| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| H0005 |
Alcohol and/or drug services; group counseling by a clinician |
37,048 |
7,224 |
$2.65M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
14,705 |
13,831 |
$1.78M |
| G0378 |
Hospital observation service, per hour |
7,986 |
4,764 |
$1.69M |
| 96361 |
Intravenous infusion, hydration; each additional hour |
8,582 |
7,228 |
$1.66M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
15,856 |
12,677 |
$1.53M |
| G0396 |
Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and brief intervention 15 to 30 minutes |
12,894 |
7,936 |
$1.39M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
9,549 |
8,980 |
$1.27M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
12,541 |
11,418 |
$1.14M |
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
12,796 |
2,513 |
$1.13M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
10,258 |
9,718 |
$1.11M |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
4,710 |
4,616 |
$1.11M |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
10,856 |
8,221 |
$844K |
| 70450 |
Computed tomography, head or brain; without contrast material |
3,272 |
3,196 |
$818K |
| 80053 |
Comprehensive metabolic panel |
45,356 |
39,114 |
$813K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
2,976 |
2,961 |
$728K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
1,639 |
1,614 |
$573K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
1,964 |
1,938 |
$533K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
17,264 |
12,150 |
$521K |
| Q9992 |
Injection, buprenorphine extended-release (sublocade), greater than 100 mg |
266 |
258 |
$447K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
3,300 |
3,086 |
$439K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
3,821 |
3,080 |
$438K |
| 36415 |
Collection of venous blood by venipuncture |
62,740 |
50,275 |
$422K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
4,288 |
4,286 |
$382K |
| 95810 |
Polysomnography; sleep staging with 4 or more additional parameters |
616 |
607 |
$381K |
| H0002 |
Behavioral health screening to determine eligibility for admission to treatment program |
2,250 |
1,952 |
$368K |
| T1023 |
Screening to determine the appropriateness of consideration of an individual for participation in a specified program, project or treatment protocol, per encounter |
6,559 |
2,499 |
$358K |
| G0397 |
Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and intervention, greater than 30 minutes |
2,513 |
1,834 |
$331K |
| S9480 |
Intensive outpatient psychiatric services, per diem |
2,645 |
393 |
$311K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
2,172 |
1,971 |
$295K |
| 93975 |
|
954 |
936 |
$276K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
2,275 |
2,117 |
$266K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
1,042 |
1,027 |
$253K |
| Q9991 |
Injection, buprenorphine extended-release (sublocade), less than or equal to 100 mg |
143 |
137 |
$236K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
2,322 |
2,061 |
$231K |
| H0001 |
Alcohol and/or drug assessment |
1,451 |
1,197 |
$207K |
| 93970 |
|
506 |
493 |
$203K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
