| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
129,284 |
119,548 |
$10.73M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
89,316 |
82,509 |
$8.61M |
| H2019 |
Therapeutic behavioral services, per 15 minutes |
5,783 |
5,774 |
$4.19M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
31,784 |
29,411 |
$3.66M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
28,715 |
26,573 |
$3.36M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
28,219 |
26,471 |
$3.28M |
| 96361 |
Intravenous infusion, hydration; each additional hour |
16,765 |
14,160 |
$3.05M |
| 90834 |
Psychotherapy, 45 minutes with patient |
22,366 |
15,625 |
$3.01M |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
12,418 |
11,945 |
$2.13M |
| 70450 |
Computed tomography, head or brain; without contrast material |
11,566 |
10,939 |
$1.89M |
| 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 |
19,773 |
17,322 |
$1.53M |
| 80053 |
Comprehensive metabolic panel |
78,339 |
65,930 |
$1.47M |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
10,390 |
10,382 |
$1.29M |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
7,665 |
6,100 |
$1.21M |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
10,548 |
10,435 |
$1.18M |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
11,374 |
10,993 |
$1.02M |
| 93975 |
|
2,294 |
2,201 |
$953K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
10,375 |
9,418 |
$939K |
| 90832 |
Psychotherapy, 30 minutes with patient |
8,940 |
7,477 |
$916K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
9,757 |
9,594 |
$908K |
| 90791 |
Psychiatric diagnostic evaluation |
5,222 |
4,493 |
$871K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
5,306 |
4,808 |
$841K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
5,877 |
5,614 |
$814K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
6,712 |
6,588 |
$759K |
| H2018 |
Psychosocial rehabilitation services, per diem |
1,630 |
1,630 |
$750K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
2,847 |
2,721 |
$741K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
3,339 |
3,213 |
$695K |
| 99215 |
Prolong outpt/office vis |
5,491 |
5,283 |
$620K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
6,011 |
5,790 |
$615K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
6,047 |
5,968 |
$615K |
| 92552 |
|
9,146 |
9,131 |
$550K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
5,181 |
5,025 |
$547K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
9,585 |
9,271 |
$490K |
| J2426 |
Injection, paliperidone palmitate extended release (invega sustenna), 1 mg |
261 |
257 |
$483K |
| 99442 |
|
4,162 |
4,008 |
$420K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
3,852 |
3,510 |
$415K |
| 99441 |
|
3,816 |
3,661 |
$400K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
13,905 |
12,833 |
$396K |
| 90837 |
Psychotherapy, 53 minutes with patient |
2,838 |
2,101 |
$383K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
2,995 |
2,301 |
$363K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
602 |
579 |
$344K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
3,207 |
3,083 |
$316K |
| 76801 |
|
4,293 |
3,676 |
$302K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
8,077 |
6,536 |
$284K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
2,387 |
2,310 |
$280K |
| 99223 |
Prolong inpt eval add15 m |
2,356 |
2,290 |
