| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
311,757 |
273,010 |
$30.19M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
18,983 |
17,642 |
$3.95M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
21,687 |
20,424 |
$3.08M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
3,106 |
2,824 |
$906K |
| D7140 |
Extraction, erupted tooth or exposed root |
527 |
203 |
$899K |
| D2930 |
Prefabricated stainless steel crown - primary tooth |
1,521 |
347 |
$802K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
15,725 |
15,063 |
$702K |
| G0330 |
Facility services for dental rehabilitation procedure(s) performed on a patient who requires monitored anesthesia (e.g., general, intravenous sedation (monitored anesthesia care) and use of an operating room |
309 |
247 |
$584K |
| 92507 |
Treatment of speech, language, voice, communication, and/or auditory processing disorder |
7,687 |
2,254 |
$489K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
4,398 |
4,045 |
$481K |
| D3220 |
Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction |
907 |
287 |
$460K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
1,507 |
904 |
$253K |
| 90834 |
Psychotherapy, 45 minutes with patient |
2,142 |
1,253 |
$224K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
5,030 |
4,927 |
$220K |
| 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 |
3,858 |
2,365 |
$168K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
6,615 |
6,393 |
$138K |
| 71045 |
Radiologic examination, chest; single view |
2,562 |
2,377 |
$125K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
2,658 |
2,441 |
$119K |
| 0202U |
Oncology (prostate), multianalyte, gene expression profiling |
395 |
386 |
$116K |
| D1351 |
Sealant - per tooth |
216 |
69 |
$116K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
11,541 |
11,043 |
$108K |
| C9803 |
Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
10,286 |
8,387 |
$96K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
1,242 |
1,165 |
$95K |
| 59025 |
Fetal non-stress test |
876 |
653 |
$95K |
| 41899 |
Unlisted procedure, dentoalveolar structures |
178 |
153 |
$94K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
1,690 |
1,631 |
$91K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,422 |
1,388 |
$90K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
1,012 |
964 |
$86K |
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
1,956 |
169 |
$79K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
2,129 |
744 |
$77K |
| 71046 |
Radiologic examination, chest; 2 views |
1,143 |
1,041 |
$54K |
| 90473 |
|
1,233 |
1,203 |
$51K |
| 90686 |
|
5,841 |
5,727 |
$44K |
| 36415 |
Collection of venous blood by venipuncture |
48,449 |
42,612 |
$42K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
1,275 |
1,173 |
$42K |
| 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 |
3,067 |
1,765 |
$38K |
| 93296 |
|
2,615 |
2,478 |
$37K |
| U0001 |
Cdc 2019 novel coronavirus (2019-ncov) real-time rt-pcr diagnostic panel |
2,034 |
1,415 |
$32K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
280 |
277 |
$22K |
| 90791 |
Psychiatric diagnostic evaluation |
140 |
130 |
$21K |
| G0379 |
Direct admission of patient for hospital observation care |
341 |
294 |
$20K |
| 90670 |
|
3,186 |
3,143 |
$20K |
| 70450 |
Computed tomography, head or brain; without contrast material |
122 |
115 |
$20K |
| 95117 |
|
369 |
135 |
$16K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
422 |
305 |
$15K |
| 11721 |
|
1,419 |
1,374 |
$14K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
84 |
52 |
$14K |
| 31575 |
|
102 |
100 |
$13K |
| H0003 |
