| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
Emergency department visit for the evaluation and management, high severity |
45,264 |
40,031 |
$4.21M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
31,041 |
27,787 |
$2.96M |
| 36415 |
Collection of venous blood by venipuncture |
47,565 |
31,449 |
$1.88M |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
14,708 |
6,666 |
$1.13M |
| J9271 |
Injection, pembrolizumab, 1 mg |
1,010 |
648 |
$1.11M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
18,101 |
15,365 |
$1.04M |
| 77336 |
|
3,399 |
1,249 |
$875K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
6,119 |
5,333 |
$869K |
| 70450 |
Computed tomography, head or brain; without contrast material |
7,631 |
6,516 |
$835K |
| 77387 |
|
2,159 |
172 |
$830K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
46,124 |
40,700 |
$784K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
43,269 |
38,645 |
$752K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
88,676 |
57,953 |
$737K |
| 0202U |
Oncology (prostate), multianalyte, gene expression profiling |
12,109 |
11,579 |
$659K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
4,778 |
4,109 |
$619K |
| J9035 |
Injection, bevacizumab, 10 mg |
1,837 |
687 |
$419K |
| G0382 |
Level 3 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room or emergency department; (2) it is held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment; or (3) during the calendar year immediately preceding the calendar year in which a determination under 42 cfr 489.24 is being made, based on a representative sample of patient visits that occurred during that calendar year, it provides at least one-third of all of its outpatient visits for the treatment of emergency medical conditions on an urgent basis without requiring a previously scheduled appointment) |
30,789 |
24,750 |
$414K |
| G0378 |
Hospital observation service, per hour |
15,574 |
8,879 |
$386K |
| 77300 |
|
1,428 |
923 |
$344K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
35,230 |
31,878 |
$333K |
| 77523 |
|
984 |
68 |
$330K |
| 96415 |
|
3,332 |
1,797 |
$323K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
44,945 |
31,978 |
$309K |
| 78815 |
Positron emission tomography (PET) for limited area imaging |
2,930 |
2,154 |
$299K |
| 80053 |
Comprehensive metabolic panel |
21,545 |
13,240 |
$273K |
| 87633 |
Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets |
6,241 |
5,745 |
$255K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
1,518 |
1,353 |
$230K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
8,507 |
6,349 |
$226K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
2,995 |
2,735 |
$220K |
| 82962 |
|
8,259 |
4,515 |
$207K |
| 71046 |
Radiologic examination, chest; 2 views |
24,057 |
20,395 |
$190K |
| J2505 |
Injection, pegfilgrastim, 6 mg |
777 |
448 |
$187K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
8,002 |
1,515 |
$179K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
1,470 |
1,177 |
$177K |
| 96417 |
|
4,025 |
2,055 |
$166K |
| 87081 |
|
27,522 |
25,317 |
$163K |
| 80076 |
|
20,010 |
15,689 |
$151K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
9,315 |
5,510 |
$151K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
1,430 |
1,229 |
$149K |
| 96416 |
|
1,753 |
918 |
$146K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
8,815 |
8,246 |
$146K |
| J1642 |
Injection, heparin sodium, (heparin lock flush), per 10 units |
14,336 |
6,905 |
$143K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
11,457 |
10,517 |
$142K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
10,865 |
8,361 |
$142K |
| 96402 |
|
3,104 |