$272K |
| 90686 |
|
12,272 |
12,205 |
$271K |
| 90833 |
Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) |
5,202 |
4,988 |
$269K |
| 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 |
13,873 |
12,442 |
$269K |
| 80061 |
Lipid panel |
19,635 |
17,728 |
$262K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
4,133 |
1,304 |
$255K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
1,278 |
1,264 |
$251K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
7,323 |
7,086 |
$250K |
| 93970 |
|
640 |
615 |
$249K |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
3,528 |
3,453 |
$245K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
13,757 |
12,712 |
$241K |
| 36415 |
Collection of venous blood by venipuncture |
78,321 |
62,487 |
$238K |
| G0444 |
Annual depression screening, 5 to 15 minutes |
8,791 |
8,456 |
$235K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
9,117 |
8,257 |
$231K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
16,499 |
14,088 |
$225K |
| 12001 |
|
585 |
581 |
$216K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
4,106 |
3,793 |
$216K |
| 99205 |
Prolong outpt/office vis |
1,827 |
1,788 |
$211K |
| 90847 |
Family psychotherapy with the patient present, 50 minutes |
1,004 |
780 |
$205K |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
5,559 |
2,126 |
$201K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
4,412 |
4,248 |
$201K |
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
3,314 |
1,190 |
$193K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
5,700 |
5,379 |
$190K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
668 |
618 |
$181K |
| 71046 |
Radiologic examination, chest; 2 views |
30,244 |
29,222 |
$145K |
| 71250 |
|
1,569 |
1,427 |
$144K |
| 76830 |
Ultrasound, transvaginal |
5,355 |
5,151 |
$139K |
| 99173 |
|
8,800 |
8,776 |
$134K |
| 99233 |
Prolong inpt eval add15 m |
2,310 |
1,157 |
$131K |
| 90715 |
|
5,694 |
5,645 |
$131K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
1,231 |
1,221 |
$130K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
9,691 |
8,151 |
$129K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
329 |
310 |
$119K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
3,285 |
1,052 |
$119K |
| 86850 |
|
4,365 |
3,984 |
$117K |
| 93971 |
|
2,401 |
2,278 |
$117K |
| 88142 |
|
5,297 |
5,095 |
$115K |
| 12011 |
|
327 |
323 |
$113K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
568 |
565 |
$112K |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
16,376 |
14,557 |
$111K |
| 86901 |
|
5,932 |
5,376 |
$110K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
7,390 |
7,117 |
$109K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
2,865 |
2,753 |
$107K |
| 76770 |
|
583 |
537 |
$105K |
| G0378 |
Hospital observation service, per hour |
2,022 |
1,872 |
$98K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
2,064 |
1,748 |
$97K |
| 90670 |
|
4,899 |
4,891 |
$95K |
| 99406 |
|
3,097 |
2,967 |
$95K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
2,935 |
2,565 |
$94K |
| 99443 |
|
910 |
891 |
$93K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
584 |
564 |
$93K |
| 99385 |
|
918 |
895 |
$93K |
| 70496 |
|
417 |
393 |
$92K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
3,258 |
3,196 |
$92K |
| 90651 |
|
2,876 |
2,865 |
$89K |
| 99188 |
|
1,893 |
1,891 |
$88K |
| 71045 |
