| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 0450 |
Emergency room services |
213,960 |
189,153 |
$54.79M |
| 80053 |
Comprehensive metabolic panel |
106,388 |
96,918 |
$13.70M |
| 0250 |
|
133,189 |
63,422 |
$10.74M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
11,242 |
10,472 |
$3.65M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
8,822 |
8,108 |
$2.77M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
8,675 |
8,098 |
$2.37M |
| 71046 |
Radiologic examination, chest; 2 views |
21,054 |
20,492 |
$2.16M |
| 0762 |
|
3,251 |
1,762 |
$2.05M |
| 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 |
11,273 |
10,098 |
$1.59M |
| 80048 |
Basic metabolic panel (calcium, ionized) |
10,073 |
9,099 |
$1.42M |
| 83880 |
|
12,771 |
11,761 |
$1.25M |
| 71045 |
Radiologic examination, chest; single view |
35,116 |
33,331 |
$970K |
| 0206 |
|
342 |
326 |
$930K |
| 87631 |
|
4,102 |
4,040 |
$802K |
| 86850 |
|
5,692 |
5,469 |
$760K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
16,311 |
15,909 |
$754K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
7,381 |
7,359 |
$730K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
2,388 |
2,202 |
$711K |
| Z7502 |
|
17,696 |
17,345 |
$667K |
| 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 |
10,936 |
10,618 |
$659K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
8,571 |
8,419 |
$651K |
| 70450 |
Computed tomography, head or brain; without contrast material |
10,905 |
10,553 |
$642K |
| 77386 |
|
1,678 |
163 |
$605K |
| 0510 |
|
3,594 |
2,636 |
$550K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,404 |
904 |
$537K |
| 0160 |
|
968 |
657 |
$470K |
| 97139 |
|
19,965 |
4,184 |
$451K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
105,841 |
94,908 |
$429K |
| 77300 |
|
613 |
546 |
$405K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
62,327 |
56,439 |
$315K |
| 73562 |
|
2,857 |
2,820 |
$311K |
| 73610 |
|
2,240 |
2,215 |
$309K |
| 84484 |
|
33,503 |
29,413 |
$301K |
| Z9725 |
|
6,798 |
6,652 |
$292K |
| 73030 |
|
2,941 |
2,903 |
$275K |
| 87186 |
|
5,753 |
5,365 |
$259K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
2,058 |
1,395 |
$246K |
| 86780 |
|
32,317 |
30,793 |
$246K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
4,452 |
4,431 |
$243K |
| 73630 |
|
2,668 |
2,640 |
$243K |
| 73130 |
|
2,016 |
1,994 |
$237K |
| 93458 |
|
202 |
200 |
$234K |
| J3490 |
Unclassified drugs |
71,112 |
36,922 |
$229K |
| 97750 |
|
5,195 |
2,705 |
$225K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
5,547 |
5,469 |
$216K |
| 74018 |
|
2,389 |
2,320 |
$212K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
23,757 |
22,085 |
$208K |
| 72100 |
|
1,584 |
1,575 |
$208K |
| 83605 |
|
16,643 |
15,231 |
$206K |
| 0761 |
|
1,155 |
823 |
$201K |
| G0299 |
Direct skilled nursing services of a registered nurse (rn) in the home health or hospice setting, each 15 minutes |
724 |
172 |
$198K |
| 76830 |
Ultrasound, transvaginal |
4,390 |
4,335 |
$186K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
4,543 |
4,441 |
$184K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
937 |
930 |
$169K |
| 73110 |
|
1,294 |
1,277 |
$164K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
5,236 |
4,128 |
$164K |
| 81003 |
|
16,113 |
15,330 |
$150K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
