| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
34,917 |
27,016 |
$5.94M |
| Y7506 |
|
33,842 |
28,948 |
$4.63M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
24,099 |
18,942 |
$3.56M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
24,404 |
18,487 |
$2.92M |
| X4011 |
State-specific procedure code |
12,018 |
11,344 |
$2.86M |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
36,818 |
33,263 |
$1.80M |
| 80053 |
Comprehensive metabolic panel |
32,522 |
30,080 |
$1.51M |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
5,228 |
5,026 |
$512K |
| 81001 |
|
7,443 |
7,105 |
$444K |
| 59025 |
Fetal non-stress test |
3,470 |
2,248 |
$364K |
| X4006 |
|
377 |
334 |
$248K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
2,862 |
2,692 |
$240K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
4,478 |
4,278 |
$235K |
| 71045 |
Radiologic examination, chest; single view |
4,091 |
3,905 |
$227K |
| X4003 |
|
1,686 |
964 |
$202K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
1,752 |
1,722 |
$157K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
3,330 |
2,846 |
$153K |
| 97597 |
|
1,990 |
1,357 |
$146K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
738 |
721 |
$129K |
| 84484 |
|
3,583 |
2,780 |
$112K |
| 83690 |
|
1,336 |
1,292 |
$108K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
317 |
296 |
$104K |
| 71046 |
Radiologic examination, chest; 2 views |
410 |
400 |
$85K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
378 |
316 |
$84K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
2,662 |
2,512 |
$83K |
| 85610 |
|
1,090 |
1,026 |
$81K |
| 84443 |
Thyroid stimulating hormone (TSH) |
2,864 |
2,719 |
$71K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
382 |
362 |
$60K |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
557 |
510 |
$51K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
727 |
708 |
$49K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
123 |
117 |
$43K |
| 85730 |
|
303 |
289 |
$39K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
440 |
428 |
$37K |
| 87081 |
|
503 |
499 |
$35K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
215 |
141 |
$33K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
124 |
101 |
$29K |
| 83880 |
|
688 |
647 |
$29K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
94 |
94 |
$26K |
| 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 |
942 |
886 |
$22K |
| 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 |
263 |
242 |
$20K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
245 |
236 |
$20K |
| 81003 |
|
587 |
568 |
$17K |
| 86140 |
|
282 |
276 |
$16K |
| 85652 |
|
237 |
231 |
$15K |
| 87631 |
|
46 |
44 |
$14K |
| 36591 |
|
227 |
163 |
$14K |
| 70450 |
Computed tomography, head or brain; without contrast material |
147 |
138 |
$14K |
| 82077 |
|
995 |
929 |
$14K |
| 84703 |
|
228 |
224 |
$12K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
148 |
142 |
$12K |
| 81025 |
|
113 |
112 |
$12K |
| 80076 |
|
174 |
169 |
$10K |
| 87807 |
|
26 |
25 |
$10K |
| 82565 |
|
147 |
143 |
$10K |
| 85027 |
|
41 |
39 |
$9K |
| 86235 |
|
62 |
62 |
$9K |
| 93017 |
|
61 |
61 |
$9K |
| G0378 |
Hospital observation service, per hour |
26 |
24 |
$8K |
| 83516 |
|
77 |
62 |
$8K |
| 0240U |
|
66 |
64 |
$8K |
| 82728 |
|
302 |
276 |
$8K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
77 |
77 |
$6K |
| 83615 |
|
329 |
295 |
$6K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
13 |
13 |
$6K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
47 |
41 |
$6K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
26 |
25 |
$5K |
| 84466 |
|
195 |
182 |
$5K |
| 86200 |
|
38 |
38 |
$4K |
| 86225 |
|
40 |
40 |
$4K |
| 87634 |
|
12 |
12 |
$4K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
39 |
37 |
$4K |
| 83540 |
|
195 |
182 |
$4K |
| 86431 |
|
37 |
37 |
$4K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
31 |
25 |
$4K |
| 36415 |
Collection of venous blood by venipuncture |
698 |
557 |
$4K |
| 96367 |
|
95 |
61 |
$3K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
105 |
80 |
$3K |
| 87801 |
Infectious agent detection by nucleic acid; amplified probe, multiple organisms |
16 |
12 |
$3K |
| 82746 |
|
121 |
109 |
$3K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
185 |
178 |
$3K |
| Y7507 |
|
52 |
37 |
$3K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
25 |
24 |
$2K |
| 82607 |
|
94 |
84 |
$2K |
| 95816 |
|
12 |
12 |
$2K |
| 83735 |
|
608 |
584 |
$2K |
| 82550 |
|
12 |
12 |
$1K |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
26 |
26 |
$976.25 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
13 |
13 |
$948.26 |
| 87653 |
|
13 |
13 |
$858.88 |
| 86160 |
|
12 |
12 |
$843.47 |
| 74018 |
|
12 |
12 |
$737.02 |
| 80061 |
Lipid panel |
55 |
54 |
$694.62 |
| 86039 |
|
12 |
12 |
$667.47 |
| 73120 |
|
12 |
12 |
$639.68 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
12 |
12 |
$637.50 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
120 |
116 |
$556.10 |
| 86038 |
|
12 |
12 |
$495.93 |
| 77336 |
|
21 |
12 |
$403.42 |
| 84702 |
|
41 |
40 |
$363.07 |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
15 |
15 |
$337.96 |
| J3490 |
Unclassified drugs |
1,798 |
1,309 |
$335.70 |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
46 |
13 |
$189.73 |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
27 |
26 |
$168.42 |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
27 |
26 |
$168.42 |
| 83605 |
|
27 |
27 |
$167.46 |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
15 |
14 |
$140.35 |
| 84165 |
|
13 |
12 |
$63.27 |
| 87088 |
|
13 |
12 |
$29.12 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
85 |
76 |
$28.35 |
| J2704 |
Injection, propofol, 10 mg |
292 |
184 |
$9.72 |
| C9803 |
Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
100 |
96 |
$0.00 |
| J7030 |
Infusion, normal saline solution , 1000 cc |
76 |
53 |
$0.00 |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
180 |
172 |
$0.00 |
| J0744 |
Injection, ciprofloxacin for intravenous infusion, 200 mg |
39 |
38 |
$0.00 |
| A9270 |
Non-covered item or service |
68 |
65 |
$0.00 |
| J7050 |
Infusion, normal saline solution, 250 cc |
59 |
39 |
$0.00 |
| J1642 |
Injection, heparin sodium, (heparin lock flush), per 10 units |
16 |
12 |
$0.00 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
15 |
13 |
$0.00 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
46 |
43 |
$0.00 |
| J2003 |
Injection, lidocaine hydrochloride, 1 mg |
17 |
14 |
$0.00 |