| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
Emergency department visit for the evaluation and management, high severity |
16,593 |
15,678 |
$3.70M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
19,742 |
18,873 |
$2.94M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
5,580 |
5,187 |
$1.63M |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
7,877 |
7,246 |
$923K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
44,701 |
42,170 |
$548K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
6,302 |
5,782 |
$381K |
| 69436 |
Tympanostomy (requiring insertion of ventilating tube), general anesthesia |
356 |
341 |
$290K |
| 0202U |
Oncology (prostate), multianalyte, gene expression profiling |
624 |
611 |
$204K |
| 87428 |
|
5,649 |
5,522 |
$195K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
4,446 |
4,108 |
$176K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
415 |
405 |
$143K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
10,040 |
9,766 |
$142K |
| 71046 |
Radiologic examination, chest; 2 views |
2,740 |
2,581 |
$128K |
| 43249 |
|
112 |
107 |
$109K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
3,084 |
2,962 |
$87K |
| 94060 |
|
416 |
405 |
$77K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
26,410 |
23,869 |
$60K |
| 42820 |
Tonsillectomy and adenoidectomy; younger than age 12 |
13 |
13 |
$58K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
580 |
542 |
$47K |
| 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 |
648 |
604 |
$42K |
| 71045 |
Radiologic examination, chest; single view |
726 |
683 |
$35K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
402 |
383 |
$35K |
| 80053 |
Comprehensive metabolic panel |
20,425 |
18,418 |
$33K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
313 |
257 |
$32K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
231 |
106 |
$29K |
| G0379 |
Direct admission of patient for hospital observation care |
12 |
12 |
$25K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
3,435 |
3,289 |
$23K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
509 |
500 |
$22K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
609 |
591 |
$19K |
| 62323 |
|
44 |
41 |
$16K |
| 36415 |
Collection of venous blood by venipuncture |
7,508 |
6,450 |
$16K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
609 |
591 |
$16K |
| 80061 |
Lipid panel |
1,105 |
1,073 |
$12K |
| 87070 |
|
1,508 |
1,402 |
$11K |
| 84443 |
Thyroid stimulating hormone (TSH) |
1,204 |
1,139 |
$10K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
12 |
12 |
$10K |
| 83655 |
|
825 |
811 |
$9K |
| 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 |
414 |
385 |
$9K |
| 70450 |
Computed tomography, head or brain; without contrast material |
52 |
49 |
$9K |
| 80050 |
General health panel |
169 |
166 |
$7K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
66 |
64 |
$7K |
| 87807 |
|
599 |
582 |
$7K |
| 43235 |
|
14 |
13 |
$6K |
| 86900 |
|
64 |
56 |
$6K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
4,520 |
4,241 |
$6K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
12 |
12 |
$4K |
| 45378 |
Colonoscopy, flexible; diagnostic, including collection of specimen(s) |
13 |
12 |
$4K |
| 87081 |
|
784 |
740 |
$4K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
3,812 |
3,611 |
$4K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
28 |
26 |
$3K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
2,058 |
1,894 |
$3K |
| 81001 |
|
6,176 |
5,711 |
$3K |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
1,871 |
1,386 |
$3K |
| 83721 |
|
442 |
428 |
$3K |
| 86780 |
|
283 |
268 |
$3K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
4,739 |
4,175 |
$3K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
85 |
25 |
$2K |
| 85027 |
|
747 |
709 |
$2K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
627 |
593 |
$2K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
733 |
685 |
$2K |
| 97597 |
|
25 |
15 |
$2K |
| S9455 |
Diabetic management program, group session |
14 |
12 |
$2K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
266 |
251 |
$2K |
| J2175 |
Injection, meperidine hydrochloride, per 100 mg |
1,300 |
1,131 |
$2K |
| 59025 |