23,839 |
21,671 |
$144K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
18,624 |
16,679 |
$140K |
| 77301 |
|
162 |
156 |
$135K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
4,429 |
4,354 |
$135K |
| 81001 |
|
45,892 |
43,892 |
$135K |
| 82962 |
|
14,107 |
10,540 |
$133K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
22,839 |
21,903 |
$130K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
13,225 |
12,512 |
$129K |
| 77334 |
|
543 |
430 |
$128K |
| 93971 |
|
1,970 |
1,916 |
$124K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
14,754 |
14,274 |
$122K |
| 83690 |
|
37,936 |
35,725 |
$120K |
| J1756 |
Injection, iron sucrose, 1 mg |
316 |
130 |
$119K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
870 |
869 |
$114K |
| 77066 |
Tomosynthesis, mammo |
1,033 |
1,028 |
$113K |
| 76801 |
|
3,737 |
3,416 |
$109K |
| 73502 |
|
1,147 |
1,125 |
$104K |
| 77336 |
|
2,478 |
996 |
$103K |
| 76642 |
|
1,787 |
1,747 |
$102K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
1,713 |
1,684 |
$100K |
| 70486 |
|
771 |
770 |
$99K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
164 |
162 |
$94K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
4,421 |
4,391 |
$93K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
3,714 |
3,698 |
$91K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
26,773 |
26,566 |
$86K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
11,136 |
10,318 |
$84K |
| 72040 |
|
566 |
562 |
$83K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
4,210 |
2,399 |
$82K |
| 82803 |
|
8,713 |
8,159 |
$80K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
11,994 |
10,881 |
$78K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
2,070 |
2,046 |
$78K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
9,307 |
9,112 |
$78K |
| 78815 |
Positron emission tomography (PET) for limited area imaging |
41 |
40 |
$76K |
| 77065 |
Tomosynthesis, mammo |
898 |
894 |
$73K |
| 87420 |
|
313 |
308 |
$73K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
870 |
760 |
$72K |
| 84702 |
|
14,150 |
13,286 |
$72K |
| A9577 |
Injection, gadobenate dimeglumine (multihance), per ml |
1,117 |
1,092 |
$72K |
| 76641 |
|
998 |
975 |
$72K |
| 86900 |
|
7,283 |
6,967 |
$69K |
| 97802 |
|
467 |
465 |
$68K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
783 |
771 |
$67K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
212 |
211 |
$65K |
| 71250 |
|
656 |
650 |
$64K |
| G0378 |
Hospital observation service, per hour |
551 |
487 |
$63K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
380 |
284 |
$62K |
| 76770 |
|
1,135 |
1,126 |
$62K |
| 73080 |
|
652 |
647 |
$62K |
| 97799 |
|
2,242 |
498 |
$61K |
| 86803 |
|
21,297 |
21,219 |
$60K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
2,671 |
2,431 |
$59K |
| 0272 |
|
1,082 |
1,053 |
$54K |
| 59025 |
Fetal non-stress test |
6,398 |
4,854 |
$53K |
| 74183 |
|
227 |
227 |
$52K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
537 |
527 |
$49K |
| G0151 |
Services performed by a qualified physical therapist in the home health or hospice setting, each 15 minutes |
175 |
68 |
$48K |
| 87428 |
|
448 |
444 |
$46K |
| 87077 |
|
6,193 |
5,779 |
$46K |
| J1644 |
Injection, heparin sodium, per 1000 units |
3,503 |
1,850 |
$42K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
