| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
41,245 |
36,264 |
$6.22M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
27,650 |
25,665 |
$4.37M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
24,906 |
22,828 |
$3.70M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
20,990 |
19,899 |
$3.38M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
18,474 |
15,296 |
$2.66M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
13,350 |
12,839 |
$2.06M |
| 93458 |
|
1,072 |
1,067 |
$1.90M |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
7,467 |
7,083 |
$1.17M |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
2,729 |
2,630 |
$1.06M |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
4,610 |
3,814 |
$830K |
| J9271 |
Injection, pembrolizumab, 1 mg |
95 |
76 |
$807K |
| 70450 |
Computed tomography, head or brain; without contrast material |
2,686 |
2,621 |
$749K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
1,008 |
1,005 |
$700K |
| 99215 |
Prolong outpt/office vis |
4,385 |
3,567 |
$661K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
8,271 |
2,879 |
$616K |
| 93975 |
|
1,152 |
1,145 |
$501K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
734 |
730 |
$501K |
| 45378 |
Colonoscopy, flexible; diagnostic, including collection of specimen(s) |
578 |
575 |
$486K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
1,998 |
1,970 |
$474K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
29,400 |
27,219 |
$457K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
1,685 |
1,446 |
$440K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
2,075 |
1,400 |
$433K |
| 80053 |
Comprehensive metabolic panel |
26,657 |
24,278 |
$407K |
| 96415 |
|
804 |
640 |
$404K |
| 86850 |
|
12,513 |
11,741 |
$391K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
12,275 |
11,865 |
$366K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
1,966 |
1,956 |
$355K |
| 86901 |
|
13,060 |
11,787 |
$351K |
| 80076 |
|
15,041 |
14,259 |
$349K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
11,964 |
11,892 |
$339K |
| 76818 |
|
4,462 |
2,018 |
$315K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
12,653 |
12,441 |
$308K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,815 |
1,801 |
$298K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
4,071 |
3,186 |
$282K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
2,258 |
1,454 |
$258K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
12,648 |
12,436 |
$256K |
| 77336 |
|
578 |
262 |
$249K |
| 92551 |
|
2,997 |
2,984 |
$234K |
| 86900 |
|
13,131 |
11,821 |
$231K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
2,667 |
1,168 |
$218K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,382 |
1,351 |
$208K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,299 |
1,290 |
$200K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
732 |
727 |
$189K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
4,112 |
3,907 |
$188K |
| 80061 |
Lipid panel |
14,853 |
14,760 |
$187K |
| 54150 |
|
165 |
165 |
$187K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
5,822 |
5,768 |
$186K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
2,120 |
2,111 |
$179K |
| 87633 |
Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets |
2,622 |
2,589 |
$174K |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
5,951 |
5,942 |
$173K |
| 45385 |
Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) |
279 |
276 |
$170K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
5,405 |
2,080 |
$167K |