369 |
369 |
$194K |
| H0014 |
Alcohol and/or drug services; ambulatory detoxification |
1,386 |
743 |
$191K |
| 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 |
2,501 |
2,452 |
$175K |
| C1776 |
Joint device (implantable) |
163 |
162 |
$165K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
4,712 |
4,673 |
$165K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
2,045 |
1,791 |
$162K |
| 59025 |
Fetal non-stress test |
1,884 |
1,588 |
$160K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
6,181 |
4,993 |
$159K |
| H0033 |
Oral medication administration, direct observation |
4,397 |
987 |
$155K |
| 86900 |
|
4,430 |
4,284 |
$149K |
| 99205 |
Prolong outpt/office vis |
1,371 |
400 |
$149K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
4,893 |
4,816 |
$146K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
1,752 |
1,014 |
$143K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,726 |
1,703 |
$143K |
| 0223U |
|
614 |
573 |
$140K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
3,966 |
3,691 |
$138K |
| H0050 |
Alcohol and/or drug services, brief intervention, per 15 minutes |
1,525 |
1,213 |
$133K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
4,749 |
4,730 |
$129K |
| 93017 |
|
1,330 |
1,317 |
$128K |
| 76641 |
|
2,653 |
2,645 |
$118K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
1,060 |
983 |
$112K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,249 |
1,244 |
$111K |
| H2036 |
Alcohol and/or other drug treatment program, per diem |
938 |
90 |
$110K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
4,881 |
4,807 |
$109K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
1,262 |
929 |
$107K |
| 84443 |
Thyroid stimulating hormone (TSH) |
10,398 |
10,129 |
$103K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
1,775 |
1,743 |
$96K |
| 88342 |
|
1,460 |
1,448 |
$95K |
| 80061 |
Lipid panel |
9,528 |
9,464 |
$94K |
| 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 |
2,600 |
1,994 |
$94K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
10,835 |
9,979 |
$90K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
207 |
203 |
$89K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
1,899 |
1,868 |
$88K |
| 76801 |
|
934 |
870 |
$88K |
| 86850 |
|
4,971 |
4,817 |
$88K |
| C1713 |
Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) |
322 |
320 |
$86K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
1,475 |
1,275 |
$82K |
| G0379 |
Direct admission of patient for hospital observation care |
946 |
887 |
$80K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
480 |
477 |
$80K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
195 |
195 |
$80K |
| H0004 |
Behavioral health counseling and therapy, per 15 minutes |
1,278 |
1,001 |
$78K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
42,869 |
36,365 |
$77K |
| 78815 |
Positron emission tomography (PET) for limited area imaging |
99 |
97 |
$76K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
4,802 |
4,087 |
$73K |
| C9803 |
Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
9,056 |
8,605 |
$72K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
7,708 |
7,450 |
$68K |
| 86901 |
|
4,922 |
4,767 |
$65K |
| 87637 |
Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV |
657 |
644 |
$62K |
| 70496 |
|
258 |
256 |
$61K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
695 |
687 |
$60K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
8,295 |
8,214 |
$60K |
| 47562 |
|
25 |
25 |
$59K |
| 93971 |
|
892 |
867 |
$58K |
| H2001 |
Rehabilitation program, per 1/2 day |
598 |
137 |
$58K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
4,272 |
4,270 |
$57K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
1,367 |
1,345 |
$56K |
| 81220 |
CFTR (cystic fibrosis transmembrane conductance regulator) gene analysis; common variants |
173 |
173 |
$55K |
| 99215 |
Prolong outpt/office vis |
617 |
510 |
$55K |
| 76830 |
Ultrasound, transvaginal |
1,436 |
1,412 |
$52K |
| 96367 |
|
677 |
384 |
$52K |
| 77065 |
Tomosynthesis, mammo |
550 |
511 |
$50K |
| 83880 |
|
1,953 |
1,845 |
$50K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
522 |
516 |
$48K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
1,486 |
1,470 |
$47K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
1,187 |
1,162 |
$46K |
| 71046 |
Radiologic examination, chest; 2 views |
5,914 |
5,735 |
$45K |
| 97161 |
|
505 |
501 |
$44K |
| 77066 |
Tomosynthesis, mammo |
459 |
455 |
$43K |
| 95806 |
|
774 |
729 |
$43K |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
1,228 |
1,192 |
$41K |
| 88307 |
|
551 |
544 |
$39K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
274 |
227 |
$36K |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
1,127 |
1,120 |
$34K |
| 86780 |
|
3,275 |
3,229 |
$34K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
2,471 |
2,455 |
$34K |
| 88142 |
|
1,560 |
1,554 |
$33K |
| 81001 |
|
12,445 |
11,764 |
$33K |
| 84439 |
|
5,019 |
4,920 |
$33K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
1,427 |
526 |
$32K |
| U0001 |
Cdc 2019 novel coronavirus (2019-ncov) real-time rt-pcr diagnostic panel |
1,014 |
980 |
$32K |
| 90686 |
|
1,970 |
1,965 |
$32K |
| H0038 |
Self-help/peer services, per 15 minutes |
323 |
213 |
$30K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
183 |
179 |
$28K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
691 |
656 |
$28K |
| 87480 |
|
1,883 |
1,852 |
$27K |
| 97165 |
|
386 |
384 |
$24K |
| 99385 |
|
252 |
250 |
$24K |
| 88304 |
|
746 |
738 |
$23K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
751 |
742 |
$23K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
8,415 |
6,977 |
$22K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
4,404 |
4,246 |
$22K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
251 |
247 |
$21K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
481 |
474 |
$21K |
| 86803 |
|
2,531 |
2,509 |
$20K |
| 88112 |
|
377 |
373 |
$20K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
13,539 |
11,836 |
$19K |
| 82607 |
|
1,904 |
1,874 |
$19K |
| 90715 |
|
831 |
828 |
$18K |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
2,930 |
2,635 |
$18K |
| 93458 |
|
12 |
12 |
$18K |
| 90670 |
|
1,020 |
1,018 |
$17K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
776 |
439 |
$17K |
| 82728 |
|
1,915 |
1,859 |
$17K |
| 87660 |
|
2,026 |
1,993 |
$15K |
| 85027 |
|
6,245 |
5,524 |
$15K |
