |
$514.32 |
| 87116 |
|
26 |
24 |
$513.23 |
| 84466 |
|
92 |
89 |
$512.59 |
| 88230 |
|
13 |
13 |
$489.87 |
| 69200 |
|
64 |
63 |
$478.40 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
429 |
355 |
$468.42 |
| 81404 |
|
26 |
25 |
$466.48 |
| 87427 |
|
126 |
124 |
$457.99 |
| 89230 |
|
18 |
18 |
$448.95 |
| 0054A |
|
12 |
12 |
$448.00 |
| L4386 |
Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
180 |
169 |
$446.41 |
| 90715 |
|
54 |
53 |
$402.51 |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
915 |
886 |
$388.07 |
| 81302 |
|
14 |
14 |
$386.03 |
| 84702 |
|
172 |
168 |
$384.17 |
| 84202 |
|
94 |
93 |
$375.01 |
| 86769 |
|
233 |
223 |
$369.61 |
| 84155 |
|
538 |
488 |
$356.99 |
| 85613 |
|
56 |
55 |
$354.35 |
| 84210 |
|
42 |
41 |
$347.39 |
| 86704 |
|
77 |
76 |
$346.44 |
| 93246 |
|
37 |
37 |
$342.61 |
| 74220 |
|
14 |
12 |
$334.87 |
| 12051 |
|
12 |
12 |
$323.29 |
| D1110 |
Prophylaxis - adult |
98 |
93 |
$321.95 |
| 86592 |
|
90 |
87 |
$318.61 |
| J1644 |
Injection, heparin sodium, per 1000 units |
2,309 |
1,534 |
$313.76 |
| 88271 |
|
17 |
12 |
$311.67 |
| 83090 |
|
12 |
12 |
$308.53 |
| 72070 |
|
66 |
63 |
$306.82 |
| 80203 |
|
31 |
28 |
$302.94 |
| 90732 |
|
52 |
51 |
$298.11 |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
26 |
26 |
$283.73 |
| J0134 |
Injection, acetaminophen (fresenius kabi), not therapeutically equivalent to j0131, 10 mg |
686 |
478 |
$268.36 |
| 87536 |
|
14 |
13 |
$266.11 |
| J0137 |
Injection, acetaminophen (hikma), not therapeutically equivalent to j0131, 10 mg |
18 |
15 |
$264.56 |
| 86413 |
|
108 |
106 |
$235.86 |
| 86015 |
|
232 |
232 |
$234.41 |
| J7050 |
Infusion, normal saline solution, 250 cc |
925 |
694 |
$231.51 |
| D0274 |
Bitewings - four radiographic images |
413 |
386 |
$220.32 |
| 82397 |
|
44 |
28 |
$214.90 |
| C1894 |
Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser |
13 |
12 |
$214.31 |
| 87328 |
|
38 |
37 |
$207.17 |
| 72190 |
|
12 |
12 |
$176.98 |
| 94799 |
|
70 |
65 |
$174.93 |
| C1725 |
Catheter, transluminal angioplasty, non-laser (may include guidance, infusion/perfusion capability) |
43 |
43 |
$171.80 |
| 93247 |
|
37 |
37 |
$171.29 |
| Q9958 |
High osmolar contrast material, up to 149 mg/ml iodine concentration, per ml |
221 |
209 |
$166.12 |
| 81408 |
|
12 |
12 |
$153.79 |
| 82374 |
|
150 |
147 |
$142.05 |
| 87305 |
|
32 |
29 |
$139.19 |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
638 |
631 |
$137.85 |
| 87329 |
|
38 |
37 |
$129.81 |
| J7611 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, concentrated form, 1 mg |
1,026 |
887 |
$124.13 |
| 87641 |
|
12 |
12 |
$123.90 |
| 80074 |
|
13 |
13 |
$120.77 |
| J2060 |
Injection, lorazepam, 2 mg |
170 |
121 |
$120.07 |
| J9100 |
Injection, cytarabine, 100 mg |
251 |
60 |
$118.29 |
| 86703 |
|
25 |
25 |
$116.36 |
| 86021 |
|
44 |
39 |
$112.48 |
| 87106 |
|
129 |
127 |
$109.35 |
| 82232 |
|
15 |
12 |
$98.32 |
| 87186 |
|
248 |
236 |
$96.95 |
| 86361 |
|
67 |
64 |
$81.66 |
| 86688 |
|
26 |
25 |
$78.23 |
| 87207 |
|
30 |
29 |
$74.16 |
| 86687 |
|
26 |
25 |
$71.39 |
| 87640 |
|
12 |
12 |
$70.56 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
557 |
539 |
$59.06 |
| J7507 |
Tacrolimus, immediate release, oral, 1 mg |
165 |
65 |
$44.69 |
| J2919 |