| 93976 |
|
354 |
354 |
$166K |
| 97161 |
|
1,286 |
1,280 |
$152K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
7,111 |
6,527 |
$148K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
471 |
469 |
$144K |
| C9600 |
Percutaneous transcatheter placement of drug eluting intracoronary stent(s), with coronary angioplasty when performed; single major coronary artery or branch |
41 |
40 |
$129K |
| 99205 |
Prolong outpt/office vis |
851 |
845 |
$125K |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
4,579 |
4,568 |
$123K |
| P9016 |
Red blood cells, leukocytes reduced, each unit |
246 |
202 |
$116K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
1,949 |
1,625 |
$115K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
1,360 |
1,357 |
$115K |
| 90686 |
|
6,227 |
6,197 |
$115K |
| J2323 |
Injection, natalizumab, 1 mg |
25 |
25 |
$115K |
| 83880 |
|
3,950 |
3,821 |
$114K |
| 36415 |
Collection of venous blood by venipuncture |
18,774 |
15,774 |
$104K |
| 10060 |
|
292 |
284 |
$104K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
657 |
657 |
$103K |
| 87486 |
|
2,634 |
2,600 |
$100K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
9,943 |
9,357 |
$99K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
261 |
260 |
$99K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
480 |
466 |
$98K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
1,990 |
1,607 |
$97K |
| 12001 |
|
204 |
202 |
$97K |
| 96161 |
|
1,937 |
1,928 |
$94K |
| 86480 |
|
1,778 |
1,769 |
$94K |
| 76801 |
|
1,106 |
1,054 |
$93K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
14,287 |
14,168 |
$92K |
| 88342 |
|
1,661 |
1,573 |
$91K |
| 76770 |
|
378 |
377 |
$88K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
204 |
200 |
$86K |
| 84443 |
Thyroid stimulating hormone (TSH) |
16,660 |
16,311 |
$85K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
244 |
244 |
$83K |
| 10E0XZZ |
|
124 |
16 |
$81K |
| 70460 |
|
262 |
252 |
$78K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
6,173 |
5,381 |
$77K |
| 76830 |
Ultrasound, transvaginal |
2,305 |
2,216 |
$75K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
51,779 |
47,343 |
$74K |
| 86701 |
|
7,207 |
7,184 |
$73K |
| 12011 |
|
158 |
157 |
$72K |
| 86780 |
|
7,334 |
7,292 |
$69K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
423 |
422 |
$68K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
334 |
331 |
$66K |
| 77386 |
|
378 |
32 |
$63K |
| 94060 |
|
368 |
368 |
$62K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
283 |
210 |
$62K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
1,257 |
1,207 |
$61K |
| 93017 |
|
982 |
977 |
$60K |
| 83655 |
|
3,972 |
3,957 |
$59K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
367 |
367 |
$58K |
| 93970 |
|
165 |
164 |
$57K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
185 |
181 |
$56K |
| 87536 |
|
786 |
774 |
$55K |
| 76820 |
|
1,508 |
754 |
$55K |
| 90670 |
|
4,852 |
4,834 |
$54K |
| 90715 |
|
2,465 |
2,441 |
$54K |
| 36430 |
|
121 |
95 |
$54K |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
2,634 |
2,598 |
$51K |
| 87581 |
|
2,634 |
2,600 |
$51K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
515 |
502 |
$50K |
| 77300 |
|
139 |
138 |
$50K |
| J3490 |
Unclassified drugs |
228 |
184 |
$48K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
6,518 |
5,507 |
$46K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
300 |
299 |
$45K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
1,005 |
753 |
$45K |
| 93303 |
