| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
331,573 |
293,959 |
$15.96M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
68,766 |
59,110 |
$7.95M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
42,848 |
36,973 |
$6.66M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
9,657 |
8,636 |
$1.74M |
| 36415 |
Collection of venous blood by venipuncture |
83,424 |
74,603 |
$1.06M |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
9,241 |
8,680 |
$821K |
| J2315 |
Injection, naltrexone, depot form, 1 mg |
598 |
551 |
$565K |
| J0585 |
Injection, onabotulinumtoxina, 1 unit |
919 |
697 |
$557K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
5,197 |
4,794 |
$358K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
2,273 |
2,185 |
$330K |
| 59410 |
|
619 |
606 |
$311K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
4,709 |
3,442 |
$286K |
| 90834 |
Psychotherapy, 45 minutes with patient |
4,188 |
2,725 |
$254K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
1,575 |
810 |
$222K |
| 71046 |
Radiologic examination, chest; 2 views |
8,432 |
7,955 |
$167K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
2,028 |
1,953 |
$157K |
| 64615 |
|
505 |
492 |
$145K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
4,246 |
2,330 |
$143K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
2,007 |
1,970 |
$135K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
2,929 |
2,879 |
$121K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
28,931 |
26,457 |
$113K |
| 76801 |
|
1,509 |
1,093 |
$109K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
1,702 |
1,579 |
$108K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
7,303 |
7,065 |
$100K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
424 |
417 |
$90K |
| 73630 |
|
2,785 |
2,404 |
$88K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
2,067 |
1,900 |
$86K |
| 95004 |
Percutaneous tests with allergenic extracts, immediate type reaction |
149 |
144 |
$83K |
| 80053 |
Comprehensive metabolic panel |
9,653 |
9,249 |
$80K |
| 95810 |
Polysomnography; sleep staging with 4 or more additional parameters |
150 |
129 |
$77K |
| 20610 |
|
447 |
388 |
$77K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
674 |
664 |
$75K |
| 59025 |
Fetal non-stress test |
896 |
421 |
$71K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,208 |
1,179 |
$69K |
| 99490 |
Ccm add 20min |
1,696 |
1,665 |
$68K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
1,305 |
1,270 |
$59K |
| 45385 |
Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) |
107 |
54 |
$56K |
| 90837 |
Psychotherapy, 53 minutes with patient |
654 |
437 |
$53K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
602 |
583 |
$52K |
| 64493 |
|
74 |
38 |
$52K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
803 |
782 |
$50K |
| Q3014 |
Telehealth originating site facility fee |
4,162 |
3,709 |
$46K |
| 11721 |
|
2,030 |
1,954 |
$46K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
7,014 |
6,800 |
$45K |
| 84443 |
Thyroid stimulating hormone (TSH) |
3,730 |
3,580 |
$44K |
| 80061 |
Lipid panel |
3,260 |
3,177 |
$40K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
6,394 |
5,877 |
$40K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
493 |
363 |
$38K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
677 |
532 |
$37K |
| 76830 |
Ultrasound, transvaginal |
535 |
419 |
$37K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
431 |
372 |
$34K |
| 73564 |
|
987 |
950 |
$33K |
| 90686 |
|
3,618 |
3,559 |
$31K |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
5,741 |
4,927 |
$30K |
| 0001A |
|
1,367 |
1,352 |
$29K |
| 99460 |
|
513 |
504 |
$28K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
1,473 |
1,458 |
$28K |
| 20611 |
|
119 |
94 |
$28K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
1,215 |
1,043 |
$28K |
| 90791 |
Psychiatric diagnostic evaluation |
268 |
263 |
$26K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
589 |
570 |
$26K |
| 73110 |
|
816 |
720 |
$25K |
| 73610 |
|
1,150 |
1,090 |
$25K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
1,463 |
1,453 |
$24K |
| 01967 |
Neuraxial labor analgesia/anesthesia for planned vaginal delivery |
195 |
181 |
$24K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
1,824 |
1,794 |
$24K |
| 0002A |
|
1,177 |
1,167 |
$23K |
| 92557 |
|
246 |
243 |
$23K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
475 |
148 |
$22K |
| 71045 |