1,787 |
$139K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
2,660 |
2,445 |
$131K |
| 87428 |
|
9,455 |
8,843 |
$126K |
| J2506 |
Injection, pegfilgrastim, excludes biosimilar, 0.5 mg |
313 |
170 |
$121K |
| J9355 |
Injection, trastuzumab, excludes biosimilar, 10 mg |
1,467 |
435 |
$112K |
| 77334 |
|
1,389 |
835 |
$111K |
| 81003 |
|
14,395 |
12,088 |
$109K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
3,150 |
2,933 |
$106K |
| 86850 |
|
5,933 |
4,492 |
$105K |
| 86901 |
|
6,011 |
4,632 |
$94K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
3,864 |
2,653 |
$94K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
4,100 |
1,123 |
$86K |
| 87088 |
|
13,522 |
11,715 |
$85K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
4,895 |
4,539 |
$84K |
| 73630 |
|
3,664 |
3,281 |
$81K |
| 86900 |
|
6,299 |
4,806 |
$81K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
18,211 |
10,880 |
$78K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
1,789 |
1,373 |
$75K |
| 96411 |
|
1,527 |
856 |
$75K |
| P9040 |
Red blood cells, leukocytes reduced, irradiated, each unit |
1,033 |
538 |
$73K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
1,785 |
1,677 |
$73K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
600 |
522 |
$73K |
| J9395 |
Injection, fulvestrant, 25 mg |
1,324 |
827 |
$71K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
16,924 |
10,650 |
$66K |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
5,378 |
4,904 |
$65K |
| 96367 |
|
8,324 |
4,256 |
$63K |
| 87430 |
|
27,923 |
25,627 |
$60K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
8,939 |
4,448 |
$59K |
| J7050 |
Infusion, normal saline solution, 250 cc |
5,688 |
2,904 |
$58K |
| 77412 |
|
768 |
95 |
$57K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
2,947 |
2,355 |
$56K |
| 82947 |
|
10,690 |
7,945 |
$55K |
| 73610 |
|
2,901 |
2,631 |
$55K |
| 97161 |
|
2,353 |
1,898 |
$55K |
| A9270 |
Non-covered item or service |
13,924 |
4,684 |
$53K |
| 72131 |
|
895 |
775 |
$53K |
| J0185 |
Injection, aprepitant, 1 mg |
1,467 |
877 |
$52K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
6,703 |
5,234 |
$51K |
| J2469 |
Injection, palonosetron hcl, 25 mcg |
3,882 |
2,163 |
$51K |
| A9552 |
Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries |
2,421 |
1,863 |
$50K |
| J3489 |
Injection, zoledronic acid, 1 mg |
1,208 |
905 |
$49K |
| 86738 |
|
2,645 |
2,504 |
$48K |
| 73130 |
|
2,423 |
2,169 |
$48K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
35,566 |
31,975 |
$47K |
| 73562 |
|
3,088 |
2,579 |
$46K |
| J9263 |
Injection, oxaliplatin, 0.5 mg |
987 |
295 |
$45K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
8,844 |
5,617 |
$45K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
5,399 |
3,577 |
$42K |
| 77295 |
|
175 |
104 |
$42K |
| 87581 |
|
4,028 |
3,697 |
$41K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
1,154 |
1,100 |
$41K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
1,017 |
867 |
$40K |
| 77301 |
|
185 |
112 |
$39K |
| 87486 |
|
5,379 |
4,903 |
$36K |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
5,148 |
2,726 |
$35K |
| 96401 |
|
1,104 |
308 |
$35K |
| G0381 |
Level 2 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room or emergency department; (2) it is held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment; or (3) during the calendar year immediately preceding the calendar year in which a determination under 42 cfr 489.24 is being made, based on a representative sample of patient visits that occurred during that calendar year, it provides at least one-third of all of its outpatient visits for the treatment of emergency medical conditions on an urgent basis without requiring a previously scheduled appointment) |