Transthoracic echocardiography for congenital cardiac anomalies, follow-up or limited study |
543 |
522 |
$44K |
| 86769 |
|
1,267 |
1,259 |
$43K |
| 88304 |
|
991 |
976 |
$42K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
3,388 |
2,650 |
$41K |
| 87088 |
|
9,955 |
9,531 |
$40K |
| 71046 |
Radiologic examination, chest; 2 views |
10,165 |
9,898 |
$38K |
| 77334 |
|
102 |
90 |
$37K |
| 82607 |
|
4,329 |
4,291 |
$37K |
| 87340 |
|
5,617 |
5,596 |
$36K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
85 |
82 |
$35K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
22,982 |
20,852 |
$35K |
| 76813 |
|
675 |
673 |
$35K |
| 93320 |
|
539 |
520 |
$35K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
229 |
228 |
$34K |
| 82728 |
|
4,207 |
4,066 |
$34K |
| 90680 |
|
3,210 |
3,198 |
$33K |
| 88307 |
|
349 |
328 |
$32K |
| 99385 |
|
211 |
210 |
$32K |
| 82803 |
|
1,131 |
965 |
$31K |
| 96367 |
|
268 |
200 |
$31K |
| 90698 |
|
3,147 |
3,139 |
$31K |
| 96127 |
|
1,162 |
1,160 |
$30K |
| 36416 |
|
1,401 |
1,346 |
$30K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
207 |
207 |
$30K |
| 93351 |
|
76 |
75 |
$30K |
| 80050 |
General health panel |
224 |
223 |
$30K |
| 77412 |
|
98 |
12 |
$29K |
| 85610 |
|
12,330 |
11,496 |
$27K |
| 86762 |
|
2,429 |
2,419 |
$26K |
| 86803 |
|
3,424 |
3,411 |
$24K |
| 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 |
740 |
720 |
$24K |
| 83020 |
|
2,186 |
2,161 |
$23K |
| 90633 |
|
2,220 |
2,213 |
$23K |
| 76536 |
|
338 |
336 |
$22K |
| 93350 |
|
207 |
207 |
$22K |
| 99173 |
|
1,710 |
1,703 |
$21K |
| 86706 |
|
3,307 |
3,298 |
$21K |
| 84153 |
|
1,241 |
1,225 |
$20K |
| J0185 |
Injection, aprepitant, 1 mg |
185 |
122 |
$20K |
| 29125 |
|
80 |
79 |
$20K |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
882 |
864 |
$20K |
| 86360 |
|
551 |
541 |
$20K |
| 70486 |
|
318 |
314 |
$20K |
| 84439 |
|
3,934 |
3,803 |
$19K |
| 99386 |
|
129 |
129 |
$19K |
| 85730 |
|
8,913 |
8,531 |
$19K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
470 |
464 |
$18K |
| 86003 |
|
232 |
222 |
$18K |
| 92507 |
Treatment of speech, language, voice, communication, and/or auditory processing disorder |
125 |
42 |
$18K |
| 93325 |
|
736 |
703 |
$18K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
46 |
46 |
$18K |
| 86787 |
|
2,721 |
2,709 |
$17K |
| 88142 |
|
659 |
658 |
$17K |
| 83970 |
|
439 |
431 |
$16K |
| 84702 |
|
3,558 |
3,051 |
$16K |
| 76000 |
|
186 |
185 |
$15K |
| 80055 |
|
126 |
126 |
$15K |
| 87637 |
Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV |
644 |
637 |
$15K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
879 |
852 |
$15K |
| 90651 |
|
966 |
964 |
$15K |
| 90723 |
|
1,390 |
1,387 |
$13K |
| 90648 |
|
1,373 |
1,369 |
$13K |
| J7050 |
Infusion, normal saline solution, 250 cc |
1,292 |
768 |
$13K |
| 86704 |
|
2,486 |
2,482 |
$13K |
| 71045 |
Radiologic examination, chest; single view |
2,600 |
2,489 |
$13K |
| 90744 |
|
1,173 |
1,169 |
$12K |
| 82746 |
|
1,774 |
1,767 |
$12K |
| 85027 |
|
6,373 |
5,913 |
$12K |
| 96417 |
|
473 |
336 |
$12K |
| 90716 |
|
1,131 |
1,130 |
$12K |
| 90707 |
|
1,128 |
1,127 |
$11K |
| 83540 |
|
3,110 |
3,078 |
$11K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
662 |
659 |
$11K |
| 80047 |
|
472 |
441 |
$10K |
| 88360 |
|
119 |
119 |
$9K |
| 95813 |
|
38 |
37 |
$9K |
| 77080 |
|
104 |
104 |
$9K |
| 88341 |
|
229 |
155 |
$9K |
| 90734 |
|
766 |
765 |
$9K |
| 81025 |
|
3,294 |
3,241 |
$9K |
| 87081 |
|
2,306 |
2,294 |
$9K |
| 94729 |
|
369 |
369 |
$9K |
| 90710 |
|
739 |
736 |
$8K |
| 76827 |
