| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 0450 |
Emergency room services |
134,937 |
114,163 |
$1.91M |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
10,873 |
9,626 |
$1.38M |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
32,512 |
25,982 |
$961K |
| 78815 |
Positron emission tomography (PET) for limited area imaging |
1,440 |
1,316 |
$767K |
| A0429 |
Ambulance service, basic life support, emergency transport (bls-emergency) |
20,841 |
15,456 |
$727K |
| 80053 |
Comprehensive metabolic panel |
108,738 |
89,972 |
$697K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
12,278 |
10,598 |
$643K |
| 70450 |
Computed tomography, head or brain; without contrast material |
12,119 |
10,958 |
$567K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
25,552 |
18,516 |
$513K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
13,126 |
10,478 |
$501K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
107,878 |
88,323 |
$487K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
39,877 |
34,674 |
$429K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
6,264 |
5,629 |
$429K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
2,990 |
2,663 |
$369K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
23,313 |
16,585 |
$347K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
1,953 |
1,766 |
$270K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
3,580 |
3,333 |
$256K |
| J9271 |
Injection, pembrolizumab, 1 mg |
48 |
38 |
$254K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
19,509 |
14,677 |
$250K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
8,253 |
5,280 |
$249K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
6,117 |
5,631 |
$246K |
| 93976 |
|
3,146 |
2,800 |
$239K |
| 93971 |
|
3,188 |
2,936 |
$215K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
6,019 |
5,256 |
$180K |
| 99199 |
Unlisted special service, procedure or report |
3,631 |
3,487 |
$180K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
4,352 |
3,986 |
$179K |
| 71045 |
Radiologic examination, chest; single view |
23,504 |
20,838 |
$179K |
| A9552 |
Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries |
1,449 |
1,356 |
$177K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
1,535 |
1,519 |
$177K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
27,637 |
20,197 |
$177K |
| 71046 |
Radiologic examination, chest; 2 views |
13,779 |
12,870 |
$174K |
| 76830 |
Ultrasound, transvaginal |
3,746 |
3,379 |
$172K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
1,675 |
1,509 |
$171K |
| 93970 |
|
1,488 |
1,382 |
$164K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
9,462 |
8,484 |
$153K |
| J3490 |
Unclassified drugs |
19,362 |
10,548 |
$152K |
| 84484 |
|
27,805 |
22,970 |
$146K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
5,953 |
4,861 |
$146K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
1,768 |
1,611 |
$145K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
7,410 |
6,041 |
$139K |
| 77066 |
Tomosynthesis, mammo |
1,501 |
1,451 |
$139K |
| G0378 |
Hospital observation service, per hour |
834 |
783 |
$138K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
2,323 |
2,209 |
$138K |
| Z9725 |
|
3,113 |
3,045 |
$133K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
3,325 |
2,002 |
$126K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
6,475 |
1,805 |
$108K |
| 88307 |
|
986 |
858 |
$100K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
