| Code | Description | Claims | Beneficiaries | Total Paid |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
90,799 |
77,670 |
$12.00M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
57,705 |
51,172 |
$7.01M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
39,731 |
35,667 |
$6.32M |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
198,210 |
141,891 |
$5.34M |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
30,133 |
26,666 |
$4.66M |
| 99215 |
Prolong outpt/office vis |
35,731 |
32,801 |
$4.56M |
| 96361 |
Intravenous infusion, hydration; each additional hour |
13,779 |
12,150 |
$4.35M |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
33,620 |
29,375 |
$4.05M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
23,955 |
22,081 |
$3.51M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
21,446 |
19,802 |
$2.98M |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
36,286 |
13,876 |
$2.11M |
| J0585 |
Injection, onabotulinumtoxina, 1 unit |
5,137 |
3,211 |
$2.07M |
| 45385 |
Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) |
2,306 |
2,255 |
$1.76M |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
3,086 |
2,976 |
$1.69M |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
2,121 |
2,073 |
$1.61M |
| U0004 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc, making use of high throughput technologies as described by cms-2020-01-r |
28,281 |
26,042 |
$1.59M |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
11,408 |
10,578 |
$1.32M |
| 20610 |
|
7,984 |
7,029 |
$1.26M |
| 70450 |
Computed tomography, head or brain; without contrast material |
10,972 |
9,998 |
$1.14M |
| 78815 |
Positron emission tomography (PET) for limited area imaging |
1,560 |
1,467 |
$1.13M |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
5,235 |
3,584 |
$1.12M |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
4,285 |
4,085 |
$1.10M |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
9,665 |
9,449 |
$1.07M |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
6,463 |
6,145 |
$1.01M |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
10,766 |
10,431 |
$875K |
| 62323 |
|
2,306 |
2,232 |
$852K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
22,278 |
8,447 |
$789K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
12,279 |
12,124 |
$771K |
| 74183 |
|
3,095 |
2,935 |
$723K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
5,699 |
5,604 |
$652K |
| 67028 |
Intravitreal injection of a pharmacologic agent |
4,604 |
4,233 |
$643K |
| 43235 |
|
971 |
939 |
$632K |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
6,379 |
6,101 |
$629K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
4,587 |
4,304 |
$597K |
| 11102 |
|
1,242 |
1,167 |
$568K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
17,500 |
15,128 |
$568K |
| 64615 |
|
2,115 |
2,016 |
$554K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
4,323 |
4,179 |
$539K |
| 80053 |
Comprehensive metabolic panel |
107,955 |
93,438 |
$471K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
3,627 |
3,484 |
$469K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
27,718 |
26,914 |
$467K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
4,861 |
4,399 |
$437K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
4,562 |
4,333 |
$434K |
| 96415 |
|
2,022 |
1,516 |
$425K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
4,868 |
3,876 |
$425K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
109,505 |
91,983 |
$416K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