|
251 |
246 |
$8K |
| 81001 |
|
11,771 |
11,327 |
$8K |
| 87070 |
|
3,518 |
3,439 |
$8K |
| 90621 |
|
367 |
367 |
$8K |
| 84481 |
|
1,138 |
1,108 |
$8K |
| 90696 |
|
707 |
704 |
$7K |
| J2469 |
Injection, palonosetron hcl, 25 mcg |
687 |
436 |
$7K |
| J1439 |
Injection, ferric carboxymaltose, 1 mg |
17 |
13 |
$7K |
| 83001 |
|
595 |
588 |
$6K |
| 76825 |
|
171 |
168 |
$6K |
| 81220 |
CFTR (cystic fibrosis transmembrane conductance regulator) gene analysis; common variants |
17 |
17 |
$6K |
| 82043 |
|
1,869 |
1,861 |
$6K |
| 20610 |
|
25 |
25 |
$6K |
| 82947 |
|
2,872 |
2,853 |
$6K |
| 86140 |
|
3,642 |
3,547 |
$6K |
| 82948 |
|
1,370 |
1,146 |
$6K |
| 84146 |
|
511 |
499 |
$6K |
| 83516 |
|
285 |
267 |
$6K |
| 71250 |
|
26 |
26 |
$6K |
| 88112 |
|
153 |
151 |
$6K |
| 86708 |
|
665 |
661 |
$5K |
| 96376 |
|
877 |
819 |
$5K |
| 12002 |
|
12 |
12 |
$5K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
2,685 |
2,613 |
$5K |
| 86255 |
|
1,024 |
1,012 |
$5K |
| 86160 |
|
387 |
368 |
$5K |
| 81003 |
|
3,805 |
3,726 |
$5K |
| 72141 |
|
14 |
14 |
$5K |
| 83525 |
|
638 |
632 |
$5K |
| 86376 |
|
515 |
512 |
$5K |
| 84154 |
|
241 |
239 |
$4K |
| 76642 |
|
67 |
67 |
$4K |
| J1756 |
Injection, iron sucrose, 1 mg |
87 |
39 |
$4K |
| 94727 |
|
339 |
339 |
$4K |
| 97535 |
Self-care/home management training, each 15 minutes |
74 |
60 |
$4K |
| 99381 |
|
26 |
26 |
$4K |
| 84402 |
|
248 |
245 |
$4K |
| 93296 |
|
57 |
57 |
$4K |
| 76821 |
|
127 |
102 |
$4K |
| 83735 |
|
5,698 |
5,009 |
$4K |
| 73564 |
|
1,252 |
1,217 |
$3K |
| 86695 |
|
148 |
147 |
$3K |
| 92134 |
|
29 |
29 |
$3K |
| 83002 |
|
367 |
363 |
$3K |
| 96040 |
|
90 |
90 |
$3K |
| 87186 |
|
1,204 |
1,178 |
$3K |
| 72100 |
|
610 |
610 |
$3K |
| 76641 |
|
45 |
45 |
$3K |
| 83690 |
|
7,140 |
6,776 |
$3K |
| 90619 |
|
41 |
41 |
$3K |
| 86355 |
|
76 |
74 |
$3K |
| 73562 |
|
509 |
490 |
$3K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
862 |
855 |
$3K |
| 84550 |
|
1,177 |
1,105 |
$2K |
| 84484 |
|
7,780 |
6,710 |
$2K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
14 |
14 |
$2K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
2,519 |
1,959 |
$2K |
| 86334 |
|
182 |
177 |
$2K |
| 83615 |
|
1,409 |
1,304 |
$2K |
| 73030 |
|
1,004 |
969 |
$2K |
| 97162 |
|
13 |
12 |
$2K |
| 97802 |
|
41 |
41 |
$2K |
| J9267 |
Injection, paclitaxel, 1 mg |
129 |
68 |
$2K |
| 73630 |
|
1,358 |
1,331 |
$2K |
| 86304 |
|
463 |
414 |
$2K |
| C1769 |
Guide wire |
933 |
921 |
$2K |
| 86235 |
|
241 |
237 |
$2K |
| 93923 |
|
12 |
12 |
$2K |
| 99429 |
|
127 |
122 |
$2K |
| 85045 |
|
1,713 |
1,589 |
$2K |
| C1713 |
Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) |
100 |
100 |
$2K |
| 90697 |
|
30 |
26 |
$2K |
| 84460 |
|
350 |
343 |
$2K |
| 86430 |
|
477 |
475 |
$2K |
| 84165 |
|
338 |
327 |
$2K |
| 84450 |
|
350 |
343 |
$2K |
| 82550 |
|
990 |
973 |
$2K |
| 84134 |
|
244 |
243 |
$2K |
| U0001 |
Cdc 2019 novel coronavirus (2019-ncov) real-time rt-pcr diagnostic panel |
508 |
461 |
$2K |
| 85652 |
|
2,028 |
1,987 |
$2K |
| 84681 |
|
92 |
92 |
$2K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
1,611 |
1,568 |
$2K |
| 84100 |
|
2,848 |
2,605 |
$1K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
1,892 |
1,835 |
$1K |
| 83605 |
|
3,235 |
2,969 |
$1K |
| 94726 |
|
13 |
13 |
$1K |
| 72170 |
|
1,202 |
1,162 |
$1K |
| 82677 |
|
151 |
149 |
$1K |
| 82378 |
|
279 |
250 |
$1K |
| 86359 |
|
77 |
75 |
$1K |
| 86357 |
|
76 |
74 |
$1K |
| 82785 |
|
111 |
111 |
$1K |
| 73610 |
|
1,213 |
1,174 |
$1K |
| 85378 |
|
761 |
747 |
$1K |