25,659 |
19,271 |
$99K |
| J1170 |
Injection, hydromorphone, up to 4 mg |
14,426 |
10,083 |
$95K |
| P9016 |
Red blood cells, leukocytes reduced, each unit |
934 |
734 |
$95K |
| 71250 |
|
2,211 |
2,118 |
$93K |
| 76642 |
|
1,861 |
1,620 |
$92K |
| 59025 |
Fetal non-stress test |
5,146 |
2,648 |
$87K |
| 76801 |
|
1,901 |
1,565 |
$87K |
| 83690 |
|
23,901 |
20,082 |
$87K |
| J1815 |
Injection, insulin, per 5 units |
2,772 |
1,605 |
$85K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
1,828 |
1,535 |
$84K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
1,162 |
1,059 |
$82K |
| Z7502 |
|
2,399 |
2,266 |
$76K |
| 97139 |
|
3,133 |
443 |
$73K |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
8,085 |
7,389 |
$68K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
15,966 |
12,157 |
$68K |
| 83880 |
|
5,305 |
4,687 |
$66K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
2,955 |
2,553 |
$63K |
| 70549 |
|
372 |
302 |
$61K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
3,609 |
3,284 |
$59K |
| 70496 |
|
406 |
347 |
$58K |
| 76770 |
|
1,788 |
1,651 |
$57K |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
9,451 |
7,825 |
$56K |
| 84703 |
|
22,549 |
19,407 |
$55K |
| 73564 |
|
3,026 |
2,695 |
$52K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
2,851 |
1,723 |
$51K |
| 36430 |
|
1,114 |
788 |
$51K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
3,514 |
1,933 |
$51K |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
8,007 |
6,163 |
$51K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
5,638 |
4,578 |
$50K |
| J7050 |
Infusion, normal saline solution, 250 cc |
15,444 |
6,909 |
$50K |
| C1769 |
Guide wire |
1,349 |
1,126 |
$50K |
| 70498 |
|
411 |
346 |
$49K |
| 96367 |
|
1,877 |
1,219 |
$48K |
| 73610 |
|
3,246 |
2,993 |
$48K |
| 73630 |
|
3,423 |
3,080 |
$48K |
| 0270 |
|
49,592 |
30,364 |
$47K |
| 73030 |
|
3,248 |
2,969 |
$47K |
| G0279 |
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) |
1,486 |
1,428 |
$46K |
| 0202U |
Oncology (prostate), multianalyte, gene expression profiling |
397 |
370 |
$45K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
2,120 |
1,944 |
$45K |
| 90715 |
|
2,127 |
1,958 |
$44K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
3,509 |
3,300 |
$44K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
1,852 |
1,679 |
$44K |
| J2704 |
Injection, propofol, 10 mg |
6,164 |
5,143 |
$43K |
| 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 |
1,395 |
1,288 |
$40K |
| 84145 |
|
3,509 |
2,845 |
$40K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
7,193 |
5,339 |
$39K |
| 88341 |
|
836 |
749 |
$39K |
| 77065 |
Tomosynthesis, mammo |
505 |
458 |
$39K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
8,356 |
6,118 |
$38K |
| 81001 |
|
24,128 |
21,064 |
$38K |
| 97750 |
|
1,075 |
611 |
$37K |
| 81025 |
|
2,782 |
2,524 |
$37K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
8,636 |
6,918 |
$36K |
| 73110 |
|
2,446 |
2,269 |
$35K |
| 72100 |
|
2,106 |
1,982 |
$35K |
| 70486 |
|
536 |
496 |
$33K |
| 73130 |
|
2,431 |
2,217 |
$33K |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
6,983 |
5,753 |
$32K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
1,415 |
1,266 |
$31K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
1,412 |
1,266 |
$31K |
| 74178 |
|
290 |
275 |
$30K |
| 84443 |
Thyroid stimulating hormone (TSH) |
3,798 |
3,287 |
$30K |
| 83735 |
|
8,816 |