Fetal non-stress test |
13 |
12 |
$2K |
| 36591 |
|
31 |
25 |
$1K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
812 |
644 |
$1K |
| J7042 |
5% dextrose/normal saline (500 ml = 1 unit) |
1,315 |
1,260 |
$1K |
| 81003 |
|
1,559 |
1,462 |
$1K |
| 84439 |
|
140 |
137 |
$990.36 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
361 |
341 |
$981.07 |
| 85018 |
|
289 |
287 |
$624.99 |
| 86803 |
|
61 |
54 |
$542.40 |
| 86762 |
|
60 |
53 |
$534.57 |
| 86787 |
|
63 |
55 |
$503.14 |
| 86703 |
|
59 |
52 |
$494.76 |
| 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 |
541 |
484 |
$488.92 |
| 81002 |
|
177 |
172 |
$486.74 |
| 84703 |
|
326 |
302 |
$454.89 |
| 82947 |
|
173 |
162 |
$444.19 |
| 87653 |
|
16 |
15 |
$433.42 |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
211 |
198 |
$421.96 |
| 87340 |
|
60 |
53 |
$382.59 |
| 84460 |
|
87 |
87 |
$367.30 |
| J2704 |
Injection, propofol, 10 mg |
106 |
103 |
$328.53 |
| 84702 |
|
24 |
19 |
$302.55 |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
14 |
13 |
$256.84 |
| 81025 |
|
387 |
371 |
$222.26 |
| 87660 |
|
12 |
12 |
$212.36 |
| 87510 |
|
12 |
12 |
$212.36 |
| 87480 |
|
12 |
12 |
$209.55 |
| 86850 |
|
101 |
93 |
$180.81 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
256 |
241 |
$158.16 |
| 82950 |
|
28 |
26 |
$141.88 |
| 82550 |
|
130 |
103 |
$131.08 |
| 85004 |
|
17 |
16 |
$128.86 |
| 84484 |
|
1,546 |
1,269 |
$96.63 |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
122 |
99 |
$94.46 |
| 87077 |
|
13 |
13 |
$92.16 |
| 86704 |
|
13 |
13 |
$91.60 |
| 80306 |
|
1,737 |
1,594 |
$83.12 |
| A0427 |
Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) |
19 |
15 |
$82.24 |
| 86706 |
|
13 |
13 |
$81.60 |
| 83550 |
|
12 |
12 |
$66.40 |
| 83735 |
|
588 |
547 |
$64.03 |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
124 |
102 |
$63.85 |
| 87147 |
|
14 |
13 |
$59.04 |
| G0500 |
Moderate sedation services provided by the same physician or other qualified health care professional performing a gastrointestinal endoscopic service that sedation supports, requiring the presence of an independent trained observer to assist in the monitoring of the patient's level of consciousness and physiological status; initial 15 minutes of intra-service time; patient age 5 years or older (additional time may be reported with 99153, as appropriate) |
1,398 |
1,343 |
$57.23 |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
877 |
562 |
$53.49 |
| 83540 |
|
12 |
12 |
$49.20 |
| J2060 |
Injection, lorazepam, 2 mg |
114 |
103 |
$38.44 |
| 82077 |
|
878 |
755 |
$28.55 |
| A0425 |
Ground mileage, per statute mile |
94 |
65 |
$24.58 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
127 |
111 |
$22.53 |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
15 |
14 |
$18.31 |
| 80143 |
|
62 |
55 |
$15.84 |
| 80179 |
|
60 |
54 |
$15.84 |
| 99153 |
Mod sedat endo service >5yrs |
455 |
440 |
$14.49 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
12 |
12 |
$6.76 |
| 83690 |
|
1,274 |
1,183 |
$6.55 |
| C1729 |
Catheter, drainage |
72 |
69 |
$0.00 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
107 |
101 |
$0.00 |
| 94726 |
|
276 |
269 |
$0.00 |
| 87633 |
Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets |
60 |
56 |
$0.00 |
| 94729 |
|
292 |
285 |
$0.00 |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
60 |
56 |
$0.00 |
| 80076 |
|
19 |
17 |
$0.00 |
| 84145 |
|
28 |
28 |
$0.00 |
| 74019 |
|
43 |
38 |
$0.00 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
161 |
153 |
$0.00 |
| 86901 |
|
64 |
56 |
$0.00 |
| 88304 |
|
134 |
119 |
$0.00 |
| A9585 |
Injection, gadobutrol, 0.1 ml |
38 |
38 |
$0.00 |
| 82962 |
|
60 |
40 |
$0.00 |
| 0064U |
|
35 |
29 |
$0.00 |
| 0352U |
|
111 |
106 |
$0.00 |
| 86140 |
|
474 |
448 |
$0.00 |
| 82150 |
|
81 |
75 |
$0.00 |
| 87581 |
|
60 |
56 |
$0.00 |
| 83605 |
|
293 |
272 |
$0.00 |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
13 |
13 |
$0.00 |
| 87486 |
|
60 |
56 |
$0.00 |
| 85379 |
|
27 |
25 |
$0.00 |
| A9270 |
Non-covered item or service |
14 |
14 |
$0.00 |
| 83615 |
|
12 |
12 |
$0.00 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
14 |
12 |
$0.00 |
| G0378 |
Hospital observation service, per hour |
15 |
13 |
$0.00 |