| Code | Description | Claims | Beneficiaries | Total Paid |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
43,704 |
42,218 |
$6.12M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
26,237 |
25,401 |
$4.17M |
| T1015 |
Clinic visit/encounter, all-inclusive |
52,420 |
13,877 |
$1.85M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
22,809 |
21,866 |
$1.78M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
9,306 |
8,991 |
$1.67M |
| 99050 |
|
9,837 |
9,342 |
$978K |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
8,843 |
8,727 |
$963K |
| G0378 |
Hospital observation service, per hour |
1,078 |
929 |
$930K |
| 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 |
7,345 |
7,093 |
$575K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
9,478 |
9,308 |
$498K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
2,826 |
2,748 |
$487K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
4,038 |
4,038 |
$403K |
| 80053 |
Comprehensive metabolic panel |
20,041 |
19,171 |
$202K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
5,017 |
4,928 |
$176K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
29,425 |
28,068 |
$152K |
| S9083 |
Global fee urgent care centers |
1,262 |
1,201 |
$133K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
15,052 |
14,212 |
$125K |
| 80050 |
General health panel |
2,871 |
2,784 |
$124K |
| 95810 |
Polysomnography; sleep staging with 4 or more additional parameters |
399 |
386 |
$110K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
543 |
540 |
$107K |
| X0616 |
|
376 |
376 |
$76K |
| X0620 |
|
392 |
380 |
$75K |
| 80061 |
Lipid panel |
4,798 |
4,692 |
$64K |
| 97161 |
|
893 |
888 |
$62K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
7,754 |
7,411 |
$61K |
| 70450 |
Computed tomography, head or brain; without contrast material |
929 |
893 |
$57K |
| 97162 |
|
782 |
771 |
$53K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
290 |
281 |
$50K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
858 |
809 |
$48K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
1,541 |
1,505 |
$44K |
| 87631 |
|
316 |
313 |
$44K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
519 |
503 |
$43K |
| 71046 |
Radiologic examination, chest; 2 views |
4,006 |
3,887 |
$42K |
| 81001 |
|
13,961 |
13,472 |
$41K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
2,881 |
2,835 |
$41K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
426 |
416 |
$37K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
411 |
281 |
$35K |
| 83690 |
|
8,019 |
7,743 |
$35K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
5,218 |
5,117 |
$35K |
| 84443 |
Thyroid stimulating hormone (TSH) |
1,669 |
1,611 |
$34K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
115 |
113 |
$28K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
3,572 |
3,395 |
$27K |
| 87070 |
|
3,715 |
3,643 |
$26K |
| 95811 |
|
42 |
42 |
$22K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
975 |
908 |
$21K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
973 |
906 |
$21K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
488 |
470 |
$20K |
| 71045 |
Radiologic examination, chest; single view |
3,806 |
3,662 |
$20K |
| 80081 |
|
240 |
233 |
$20K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
271 |
263 |
$19K |
| 83735 |
|
2,744 |
2,598 |
$18K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
629 |
607 |
$17K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
249 |
245 |
$16K |
| 93971 |
|
269 |
253 |
$16K |
| 84484 |
|
2,075 |
1,897 |
$15K |
| 97164 |
|
407 |
401 |
$15K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
379 |
213 |
$14K |
| 84702 |
|
842 |
666 |
$13K |
| 80076 |
|
1,633 |
1,592 |
$13K |
| 73564 |
|
732 |
607 |
$12K |
| 97163 |
|
200 |
200 |
$12K |
| 83880 |
|
480 |
457 |
$12K |
| 86803 |
|
641 |
628 |
$12K |
| 82728 |
|
1,010 |
976 |
$12K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
118 |
115 |
$11K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
1,661 |
1,622 |
$11K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
358 |
336 |
$11K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
515 |
514 |
$11K |
| 82607 |
|
983 |
957 |
$10K |
| J1756 |
Injection, iron sucrose, 1 mg |