3,544 |
3,496 |
$42K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
3,649 |
3,467 |
$39K |
| 85730 |
|
11,900 |
11,398 |
$39K |
| 85610 |
|
23,137 |
19,386 |
$39K |
| Z7610 |
|
6,354 |
3,537 |
$37K |
| 73590 |
|
992 |
975 |
$37K |
| T1999 |
Miscellaneous therapeutic items and supplies, retail purchases, not otherwise classified; identify product in "remarks" |
42,044 |
20,872 |
$36K |
| 71101 |
|
185 |
184 |
$35K |
| 99199 |
Unlisted special service, procedure or report |
713 |
574 |
$35K |
| 83735 |
|
11,595 |
9,974 |
$34K |
| 84443 |
Thyroid stimulating hormone (TSH) |
2,058 |
2,021 |
$33K |
| J1815 |
Injection, insulin, per 5 units |
2,306 |
1,562 |
$33K |
| 77338 |
|
194 |
185 |
$33K |
| 76870 |
|
554 |
535 |
$30K |
| 81025 |
|
12,391 |
12,007 |
$30K |
| G0279 |
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) |
1,380 |
1,373 |
$30K |
| 85027 |
|
11,498 |
10,677 |
$30K |
| 86308 |
|
268 |
266 |
$29K |
| 87040 |
|
6,558 |
5,723 |
$29K |
| 70498 |
|
395 |
390 |
$25K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
8,304 |
7,914 |
$24K |
| 0270 |
|
17,808 |
7,811 |
$24K |
| 72110 |
|
245 |
243 |
$23K |
| 77080 |
|
653 |
649 |
$22K |
| 87633 |
Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets |
302 |
301 |
$21K |
| 93970 |
|
275 |
273 |
$21K |
| J0561 |
Injection, penicillin g benzathine, 100,000 units |
275 |
258 |
$21K |
| 70496 |
|
335 |
330 |
$21K |
| 74170 |
|
108 |
108 |
$21K |
| 85379 |
|
4,418 |
4,331 |
$21K |
| 87641 |
|
2,148 |
2,082 |
$20K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
19,336 |
17,669 |
$20K |
| 36415 |
Collection of venous blood by venipuncture |
12,561 |
10,770 |
$19K |
| 74178 |
|
85 |
84 |
$19K |
| 93325 |
|
189 |
186 |
$19K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
13,481 |
12,469 |
$17K |
| 76536 |
|
349 |
348 |
$17K |
| 86592 |
|
2,156 |
1,935 |
$17K |
| 82550 |
|
5,754 |
5,467 |
$17K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
3,477 |
3,431 |
$16K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
2,765 |
2,628 |
$16K |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
2,240 |
2,116 |
$15K |
| A9552 |
Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries |
42 |
41 |
$15K |
| 72131 |
|
132 |
131 |
$15K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
8,381 |
7,752 |
$15K |
| 85007 |
|
9,366 |
8,713 |
$14K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
833 |
722 |
$13K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
18,876 |
18,014 |
$12K |
| 73090 |
|
456 |
451 |
$12K |
| J2704 |
Injection, propofol, 10 mg |
454 |
438 |
$12K |
| 97803 |
|
166 |
166 |
$11K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
1,741 |
1,714 |
$11K |
| 84703 |
|
3,461 |
3,409 |
$11K |
| 86901 |
|
7,279 |
6,966 |
$11K |
| 73564 |
|
292 |
292 |
$11K |
| 96376 |
|
348 |
272 |
$10K |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
11,065 |
9,217 |
$9K |
| 99070 |
|
1,374 |
476 |
$9K |
| 86140 |
|
5,680 |
5,550 |
$9K |
| 77470 |
|
26 |
26 |
$9K |
| 99152 |
|
541 |
522 |
$9K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
26 |
26 |
$9K |
| 73620 |
|
223 |
219 |
$8K |
| 82330 |
|
2,685 |
2,603 |
$7K |
| 93798 |
|
282 |
64 |
$7K |
| 87522 |
Neg quan hep c or qual rna |
1,069 |
1,063 |
$7K |
| 87634 |
|
32 |
32 |
$7K |
| 90715 |
|
1,605 |
1,601 |