2,593 |
2,464 |
$411K |
| 95806 |
|
502 |
501 |
$411K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
3,534 |
3,331 |
$404K |
| 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 |
12,942 |
11,468 |
$387K |
| 93971 |
|
3,256 |
3,013 |
$378K |
| 93975 |
|
4,193 |
3,978 |
$368K |
| 97803 |
|
6,009 |
5,463 |
$368K |
| 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 |
21,576 |
19,969 |
$367K |
| 76770 |
|
3,370 |
3,191 |
$367K |
| 84443 |
Thyroid stimulating hormone (TSH) |
41,577 |
40,367 |
$367K |
| 52000 |
|
518 |
507 |
$365K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
12,336 |
12,172 |
$341K |
| 76830 |
Ultrasound, transvaginal |
4,001 |
3,865 |
$336K |
| 97161 |
|
6,793 |
6,386 |
$322K |
| 76642 |
|
3,270 |
3,130 |
$304K |
| G0378 |
Hospital observation service, per hour |
10,876 |
4,839 |
$302K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
57,088 |
55,110 |
$300K |
| 31575 |
|
1,447 |
1,379 |
$292K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
2,204 |
2,079 |
$290K |
| 95004 |
Percutaneous tests with allergenic extracts, immediate type reaction |
305 |
302 |
$290K |
| 71250 |
|
5,618 |
5,296 |
$290K |
| J2357 |
Injection, omalizumab, 5 mg |
172 |
113 |
$279K |
| J3490 |
Unclassified drugs |
9,976 |
7,934 |
$268K |
| 95886 |
|
1,546 |
1,447 |
$262K |
| G2023 |
Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
6,185 |
5,757 |
$255K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
9,358 |
9,024 |
$254K |
| 71046 |
Radiologic examination, chest; 2 views |
22,093 |
20,408 |
$248K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
1,427 |
1,347 |
$248K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
9,289 |
8,955 |
$247K |
| 76536 |
|
2,328 |
2,270 |
$244K |
| 95811 |
|
363 |
341 |
$235K |
| G0121 |
Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk |
188 |
187 |
$235K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
3,629 |
3,391 |
$231K |
| 31231 |
|
1,002 |
952 |
$219K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
846 |
821 |
$216K |
| S9485 |
Crisis intervention mental health services, per diem |
380 |
333 |
$214K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
62,449 |
53,571 |
$213K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
57,852 |
50,302 |
$210K |
| 82607 |
|
24,883 |
24,168 |
$209K |
| 80061 |
Lipid panel |
56,974 |
54,959 |
$203K |
| 80050 |
General health panel |
10,084 |
9,703 |
$202K |
| 45378 |
Colonoscopy, flexible; diagnostic, including collection of specimen(s) |
190 |
180 |
$197K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
16,060 |
12,916 |
$193K |
| 85027 |
|
54,897 |
48,753 |
$190K |
| J0178 |
Injection, aflibercept, 1 mg |
438 |
405 |
$190K |
| 66984 |
Extracapsular cataract removal with insertion of intraocular lens prosthesis |
345 |
322 |
$189K |
| 17110 |
|
1,073 |
1,025 |
$187K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
20,182 |
17,700 |
$181K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
6,383 |
4,633 |
$179K |
| 77080 |
|
3,291 |
3,246 |
$173K |
| 94060 |
|
2,641 |
2,495 |
$166K |
| 82728 |
|
21,716 |
20,752 |
$162K |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
6,617 |
6,534 |
$157K |
| 93321 |
|
947 |
908 |
$154K |
| 92557 |
|
3,183 |
3,052 |
$145K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
12,384 |
11,755 |
$143K |
| 84484 |
|
18,194 |
15,402 |
$143K |
| 77065 |
Tomosynthesis, mammo |
1,961 |
1,791 |
$139K |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
4,764 |