2,375 |
1,939 |
$34K |
| 75574 |
|
425 |
386 |
$33K |
| 36430 |
|
1,307 |
604 |
$33K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
2,302 |
1,863 |
$32K |
| 88341 |
|
954 |
719 |
$32K |
| C1769 |
Guide wire |
891 |
712 |
$32K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
2,114 |
2,005 |
$32K |
| 73110 |
|
1,866 |
1,644 |
$30K |
| 71250 |
|
1,223 |
937 |
$29K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
21,083 |
15,356 |
$27K |
| 96523 |
|
3,098 |
1,989 |
$27K |
| 81025 |
|
8,990 |
8,319 |
$27K |
| 87507 |
|
652 |
611 |
$27K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
12,899 |
9,790 |
$27K |
| 10060 |
|
370 |
339 |
$27K |
| 44970 |
|
55 |
51 |
$27K |
| 99215 |
Prolong outpt/office vis |
1,200 |
1,110 |
$27K |
| Q5101 |
Injection, filgrastim-sndz, biosimilar, (zarxio), 1 microgram |
609 |
122 |
$25K |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
2,203 |
1,434 |
$25K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
7,671 |
5,220 |
$25K |
| 93970 |
|
1,550 |
1,334 |
$24K |
| J0897 |
Injection, denosumab, 1 mg |
732 |
424 |
$24K |
| 74018 |
|
1,932 |
1,765 |
$24K |
| J0640 |
Injection, leucovorin calcium, per 50 mg |
1,784 |
715 |
$24K |
| 81001 |
|
18,627 |
16,094 |
$24K |
| 84112 |
|
159 |
148 |
$23K |
| 76801 |
|
1,576 |
1,382 |
$23K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
2,414 |
1,963 |
$22K |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
2,251 |
1,802 |
$22K |
| 87807 |
|
2,987 |
2,781 |
$21K |
| J1170 |
Injection, hydromorphone, up to 4 mg |
2,743 |
1,737 |
$21K |
| 73030 |
|
1,957 |
1,648 |
$21K |
| 76830 |
Ultrasound, transvaginal |
1,485 |
1,390 |
$21K |
| 87186 |
|
4,788 |
4,174 |
$20K |
| 84132 |
|
5,644 |
4,774 |
$20K |
| 77386 |
|
214 |
15 |
$20K |
| 87040 |
|
3,275 |
2,860 |
$20K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
1,654 |
1,383 |
$20K |
| 73080 |
|
976 |
870 |
$19K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
2,746 |
1,907 |
$19K |
| 80047 |
|
1,594 |
1,432 |
$18K |
| 72100 |
|
1,561 |
1,344 |
$18K |
| G8978 |
Mobility: walking & moving around functional limitation, current status, at therapy episode outset and at reporting intervals |
543 |
423 |
$18K |
| C1894 |
Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser |
605 |
480 |
$18K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
1,416 |
1,263 |
$18K |
| J2704 |
Injection, propofol, 10 mg |
3,040 |
1,634 |
$18K |
| 71045 |
Radiologic examination, chest; single view |
8,318 |
7,172 |
$18K |
| G8979 |
Mobility: walking & moving around functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting |
677 |
468 |
$17K |
| J9190 |
Injection, fluorouracil, 500 mg |
1,154 |
555 |
$17K |
| J0690 |
Injection, cefazolin sodium, 500 mg |
1,182 |
867 |
$17K |
| 77338 |
|
48 |
26 |
$17K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
1,050 |
879 |
$16K |
| 88185 |
|
684 |
397 |
$15K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
4,719 |
3,805 |
$15K |
| 88342 |
|
1,365 |
1,054 |
$14K |
| G0383 |
Level 4 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room or emergency department; (2) it is held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment; or (3) during the calendar year immediately preceding the calendar year in which a determination under 42 cfr 489.24 is being made, based on a representative sample of patient visits that occurred during that calendar year, it provides at least one-third of all of its outpatient visits for the treatment of emergency medical conditions on an urgent basis without requiring a previously scheduled appointment) |