Alcohol and/or drug screening; laboratory analysis of specimens for presence of alcohol and/or drugs |
798 |
670 |
$13K |
| 97535 |
Self-care/home management training, each 15 minutes |
769 |
299 |
$12K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
82 |
75 |
$12K |
| 87428 |
|
332 |
327 |
$11K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
49 |
49 |
$10K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
740 |
645 |
$9K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
30 |
25 |
$9K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
187 |
184 |
$8K |
| 87081 |
|
12,018 |
11,603 |
$8K |
| 76801 |
|
77 |
66 |
$7K |
| 84443 |
Thyroid stimulating hormone (TSH) |
1,174 |
1,099 |
$7K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
1,977 |
1,807 |
$7K |
| 80053 |
Comprehensive metabolic panel |
13,515 |
11,986 |
$7K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
207 |
173 |
$7K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
29,570 |
25,925 |
$7K |
| 20610 |
|
46 |
37 |
$6K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
1,509 |
1,391 |
$6K |
| 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 |
396 |
383 |
$6K |
| 97597 |
|
60 |
38 |
$6K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
59 |
51 |
$5K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
5,600 |
5,017 |
$5K |
| 0012A |
|
170 |
164 |
$5K |
| 90837 |
Psychotherapy, 53 minutes with patient |
32 |
15 |
$4K |
| 80055 |
|
725 |
677 |
$4K |
| 0011A |
|
162 |
159 |
$3K |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
148 |
114 |
$3K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
20,602 |
20,012 |
$3K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
107 |
95 |
$3K |
| 90651 |
|
96 |
96 |
$3K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
8,436 |
7,629 |
$2K |
| 94060 |
|
13 |
12 |
$2K |
| 83655 |
|
448 |
421 |
$2K |
| 90734 |
|
101 |
100 |
$2K |
| 90847 |
Family psychotherapy with the patient present, 50 minutes |
18 |
13 |
$2K |
| 80061 |
Lipid panel |
155 |
148 |
$2K |
| 93297 |
|
136 |
130 |
$2K |
| 81001 |
|
5,302 |
4,890 |
$2K |
| 86140 |
|
4,185 |
3,813 |
$2K |
| 96127 |
|
2,648 |
2,573 |
$1K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
107 |
95 |
$1K |
| 83605 |
|
1,119 |
1,016 |
$1K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
8,593 |
8,000 |
$1K |
| 77336 |
|
20 |
13 |
$1K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
7,694 |
6,197 |
$1K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
14 |
13 |
$1K |
| 73630 |
|
209 |
179 |
$1K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
12 |
12 |
$1K |
| 83690 |
|
1,512 |
1,394 |
$1K |
| 90677 |
|
324 |
323 |
$1K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
1,584 |
1,462 |
$1K |
| G0378 |
Hospital observation service, per hour |
553 |
473 |
$1K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
38 |
14 |
$991.79 |
| 85027 |
|
1,208 |
1,138 |
$908.21 |
| 86780 |
|
67 |
61 |
$830.07 |
| 84439 |
|
222 |
204 |
$826.06 |
| 90832 |
Psychotherapy, 30 minutes with patient |
20 |
12 |
$694.27 |
| 0002A |
|
27 |
27 |
$692.30 |
| 69210 |
|
57 |
53 |
$639.25 |
| Q3014 |
Telehealth originating site facility fee |
263 |
241 |
$487.26 |
| 80069 |
|
176 |
167 |
$444.10 |
| 83970 |
|
44 |
40 |
$440.81 |
| 84460 |
|
1,026 |
929 |
$419.87 |
| 84450 |
|
1,026 |
929 |
$410.11 |
| 82565 |
|
1,067 |
966 |
$399.04 |
| 84520 |
|
1,012 |
930 |
$305.75 |
| 85018 |
|
645 |
610 |
$257.68 |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
28 |
25 |
$250.07 |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
45 |
42 |
$236.52 |
| 85652 |
|
1,071 |
970 |
$215.60 |
| 87807 |
|
1,200 |
1,169 |