6,669 |
$29K |
| J2060 |
Injection, lorazepam, 2 mg |
7,400 |
5,344 |
$29K |
| 93798 |
|
2,563 |
431 |
$28K |
| 75574 |
|
211 |
200 |
$28K |
| 82962 |
|
12,860 |
6,597 |
$27K |
| J0690 |
Injection, cefazolin sodium, 500 mg |
4,550 |
3,459 |
$27K |
| 83605 |
|
5,191 |
4,325 |
$27K |
| 96376 |
|
10,070 |
7,028 |
$27K |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
7,464 |
5,285 |
$26K |
| 85027 |
|
7,829 |
6,856 |
$25K |
| 87040 |
|
3,514 |
2,814 |
$24K |
| 85379 |
|
4,396 |
3,924 |
$23K |
| 77386 |
|
142 |
14 |
$23K |
| 73502 |
|
1,486 |
1,357 |
$22K |
| C1894 |
Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser |
757 |
687 |
$22K |
| 74174 |
|
102 |
89 |
$21K |
| 77334 |
|
128 |
92 |
$21K |
| 88360 |
|
287 |
248 |
$21K |
| 0160 |
|
2,647 |
1,490 |
$21K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
6,098 |
4,893 |
$20K |
| J1453 |
Injection, fosaprepitant, 1 mg |
218 |
143 |
$20K |
| 72141 |
|
278 |
244 |
$20K |
| 70544 |
|
529 |
444 |
$19K |
| 76641 |
|
307 |
268 |
$19K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
457 |
456 |
$19K |
| 77336 |
|
504 |
212 |
$18K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
4,946 |
4,389 |
$18K |
| 73080 |
|
1,227 |
1,143 |
$18K |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
4,853 |
4,248 |
$17K |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
1,961 |
1,650 |
$17K |
| J2710 |
Injection, neostigmine methylsulfate, up to 0.5 mg |
756 |
694 |
$17K |
| 80305 |
|
2,396 |
2,052 |
$16K |
| 87077 |
|
3,545 |
3,188 |
$15K |
| J3370 |
Injection, vancomycin hcl, 500 mg |
2,140 |
1,305 |
$15K |
| M0243 |
Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring |
201 |
184 |
$15K |
| 85610 |
|
8,623 |
7,331 |
$15K |
| 0762 |
|
781 |
481 |
$15K |
| 88342 |
|
1,278 |
1,143 |
$14K |
| 84702 |
|
2,465 |
2,003 |
$14K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
534 |
491 |
$14K |
| 76870 |
|
434 |
391 |
$14K |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
3,909 |
3,178 |
$13K |
| J1642 |
Injection, heparin sodium, (heparin lock flush), per 10 units |
3,569 |
1,446 |
$13K |
| 72131 |
|
265 |
230 |
$13K |
| 81003 |
|
12,014 |
10,821 |
$13K |
| L1830 |
Knee orthosis, immobilizer, canvas longitudinal, prefabricated, off-the-shelf |
219 |
190 |
$13K |
| 77049 |
|
40 |
39 |
$13K |
| 93880 |
|
164 |
153 |
$13K |
| 76536 |
|
468 |
460 |
$13K |
| J2543 |
Injection, piperacillin sodium/tazobactam sodium, 1 gram/0.125 grams (1.125 grams) |
1,031 |
471 |
$12K |
| 0360 |
|
3,536 |
2,755 |
$12K |
| 88304 |
|
872 |
795 |
$12K |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
711 |
653 |
$12K |
| 73562 |
|
992 |
868 |
$11K |
| 0250 |
|
7,411 |
4,373 |
$11K |
| 80061 |
Lipid panel |
1,568 |
1,462 |
$11K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
1,961 |
1,812 |
$10K |
| 36415 |
Collection of venous blood by venipuncture |
22,246 |
18,917 |
$10K |
| 87081 |
|
3,617 |
3,249 |
$10K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
516 |
450 |
$10K |
| 87186 |
|
2,568 |
2,288 |
$10K |
| 96417 |
|
336 |
210 |
$10K |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
1,716 |
1,101 |
$10K |
| 73140 |
|
1,253 |
1,203 |
$10K |
| 70491 |
|
99 |
80 |
$9K |
| 12001 |
|
1,275 |
1,219 |
$9K |
| 99070 |
|
1,244 |
773 |
$9K |
| 86923 |
|
652 |
561 |
$9K |
| 74018 |
|
952 |
883 |
$9K |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
869 |
672 |
$9K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