2,954 |
2,246 |
$14K |
| 80051 |
|
2,834 |
2,403 |
$14K |
| 73140 |
|
721 |
651 |
$14K |
| 87077 |
|
5,513 |
4,786 |
$14K |
| J9312 |
Injection, rituximab, 10 mg |
113 |
53 |
$13K |
| 82565 |
|
7,987 |
6,821 |
$13K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
1,585 |
1,481 |
$13K |
| J0561 |
Injection, penicillin g benzathine, 100,000 units |
450 |
419 |
$13K |
| 96409 |
|
172 |
91 |
$13K |
| 85027 |
|
5,365 |
3,777 |
$13K |
| 76775 |
|
468 |
411 |
$13K |
| 84520 |
|
7,848 |
6,710 |
$12K |
| 83735 |
|
8,086 |
5,218 |
$12K |
| 85610 |
|
12,699 |
10,067 |
$12K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
691 |
643 |
$12K |
| 86923 |
|
1,090 |
701 |
$11K |
| 72040 |
|
528 |
489 |
$11K |
| 96376 |
|
4,462 |
2,471 |
$11K |
| 82378 |
|
4,296 |
2,866 |
$11K |
| 96368 |
|
1,561 |
930 |
$10K |
| P9016 |
Red blood cells, leukocytes reduced, each unit |
82 |
58 |
$10K |
| J1644 |
Injection, heparin sodium, per 1000 units |
1,240 |
721 |
$10K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
1,525 |
1,420 |
$10K |
| 85730 |
|
11,298 |
9,164 |
$10K |
| 87116 |
|
175 |
115 |
$10K |
| 73502 |
|
941 |
817 |
$10K |
| 82150 |
|
2,167 |
1,945 |
$10K |
| 83615 |
|
5,687 |
3,654 |
$10K |
| 84295 |
|
5,028 |
4,279 |
$10K |
| 12011 |
|
403 |
358 |
$9K |
| 84100 |
|
2,831 |
1,917 |
$9K |
| 76770 |
|
289 |
252 |
$9K |
| 86308 |
|
1,321 |
1,234 |
$9K |
| 71101 |
|
518 |
433 |
$9K |
| 77290 |
|
76 |
52 |
$8K |
| 82374 |
|
4,920 |
4,191 |
$8K |
| 82435 |
|
4,996 |
4,255 |
$8K |
| 85379 |
|
3,114 |
2,757 |
$8K |
| 84145 |
|
1,605 |
1,321 |
$7K |
| 99205 |
Prolong outpt/office vis |
241 |
221 |
$7K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
258 |
242 |
$7K |
| 74021 |
|
637 |
586 |
$7K |
| 73590 |
|
511 |
441 |
$7K |
| 84484 |
|
11,677 |
8,926 |
$7K |
| 84703 |
|
9,262 |
8,375 |
$6K |
| 80061 |
Lipid panel |
2,605 |
2,133 |
$6K |
| 96377 |
|
307 |
184 |
$6K |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
1,583 |
1,098 |
$6K |
| 83880 |
|
2,261 |
1,907 |
$6K |
| 84443 |
Thyroid stimulating hormone (TSH) |
4,767 |
3,695 |
$6K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
111 |
87 |
$6K |
| 86300 |
|
1,972 |
1,292 |
$6K |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
244 |
213 |
$5K |
| 70491 |
|
43 |
36 |
$5K |
| 83690 |
|
9,018 |
7,662 |
$5K |
| J9217 |
Leuprolide acetate (for depot suspension), 7.5 mg |
279 |
200 |
$5K |
| 87205 |
|
1,583 |
1,330 |
$5K |
| 12001 |
|
344 |
310 |
$5K |
| G8988 |
Self care functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting |
123 |
114 |
$5K |
| J2370 |
Injection, phenylephrine hcl, up to 1 ml |
218 |
193 |
$4K |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
1,951 |
813 |
$4K |
| 73090 |
|
304 |
263 |
$4K |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
1,258 |
1,098 |
$4K |
| 97162 |
|
58 |
51 |
$4K |
| 88304 |
|
593 |
519 |
$4K |
| 87070 |
|
917 |
725 |
$4K |
| J9045 |
Injection, carboplatin, 50 mg |
1,058 |
558 |
$4K |
| 80069 |
|
130 |
97 |
$4K |
| 83883 |
|
994 |
345 |
$3K |
| 64483 |
|
82 |
66 |
$3K |
| J9267 |
Injection, paclitaxel, 1 mg |
456 |
184 |
$3K |
| Q5119 |
Injection, rituximab-pvvr, biosimilar, (ruxience), 10 mg |
33 |
12 |
$3K |
| 82784 |
|
1,328 |
907 |
$3K |
| 70486 |
|
45 |
39 |
$3K |
| 84550 |
|
2,263 |
1,306 |
$3K |
| 87210 |
|
902 |
845 |
$3K |
| 82310 |
|
631 |
555 |
$3K |
| 82728 |
|
2,759 |
2,097 |
$3K |
| 29125 |
|
348 |
304 |
$3K |
| 29515 |
|
119 |
109 |
$3K |
| G8987 |
Self care functional limitation, current status, at therapy episode outset and at reporting intervals |
103 |
97 |
$3K |
| J3490 |
Unclassified drugs |
1,312 |
802 |
$3K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