| Q3014 |
Telehealth originating site facility fee |
600 |
558 |
$15K |
| 83655 |
|
1,357 |
1,337 |
$15K |
| 90698 |
|
894 |
893 |
$14K |
| 76937 |
|
93 |
92 |
$14K |
| 99460 |
|
226 |
226 |
$13K |
| D0140 |
Limited oral evaluation - problem focused |
400 |
197 |
$13K |
| D1110 |
Prophylaxis - adult |
332 |
127 |
$13K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,890 |
1,869 |
$13K |
| 71250 |
|
122 |
120 |
$13K |
| 81002 |
|
1,501 |
1,314 |
$13K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
155 |
155 |
$12K |
| 87510 |
|
1,831 |
1,800 |
$12K |
| 81329 |
|
94 |
93 |
$12K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
267 |
146 |
$11K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
105 |
105 |
$11K |
| 87340 |
|
1,630 |
1,612 |
$10K |
| 72197 |
|
27 |
27 |
$10K |
| G0475 |
Hiv antigen/antibody, combination assay, screening |
722 |
717 |
$10K |
| 83550 |
|
1,987 |
1,936 |
$10K |
| 84702 |
|
2,064 |
1,800 |
$9K |
| 90680 |
|
560 |
559 |
$9K |
| D7140 |
Extraction, erupted tooth or exposed root |
159 |
71 |
$9K |
| 85610 |
|
3,348 |
2,692 |
$9K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
66 |
66 |
$9K |
| 90651 |
|
330 |
330 |
$9K |
| 83540 |
|
2,084 |
2,009 |
$9K |
| 90633 |
|
608 |
606 |
$9K |
| 99406 |
|
679 |
640 |
$8K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
120 |
105 |
$8K |
| 97116 |
|
323 |
206 |
$8K |
| C1781 |
Mesh (implantable) |
41 |
41 |
$8K |
| 45378 |
Colonoscopy, flexible; diagnostic, including collection of specimen(s) |
12 |
12 |
$8K |
| 81025 |
|
2,108 |
2,057 |
$8K |
| 99222 |
Initial hospital care, per day, moderate complexity |
109 |
108 |
$8K |
| 71045 |
Radiologic examination, chest; single view |
6,356 |
6,039 |
$8K |
| 87653 |
|
293 |
290 |
$8K |
| 83735 |
|
6,283 |
5,171 |
$7K |
| G0279 |
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) |
211 |
210 |
$7K |
| 82746 |
|
815 |
809 |
$7K |
| 90882 |
|
109 |
89 |
$7K |
| 70491 |
|
26 |
26 |
$7K |
| 90744 |
|
429 |
426 |
$7K |
| 77336 |
|
122 |
54 |
$7K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
12 |
12 |
$7K |
| 81003 |
|
2,037 |
1,981 |
$7K |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
5,207 |
4,749 |
$7K |
| 86762 |
|
887 |
880 |
$7K |
| 84153 |
|
406 |
401 |
$6K |
| 82043 |
|
1,350 |
1,336 |
$6K |
| 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 |
1,564 |
1,205 |
$6K |
| M0243 |
Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring |
35 |
34 |
$6K |
| 87150 |
|
149 |
147 |
$6K |
| 96127 |
|
2,556 |
2,384 |
$6K |
| 82570 |
|
1,554 |
1,471 |
$6K |
| 76813 |
|
102 |
101 |
$6K |
| 87077 |
|
1,410 |
1,372 |
$5K |
| J3490 |
Unclassified drugs |
421 |
366 |
$5K |
| G0103 |
Prostate cancer screening; prostate specific antigen test (psa) |
350 |
333 |
$5K |
| 81420 |
Fetal chromosomal aneuploidy genomic sequence analysis panel |
13 |
12 |
$5K |
| 86618 |
|
557 |
432 |
$5K |
| 0002A |
|
179 |
179 |
$5K |
| 82962 |
|
1,070 |
826 |
$4K |
| 77080 |
|
51 |
51 |
$4K |
| G2023 |
Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
157 |
153 |
$4K |
| 86235 |
|
58 |
57 |
$4K |
| 86920 |
|
153 |
137 |
$4K |
| 88341 |
|
124 |
121 |
$4K |
| 99442 |
|
74 |
67 |
$4K |
| 84481 |
|
352 |
339 |
$4K |
| 82105 |