657 |
618 |
$9K |
| 97162 |
|
785 |
764 |
$8K |
| Z7610 |
|
577 |
432 |
$8K |
| 10060 |
|
871 |
803 |
$8K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
1,249 |
414 |
$8K |
| 85730 |
|
3,196 |
2,833 |
$7K |
| J0330 |
Injection, succinylcholine chloride, up to 20 mg |
615 |
557 |
$7K |
| C9803 |
Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
995 |
950 |
$7K |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
2,563 |
2,216 |
$7K |
| 12011 |
|
772 |
738 |
$7K |
| 87633 |
Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets |
42 |
41 |
$6K |
| 73590 |
|
491 |
447 |
$6K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,875 |
1,769 |
$6K |
| 96415 |
|
171 |
101 |
$6K |
| 77300 |
|
77 |
65 |
$6K |
| M0222 |
Intravenous injection, bebtelovimab, includes injection and post administration monitoring |
55 |
52 |
$6K |
| C1887 |
Catheter, guiding (may include infusion/perfusion capability) |
149 |
141 |
$6K |
| 86140 |
|
2,218 |
1,846 |
$6K |
| A9270 |
Non-covered item or service |
11,922 |
4,013 |
$6K |
| 87070 |
|
1,648 |
1,485 |
$5K |
| 86901 |
|
4,192 |
3,641 |
$5K |
| 99499 |
|
112 |
97 |
$5K |
| J1644 |
Injection, heparin sodium, per 1000 units |
1,555 |
884 |
$5K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,860 |
1,700 |
$5K |
| 86900 |
|
4,199 |
3,642 |
$5K |
| S0164 |
Injection, pantoprazole sodium, 40 mg |
516 |
311 |
$5K |
| J0585 |
Injection, onabotulinumtoxina, 1 unit |
23 |
13 |
$5K |
| 82550 |
|
1,230 |
995 |
$4K |
| 73090 |
|
400 |
366 |
$4K |
| 72072 |
|
231 |
223 |
$4K |
| 77080 |
|
153 |
148 |
$4K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
32 |
27 |
$4K |
| 82805 |
|
304 |
267 |
$4K |
| J3486 |
Injection, ziprasidone mesylate, 10 mg |
138 |
104 |
$4K |
| L4386 |
Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
70 |
64 |
$3K |
| 84439 |
|
798 |
685 |
$3K |
| A4648 |
Tissue marker, implantable, any type, each |
166 |
138 |
$3K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
1,355 |
448 |
$3K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
174 |
160 |
$3K |
| J2370 |
Injection, phenylephrine hcl, up to 1 ml |
415 |
379 |
$3K |
| 0370 |
|
3,243 |
3,086 |
$3K |
| 87205 |
|
1,862 |
1,649 |
$3K |
| 86850 |
|
2,763 |
2,378 |
$3K |
| V5008 |
Hearing screening |
115 |
109 |
$3K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
190 |
167 |
$3K |
| 86304 |
|
492 |
358 |
$3K |
| J0134 |
Injection, acetaminophen (fresenius kabi), not therapeutically equivalent to j0131, 10 mg |
223 |
196 |
$3K |
| M0239 |
Intravenous infusion, bamlanivimab-xxxx, includes infusion and post administration monitoring |
31 |
22 |
$3K |
| 72040 |
|
153 |
140 |
$3K |
| 85652 |
|
1,659 |
1,388 |
$2K |
| 86308 |
|
836 |
755 |
$2K |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
953 |
448 |
$2K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
1,075 |
705 |
$2K |
| 82077 |
|
273 |
141 |
$2K |
| J1940 |
Injection, furosemide, up to 20 mg |
626 |
466 |
$2K |
| J8540 |
Dexamethasone, oral, 0.25 mg |
267 |
220 |
$2K |
| A9500 |
Technetium tc-99m sestamibi, diagnostic, per study dose |
46 |
39 |
$2K |
| 73700 |
|
28 |
25 |
$2K |
| 85046 |
|
785 |
713 |
$2K |
| M0247 |
Intravenous infusion, sotrovimab, includes infusion and post administration monitoring |
20 |
18 |
$2K |
| Q9957 |
Injection, perflutren lipid microspheres, per ml |
68 |
53 |
$2K |
| J0360 |
Injection, hydralazine hcl, up to 20 mg |
345 |
257 |
$2K |
| 0272 |
|
2,266 |