$208.44 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
30 |
29 |
$202.00 |
| 82570 |
|
97 |
94 |
$181.33 |
| 85610 |
|
3,201 |
1,750 |
$178.12 |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
58 |
52 |
$167.87 |
| 82962 |
|
7,043 |
6,529 |
$144.56 |
| 84484 |
|
2,379 |
1,846 |
$144.20 |
| 82728 |
|
72 |
68 |
$143.49 |
| 84550 |
|
88 |
83 |
$128.46 |
| 82950 |
|
27 |
27 |
$124.44 |
| 51798 |
|
228 |
215 |
$116.72 |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
16 |
13 |
$105.21 |
| 83735 |
|
1,048 |
962 |
$105.19 |
| 84156 |
|
71 |
68 |
$103.38 |
| P9603 |
Travel allowance one way in connection with medically necessary laboratory specimen collection drawn from home bound or nursing home bound patient; prorated miles actually travelled |
206 |
131 |
$97.04 |
| 90744 |
|
310 |
308 |
$85.91 |
| 82607 |
|
45 |
42 |
$85.55 |
| 0001A |
|
14 |
14 |
$85.38 |
| 73610 |
|
19 |
12 |
$83.58 |
| 82746 |
|
45 |
42 |
$83.40 |
| 83550 |
|
58 |
54 |
$82.41 |
| 86003 |
|
22 |
14 |
$72.74 |
| 87430 |
|
470 |
462 |
$64.20 |
| 83540 |
|
60 |
56 |
$61.05 |
| 84425 |
|
18 |
16 |
$60.51 |
| 81003 |
|
515 |
488 |
$52.21 |
| 82785 |
|
21 |
13 |
$51.96 |
| Q0114 |
Fern test |
12 |
12 |
$40.92 |
| 81000 |
|
556 |
515 |
$37.90 |
| 82525 |
|
18 |
16 |
$35.37 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
63 |
63 |
$33.88 |
| 84630 |
|
17 |
15 |
$32.46 |
| 96160 |
|
129 |
119 |
$27.70 |
| 90656 |
|
14 |
14 |
$26.52 |
| 81025 |
|
133 |
130 |
$25.29 |
| 99000 |
|
12 |
12 |
$12.70 |
| 80305 |
|
13 |
13 |
$12.21 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
774 |
662 |
$11.98 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
367 |
302 |
$10.33 |
| J2704 |
Injection, propofol, 10 mg |
359 |
288 |
$9.37 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
634 |
499 |
$8.66 |
| 83615 |
|
27 |
24 |
$7.22 |
| 85730 |
|
39 |
37 |
$5.88 |
| 82043 |
|
13 |
13 |
$5.68 |
| 96138 |
|
44 |
36 |
$3.38 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
1,472 |
1,350 |
$0.76 |
| 90698 |
|
2,661 |
2,626 |
$0.01 |
| 90648 |
|
674 |
665 |
$0.00 |
| 87633 |
Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets |
382 |
371 |
$0.00 |
| 92504 |
|
15 |
13 |
$0.00 |
| 90633 |
|
622 |
593 |
$0.00 |
| 85007 |
|
30 |
25 |
$0.00 |
| J7030 |
Infusion, normal saline solution , 1000 cc |
56 |
53 |
$0.00 |
| 90681 |
|
112 |
112 |
$0.00 |
| 80076 |
|
25 |
25 |
$0.00 |
| 90715 |
|
24 |
24 |
$0.00 |
| 95004 |
Percutaneous tests with allergenic extracts, immediate type reaction |
52 |
51 |
$0.00 |
| 90461 |
|
25 |
25 |
$0.00 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
19 |
12 |
$0.00 |
| 90707 |
|
15 |
15 |
$0.00 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
95 |
90 |
$0.00 |
| 90685 |
|
44 |
43 |
$0.00 |
| 90710 |
|
41 |
41 |
$0.00 |
| 94729 |
|
13 |
12 |
$0.00 |
| 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 |
34 |
28 |
$0.00 |
| 90723 |
|
444 |
439 |
$0.00 |
| 90680 |
|
966 |
946 |
$0.00 |
| 84703 |
|
212 |
195 |
$0.00 |
| G0399 |
Home sleep test (hst) with type iii portable monitor, unattended; minimum of 4 channels: 2 respiratory movement/airflow, 1 ecg/heart rate and 1 oxygen saturation |
124 |
109 |
$0.00 |
| 95885 |
|
59 |
38 |
$0.00 |
| 82077 |
|
102 |
91 |
$0.00 |
| 90696 |
|
29 |
29 |
$0.00 |
| 83880 |
|
89 |
82 |
$0.00 |
| 96139 |
|
80 |
36 |
$0.00 |
| 96376 |
|
14 |
12 |
$0.00 |
| 80047 |
|
37 |
25 |
$0.00 |
| J8597 |
Antiemetic drug, oral, not otherwise specified |
38 |
37 |
$0.00 |
| 90716 |
|
14 |
14 |
$0.00 |
| 85379 |
|
26 |
25 |
$0.00 |
| 99406 |
|
13 |
12 |
$0.00 |
| 86308 |
|
12 |
12 |
$0.00 |
| 83986 |
|
12 |
12 |
$0.00 |
| 74019 |
|
12 |
12 |
$0.00 |
| 80081 |
|
14 |
12 |
$0.00 |