Radiologic examination, chest; single view |
1,477 |
1,398 |
$22K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
1,559 |
860 |
$21K |
| 81001 |
|
4,743 |
4,378 |
$21K |
| 92507 |
Treatment of speech, language, voice, communication, and/or auditory processing disorder |
351 |
84 |
$20K |
| 00170 |
Anesthesia for intraoral procedures, including biopsy |
129 |
65 |
$20K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,884 |
1,834 |
$20K |
| 94010 |
|
263 |
255 |
$20K |
| 64483 |
|
38 |
25 |
$19K |
| 70450 |
Computed tomography, head or brain; without contrast material |
757 |
740 |
$18K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
39 |
39 |
$17K |
| 41899 |
Unlisted procedure, dentoalveolar structures |
37 |
37 |
$17K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
679 |
601 |
$17K |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
2,571 |
2,398 |
$16K |
| G0432 |
Infectious agent antibody detection by enzyme immunoassay (eia) technique, hiv-1 and/or hiv-2, screening |
567 |
539 |
$16K |
| 91320 |
|
147 |
142 |
$13K |
| G0475 |
Hiv antigen/antibody, combination assay, screening |
326 |
318 |
$13K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
450 |
423 |
$13K |
| 76642 |
|
185 |
161 |
$13K |
| A4550 |
Surgical trays |
523 |
383 |
$13K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
451 |
424 |
$12K |
| 95811 |
|
24 |
13 |
$12K |
| 84484 |
|
1,057 |
958 |
$12K |
| 86803 |
|
863 |
830 |
$11K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
3,536 |
3,240 |
$11K |
| 45378 |
Colonoscopy, flexible; diagnostic, including collection of specimen(s) |
23 |
12 |
$10K |
| 85610 |
|
2,736 |
2,001 |
$10K |
| 86140 |
|
1,872 |
1,816 |
$10K |
| 86708 |
|
805 |
767 |
$9K |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
3,023 |
2,838 |
$9K |
| 99239 |
Hospital discharge day management, more than 30 minutes |
146 |
133 |
$9K |
| 97161 |
|
175 |
170 |
$9K |
| 86706 |
|
842 |
803 |
$8K |
| 99233 |
Prolong inpt eval add15 m |
129 |
50 |
$8K |
| 87340 |
|
892 |
851 |
$8K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
120 |
117 |
$8K |
| 86592 |
|
1,065 |
1,018 |
$8K |
| 73130 |
|
432 |
397 |
$8K |
| 86704 |
|
751 |
725 |
$8K |
| 0004A |
|
430 |
387 |
$8K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
44 |
39 |
$8K |
| 92567 |
|
489 |
481 |
$7K |
| 69436 |
Tympanostomy (requiring insertion of ventilating tube), general anesthesia |
15 |
15 |
$7K |
| 85027 |
|
1,550 |
1,470 |
$7K |
| G0008 |
Administration of influenza virus vaccine |
542 |
535 |
$7K |
| 73030 |
|
328 |
306 |
$7K |
| 90682 |
|
172 |
169 |
$7K |
| J1030 |
Injection, methylprednisolone acetate, 40 mg |
156 |
142 |
$7K |
| 99223 |
Prolong inpt eval add15 m |
60 |
56 |
$7K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
146 |
142 |
$6K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
12 |
12 |
$6K |
| 83690 |
|
1,443 |
1,391 |
$6K |
| 81025 |
|
1,061 |
1,041 |
$6K |
| A6021 |
Collagen dressing, sterile, size 16 sq. in. or less, each |
1,429 |
783 |
$5K |
| 90662 |
|
131 |
131 |
$5K |
| 90480 |
|
159 |
154 |
$5K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
505 |
267 |
$5K |
| 94060 |
|
25 |
25 |
$5K |
| 0071A |
|
217 |
215 |
$5K |
| 51798 |
|
145 |
141 |
$5K |
| 73140 |
|
157 |
145 |
$4K |
| E0603 |
Breast pump, electric (ac and/or dc), any type |
15 |
14 |
$4K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
622 |
604 |
$4K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
4,272 |
3,793 |
$4K |
| 69210 |
|
103 |
98 |
$4K |
| 82947 |
|
961 |
908 |
$4K |
| 0353U |
|
237 |
228 |
$4K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
3,173 |
2,842 |
$3K |
| 85379 |
|
373 |
366 |
$3K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
155 |
80 |
$3K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
60 |
56 |
$3K |
| 92587 |
|
17 |
15 |
$3K |
| 0072A |
|
130 |
129 |
$3K |
| 93971 |
|
94 |
81 |
$3K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
2,379 |
1,280 |
$3K |
| 87081 |
|
371 |
357 |
$3K |
| 82150 |
|
1,172 |
941 |
$3K |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
55 |
37 |
$3K |
| 84450 |
|
1,078 |
856 |
$3K |
| 0124A |
|
122 |
119 |
$3K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
47 |
43 |
$2K |
| 84075 |
|
1,076 |
854 |
$2K |
| 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 |
32 |
31 |
$2K |
| 31575 |
|
14 |
14 |
$2K |
| 82247 |
|
1,078 |
856 |
$2K |
| 84520 |
|
957 |
907 |
$2K |
| 82728 |