2,190 |
912 |
$10K |
| 84439 |
|
1,253 |
1,217 |
$10K |
| 73610 |
|
642 |
598 |
$10K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
421 |
411 |
$9K |
| 76770 |
|
233 |
228 |
$9K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
70 |
70 |
$9K |
| 83970 |
|
227 |
219 |
$8K |
| 73630 |
|
820 |
734 |
$8K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
269 |
187 |
$8K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
217 |
197 |
$8K |
| 71250 |
|
143 |
141 |
$8K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
54 |
53 |
$8K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
105 |
104 |
$7K |
| 81003 |
|
2,392 |
2,295 |
$7K |
| 85027 |
|
1,094 |
1,014 |
$7K |
| 76536 |
|
144 |
139 |
$7K |
| 73030 |
|
550 |
501 |
$7K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
33 |
32 |
$6K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
27 |
27 |
$6K |
| 73502 |
|
370 |
348 |
$6K |
| 83540 |
|
779 |
750 |
$6K |
| 72100 |
|
371 |
364 |
$6K |
| 84153 |
|
261 |
250 |
$6K |
| 82570 |
|
818 |
780 |
$6K |
| 96367 |
|
289 |
185 |
$6K |
| 90715 |
|
541 |
479 |
$6K |
| 93970 |
|
70 |
67 |
$6K |
| 86003 |
|
45 |
45 |
$5K |
| 85610 |
|
1,693 |
1,513 |
$5K |
| 85730 |
|
1,012 |
955 |
$5K |
| 73130 |
|
560 |
467 |
$5K |
| 85379 |
|
565 |
535 |
$5K |
| 81002 |
|
1,500 |
1,464 |
$5K |
| 82784 |
|
252 |
246 |
$5K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
160 |
138 |
$5K |
| 86480 |
|
70 |
68 |
$5K |
| 73562 |
|
339 |
263 |
$5K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
128 |
125 |
$4K |
| 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 |
82 |
75 |
$4K |
| 70496 |
|
28 |
27 |
$4K |
| 73110 |
|
422 |
384 |
$4K |
| 86618 |
|
173 |
164 |
$4K |
| 87340 |
|
284 |
276 |
$4K |
| 86038 |
|
270 |
260 |
$4K |
| 70486 |
|
59 |
58 |
$4K |
| 45385 |
Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) |
12 |
12 |
$4K |
| 87186 |
|
537 |
510 |
$4K |
| 82043 |
|
488 |
475 |
$4K |
| 87077 |
|
549 |
521 |
$4K |
| 87040 |
|
212 |
200 |
$3K |
| 83550 |
|
696 |
670 |
$3K |
| 72110 |
|
176 |
171 |
$3K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
360 |
350 |
$3K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
16 |
16 |
$3K |
| 86850 |
|
400 |
380 |
$3K |
| 93017 |
|
86 |
81 |
$3K |
| 76801 |
|
102 |
96 |
$3K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
2,397 |
2,034 |
$3K |
| 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 |
1,064 |
1,027 |
$3K |
| 86140 |
|
915 |
890 |
$3K |
| 83605 |
|
415 |
392 |
$3K |
| 97167 |
|
39 |
39 |
$3K |
| 84403 |
|
95 |
95 |
$3K |
| 70498 |
|
16 |
16 |
$2K |
| 84146 |
|
99 |
97 |
$2K |
| 85652 |
|
752 |
726 |
$2K |
| 82746 |
|
238 |
229 |
$2K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
253 |
199 |
$2K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
19,281 |
15,646 |
$2K |
| 86255 |
|
122 |
122 |
$2K |
| 73560 |
|
164 |
142 |
$2K |
| 86901 |
|
511 |
480 |
$2K |
| 86800 |
|
103 |
97 |
$2K |
| 86900 |
|
511 |
480 |
$2K |
| 82550 |
|
298 |
294 |
$2K |
| 86592 |
|
464 |
453 |
$2K |
| 76870 |
|
44 |
40 |
$2K |
| 36415 |
Collection of venous blood by venipuncture |
2,148 |
1,862 |
$2K |
| 73590 |
|
146 |
132 |
$2K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
29 |
29 |
$2K |
| 83001 |
|
93 |
93 |
$2K |
| 82948 |
|
775 |
647 |
$2K |
| 87637 |
Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV |
112 |
109 |
$1K |
| J3490 |
Unclassified drugs |
1,664 |
934 |
$1K |
| 87147 |
|
305 |
294 |
$1K |
| 84402 |
|
53 |
53 |
$1K |
| 73080 |
|
161 |
151 |
$1K |
| 86430 |
|
185 |
176 |
$1K |
| 87430 |
|
199 |
197 |
$1K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
25 |
24 |
$1K |
| 84156 |
|
306 |
284 |
$1K |
| 73140 |
|
171 |
160 |
$1K |
| 72040 |
|
83 |
83 |
$1K |
| 82950 |
|
161 |
158 |
$1K |
| 84703 |
|
108 |
105 |
$1K |
| J2704 |
Injection, propofol, 10 mg |
6,382 |
4,137 |
$995.42 |
| 86376 |
|
124 |
119 |
$994.99 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
426 |
376 |
$993.50 |
| 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) |
13 |
12 |
$965.44 |
| 84550 |
|
157 |
144 |
$947.26 |
| 81025 |
|
703 |
621 |
$933.44 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
1,364 |
1,201 |
$930.14 |
| 74018 |
|
88 |
84 |
$920.14 |
| 72050 |
|
43 |