Radiologic examination, chest; single view |
20,797 |
18,315 |
$87K |
| C9803 |
Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
13,379 |
12,251 |
$85K |
| 99460 |
|
1,248 |
1,246 |
$84K |
| 94726 |
|
608 |
594 |
$84K |
| 86900 |
|
6,012 |
5,450 |
$83K |
| 94060 |
|
735 |
723 |
$83K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
5,794 |
5,551 |
$79K |
| 83880 |
|
2,754 |
2,623 |
$78K |
| 90633 |
|
3,936 |
3,924 |
$76K |
| 99239 |
Hospital discharge day management, more than 30 minutes |
1,297 |
1,265 |
$74K |
| 99381 |
|
705 |
690 |
$73K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
1,403 |
1,393 |
$72K |
| 90680 |
|
3,724 |
3,720 |
$72K |
| 90707 |
|
3,532 |
3,513 |
$69K |
| 84443 |
Thyroid stimulating hormone (TSH) |
20,982 |
19,112 |
$69K |
| 96160 |
|
2,089 |
2,079 |
$68K |
| T1015 |
Clinic visit/encounter, all-inclusive |
266 |
266 |
$67K |
| 90716 |
|
3,173 |
3,159 |
$67K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
19,931 |
17,804 |
$66K |
| 12002 |
|
175 |
173 |
$63K |
| 70486 |
|
1,140 |
1,103 |
$61K |
| 88342 |
|
981 |
978 |
$61K |
| 90734 |
|
2,827 |
2,819 |
$61K |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
2,058 |
1,902 |
$60K |
| 77066 |
Tomosynthesis, mammo |
956 |
912 |
$59K |
| 86480 |
|
1,200 |
1,111 |
$59K |
| D1110 |
Prophylaxis - adult |
1,036 |
708 |
$59K |
| 90677 |
|
1,164 |
1,162 |
$58K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
787 |
759 |
$57K |
| 70491 |
|
216 |
202 |
$56K |
| 99177 |
|
3,668 |
3,659 |
$52K |
| 29125 |
|
288 |
281 |
$50K |
| 83655 |
|
4,147 |
4,064 |
$50K |
| 97803 |
|
1,687 |
1,567 |
$49K |
| 76641 |
|
1,716 |
1,486 |
$47K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
68,569 |
58,528 |
$46K |
| 58661 |
|
32 |
29 |
$45K |
| 90723 |
|
2,337 |
2,332 |
$42K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
1,828 |
1,712 |
$39K |
| 85610 |
|
12,140 |
10,747 |
$39K |
| 10060 |
|
146 |
145 |
$38K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
5,565 |
5,043 |
$37K |
| 90697 |
|
1,660 |
1,658 |
$36K |
| 99383 |
|
343 |
332 |
$36K |
| 97161 |
|
426 |
423 |
$35K |
| 97802 |
|
1,220 |
1,220 |
$35K |
| 76642 |
|
1,481 |
1,387 |
$34K |
| 90696 |
|
1,683 |
1,678 |
$33K |
| 77065 |
Tomosynthesis, mammo |
499 |
441 |
$32K |
| 87536 |
|
410 |
404 |
$32K |
| 90648 |
|
1,761 |
1,756 |
$31K |
| 99231 |
Subsequent hospital care, per day, straightforward or low complexity |
1,828 |
1,175 |
$31K |
| 76775 |
|
561 |
533 |
$31K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
473 |
458 |
$30K |
| 90647 |
|
1,529 |
1,527 |
$30K |
| 84439 |
|
8,550 |
7,836 |
$30K |
| 90700 |
|
1,530 |
1,527 |
$29K |
| 93458 |
|
24 |
24 |
$27K |
| 76536 |
|
1,079 |
998 |
$26K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
30,074 |
24,993 |
$26K |
| 88304 |
|
909 |
903 |
$25K |
| 97597 |
|
119 |
66 |
$25K |
| 86780 |
|
4,715 |
4,329 |
$25K |
| 82803 |
|
1,341 |
1,254 |
$25K |
| 59025 |
Fetal non-stress test |
143 |
116 |
$24K |
| J0401 |
Injection, aripiprazole (abilify maintena), 1 mg |
13 |
12 |
$23K |
| 81025 |
|
7,256 |
7,080 |
$22K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
166 |
154 |
$22K |
| H2011 |
Crisis intervention service, per 15 minutes |
206 |
182 |
$22K |
| 31575 |
|
90 |
86 |
$21K |
| 94729 |
|
637 |
623 |
$21K |
| 87660 |
|
5,302 |
4,904 |
$21K |
| D0120 |
Periodic oral evaluation - established patient |