|
149 |
148 |
$2K |
| 82565 |
|
984 |
933 |
$2K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
22 |
21 |
$2K |
| 97597 |
|
17 |
13 |
$2K |
| 74018 |
|
115 |
106 |
$2K |
| E0604 |
Breast pump, hospital grade, electric (ac and / or dc), any type |
66 |
66 |
$2K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
26 |
13 |
$2K |
| 84460 |
|
428 |
415 |
$2K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
41 |
37 |
$2K |
| 77066 |
Tomosynthesis, mammo |
15 |
15 |
$2K |
| 90691 |
|
327 |
326 |
$2K |
| 72100 |
|
51 |
51 |
$2K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
27 |
26 |
$1K |
| 81003 |
|
452 |
433 |
$1K |
| 0003A |
|
78 |
73 |
$1K |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
25 |
25 |
$1K |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
956 |
914 |
$1K |
| 80051 |
|
397 |
375 |
$1K |
| 76536 |
|
22 |
14 |
$1K |
| 0013A |
|
56 |
51 |
$1K |
| 80076 |
|
182 |
176 |
$1K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
28 |
28 |
$1K |
| J2704 |
Injection, propofol, 10 mg |
701 |
646 |
$995.10 |
| 90656 |
|
129 |
127 |
$992.79 |
| 0352U |
|
15 |
14 |
$972.85 |
| G0279 |
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) |
57 |
56 |
$935.97 |
| 84439 |
|
95 |
92 |
$922.38 |
| 87634 |
|
44 |
44 |
$891.40 |
| 72125 |
Computed tomography, cervical spine; without contrast material |
28 |
28 |
$877.52 |
| 99406 |
|
31 |
30 |
$684.05 |
| 84145 |
|
46 |
44 |
$657.72 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
826 |
740 |
$651.63 |
| 97165 |
|
12 |
12 |
$633.08 |
| 64494 |
|
74 |
38 |
$615.31 |
| 99454 |
|
26 |
26 |
$608.48 |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
12 |
12 |
$606.84 |
| 83880 |
|
26 |
25 |
$604.56 |
| 87807 |
|
39 |
39 |
$573.42 |
| 70486 |
|
38 |
37 |
$564.32 |
| 87210 |
|
93 |
91 |
$502.54 |
| 86850 |
|
50 |
49 |
$471.63 |
| 95885 |
|
25 |
25 |
$455.14 |
| 0073A |
|
15 |
15 |
$448.87 |
| 88142 |
|
26 |
25 |
$379.86 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
136 |
134 |
$368.94 |
| 88141 |
|
14 |
14 |
$331.38 |
| 83735 |
|
93 |
91 |
$331.16 |
| J8540 |
Dexamethasone, oral, 0.25 mg |
448 |
272 |
$297.96 |
| 73502 |
|
15 |
14 |
$285.51 |
| 73560 |
|
13 |
13 |
$264.16 |
| 90651 |
|
30 |
30 |
$255.16 |
| 90847 |
Family psychotherapy with the patient present, 50 minutes |
12 |
12 |
$239.04 |
| 85730 |
|
73 |
71 |
$218.66 |
| 82374 |
|
51 |
50 |
$173.16 |
| 85652 |
|
42 |
39 |
$172.46 |
| 82607 |
|
28 |
28 |
$163.53 |
| 88304 |
|
13 |
12 |
$144.52 |
| 84132 |
|
51 |
50 |
$144.09 |
| 84295 |
|
51 |
50 |
$137.65 |
| Q9966 |
Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml |
338 |
296 |
$124.79 |
| 84702 |
|
12 |
12 |
$106.90 |
| 83605 |
|
41 |
38 |
$98.28 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
52 |
44 |
$70.99 |
| 86900 |
|
12 |
12 |
$65.71 |
| S0020 |
Injection, bupivicaine hydrochloride, 30 ml |
39 |
38 |
$55.66 |
| J7050 |
Infusion, normal saline solution, 250 cc |
29 |
25 |
$53.58 |
| J1010 |
Injection, methylprednisolone acetate, 1 mg |
16 |
15 |
$44.34 |
| J0744 |
Injection, ciprofloxacin for intravenous infusion, 200 mg |
12 |
12 |
$27.48 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
43 |
43 |
$25.64 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
28 |
28 |
$16.50 |
| J7620 |
Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme |
13 |
12 |
$9.91 |
| S0119 |
Ondansetron, oral, 4 mg (for circumstances falling under the medicare statute, use hcpcs q code) |
72 |
64 |
$7.59 |
| 87205 |
|
80 |
68 |
$4.67 |
| 90688 |
|
40 |
40 |
$0.00 |
| 0011A |
|
13 |
12 |
$0.00 |
| 87070 |
|
44 |
38 |
$0.00 |
| 0012A |
|
16 |
15 |
$0.00 |
| 87176 |
|
44 |
38 |
$0.00 |
| J2795 |
Injection, ropivacaine hydrochloride, 1 mg |
14 |
12 |
$0.00 |
| A6212 |
Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing |
190 |
79 |
$0.00 |
| A6199 |
Alginate or other fiber gelling dressing, wound filler, sterile, per 6 inches |
25 |
12 |
$0.00 |
| A6209 |
Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
240 |
111 |
$0.00 |
| A6210 |
Foam dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing |
77 |
41 |
$0.00 |
| J0171 |
Injection, adrenalin, epinephrine, 0.1 mg |
26 |
26 |
$0.00 |
| G0438 |
Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit |
26 |
24 |
$0.00 |
| 87400 |
|
86 |
43 |
$0.00 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
13 |
13 |
$0.00 |
| G1004 |
Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program |
14 |
14 |
$0.00 |