4,729 |
$136K |
| 77066 |
Tomosynthesis, mammo |
1,633 |
1,600 |
$136K |
| 84466 |
|
19,984 |
19,143 |
$136K |
| 87631 |
|
2,119 |
2,008 |
$131K |
| G0105 |
Colorectal cancer screening; colonoscopy on individual at high risk |
106 |
106 |
$129K |
| 73221 |
|
562 |
529 |
$129K |
| 93351 |
|
1,082 |
1,036 |
$128K |
| 86480 |
|
3,120 |
3,012 |
$124K |
| 72141 |
|
690 |
668 |
$124K |
| 84702 |
|
11,199 |
10,154 |
$122K |
| 93017 |
|
1,701 |
1,618 |
$117K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
1,978 |
1,716 |
$115K |
| 84153 |
|
8,806 |
8,519 |
$115K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
580 |
460 |
$115K |
| 90686 |
|
5,738 |
5,570 |
$110K |
| 83970 |
|
6,584 |
6,202 |
$108K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
15,649 |
14,755 |
$108K |
| 86803 |
|
10,659 |
10,379 |
$108K |
| 83735 |
|
36,447 |
25,893 |
$106K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
2,330 |
1,206 |
$105K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
5,653 |
5,441 |
$102K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
3,931 |
3,793 |
$101K |
| 97802 |
|
1,402 |
1,331 |
$100K |
| 92134 |
|
9,741 |
9,087 |
$96K |
| 64493 |
|
120 |
106 |
$95K |
| 83880 |
|
6,677 |
6,037 |
$92K |
| 84403 |
|
5,783 |
5,566 |
$91K |
| 93325 |
|
1,526 |
1,446 |
$91K |
| 90750 |
|
1,001 |
997 |
$89K |
| 85610 |
|
46,886 |
34,519 |
$89K |
| 0011A |
|
3,168 |
3,066 |
$84K |
| 95117 |
|
1,917 |
1,098 |
$82K |
| 94010 |
|
2,316 |
2,200 |
$82K |
| 86140 |
|
25,148 |
22,956 |
$80K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
18,759 |
16,703 |
$75K |
| J1644 |
Injection, heparin sodium, per 1000 units |
6,472 |
3,305 |
$74K |
| ATP14 |
|
12,606 |
10,989 |
$74K |
| 73562 |
|
7,118 |
6,508 |
$74K |
| 73130 |
|
5,932 |
5,158 |
$73K |
| 90715 |
|
3,106 |
2,972 |
$73K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
23,345 |
15,328 |
$72K |
| 83540 |
|
20,294 |
19,449 |
$71K |
| 73630 |
|
7,667 |
6,510 |
$70K |
| Q3014 |
Telehealth originating site facility fee |
26,832 |
23,005 |
$70K |
| 94729 |
|
3,239 |
3,054 |
$70K |
| G0399 |
Home sleep test (hst) with type iii portable monitor, unattended; minimum of 4 channels: 2 respiratory movement/airflow, 1 ecg/heart rate and 1 oxygen saturation |
527 |
522 |
$69K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
1,612 |
1,507 |
$69K |
| ATP08 |
|
12,889 |
10,832 |
$68K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
201 |
185 |
$68K |
| 77336 |
|
1,127 |
501 |
$68K |
| 99385 |
|
651 |
643 |
$68K |
| 92083 |
|
3,038 |
2,877 |
$67K |
| 0001A |
|
2,433 |
2,246 |
$67K |
| 81003 |
|
54,999 |
48,724 |
$67K |
| 73030 |
|
6,854 |
6,090 |
$64K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
2,144 |
1,975 |
$64K |
| 99218 |
|
131 |
77 |
$63K |
| C9257 |
Injection, bevacizumab, 0.25 mg |
1,930 |
1,780 |
$63K |
| 11100 |
|
290 |
275 |
$61K |
| 87522 |
Neg quan hep c or qual rna |
1,906 |
1,818 |
$61K |
| 84270 |
|
4,535 |
4,372 |
$61K |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
17,146 |
15,958 |
$60K |
| 72100 |
|
3,396 |
3,275 |
$60K |
| 83690 |
|
13,957 |
12,670 |
$59K |
| 11900 |
|
256 |
248 |
$58K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
14,223 |
11,859 |
$57K |
| 17000 |
|
655 |
628 |
$56K |
| J1745 |
Injection, infliximab, excludes biosimilar, 10 mg |
94 |
61 |
$55K |
| 92341 |
|
1,591 |
1,574 |
$55K |
| 88342 |
|
3,292 |
2,934 |
$54K |
| 73610 |
|
5,809 |
4,998 |
$54K |
| 87088 |
|
11,916 |
10,976 |
$53K |
| 49083 |
|
120 |
51 |
$53K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