|
362 |
357 |
$4K |
| 86665 |
|
316 |
315 |
$4K |
| 86617 |
|
191 |
158 |
$4K |
| 80047 |
|
202 |
198 |
$4K |
| 93225 |
|
52 |
52 |
$3K |
| 85018 |
|
1,109 |
970 |
$3K |
| 87186 |
|
1,073 |
1,046 |
$3K |
| 93356 |
|
444 |
442 |
$3K |
| 72100 |
|
279 |
277 |
$3K |
| 76818 |
|
31 |
14 |
$3K |
| 86140 |
|
1,736 |
1,614 |
$3K |
| 70486 |
|
76 |
75 |
$3K |
| 97535 |
Self-care/home management training, each 15 minutes |
433 |
322 |
$3K |
| A9575 |
Injection, gadoterate meglumine, 0.1 ml |
1,631 |
1,592 |
$3K |
| 70498 |
|
188 |
187 |
$3K |
| 0001A |
|
158 |
158 |
$3K |
| 90734 |
|
146 |
146 |
$3K |
| 83690 |
|
7,212 |
6,698 |
$3K |
| 77062 |
|
25 |
25 |
$3K |
| 76775 |
|
31 |
30 |
$2K |
| 77061 |
|
30 |
30 |
$2K |
| 85730 |
|
2,186 |
2,074 |
$2K |
| 87088 |
|
564 |
552 |
$2K |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
71 |
55 |
$2K |
| 84403 |
|
98 |
97 |
$2K |
| 86038 |
|
299 |
297 |
$2K |
| 86706 |
|
281 |
277 |
$2K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
12 |
12 |
$2K |
| 83021 |
|
181 |
181 |
$2K |
| 74246 |
|
29 |
29 |
$2K |
| 84484 |
|
9,524 |
7,591 |
$2K |
| 86769 |
|
49 |
49 |
$2K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
9,625 |
8,418 |
$2K |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
62 |
62 |
$2K |
| 92551 |
|
27 |
27 |
$2K |
| 85652 |
|
1,798 |
1,715 |
$2K |
| 86787 |
|
453 |
450 |
$2K |
| 82950 |
|
450 |
446 |
$2K |
| 76770 |
|
13 |
13 |
$2K |
| C1769 |
Guide wire |
903 |
869 |
$2K |
| 87633 |
Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets |
29 |
29 |
$2K |
| 82947 |
|
2,165 |
1,569 |
$2K |
| 80076 |
|
180 |
176 |
$2K |
| A4648 |
Tissue marker, implantable, any type, each |
49 |
49 |
$2K |
| 88312 |
|
114 |
114 |
$2K |
| 99386 |
|
13 |
13 |
$1K |
| 90674 |
|
71 |
71 |
$1K |
| 0012A |
|
44 |
44 |
$1K |
| 99201 |
|
14 |
12 |
$1K |
| 99462 |
|
57 |
57 |
$1K |
| 97162 |
|
13 |
13 |
$1K |
| 90710 |
|
88 |
88 |
$1K |
| 84703 |
|
6,612 |
6,338 |
$1K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
4,763 |
4,541 |
$1K |
| 84550 |
|
448 |
426 |
$1K |
| 90716 |
|
93 |
93 |
$1K |
| D0120 |
Periodic oral evaluation - established patient |
29 |
12 |
$1K |
| 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 |
$1K |
| 99231 |
Subsequent hospital care, per day, straightforward or low complexity |
95 |
70 |
$1K |
| 82652 |
|
40 |
40 |
$1K |
| J7050 |
Infusion, normal saline solution, 250 cc |
1,800 |
1,173 |
$1K |
| 90696 |
|
80 |
80 |
$1K |
| 82248 |
|
332 |
306 |
$1K |
| 90648 |
|
72 |
71 |
$1K |
| A9552 |
Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries |
65 |
65 |
$1K |
| J0574 |
Buprenorphine/naloxone, oral, greater than 6 mg, but less than or equal to 10 mg buprenorphine |
899 |
279 |
$1K |
| 87428 |
|
51 |
51 |
$1K |
| 87522 |
Neg quan hep c or qual rna |
39 |
38 |
$1K |
| G0472 |
Hepatitis c antibody screening, for individual at high risk and other covered indication(s) |
42 |
41 |
$1K |
| 90707 |
|
87 |
87 |
$1K |
| 83615 |
|
428 |
376 |
$1K |
| 84100 |
|
1,360 |
1,191 |
$980.29 |
| 76536 |
|
12 |
12 |
$962.43 |
| 74220 |
|
14 |
14 |
$959.87 |
| 84146 |
|
55 |
55 |
$953.98 |
| 90723 |
|
56 |
55 |
$946.05 |
| 87581 |
|
29 |
29 |
$930.08 |
| 85379 |
|
1,798 |
1,759 |