3,121 |
2,563 |
$2K |
| 83550 |
|
2,207 |
1,663 |
$2K |
| 83540 |
|
2,283 |
1,716 |
$2K |
| 90715 |
|
1,402 |
1,155 |
$2K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
14 |
12 |
$2K |
| 36416 |
|
602 |
393 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,617 |
1,286 |
$2K |
| 82272 |
|
56 |
50 |
$2K |
| 82805 |
|
357 |
301 |
$2K |
| 83605 |
|
5,555 |
4,558 |
$2K |
| 87209 |
|
45 |
39 |
$2K |
| 93976 |
|
182 |
171 |
$2K |
| G8980 |
Mobility: walking & moving around functional limitation, discharge status, at discharge from therapy or to end reporting |
184 |
122 |
$2K |
| J9171 |
Injection, docetaxel, 1 mg |
21 |
13 |
$2K |
| 82731 |
|
13 |
12 |
$2K |
| 87046 |
|
644 |
311 |
$2K |
| 86140 |
|
6,614 |
5,751 |
$2K |
| 82607 |
|
1,835 |
1,387 |
$2K |
| J9201 |
Injection, gemcitabine hydrochloride, not otherwise specified, 200 mg |
132 |
41 |
$2K |
| 82570 |
|
118 |
91 |
$2K |
| 84153 |
|
533 |
390 |
$2K |
| J1453 |
Injection, fosaprepitant, 1 mg |
77 |
41 |
$2K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
2,455 |
1,747 |
$2K |
| J9070 |
Cyclophosphamide, 100 mg |
213 |
63 |
$2K |
| 87899 |
|
545 |
273 |
$1K |
| M0243 |
Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring |
186 |
158 |
$1K |
| 82232 |
|
728 |
464 |
$1K |
| 88184 |
|
474 |
317 |
$1K |
| 87045 |
|
345 |
305 |
$1K |
| A9579 |
Injection, gadolinium-based magnetic resonance contrast agent, not otherwise specified (nos), per ml |
916 |
735 |
$1K |
| 84702 |
|
1,944 |
1,606 |
$1K |
| J9206 |
Injection, irinotecan, 20 mg |
269 |
96 |
$1K |
| 88307 |
|
13 |
12 |
$1K |
| 82040 |
|
736 |
629 |
$1K |
| Q3014 |
Telehealth originating site facility fee |
1,436 |
925 |
$1K |
| 76870 |
|
20 |
12 |
$993.08 |
| 85097 |
|
33 |
24 |
$991.28 |
| 19083 |
|
22 |
12 |
$893.57 |
| 82247 |
|
682 |
555 |
$858.91 |
| 99152 |
|
16 |
15 |
$850.64 |
| 76942 |
|
43 |
36 |
$841.57 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
2,197 |
2,145 |
$769.98 |
| 89051 |
|
115 |
78 |
$758.63 |
| 85652 |
|
1,758 |
1,513 |
$713.23 |
| 77280 |
|
42 |
25 |
$705.58 |
| 84075 |
|
231 |
209 |
$678.27 |
| 87147 |
|
399 |
364 |
$677.30 |
| G0384 |
Level 5 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room or emergency department; (2) it is held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment; or (3) during the calendar year immediately preceding the calendar year in which a determination under 42 cfr 489.24 is being made, based on a representative sample of patient visits that occurred during that calendar year, it provides at least one-third of all of its outpatient visits for the treatment of emergency medical conditions on an urgent basis without requiring a previously scheduled appointment) |
821 |
619 |
$672.86 |
| 84155 |
|
185 |
167 |
$638.51 |
| 82746 |
|
1,260 |
972 |
$622.95 |
| 95819 |
|
50 |
38 |
$578.94 |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
845 |
609 |
$562.72 |
| 69210 |
|
176 |
170 |
$527.11 |
| 86663 |
|
75 |
65 |
$489.16 |
| 84450 |
|
407 |
363 |
$459.30 |
| 84460 |
|
405 |
362 |
$444.09 |
| 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 |
895 |
557 |
$414.21 |
| 77001 |
|
13 |
12 |
$404.40 |
| 31575 |
|
16 |
12 |
$399.50 |
| A9577 |
Injection, gadobenate dimeglumine (multihance), per ml |
625 |
473 |
$385.62 |
| 87015 |
|
74 |
52 |
$357.94 |
| 87206 |
|
73 |
51 |
$357.94 |
| 87102 |
|
98 |
69 |
$357.94 |
| 97165 |
|
451 |
359 |
$322.51 |
| J2360 |
Injection, orphenadrine citrate, up to 60 mg |
347 |
300 |
$314.02 |
| 85045 |
|
801 |
584 |
$296.58 |
| 82550 |
|
1,083 |
916 |
$296.23 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
116 |
98 |
$287.78 |