532 |
414 |
$21K |
| 96367 |
|
323 |
273 |
$21K |
| 97014 |
|
1,072 |
392 |
$20K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
10,812 |
10,021 |
$19K |
| 87480 |
|
5,211 |
4,730 |
$19K |
| 82607 |
|
4,400 |
3,986 |
$19K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
97 |
59 |
$18K |
| 90620 |
|
475 |
474 |
$18K |
| 87510 |
|
5,123 |
4,693 |
$18K |
| 82728 |
|
2,992 |
2,718 |
$18K |
| 99386 |
|
176 |
165 |
$18K |
| 71271 |
|
610 |
554 |
$18K |
| 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 |
1,379 |
1,317 |
$18K |
| 97162 |
|
174 |
173 |
$17K |
| 59514 |
|
115 |
113 |
$17K |
| 69210 |
|
162 |
159 |
$17K |
| 99221 |
|
390 |
387 |
$16K |
| 88307 |
|
259 |
259 |
$16K |
| 87340 |
|
2,608 |
2,442 |
$16K |
| 93017 |
|
125 |
123 |
$15K |
| 85027 |
|
11,331 |
10,269 |
$15K |
| 84702 |
|
4,639 |
3,717 |
$15K |
| C1776 |
Joint device (implantable) |
13 |
13 |
$15K |
| 86803 |
|
4,071 |
3,647 |
$15K |
| 84153 |
|
1,210 |
1,153 |
$15K |
| 86762 |
|
1,822 |
1,665 |
$15K |
| 36430 |
|
41 |
38 |
$14K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
16,510 |
15,056 |
$14K |
| 58558 |
|
14 |
14 |
$13K |
| 84403 |
|
856 |
758 |
$13K |
| 92250 |
|
176 |
173 |
$13K |
| 86360 |
|
330 |
322 |
$12K |
| 92557 |
|
196 |
195 |
$12K |
| G0108 |
Diabetes outpatient self-management training services, individual, per 30 minutes |
233 |
218 |
$11K |
| 92567 |
|
231 |
230 |
$10K |
| 90698 |
|
589 |
589 |
$10K |
| 70498 |
|
350 |
337 |
$10K |
| 86703 |
|
675 |
655 |
$10K |
| 86765 |
|
1,521 |
1,370 |
$10K |
| 82570 |
|
5,672 |
5,005 |
$9K |
| D0140 |
Limited oral evaluation - problem focused |
275 |
225 |
$9K |
| 96415 |
|
18 |
12 |
$9K |
| 90671 |
|
409 |
409 |
$9K |
| 90685 |
|
364 |
363 |
$9K |
| 83540 |
|
4,377 |
4,012 |
$9K |
| 76870 |
|
367 |
353 |
$9K |
| 83550 |
|
4,200 |
3,855 |
$8K |
| 82043 |
|
4,613 |
4,087 |
$8K |
| 90846 |
Family psychotherapy without the patient present, 50 minutes |
65 |
59 |
$8K |
| 90732 |
|
147 |
146 |
$7K |
| 76818 |
|
159 |
79 |
$7K |
| 84146 |
|
510 |
490 |
$7K |
| 97035 |
|
491 |
162 |
$7K |
| 82746 |
|
1,280 |
1,191 |
$7K |
| 87077 |
|
2,511 |
2,395 |
$7K |
| Q3014 |
Telehealth originating site facility fee |
1,046 |
862 |
$7K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
3,107 |
3,017 |
$7K |
| D7140 |
Extraction, erupted tooth or exposed root |
75 |
56 |
$6K |
| D0274 |
Bitewings - four radiographic images |
169 |
144 |
$6K |
| A9576 |
Injection, gadoteridol, (prohance multipack), per ml |
206 |
197 |
$6K |
| 87070 |
|
8,199 |
7,915 |
$6K |
| 86140 |
|
3,565 |
3,133 |
$6K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
115 |
81 |
$6K |
| P9016 |
Red blood cells, leukocytes reduced, each unit |
15 |
12 |
$6K |
| 87186 |
|
3,435 |
3,295 |
$6K |
| H0002 |
Behavioral health screening to determine eligibility for admission to treatment program |
29 |
29 |
$6K |
| 85048 |
|
1,836 |
1,342 |
$6K |
| 77080 |
|
122 |
103 |
$6K |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
158 |
102 |
$5K |
| 86885 |
|
249 |
220 |
$5K |
| 72100 |
|
1,861 |
1,765 |
$5K |
| 86787 |
|
1,148 |
1,037 |
$5K |
| 90619 |
|
213 |
212 |
$5K |
| 83735 |
|
9,367 |
8,336 |
$5K |
| 82784 |
|
433 |
402 |
$5K |
| 99222 |
Initial hospital care, per day, moderate complexity |
54 |
53 |
$5K |
| 83970 |
|
141 |
136 |
$5K |
| J2916 |
Injection, sodium ferric gluconate complex in sucrose injection, 12.5 mg |