| 84403 |
|
67 |
66 |
$1K |
| 96411 |
|
40 |
24 |
$1K |
| 90685 |
|
66 |
65 |
$1K |
| 86800 |
|
122 |
113 |
$1K |
| 81329 |
|
20 |
20 |
$1K |
| J9045 |
Injection, carboplatin, 50 mg |
105 |
74 |
$1K |
| 74022 |
|
1,091 |
1,073 |
$1K |
| 81002 |
|
596 |
545 |
$1K |
| 82784 |
|
216 |
208 |
$1K |
| C1887 |
Catheter, guiding (may include infusion/perfusion capability) |
344 |
338 |
$1K |
| A9502 |
Technetium tc-99m tetrofosmin, diagnostic, per study dose |
101 |
98 |
$992.79 |
| 73502 |
|
502 |
486 |
$962.40 |
| 73130 |
|
943 |
915 |
$959.75 |
| J8540 |
Dexamethasone, oral, 0.25 mg |
743 |
387 |
$946.09 |
| 96402 |
|
25 |
25 |
$914.69 |
| 90681 |
|
80 |
80 |
$871.12 |
| 86592 |
|
839 |
826 |
$869.42 |
| 93291 |
|
12 |
12 |
$862.34 |
| J7030 |
Infusion, normal saline solution , 1000 cc |
8,781 |
8,162 |
$832.88 |
| 85384 |
|
574 |
499 |
$806.40 |
| 73110 |
|
758 |
717 |
$793.75 |
| 97116 |
|
22 |
16 |
$793.61 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
21 |
21 |
$783.99 |
| Q3014 |
Telehealth originating site facility fee |
93 |
88 |
$777.51 |
| 86870 |
|
27 |
27 |
$728.86 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
168 |
164 |
$721.32 |
| 86920 |
|
29 |
26 |
$717.87 |
| 82565 |
|
1,164 |
1,154 |
$691.45 |
| 73080 |
|
456 |
428 |
$684.09 |
| 83520 |
|
12 |
12 |
$655.50 |
| 76377 |
|
47 |
47 |
$648.27 |
| 82150 |
|
371 |
368 |
$646.48 |
| J2704 |
Injection, propofol, 10 mg |
5,094 |
4,578 |
$619.90 |
| 96368 |
|
18 |
12 |
$614.60 |
| 94375 |
|
80 |
80 |
$598.66 |
| 81243 |
|
21 |
20 |
$583.99 |
| 82105 |
|
162 |
159 |
$583.05 |
| 92250 |
|
12 |
12 |
$569.07 |
| 85651 |
|
446 |
437 |
$550.54 |
| 83883 |
|
148 |
137 |
$527.06 |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
15 |
15 |
$516.19 |
| 84520 |
|
1,132 |
1,122 |
$513.55 |
| 82951 |
|
178 |
175 |
$500.81 |
| 86765 |
|
215 |
208 |
$490.20 |
| 82164 |
|
13 |
13 |
$487.70 |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
700 |
657 |
$477.22 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
318 |
291 |
$457.66 |
| 85018 |
|
1,065 |
1,064 |
$457.09 |
| 82627 |
|
44 |
42 |
$455.49 |
| 84445 |
|
13 |
12 |
$439.29 |
| 84436 |
|
118 |
116 |
$433.20 |
| 88173 |
|
12 |
12 |
$427.61 |
| 82533 |
|
56 |
52 |
$426.90 |
| 87040 |
|
726 |
615 |
$415.55 |
| 82962 |
|
2,703 |
2,174 |
$408.05 |
| 82248 |
|
126 |
124 |
$406.04 |
| 72052 |
|
28 |
28 |
$405.23 |
| 82570 |
|
460 |
451 |
$400.57 |
| C1894 |
Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser |
177 |
175 |
$395.13 |
| J7060 |
5% dextrose/water (500 ml = 1 unit) |
498 |
348 |
$362.16 |
| 80320 |
|
283 |
275 |
$336.77 |
| 82330 |
|
1,045 |
1,035 |
$325.56 |
| 88300 |
|
141 |
137 |
$322.80 |
| 84132 |
|
1,096 |
1,085 |
$310.54 |
| A9575 |
Injection, gadoterate meglumine, 0.1 ml |
74 |
72 |
$302.95 |
| J1642 |
Injection, heparin sodium, (heparin lock flush), per 10 units |
392 |
257 |
$286.38 |
| 84155 |
|
106 |
101 |
$280.52 |
| 73590 |
|
362 |
348 |
$279.05 |
| 73560 |
|
191 |
188 |
$267.88 |
| 86880 |
|
14 |
14 |
$252.71 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
4,459 |
4,301 |
$244.92 |
| 80329 |
|
146 |
143 |
$233.78 |
| 84295 |
|
1,058 |
1,048 |
$223.85 |
| 85660 |
|
43 |
39 |
$220.62 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
8,594 |
8,085 |
$220.55 |
| 86317 |
|
190 |
189 |
$212.53 |
| 82435 |
|
1,029 |
1,019 |
$205.92 |
| 87625 |
|
34 |
34 |
$203.85 |
| 85014 |
|
1,429 |
1,407 |
$192.07 |
| 74019 |
|
288 |
281 |
$189.81 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
1,884 |
1,845 |
$167.82 |