Injection, methylprednisolone sodium succinate, 5 mg |
254 |
208 |
$43.20 |
| 84145 |
|
171 |
167 |
$40.85 |
| 86708 |
|
39 |
39 |
$40.41 |
| 86762 |
|
13 |
12 |
$38.15 |
| J1815 |
Injection, insulin, per 5 units |
994 |
602 |
$37.76 |
| 84132 |
|
64 |
57 |
$36.57 |
| 82166 |
|
13 |
13 |
$35.61 |
| 87220 |
|
192 |
190 |
$30.51 |
| 85004 |
|
17 |
16 |
$25.52 |
| 85247 |
|
46 |
45 |
$25.07 |
| 84300 |
|
12 |
12 |
$18.48 |
| 87015 |
|
44 |
42 |
$15.70 |
| J7644 |
Ipratropium bromide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per milligram |
2,348 |
2,186 |
$14.29 |
| J7510 |
Prednisolone oral, per 5 mg |
371 |
239 |
$13.28 |
| 85250 |
|
24 |
24 |
$12.39 |
| J1940 |
Injection, furosemide, up to 20 mg |
43 |
38 |
$8.77 |
| 86709 |
|
24 |
24 |
$5.63 |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
1,931 |
1,559 |
$3.92 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
89 |
37 |
$0.24 |
| 91307 |
|
1,073 |
929 |
$0.01 |
| B4088 |
Gastrostomy/jejunostomy tube, low-profile, any material, any type, each |
534 |
495 |
$0.00 |
| J7042 |
5% dextrose/normal saline (500 ml = 1 unit) |
215 |
170 |
$0.00 |
| 80320 |
|
158 |
149 |
$0.00 |
| J2371 |
Injection, phenylephrine hydrochloride, 20 micrograms |
90 |
90 |
$0.00 |
| 96376 |
|
30 |
26 |
$0.00 |
| J2543 |
Injection, piperacillin sodium/tazobactam sodium, 1 gram/0.125 grams (1.125 grams) |
353 |
89 |
$0.00 |
| D4212 |
|
16 |
16 |
$0.00 |
| 91301 |
|
12 |
12 |
$0.00 |
| L3923 |
Hand finger orthosis, without joints, may include soft interface, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
56 |
55 |
$0.00 |
| 87206 |
|
12 |
12 |
$0.00 |
| 91315 |
|
67 |
65 |
$0.00 |
| J7121 |
5% dextrose in lactated ringers infusion, up to 1000 cc |
32 |
26 |
$0.00 |
| C1889 |
Implantable/insertable device, not otherwise classified |
15 |
12 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
12 |
12 |
$0.00 |
| A9573 |
Injection, gadopiclenol, 1 ml |
92 |
91 |
$0.00 |
| D0272 |
Bitewings - two radiographic images |
32 |
31 |
$0.00 |
| 91305 |
|
22 |
20 |
$0.00 |
| J2370 |
Injection, phenylephrine hcl, up to 1 ml |
16 |
13 |
$0.00 |
| 74430 |
|
12 |
12 |
$0.00 |
| 91312 |
|
111 |
103 |
$0.00 |
| L1906 |
Ankle foot orthosis, multiligamentous ankle support, prefabricated, off-the-shelf |
14 |
14 |
$0.00 |
| J0694 |
Injection, cefoxitin sodium, 1 gm |
132 |
126 |
$0.00 |
| Q9961 |
High osmolar contrast material, 250-299 mg/ml iodine concentration, per ml |
159 |
156 |
$0.00 |
| 91308 |
|
250 |
219 |
$0.00 |
| 94645 |
|
342 |
320 |
$0.00 |
| 76001 |
|
27 |
27 |
$0.00 |
| J1756 |
Injection, iron sucrose, 1 mg |
78 |
39 |
$0.00 |
| 91300 |
|
3,490 |
3,079 |
$0.00 |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
46 |
37 |
$0.00 |
| 91311 |
|
201 |
185 |
$0.00 |
| 91313 |
|
24 |
19 |
$0.00 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
83 |
82 |
$0.00 |
| J0136 |
Injection, acetaminophen (b braun), not therapeutically equivalent to j0131, 10 mg |
25 |
21 |
$0.00 |
| L1851 |
Knee orthosis (ko), single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf |
39 |
37 |
$0.00 |
| J1596 |
Injection, glycopyrrolate, 0.1 mg |
42 |
39 |
$0.00 |
| 75565 |
|
24 |
24 |
$0.00 |
| J1071 |
Injection, testosterone cypionate, 1 mg |
14 |
12 |
$0.00 |