| 82977 |
|
205 |
185 |
$270.53 |
| 88108 |
|
31 |
25 |
$263.84 |
| 77370 |
|
16 |
13 |
$261.24 |
| 88360 |
|
59 |
26 |
$252.99 |
| 93923 |
|
16 |
15 |
$250.15 |
| G0380 |
Level 1 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room or emergency department; (2) it is held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment; or (3) during the calendar year immediately preceding the calendar year in which a determination under 42 cfr 489.24 is being made, based on a representative sample of patient visits that occurred during that calendar year, it provides at least one-third of all of its outpatient visits for the treatment of emergency medical conditions on an urgent basis without requiring a previously scheduled appointment) |
35 |
24 |
$238.87 |
| 93880 |
|
47 |
43 |
$224.71 |
| 36591 |
|
20 |
12 |
$222.89 |
| J2710 |
Injection, neostigmine methylsulfate, up to 0.5 mg |
67 |
55 |
$195.42 |
| 83521 |
|
661 |
210 |
$189.00 |
| 83045 |
|
294 |
252 |
$182.64 |
| 86301 |
|
273 |
161 |
$177.81 |
| J1940 |
Injection, furosemide, up to 20 mg |
73 |
40 |
$173.34 |
| 86665 |
|
147 |
65 |
$164.83 |
| J2920 |
Injection, methylprednisolone sodium succinate, up to 40 mg |
196 |
128 |
$162.95 |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
235 |
199 |
$157.66 |
| 82376 |
|
315 |
268 |
$157.25 |
| G0257 |
Unscheduled or emergency dialysis treatment for an esrd patient in a hospital outpatient department that is not certified as an esrd facility |
47 |
26 |
$154.04 |
| 73552 |
|
18 |
13 |
$148.06 |
| 86664 |
|
75 |
65 |
$126.62 |
| 84439 |
|
509 |
385 |
$123.34 |
| C9113 |
Injection, pantoprazole sodium, per vial |
396 |
199 |
$115.30 |
| 87075 |
|
163 |
119 |
$102.64 |
| 88312 |
|
38 |
27 |
$101.92 |
| 84403 |
|
76 |
52 |
$100.17 |
| 86592 |
|
196 |
183 |
$89.48 |
| 82248 |
|
173 |
111 |
$85.26 |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
67 |
37 |
$77.50 |
| 76937 |
|
19 |
16 |
$70.49 |
| J2060 |
Injection, lorazepam, 2 mg |
266 |
213 |
$53.05 |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
13 |
12 |
$52.30 |
| 80074 |
|
22 |
17 |
$47.23 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
127 |
106 |
$40.12 |
| 72072 |
|
14 |
14 |
$35.85 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
153 |
128 |
$26.73 |
| J1956 |
Injection, levofloxacin, 250 mg |
59 |
43 |
$26.62 |
| 86769 |
|
28 |
27 |
$21.29 |
| 86304 |
|
63 |
41 |
$18.98 |
| 88300 |
|
49 |
40 |
$15.34 |
| 87493 |
|
17 |
15 |
$6.06 |
| 87425 |
|
28 |
24 |
$6.05 |
| 87181 |
|
19 |
12 |
$5.48 |
| J9394 |
Injection, fulvestrant (fresenius kabi) not therapeutically equivalent to j9395, 25 mg |
83 |
58 |
$0.30 |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
561 |
546 |
$0.00 |
| 82945 |
|
52 |
36 |
$0.00 |
| J8540 |
Dexamethasone, oral, 0.25 mg |
32 |
25 |
$0.00 |
| 82077 |
|
30 |
27 |
$0.00 |
| 88311 |
|
68 |
51 |
$0.00 |
| J0360 |
Injection, hydralazine hcl, up to 20 mg |
108 |
84 |
$0.00 |
| 84157 |
|
54 |
38 |
$0.00 |
| J0330 |
Injection, succinylcholine chloride, up to 20 mg |
20 |
17 |
$0.00 |
| 99199 |
Unlisted special service, procedure or report |
315 |
300 |
$0.00 |
| 00840 |
|
35 |
29 |
$0.00 |
| 88313 |
|
13 |
12 |
$0.00 |
| M0239 |
Intravenous infusion, bamlanivimab-xxxx, includes infusion and post administration monitoring |
199 |
169 |
$0.00 |
| C1887 |
Catheter, guiding (may include infusion/perfusion capability) |
44 |
36 |
$0.00 |
| 49083 |
|
19 |
13 |
$0.00 |
| 38222 |
|
35 |
26 |
$0.00 |
| 85384 |
|
55 |
41 |
$0.00 |
| M0245 |
Intravenous infusion, bamlanivimab and etesevimab, includes infusion and post administration monitoring |
35 |
31 |
$0.00 |
| 94664 |
|
28 |
18 |
$0.00 |