$6K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
875 |
365 |
$6K |
| 74019 |
|
75 |
75 |
$6K |
| 77412 |
|
137 |
14 |
$6K |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
5,176 |
4,779 |
$6K |
| 86738 |
|
240 |
237 |
$6K |
| 84132 |
|
1,383 |
1,262 |
$6K |
| 84439 |
|
597 |
592 |
$6K |
| 74174 |
|
89 |
87 |
$6K |
| 87081 |
|
831 |
829 |
$5K |
| 93308 |
|
247 |
244 |
$5K |
| 93320 |
|
88 |
87 |
$5K |
| 97161 |
|
136 |
73 |
$5K |
| 84100 |
|
3,032 |
2,871 |
$5K |
| 82553 |
|
2,712 |
2,557 |
$5K |
| 83050 |
|
2,845 |
2,760 |
$5K |
| 93976 |
|
27 |
26 |
$4K |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
909 |
780 |
$4K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,857 |
1,770 |
$4K |
| 82375 |
|
2,762 |
2,682 |
$4K |
| C1887 |
Catheter, guiding (may include infusion/perfusion capability) |
55 |
52 |
$4K |
| 80061 |
Lipid panel |
936 |
911 |
$4K |
| 87147 |
|
1,008 |
969 |
$4K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
1,018 |
983 |
$4K |
| 70360 |
|
43 |
43 |
$4K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
803 |
797 |
$4K |
| 84295 |
|
807 |
772 |
$4K |
| 83615 |
|
260 |
227 |
$4K |
| 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 |
449 |
439 |
$4K |
| 85652 |
|
2,442 |
2,385 |
$3K |
| 94729 |
|
64 |
64 |
$3K |
| 88720 |
|
902 |
874 |
$3K |
| A9579 |
Injection, gadolinium-based magnetic resonance contrast agent, not otherwise specified (nos), per ml |
44 |
44 |
$3K |
| 73560 |
|
84 |
83 |
$3K |
| 94726 |
|
62 |
62 |
$3K |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
4,861 |
4,519 |
$3K |
| 82947 |
|
476 |
466 |
$3K |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
338 |
323 |
$3K |
| 82140 |
|
1,023 |
969 |
$3K |
| 92507 |
Treatment of speech, language, voice, communication, and/or auditory processing disorder |
109 |
88 |
$3K |
| 87637 |
Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV |
41 |
39 |
$2K |
| 82009 |
|
1,667 |
1,551 |
$2K |
| 73600 |
|
134 |
133 |
$2K |
| 75574 |
|
12 |
12 |
$2K |
| J1953 |
Injection, levetiracetam, 10 mg |
580 |
518 |
$2K |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
4,271 |
4,066 |
$2K |
| 99153 |
Mod sedat endo service >5yrs |
286 |
271 |
$2K |
| 84145 |
|
457 |
451 |
$2K |
| 94060 |
|
65 |
65 |
$2K |
| 71271 |
|
25 |
25 |
$2K |
| 85384 |
|
120 |
106 |
$2K |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
1,796 |
1,737 |
$2K |
| 82435 |
|
793 |
762 |
$2K |
| 93303 |
Transthoracic echocardiography for congenital cardiac anomalies, follow-up or limited study |
12 |
12 |
$2K |
| 0710 |
|
206 |
197 |
$2K |
| J2060 |
Injection, lorazepam, 2 mg |
2,725 |
2,363 |
$2K |
| 0370 |
|
326 |
316 |
$1K |
| 71020 |
|
77 |
45 |
$1K |
| 73120 |
|
59 |
59 |
$1K |
| 0352 |
|
119 |
118 |
$1K |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
1,512 |
1,470 |
$1K |
| 76937 |
|
70 |
65 |
$1K |
| J1170 |
Injection, hydromorphone, up to 4 mg |
1,435 |
1,188 |
$1K |
| J0690 |
Injection, cefazolin sodium, 500 mg |
121 |
102 |
$1K |
| 82150 |
|
1,417 |
1,382 |
$1K |
| 95819 |
|
26 |
26 |
$1K |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
565 |
535 |
$1K |
| 83930 |
|
280 |
264 |
$1K |
| P9016 |
Red blood cells, leukocytes reduced, each unit |
15 |
12 |
$1K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
129 |
126 |
$1K |
| 93312 |
|
12 |
12 |
$1K |
| 86593 |