| 85379 |
|
257 |
246 |
$159.08 |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
1,097 |
988 |
$155.41 |
| 82652 |
|
13 |
12 |
$137.56 |
| 87147 |
|
218 |
188 |
$135.65 |
| 85347 |
|
144 |
116 |
$128.82 |
| J7642 |
Glycopyrrolate, inhalation solution, compounded product, administered through dme, concentrated form, per milligram |
1,531 |
1,522 |
$124.61 |
| 73521 |
|
68 |
68 |
$119.63 |
| 82553 |
|
770 |
729 |
$112.41 |
| 84156 |
|
115 |
109 |
$100.89 |
| J7644 |
Ipratropium bromide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per milligram |
600 |
454 |
$93.72 |
| 93971 |
|
16 |
14 |
$93.00 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
4,940 |
4,634 |
$91.29 |
| 73090 |
|
181 |
158 |
$89.78 |
| Q9966 |
Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml |
43 |
42 |
$85.88 |
| 74018 |
|
48 |
48 |
$79.05 |
| 72082 |
|
36 |
36 |
$75.62 |
| 87181 |
|
174 |
173 |
$73.06 |
| 87045 |
|
24 |
24 |
$70.91 |
| 84166 |
|
12 |
12 |
$69.63 |
| 88720 |
|
404 |
340 |
$67.08 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
2,149 |
1,960 |
$66.69 |
| 87205 |
|
160 |
144 |
$65.70 |
| 86301 |
|
16 |
14 |
$63.89 |
| 80179 |
|
170 |
167 |
$63.82 |
| J1644 |
Injection, heparin sodium, per 1000 units |
744 |
524 |
$61.48 |
| J2370 |
Injection, phenylephrine hcl, up to 1 ml |
89 |
89 |
$61.41 |
| 72040 |
|
12 |
12 |
$61.05 |
| 87338 |
|
14 |
13 |
$57.81 |
| C9399 |
Unclassified drugs or biologicals |
888 |
807 |
$57.55 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
451 |
360 |
$56.64 |
| 82232 |
|
13 |
12 |
$50.71 |
| J2710 |
Injection, neostigmine methylsulfate, up to 0.5 mg |
485 |
483 |
$48.54 |
| 83010 |
|
14 |
14 |
$42.47 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
4,165 |
4,032 |
$40.62 |
| 82977 |
|
13 |
13 |
$36.75 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
957 |
753 |
$27.80 |
| 82247 |
|
15 |
12 |
$25.15 |
| J1630 |
Injection, haloperidol, up to 5 mg |
301 |
238 |
$21.23 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
126 |
102 |
$19.82 |
| C1758 |
Catheter, ureteral |
77 |
77 |
$18.58 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
668 |
652 |
$16.04 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
305 |
297 |
$12.52 |
| 86431 |
|
13 |
13 |
$10.71 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
24 |
24 |
$9.18 |
| 73140 |
|
55 |
53 |
$7.88 |
| 82950 |
|
15 |
15 |
$7.02 |
| J2060 |
Injection, lorazepam, 2 mg |
542 |
488 |
$6.86 |
| 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 |
1,046 |
924 |
$6.23 |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
193 |
141 |
$4.74 |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
921 |
731 |
$2.45 |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
15 |
12 |
$1.52 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
117 |
109 |
$1.05 |
| Q0163 |
Diphenhydramine hydrochloride, 50 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at time of chemotherapy treatment not to exceed a 48 hour dosage regimen |
482 |
387 |
$0.45 |
| J7042 |
5% dextrose/normal saline (500 ml = 1 unit) |
27 |
26 |
$0.16 |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
236 |
235 |
$0.00 |
| S0109 |
Methadone, oral, 5 mg |
13 |
12 |
$0.00 |
| J0330 |
Injection, succinylcholine chloride, up to 20 mg |
13 |
13 |
$0.00 |
| C2617 |
Stent, non-coronary, temporary, without delivery system |
13 |
13 |
$0.00 |
| 90461 |
|
14 |
14 |
$0.00 |
| 99080 |
|
6,695 |
1,667 |
$0.00 |
| 82010 |
|
12 |
12 |
$0.00 |
| 76857 |
|
13 |
13 |
$0.00 |
| 84145 |
|
12 |
12 |
$0.00 |