$924.45 |
| 87040 |
|
2,661 |
1,864 |
$850.53 |
| 82550 |
|
528 |
490 |
$847.27 |
| 83001 |
|
49 |
49 |
$842.54 |
| J7030 |
Infusion, normal saline solution , 1000 cc |
8,236 |
6,786 |
$793.19 |
| 82805 |
|
218 |
199 |
$791.00 |
| 87070 |
|
386 |
360 |
$770.03 |
| 73030 |
|
174 |
171 |
$748.10 |
| 86431 |
|
128 |
127 |
$736.35 |
| 74174 |
|
32 |
31 |
$717.67 |
| 96376 |
|
3,559 |
2,188 |
$711.07 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
5,318 |
4,662 |
$676.92 |
| 0054A |
|
23 |
23 |
$633.32 |
| 87563 |
|
28 |
28 |
$621.58 |
| A9500 |
Technetium tc-99m sestamibi, diagnostic, per study dose |
317 |
306 |
$616.59 |
| 83970 |
|
15 |
13 |
$612.58 |
| 92570 |
|
27 |
27 |
$593.82 |
| 80321 |
|
1,004 |
636 |
$566.32 |
| 76819 |
Fetal biophysical profile; without non-stress testing |
13 |
13 |
$559.92 |
| 83605 |
|
3,008 |
2,694 |
$557.25 |
| 86765 |
|
81 |
81 |
$556.22 |
| 0071A |
|
25 |
25 |
$554.10 |
| 73630 |
|
258 |
241 |
$503.72 |
| J2785 |
Injection, regadenoson, 0.1 mg |
13 |
13 |
$491.84 |
| 86225 |
|
44 |
44 |
$477.30 |
| 0064A |
|
15 |
15 |
$464.48 |
| C1894 |
Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser |
635 |
617 |
$463.63 |
| 90619 |
|
30 |
30 |
$434.95 |
| 99407 |
|
12 |
12 |
$429.72 |
| 90681 |
|
24 |
24 |
$428.40 |
| 85007 |
|
471 |
393 |
$416.54 |
| 0011A |
|
21 |
21 |
$407.14 |
| 82150 |
|
158 |
152 |
$399.67 |
| J2704 |
Injection, propofol, 10 mg |
6,043 |
5,895 |
$370.05 |
| 0072A |
|
15 |
14 |
$366.20 |
| 84156 |
|
209 |
193 |
$355.53 |
| 0004A |
|
41 |
41 |
$333.37 |
| 0124A |
|
16 |
16 |
$329.58 |
| J1644 |
Injection, heparin sodium, per 1000 units |
1,004 |
793 |
$313.81 |
| 82247 |
|
108 |
105 |
$312.09 |
| 90732 |
|
12 |
12 |
$308.50 |
| J2469 |
Injection, palonosetron hcl, 25 mcg |
23 |
12 |
$298.87 |
| 87625 |
|
15 |
15 |
$276.96 |
| 88106 |
|
28 |
27 |
$267.91 |
| 86709 |
|
36 |
35 |
$264.48 |
| 72110 |
|
28 |
28 |
$256.16 |
| 96417 |
|
21 |
12 |
$253.93 |
| 84075 |
|
90 |
89 |
$253.82 |
| 84460 |
|
101 |
99 |
$253.44 |
| 86696 |
|
15 |
15 |
$248.70 |
| 73130 |
|
152 |
148 |
$245.70 |
| 80346 |
|
48 |
39 |
$245.45 |
| 84450 |
|
87 |
86 |
$233.10 |
| 83002 |
|
12 |
12 |
$228.22 |
| 76642 |
|
13 |
13 |
$226.52 |
| 83520 |
|
13 |
13 |
$218.98 |
| 82565 |
|
142 |
141 |
$216.98 |
| 82040 |
|
72 |
71 |
$216.29 |
| 86039 |
|
25 |
25 |
$211.16 |
| 73610 |
|
208 |
204 |
$201.79 |
| 90700 |
|
12 |
12 |
$196.35 |
| 80074 |
|
14 |
12 |
$195.05 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
3,115 |
2,810 |
$192.11 |
| 80320 |
|
876 |
786 |
$182.92 |
| 83020 |
|
46 |
46 |
$170.82 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
1,772 |
1,504 |
$166.34 |
| 90620 |
|
12 |
12 |
$160.65 |
| 80178 |
|
28 |
28 |
$156.16 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
2,425 |
1,883 |
$150.81 |
| 80362 |
|
30 |
17 |
$150.00 |
| J2543 |
Injection, piperacillin sodium/tazobactam sodium, 1 gram/0.125 grams (1.125 grams) |
144 |
84 |
$145.47 |
| 73564 |
|
129 |
122 |
$112.20 |
| 84155 |
|
44 |
43 |
$106.98 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
756 |
530 |
$105.16 |
| J0330 |
Injection, succinylcholine chloride, up to 20 mg |
1,454 |
1,441 |
$99.02 |
| 86430 |
|
19 |
19 |
$98.83 |