|
875 |
868 |
$982.29 |
| 10060 |
|
41 |
41 |
$966.32 |
| 92522 |
|
13 |
12 |
$947.40 |
| 85018 |
|
962 |
927 |
$932.49 |
| 0301 |
|
595 |
555 |
$864.15 |
| 86923 |
|
31 |
27 |
$792.51 |
| 80051 |
|
188 |
184 |
$790.47 |
| J1940 |
Injection, furosemide, up to 20 mg |
559 |
435 |
$772.48 |
| 84550 |
|
272 |
262 |
$729.63 |
| S0077 |
Injection, clindamycin phosphate, 300 mg |
515 |
493 |
$684.81 |
| 82565 |
|
244 |
238 |
$655.76 |
| 87430 |
|
484 |
483 |
$611.58 |
| 70491 |
|
24 |
24 |
$592.17 |
| J7050 |
Infusion, normal saline solution, 250 cc |
385 |
358 |
$584.95 |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
181 |
101 |
$575.00 |
| 93880 |
|
13 |
13 |
$554.36 |
| 82010 |
|
225 |
215 |
$550.70 |
| 87070 |
|
143 |
134 |
$548.39 |
| 73060 |
|
124 |
123 |
$547.68 |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
159 |
93 |
$544.72 |
| J0171 |
Injection, adrenalin, epinephrine, 0.1 mg |
37 |
37 |
$504.24 |
| 84520 |
|
215 |
210 |
$481.21 |
| 84436 |
|
12 |
12 |
$475.00 |
| 73140 |
|
52 |
50 |
$450.08 |
| 0305 |
|
540 |
520 |
$282.35 |
| S0020 |
Injection, bupivicaine hydrochloride, 30 ml |
12 |
12 |
$278.85 |
| J3370 |
Injection, vancomycin hcl, 500 mg |
154 |
121 |
$273.54 |
| 80164 |
|
68 |
64 |
$257.82 |
| 85347 |
|
52 |
51 |
$249.68 |
| 71010 |
|
14 |
14 |
$248.18 |
| 0324 |
|
373 |
358 |
$244.09 |
| 73552 |
|
96 |
93 |
$221.10 |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
22 |
22 |
$217.51 |
| C1725 |
Catheter, transluminal angioplasty, non-laser (may include guidance, infusion/perfusion capability) |
13 |
13 |
$172.14 |
| 87529 |
|
42 |
42 |
$149.12 |
| 82570 |
|
109 |
95 |
$134.37 |
| 84156 |
|
108 |
95 |
$125.08 |
| 0300 |
|
550 |
527 |
$122.62 |
| 96367 |
|
39 |
38 |
$117.11 |
| 73100 |
|
15 |
14 |
$106.90 |
| 87210 |
|
61 |
61 |
$105.35 |
| S0164 |
Injection, pantoprazole sodium, 40 mg |
51 |
41 |
$88.11 |
| 0306 |
|
477 |
462 |
$87.54 |
| 82247 |
|
12 |
12 |
$85.20 |
| 73070 |
|
13 |
13 |
$71.73 |
| 92610 |
|
12 |
12 |
$61.87 |
| 36600 |
|
12 |
12 |
$57.14 |
| J2305 |
Injection, nitroglycerin, 5 mg |
12 |
12 |
$51.97 |
| 0730 |
|
385 |
371 |
$51.80 |
| C1894 |
Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser |
20 |
18 |
$47.46 |
| 0307 |
|
272 |
263 |
$45.87 |
| 72170 |
|
36 |
36 |
$44.95 |
| 82438 |
|
41 |
41 |
$37.68 |
| Q3014 |
Telehealth originating site facility fee |
14 |
14 |
$35.34 |
| J0360 |
Injection, hydralazine hcl, up to 20 mg |
12 |
12 |
$31.41 |
| 97116 |
|
23 |
12 |
$29.99 |
| 0258 |
|
536 |
498 |
$26.31 |
| 96368 |
|
12 |
12 |
$18.79 |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
26 |
25 |
$17.28 |
| 82272 |
|
26 |
25 |
$9.72 |
| 87205 |
|
12 |
12 |
$8.66 |
| 0636 |
|
142 |
133 |
$7.59 |
| J0456 |
Injection, azithromycin, 500 mg |
37 |
27 |
$7.11 |
| 82248 |
|
12 |
12 |
$1.20 |
| A9270 |
Non-covered item or service |
1,459 |
799 |
$0.80 |
| 0424 |
|
28 |
25 |
$0.00 |
| 0483 |
|
42 |
39 |
$0.00 |
| 0402 |
|
13 |
13 |
$0.00 |
| 0361 |
|
13 |
13 |
$0.00 |
| 0412 |
|
12 |
12 |
$0.00 |
| 0302 |
|
13 |
13 |
$0.00 |
| A9150 |
Non-prescription drugs |
542 |
202 |
$0.00 |
| 0420 |
|
179 |
173 |
$0.00 |
| 0250R |
|
12 |
12 |
$0.00 |
| 84479 |
|
12 |
12 |
$0.00 |
| Q4051 |
Splint supplies, miscellaneous (includes thermoplastics, strapping, fasteners, padding and other supplies) |
53 |
28 |
$0.00 |