43 |
$918.07 |
| 82247 |
|
127 |
96 |
$910.33 |
| 94729 |
|
39 |
39 |
$882.83 |
| 83002 |
|
55 |
55 |
$866.66 |
| 93880 |
|
14 |
12 |
$856.26 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
5,491 |
4,552 |
$846.90 |
| 84144 |
|
54 |
45 |
$829.26 |
| 82805 |
|
25 |
25 |
$792.74 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
12 |
12 |
$792.00 |
| 86200 |
|
59 |
58 |
$787.32 |
| 94726 |
|
38 |
38 |
$775.92 |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
14 |
14 |
$767.67 |
| 96375 |
Therapeutic injection; each additional sequential IV push |
85 |
66 |
$729.69 |
| 84100 |
|
140 |
137 |
$710.26 |
| J1040 |
Injection, methylprednisolone acetate, 80 mg |
158 |
151 |
$706.14 |
| 85007 |
|
208 |
181 |
$670.36 |
| 84481 |
|
29 |
26 |
$636.66 |
| 82785 |
|
40 |
40 |
$614.25 |
| 97168 |
|
17 |
17 |
$583.92 |
| 93923 |
|
12 |
12 |
$583.42 |
| 86706 |
|
43 |
41 |
$575.13 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
9,974 |
8,663 |
$564.37 |
| 86235 |
|
12 |
12 |
$558.00 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
2,997 |
2,762 |
$534.08 |
| 86704 |
|
38 |
38 |
$533.23 |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
18 |
18 |
$505.26 |
| J3360 |
Injection, diazepam, up to 5 mg |
269 |
224 |
$495.89 |
| 83615 |
|
67 |
59 |
$471.07 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
897 |
842 |
$416.88 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
1,121 |
1,017 |
$373.10 |
| J7050 |
Infusion, normal saline solution, 250 cc |
626 |
234 |
$350.38 |
| 80143 |
|
12 |
12 |
$314.34 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
2,600 |
2,266 |
$309.61 |
| 82553 |
|
31 |
31 |
$290.82 |
| 93226 |
|
13 |
13 |
$286.26 |
| 73090 |
|
32 |
32 |
$264.80 |
| 82105 |
|
13 |
13 |
$247.52 |
| 84145 |
|
16 |
16 |
$222.10 |
| 87205 |
|
46 |
45 |
$207.72 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
1,329 |
1,076 |
$207.54 |
| 76830 |
Ultrasound, transvaginal |
12 |
12 |
$176.92 |
| 82670 |
|
12 |
12 |
$176.30 |
| 94010 |
|
30 |
30 |
$163.59 |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
15 |
13 |
$162.80 |
| 71101 |
|
16 |
16 |
$149.15 |
| 83655 |
|
13 |
13 |
$142.00 |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
1,082 |
958 |
$141.28 |
| 83525 |
|
12 |
12 |
$138.60 |
| 83020 |
|
13 |
13 |
$138.60 |
| 93225 |
|
13 |
13 |
$131.40 |
| 80069 |
|
12 |
12 |
$120.57 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
3,360 |
2,683 |
$116.33 |
| 82077 |
|
67 |
60 |
$109.89 |
| 80179 |
|
12 |
12 |
$108.57 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
1,571 |
1,290 |
$102.40 |
| 84425 |
|
13 |
13 |
$91.94 |
| J1630 |
Injection, haloperidol, up to 5 mg |
506 |
453 |
$85.36 |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
19 |
14 |
$74.44 |
| J2060 |
Injection, lorazepam, 2 mg |
976 |
842 |
$69.73 |
| 99152 |
|
13 |
13 |
$59.40 |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
61 |
52 |
$56.71 |
| OP250 |
|
45 |
27 |
$22.89 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
2,394 |
2,172 |
$20.77 |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
31 |
24 |
$20.54 |
| J1644 |
Injection, heparin sodium, per 1000 units |
215 |
129 |
$7.68 |
| 94760 |
|
12 |
12 |
$0.35 |
| G1004 |
Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program |
167 |
154 |
$0.11 |
| J1010 |
Injection, methylprednisolone acetate, 1 mg |
12 |
12 |
$0.00 |
| J2795 |
Injection, ropivacaine hydrochloride, 1 mg |
72 |
68 |
$0.00 |
| J2003 |
Injection, lidocaine hydrochloride, 1 mg |
188 |
163 |
$0.00 |
| 96361 |
Intravenous infusion, hydration; each additional hour |
13 |
12 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
28 |
26 |
$0.00 |
| J1030 |
Injection, methylprednisolone acetate, 40 mg |
53 |
40 |
$0.00 |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
1,040 |
826 |
$0.00 |
| J1596 |
Injection, glycopyrrolate, 0.1 mg |
56 |
41 |
$0.00 |
| J2919 |
Injection, methylprednisolone sodium succinate, 5 mg |
49 |
44 |
$0.00 |
| J2272 |
Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg |
134 |
127 |
$0.00 |
| J1171 |
Injection, hydromorphone, 0.1 mg |
33 |
27 |
$0.00 |
| J0136 |
Injection, acetaminophen (b braun), not therapeutically equivalent to j0131, 10 mg |
85 |
81 |
$0.00 |