2,118 |
$2K |
| J0153 |
Injection, adenosine, 1 mg (not to be used to report any adenosine phosphate compounds) |
72 |
65 |
$2K |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
1,378 |
948 |
$2K |
| J1230 |
Injection, methadone hcl, up to 10 mg |
115 |
109 |
$2K |
| 82570 |
|
494 |
419 |
$1K |
| 71270 |
|
25 |
25 |
$1K |
| 12002 |
|
159 |
155 |
$1K |
| J1626 |
Injection, granisetron hydrochloride, 100 mcg |
276 |
136 |
$1K |
| 72128 |
|
14 |
12 |
$1K |
| 73660 |
|
153 |
145 |
$1K |
| 0710 |
|
3,025 |
2,714 |
$1K |
| 86922 |
|
78 |
62 |
$1K |
| 83615 |
|
424 |
327 |
$1K |
| 72110 |
|
54 |
53 |
$1K |
| 36569 |
|
36 |
36 |
$1K |
| 84100 |
|
471 |
346 |
$1K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
878 |
418 |
$1K |
| 29125 |
|
389 |
363 |
$1K |
| 71010 |
|
250 |
245 |
$1K |
| J1171 |
Injection, hydromorphone, 0.1 mg |
153 |
112 |
$1K |
| J2800 |
Injection, methocarbamol, up to 10 ml |
132 |
118 |
$1K |
| 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 |
146 |
127 |
$1K |
| 83550 |
|
339 |
299 |
$1K |
| 82728 |
|
267 |
222 |
$974.82 |
| C1729 |
Catheter, drainage |
12 |
12 |
$957.17 |
| 88112 |
|
65 |
53 |
$955.44 |
| 82378 |
|
189 |
140 |
$907.01 |
| 86780 |
|
89 |
77 |
$896.89 |
| J3480 |
Injection, potassium chloride, per 2 meq |
292 |
200 |
$870.32 |
| 93017 |
|
29 |
24 |
$855.98 |
| 83540 |
|
342 |
301 |
$854.09 |
| 88173 |
|
26 |
25 |
$842.68 |
| J1836 |
Injection, metronidazole, 10 mg |
203 |
147 |
$831.91 |
| 97116 |
|
420 |
264 |
$820.35 |
| J2919 |
Injection, methylprednisolone sodium succinate, 5 mg |
82 |
73 |
$801.73 |
| 87088 |
|
393 |
366 |
$759.25 |
| J1953 |
Injection, levetiracetam, 10 mg |
56 |
36 |
$755.08 |
| 76819 |
Fetal biophysical profile; without non-stress testing |
13 |
12 |
$739.46 |
| C9113 |
Injection, pantoprazole sodium, per vial |
162 |
132 |
$727.56 |
| 88331 |
|
25 |
24 |
$678.42 |
| 73060 |
|
57 |
52 |
$605.76 |
| 87486 |
|
42 |
41 |
$588.49 |
| 87581 |
|
42 |
41 |
$588.49 |
| 84550 |
|
289 |
247 |
$587.20 |
| 76882 |
|
16 |
13 |
$482.97 |
| 86803 |
|
38 |
38 |
$475.20 |
| G1004 |
Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program |
24,553 |
17,560 |
$469.04 |
| 0636 |
|
1,146 |
449 |
$453.07 |
| 85007 |
|
324 |
316 |
$417.38 |
| A9541 |
Technetium tc-99m sulfur colloid, diagnostic, per study dose, up to 20 millicuries |
12 |
12 |
$417.06 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
137 |
116 |
$409.96 |
| 0760 |
|
605 |
512 |
$385.92 |
| 80179 |
|
43 |
29 |
$380.24 |
| J9045 |
Injection, carboplatin, 50 mg |
16 |
12 |
$364.05 |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
40 |
36 |
$355.97 |
| A4217 |
Sterile water/saline, 500 ml |
84 |
64 |
$352.14 |
| Q3014 |
Telehealth originating site facility fee |
99 |
96 |
$342.81 |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
59 |
53 |
$324.92 |
| 88172 |
|
25 |
24 |
$260.27 |
| 73552 |
|
24 |
24 |
$259.42 |
| 84156 |
|
115 |
94 |
$253.23 |
| 80320 |
|
388 |
338 |
$249.23 |
| 87075 |
|
71 |
62 |
$246.07 |
| 0271 |
|
206 |
164 |
$236.49 |
| J1630 |
Injection, haloperidol, up to 5 mg |
340 |
263 |
$230.53 |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
42 |
36 |
$229.23 |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
12 |
12 |
$216.64 |
| 80143 |
|
44 |
29 |
$212.05 |
| 72170 |
|
25 |
25 |
$210.77 |
| 76942 |
|
13 |
13 |
$206.07 |
| 87340 |
|
32 |
28 |
$200.70 |
| 29515 |
|
56 |
52 |
$200.14 |
| 36591 |
|
64 |
49 |
$196.28 |