| 80359 |
|
18 |
14 |
$90.30 |
| 80324 |
|
18 |
14 |
$90.30 |
| 81015 |
|
42 |
41 |
$81.26 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
3,087 |
2,683 |
$77.10 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
1,810 |
1,606 |
$72.82 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
6,466 |
6,208 |
$59.44 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
5,481 |
4,940 |
$55.42 |
| 87147 |
|
12 |
12 |
$51.80 |
| 73502 |
|
25 |
24 |
$50.62 |
| 84132 |
|
222 |
211 |
$50.33 |
| 87205 |
|
140 |
117 |
$45.54 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
1,128 |
1,028 |
$40.51 |
| 86308 |
|
51 |
51 |
$38.25 |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
99 |
86 |
$36.57 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
26 |
26 |
$35.33 |
| J3370 |
Injection, vancomycin hcl, 500 mg |
258 |
205 |
$34.14 |
| J0575 |
Buprenorphine/naloxone, oral, greater than 10 mg buprenorphine |
36 |
12 |
$30.06 |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
1,421 |
830 |
$26.37 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
7,043 |
6,858 |
$25.51 |
| 84145 |
|
40 |
39 |
$25.48 |
| 72170 |
|
28 |
27 |
$25.00 |
| C9113 |
Injection, pantoprazole sodium, per vial |
66 |
51 |
$18.00 |
| 82310 |
|
13 |
13 |
$17.06 |
| J2060 |
Injection, lorazepam, 2 mg |
871 |
719 |
$12.19 |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
60 |
51 |
$11.68 |
| J2795 |
Injection, ropivacaine hydrochloride, 1 mg |
253 |
253 |
$11.52 |
| 87207 |
|
29 |
29 |
$10.18 |
| 85014 |
|
13 |
13 |
$4.06 |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
495 |
414 |
$3.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
130 |
127 |
$2.00 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
42 |
27 |
$1.80 |
| 94760 |
|
14 |
13 |
$1.54 |
| J1815 |
Injection, insulin, per 5 units |
386 |
213 |
$0.00 |
| 3074F |
|
334 |
332 |
$0.00 |
| A9270 |
Non-covered item or service |
6,199 |
4,186 |
$0.00 |
| S2900 |
Surgical techniques requiring use of robotic surgical system (list separately in addition to code for primary procedure) |
183 |
182 |
$0.00 |
| 81000 |
|
132 |
112 |
$0.00 |
| 76820 |
|
27 |
12 |
$0.00 |
| J2370 |
Injection, phenylephrine hcl, up to 1 ml |
190 |
190 |
$0.00 |
| 74019 |
|
12 |
12 |
$0.00 |
| 99000 |
|
29 |
29 |
$0.00 |
| 82803 |
|
34 |
34 |
$0.00 |
| 0352U |
|
88 |
85 |
$0.00 |
| 3078F |
|
133 |
132 |
$0.00 |
| J1596 |
Injection, glycopyrrolate, 0.1 mg |
241 |
240 |
$0.00 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
54 |
49 |
$0.00 |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
95 |
86 |
$0.00 |
| 90461 |
|
1,252 |
1,241 |
$0.00 |
| J1171 |
Injection, hydromorphone, 0.1 mg |
19 |
16 |
$0.00 |
| J0572 |
Buprenorphine/naloxone, oral, less than or equal to 3 mg buprenorphine |
59 |
26 |
$0.00 |
| A4312 |
Insertion tray without drainage bag with indwelling catheter, foley type, two-way, all silicone |
13 |
12 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
19 |
19 |
$0.00 |
| 91300 |
|
59 |
42 |
$0.00 |
| 88173 |
|
14 |
13 |
$0.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
45 |
42 |
$0.00 |
| 99173 |
|
14 |
14 |
$0.00 |
| J2550 |
Injection, promethazine hcl, up to 50 mg |
18 |
12 |
$0.00 |