180 |
99 |
$5K |
| 74183 |
|
14 |
12 |
$4K |
| 85730 |
|
6,023 |
5,757 |
$4K |
| 90656 |
|
303 |
303 |
$4K |
| 84402 |
|
270 |
242 |
$4K |
| 73630 |
|
2,722 |
2,558 |
$4K |
| 86618 |
|
786 |
747 |
$4K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
124 |
111 |
$4K |
| 94760 |
|
3,997 |
3,638 |
$4K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
144 |
138 |
$4K |
| 86706 |
|
807 |
741 |
$4K |
| 82950 |
|
833 |
813 |
$4K |
| 81001 |
|
27,064 |
25,054 |
$4K |
| 90672 |
|
182 |
182 |
$4K |
| 84484 |
|
18,789 |
14,003 |
$4K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
37 |
27 |
$4K |
| 84480 |
|
1,449 |
1,327 |
$4K |
| G0279 |
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) |
234 |
217 |
$3K |
| 81003 |
|
5,765 |
5,457 |
$3K |
| 74018 |
|
1,256 |
1,155 |
$3K |
| 99382 |
|
38 |
38 |
$3K |
| G0435 |
Infectious agent antibody detection by rapid antibody test, hiv-1 and/or hiv-2, screening |
253 |
242 |
$3K |
| 80076 |
|
402 |
396 |
$3K |
| 82248 |
|
834 |
771 |
$3K |
| 83021 |
|
171 |
136 |
$3K |
| 87150 |
|
199 |
182 |
$3K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
12,823 |
11,066 |
$3K |
| 86580 |
|
590 |
551 |
$3K |
| 83001 |
|
262 |
240 |
$3K |
| 85651 |
|
3,151 |
2,939 |
$3K |
| 86038 |
|
847 |
799 |
$3K |
| 74021 |
|
1,004 |
958 |
$3K |
| 82105 |
|
448 |
437 |
$3K |
| 90836 |
|
35 |
34 |
$3K |
| 87088 |
|
1,506 |
1,463 |
$3K |
| 99384 |
|
26 |
26 |
$3K |
| D0330 |
Panoramic radiographic image |
56 |
39 |
$3K |
| 73564 |
|
1,601 |
1,477 |
$3K |
| 83002 |
|
238 |
217 |
$2K |
| 0001A |
|
117 |
116 |
$2K |
| 84436 |
|
940 |
877 |
$2K |
| 84425 |
|
496 |
458 |
$2K |
| 29130 |
|
12 |
12 |
$2K |
| 83690 |
|
16,538 |
15,286 |
$2K |
| 73610 |
|
2,326 |
2,224 |
$2K |
| 0012A |
|
85 |
85 |
$2K |
| 96368 |
|
57 |
44 |
$2K |
| 73502 |
|
814 |
709 |
$2K |
| 73130 |
|
2,347 |
2,236 |
$2K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
14,237 |
12,771 |
$2K |
| 73030 |
|
1,745 |
1,615 |
$2K |
| P9604 |
Travel allowance one way in connection with medically necessary laboratory specimen collection drawn from home bound or nursing home bound patient; prorated trip charge |
707 |
427 |
$2K |
| 96161 |
|
71 |
69 |
$2K |
| 86328 |
|
56 |
54 |
$2K |
| 82550 |
|
1,867 |
1,715 |
$2K |
| 83020 |
|
347 |
304 |
$2K |
| 76937 |
|
12 |
12 |
$2K |
| 84481 |
|
444 |
401 |
$2K |
| 84550 |
|
1,162 |
1,018 |
$2K |
| 86431 |
|
634 |
579 |
$2K |
| 0002A |
|
75 |
75 |
$2K |
| G0297 |
Low dose ct scan (ldct) for lung cancer screening |
24 |
24 |
$2K |
| 90658 |
|
66 |
66 |
$2K |
| 0011A |
|
91 |
91 |
$2K |
| 84100 |
|
1,447 |
1,269 |
$2K |
| 99051 |
|
150 |
148 |
$2K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
190 |
189 |
$2K |
| 84703 |
|
11,868 |
11,222 |
$1K |
| 73560 |
|
811 |
716 |
$1K |
| C9399 |
Unclassified drugs or biologicals |
761 |
756 |
$1K |
| 76820 |
|
80 |
61 |
$1K |
| G2211 |
Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established) |
155 |
152 |
$1K |
| 87205 |
|
1,469 |
1,391 |
$1K |
| 76882 |
|
57 |
51 |
$1K |
| 83615 |
|
794 |
624 |
$1K |
| 85018 |
|
5,746 |
5,673 |
$1K |
| 80305 |
|
1,385 |
1,280 |
$1K |
| 84156 |
|
931 |
802 |
$1K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
17 |
12 |
$1K |
| 73110 |
|
1,374 |
1,309 |
$1K |
| D0210 |
Intraoral - complete series of radiographic images |
29 |
24 |
$1K |
| 86255 |
|
291 |
261 |