| 76098 |
|
13 |
13 |
$187.27 |
| J1810 |
Injection, droperidol and fentanyl citrate, up to 2 ml ampule |
166 |
148 |
$186.10 |
| 82607 |
|
55 |
51 |
$184.39 |
| 81002 |
|
338 |
318 |
$168.99 |
| J2469 |
Injection, palonosetron hcl, 25 mcg |
16 |
12 |
$162.77 |
| J3411 |
Injection, thiamine hcl, 100 mg |
35 |
17 |
$149.75 |
| J2470 |
Injection, pantoprazole sodium, 40 mg |
36 |
29 |
$148.17 |
| 87210 |
|
57 |
50 |
$146.71 |
| J0456 |
Injection, azithromycin, 500 mg |
23 |
12 |
$144.33 |
| 86592 |
|
30 |
26 |
$105.09 |
| J7060 |
5% dextrose/water (500 ml = 1 unit) |
26 |
12 |
$92.57 |
| 82043 |
|
13 |
13 |
$78.21 |
| 82248 |
|
18 |
15 |
$65.54 |
| 36600 |
|
57 |
52 |
$60.55 |
| J2371 |
Injection, phenylephrine hydrochloride, 20 micrograms |
12 |
12 |
$55.18 |
| 99153 |
Mod sedat endo service >5yrs |
14 |
12 |
$44.72 |
| 85045 |
|
44 |
43 |
$37.23 |
| 83935 |
|
12 |
12 |
$36.15 |
| 99152 |
|
15 |
15 |
$35.78 |
| 84300 |
|
12 |
12 |
$26.35 |
| 89051 |
|
12 |
12 |
$25.08 |
| 29130 |
|
12 |
12 |
$16.80 |
| Q0162 |
Ondansetron 1 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen |
87 |
77 |
$13.94 |
| 82272 |
|
16 |
14 |
$12.21 |
| 87420 |
|
18 |
14 |
$9.33 |
| J1956 |
Injection, levofloxacin, 250 mg |
12 |
12 |
$1.58 |
| 0637 |
|
280 |
211 |
$0.43 |
| 0390 |
|
18 |
13 |
$0.00 |
| G8979 |
Mobility: walking & moving around functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting |
226 |
217 |
$0.00 |
| 0412 |
|
18 |
17 |
$0.00 |
| 0351 |
|
142 |
113 |
$0.00 |
| 0320 |
|
353 |
252 |
$0.00 |
| 0480 |
|
32 |
26 |
$0.00 |
| 0921 |
|
79 |
74 |
$0.00 |
| 0300 |
|
1,525 |
579 |
$0.00 |
| G8978 |
Mobility: walking & moving around functional limitation, current status, at therapy episode outset and at reporting intervals |
197 |
192 |
$0.00 |
| 80301 |
|
192 |
183 |
$0.00 |
| 0278 |
|
14 |
14 |
$0.00 |
| 0402 |
|
358 |
250 |
$0.00 |
| 0403 |
|
35 |
23 |
$0.00 |
| C8929 |
Transthoracic echocardiography with contrast, or without contrast followed by with contrast, real-time with image documentation (2d), includes m-mode recording, when performed, complete, with spectral doppler echocardiography, and with color flow doppler echocardiography |
13 |
13 |
$0.00 |
| 0750 |
|
19 |
13 |
$0.00 |
| 84112 |
|
54 |
49 |
$0.00 |
| 0260 |
|
241 |
50 |
$0.00 |
| 0510 |
|
78 |
64 |
$0.00 |
| 0940 |
|
74 |
33 |
$0.00 |
| 0302 |
|
88 |
53 |
$0.00 |
| 0361 |
|
26 |
19 |
$0.00 |
| 0343 |
|
27 |
26 |
$0.00 |
| J7510 |
Prednisolone oral, per 5 mg |
12 |
12 |
$0.00 |
| 94729 |
|
12 |
12 |
$0.00 |
| 0324 |
|
337 |
322 |
$0.00 |
| 0612 |
Calcium glucon (wg critical) |
33 |
23 |
$0.00 |
| 0761 |
|
69 |
57 |
$0.00 |
| 0352 |
|
137 |
107 |
$0.00 |
| 0401 |
|
41 |
25 |
$0.00 |
| 59050 |
|
77 |
69 |
$0.00 |
| 0301 |
|
1,667 |
799 |
$0.00 |
| 0306 |
|
297 |
221 |
$0.00 |
| 80329 |
|
185 |
178 |
$0.00 |
| 0350 |
|
246 |
200 |
$0.00 |
| 0335 |
|
97 |
30 |
$0.00 |
| 0258 |
|
178 |
74 |
$0.00 |
| G8980 |
Mobility: walking & moving around functional limitation, discharge status, at discharge from therapy or to end reporting |
13 |
12 |
$0.00 |
| 0610 |
|
21 |
20 |
$0.00 |
| 27502 |
|
13 |
13 |
$0.00 |
| 0305 |
|
636 |
474 |
$0.00 |
| 27610 |
|
16 |
14 |
$0.00 |
| 0307 |
|
103 |
97 |
$0.00 |
| 0404 |
|
22 |
16 |
$0.00 |
| Q4051 |
Splint supplies, miscellaneous (includes thermoplastics, strapping, fasteners, padding and other supplies) |
63 |
17 |
$0.00 |
| 0310 |
|
68 |
39 |
$0.00 |
| 0611 |
|
33 |
28 |
$0.00 |