$1K |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
13,877 |
12,536 |
$1K |
| 87522 |
Neg quan hep c or qual rna |
24 |
24 |
$1K |
| 90660 |
|
40 |
40 |
$1K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
17 |
12 |
$885.75 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
3,030 |
2,571 |
$845.10 |
| J1815 |
Injection, insulin, per 5 units |
760 |
465 |
$818.49 |
| 82947 |
|
1,686 |
1,450 |
$810.23 |
| 99462 |
|
28 |
27 |
$785.51 |
| 90682 |
|
52 |
52 |
$782.19 |
| 90662 |
|
79 |
79 |
$766.21 |
| 90744 |
|
40 |
40 |
$747.45 |
| 80069 |
|
76 |
73 |
$738.27 |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
3,069 |
2,572 |
$720.58 |
| 81015 |
|
3,993 |
3,692 |
$693.65 |
| 74174 |
|
12 |
12 |
$686.14 |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
1,603 |
1,518 |
$677.94 |
| 11721 |
|
39 |
38 |
$677.83 |
| J0574 |
Buprenorphine/naloxone, oral, greater than 6 mg, but less than or equal to 10 mg buprenorphine |
96 |
50 |
$659.46 |
| 76821 |
|
25 |
20 |
$659.05 |
| 87040 |
|
3,476 |
1,904 |
$650.40 |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
971 |
855 |
$628.68 |
| D0220 |
Intraoral - periapical first radiographic image |
17 |
14 |
$609.10 |
| 88738 |
|
62 |
58 |
$568.46 |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
981 |
943 |
$548.33 |
| 86704 |
|
97 |
92 |
$533.03 |
| 85378 |
|
3,037 |
2,967 |
$528.65 |
| 98960 |
|
14 |
14 |
$490.45 |
| 83605 |
|
4,396 |
3,974 |
$439.96 |
| 82677 |
|
26 |
26 |
$436.93 |
| 98968 |
|
21 |
16 |
$415.20 |
| 90713 |
|
15 |
15 |
$395.16 |
| 90710 |
|
15 |
15 |
$376.50 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
9,116 |
8,938 |
$372.57 |
| 96127 |
|
9,501 |
9,374 |
$361.70 |
| 94618 |
|
13 |
13 |
$349.63 |
| 82565 |
|
107 |
104 |
$344.62 |
| 82247 |
|
140 |
105 |
$333.45 |
| 90681 |
|
17 |
17 |
$303.45 |
| 73590 |
|
454 |
430 |
$292.26 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
3,397 |
3,309 |
$280.85 |
| 80164 |
|
59 |
54 |
$276.35 |
| 82670 |
|
14 |
13 |
$251.46 |
| G0008 |
Administration of influenza virus vaccine |
107 |
107 |
$246.93 |
| 71101 |
|
262 |
254 |
$225.68 |
| 77085 |
|
19 |
15 |
$224.71 |
| 96376 |
|
3,669 |
2,867 |
$200.40 |
| 72070 |
|
110 |
105 |
$194.91 |
| 86708 |
|
25 |
25 |
$190.46 |
| 84520 |
|
65 |
63 |
$186.31 |
| 82150 |
|
90 |
84 |
$170.23 |
| 86336 |
|
26 |
26 |
$166.91 |
| 86735 |
|
47 |
39 |
$161.64 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
220 |
218 |
$156.60 |
| 73080 |
|
330 |
319 |
$155.21 |
| J2704 |
Injection, propofol, 10 mg |
5,239 |
5,186 |
$150.81 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
7,386 |
7,119 |
$135.76 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
14,651 |
13,242 |
$135.70 |
| 73140 |
|
539 |
531 |
$134.33 |
| 87807 |
|
644 |
631 |
$129.69 |
| 73090 |
|
343 |
327 |
$128.18 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
723 |
712 |
$124.20 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
859 |
808 |
$123.37 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
3,735 |
3,670 |
$118.09 |
| 72040 |
|
74 |
72 |
$115.72 |
| 80320 |
|
2,712 |
2,576 |
$112.73 |
| 85014 |
|
128 |
122 |
$111.02 |
| 73620 |
|
30 |
25 |
$109.36 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
322 |
206 |
$88.45 |
| 82140 |
|
58 |
52 |
$87.42 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
3,034 |
2,683 |
$83.36 |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
1,659 |
1,000 |
$81.40 |
| 70360 |
|
26 |
26 |
$80.23 |
| 90461 |
|
1,805 |
1,717 |
$79.22 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
1,941 |
1,830 |
$78.15 |
| 84460 |
|
29 |
27 |
$75.45 |
| 82951 |
|
12 |
12 |
$70.57 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
5,183 |
4,447 |
$66.79 |
| G0103 |
Prostate cancer screening; prostate specific antigen test (psa) |
63 |
63 |
$64.88 |
| 86617 |
|
26 |
14 |
$61.96 |
| 85007 |
|
247 |
224 |
$61.49 |
| 87147 |
|
287 |
262 |
$56.76 |
| 73120 |
|
14 |
13 |
$56.00 |
| 72170 |
|
18 |
12 |
$52.47 |
| 87808 |
|
517 |
502 |
$41.91 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
4,085 |
3,693 |
$41.37 |
| J3370 |
Injection, vancomycin hcl, 500 mg |
211 |
186 |
$36.42 |
| 88302 |
|
78 |
78 |
$35.77 |
| J1644 |
Injection, heparin sodium, per 1000 units |
690 |
530 |
$30.00 |
| 84479 |
|
12 |
12 |
$26.40 |
| 84165 |
|
16 |
12 |
$26.15 |
| J2550 |
Injection, promethazine hcl, up to 50 mg |
1,136 |
978 |
$21.83 |
| C9113 |
Injection, pantoprazole sodium, per vial |
1,551 |
1,204 |
$21.52 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
4,777 |
4,697 |
$18.92 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
3,298 |
3,105 |
$17.31 |
| 88300 |
|
191 |
190 |
$16.78 |
| 87210 |
|
225 |
207 |
$15.06 |
| 71100 |
|
25 |
25 |
$15.00 |
| J2060 |
Injection, lorazepam, 2 mg |
2,229 |
1,967 |
$14.49 |
| 86308 |
|
97 |
95 |
$13.09 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
4,770 |
4,667 |
$12.42 |
| 84132 |
|
12 |
12 |
$12.37 |
| 82962 |
|
45 |
41 |
$9.16 |
| 81002 |
|
133 |
125 |
$8.77 |
| 82010 |
|
504 |
472 |
$8.49 |
| J1630 |
Injection, haloperidol, up to 5 mg |
1,398 |
1,178 |
$8.42 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
1,290 |
1,172 |
$8.15 |
| J0171 |
Injection, adrenalin, epinephrine, 0.1 mg |
29 |
29 |
$6.74 |
| 87015 |
|
12 |
12 |
$6.50 |
| 87207 |
|
53 |
53 |
$5.99 |
| 84155 |
|
16 |
12 |
$4.40 |
| J1642 |
Injection, heparin sodium, (heparin lock flush), per 10 units |
69 |
37 |
$1.00 |
| A9270 |
Non-covered item or service |
955 |
627 |
$0.14 |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
58 |
54 |
$0.00 |
| J2919 |
Injection, methylprednisolone sodium succinate, 5 mg |
169 |
126 |
$0.00 |
| J1953 |
Injection, levetiracetam, 10 mg |
40 |
30 |
$0.00 |
| 94664 |
|
28 |
26 |
$0.00 |
| A7002 |
Tubing, used with suction pump, each |
16 |
16 |
$0.00 |
| S0028 |
Injection, famotidine, 20 mg |
31 |
30 |
$0.00 |
| 82075 |
|
243 |
207 |
$0.00 |
| J1171 |
Injection, hydromorphone, 0.1 mg |
54 |
45 |
$0.00 |
| C1769 |
Guide wire |
37 |
36 |
$0.00 |
| J0330 |
Injection, succinylcholine chloride, up to 20 mg |
102 |
102 |
$0.00 |
| J2543 |
Injection, piperacillin sodium/tazobactam sodium, 1 gram/0.125 grams (1.125 grams) |
124 |
74 |
$0.00 |
| J3480 |
Injection, potassium chloride, per 2 meq |
31 |
25 |
$0.00 |
| 1036F |
|
127 |
125 |
$0.00 |
| 88341 |
|
13 |
13 |
$0.00 |
| J2470 |
Injection, pantoprazole sodium, 40 mg |
116 |
85 |
$0.00 |
| J0360 |
Injection, hydralazine hcl, up to 20 mg |
13 |
12 |
$0.00 |
| G0379 |
Direct admission of patient for hospital observation care |
39 |
38 |
$0.00 |
| J3360 |
Injection, diazepam, up to 5 mg |
25 |
25 |
$0.00 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
14 |
14 |
$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 |
12 |
12 |
$0.00 |