1,569 |
923 |
$53K |
| 62321 |
|
96 |
82 |
$52K |
| 95018 |
|
432 |
427 |
$52K |
| 0012A |
|
1,813 |
1,793 |
$52K |
| 86780 |
|
4,478 |
4,325 |
$51K |
| 92133 |
|
3,945 |
3,798 |
$50K |
| 82746 |
|
6,150 |
5,912 |
$49K |
| 82784 |
|
5,005 |
4,621 |
$48K |
| G0279 |
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) |
2,270 |
2,171 |
$48K |
| 82105 |
|
5,826 |
5,379 |
$48K |
| G0297 |
Low dose ct scan (ldct) for lung cancer screening |
728 |
720 |
$46K |
| 87340 |
|
7,061 |
6,694 |
$46K |
| 83516 |
|
3,744 |
3,435 |
$45K |
| 84439 |
|
8,528 |
8,228 |
$43K |
| 81025 |
|
7,990 |
7,484 |
$43K |
| 86850 |
|
8,663 |
7,434 |
$42K |
| 71271 |
|
982 |
964 |
$42K |
| 86706 |
|
5,703 |
5,483 |
$41K |
| 82043 |
|
17,461 |
15,392 |
$41K |
| 90834 |
Psychotherapy, 45 minutes with patient |
7,302 |
5,358 |
$40K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
3,916 |
3,526 |
$40K |
| 86618 |
|
2,694 |
2,612 |
$39K |
| 93970 |
|
332 |
319 |
$39K |
| 93296 |
|
1,558 |
1,488 |
$39K |
| 51798 |
|
5,645 |
5,239 |
$38K |
| 98968 |
|
513 |
461 |
$38K |
| 73110 |
|
4,351 |
3,546 |
$38K |
| 86038 |
|
4,757 |
4,515 |
$38K |
| 86704 |
|
4,782 |
4,582 |
$38K |
| 73502 |
|
4,107 |
3,878 |
$37K |
| 90833 |
Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) |
2,885 |
2,741 |
$37K |
| 87102 |
|
5,914 |
5,628 |
$36K |
| 74178 |
|
193 |
187 |
$35K |
| 82670 |
|
1,711 |
1,664 |
$35K |
| 71045 |
Radiologic examination, chest; single view |
8,706 |
7,613 |
$35K |
| ATP15 |
|
6,071 |
4,876 |
$34K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
343 |
337 |
$33K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
3,210 |
3,084 |
$33K |
| 83001 |
|
2,372 |
2,311 |
$32K |
| 86900 |
|
9,227 |
7,705 |
$32K |
| J1642 |
Injection, heparin sodium, (heparin lock flush), per 10 units |
5,128 |
2,982 |
$32K |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
2,460 |
2,310 |
$32K |
| 80076 |
|
9,927 |
9,394 |
$32K |
| 94726 |
|
690 |
657 |
$31K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
233 |
208 |
$31K |
| 0002A |
|
1,000 |
990 |
$31K |
| 82248 |
|
24,957 |
22,014 |
$31K |
| 87081 |
|
6,778 |
6,484 |
$31K |
| 80197 |
|
8,279 |
5,428 |
$30K |
| 70486 |
|
278 |
261 |
$28K |
| 82274 |
|
1,755 |
1,754 |
$28K |
| 82565 |
|
10,506 |
9,956 |
$28K |
| 85379 |
|
4,505 |
4,249 |
$27K |
| 77002 |
|
1,164 |
1,092 |
$27K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
776 |
730 |
$27K |
| 87186 |
|
6,620 |
6,075 |
$27K |
| 96367 |
|
181 |
128 |
$27K |
| 83605 |
|
4,255 |
3,503 |
$27K |
| 72197 |
|
100 |
93 |
$27K |
| 82330 |
|
6,891 |
6,429 |
$27K |
| 87205 |
|
9,113 |
8,489 |
$26K |
| 97035 |
|
496 |
231 |
$26K |
| 82570 |
|
11,800 |
9,914 |
$26K |
| 87633 |
Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets |
86 |
82 |
$25K |
| 87634 |
|
550 |
535 |
$25K |
| 86160 |
|
1,862 |
1,763 |
$25K |
| 0064A |
|
983 |
944 |
$25K |
| 70496 |
|
200 |
186 |
$24K |
| 95885 |
|
146 |
141 |
$24K |
| 86901 |
|
9,174 |
7,657 |
$24K |
| 91322 |
|
349 |
346 |
$23K |
| 84146 |
|
1,540 |
1,486 |
$23K |
| 95024 |
|
135 |
135 |
$22K |
| 72040 |
|
1,114 |
1,071 |
$22K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
17,904 |
14,503 |
$22K |
| 95810 |
Polysomnography; sleep staging with 4 or more additional parameters |
24 |
24 |
$22K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
16,196 |
15,006 |
$22K |
| 84100 |
|
27,111 |
19,308 |
$22K |
| ATP17 |
|
7,997 |
7,050 |
$21K |
| 99386 |
|
216 |
214 |
$21K |
| 83002 |
|
1,449 |
1,412 |
$21K |
| 90791 |
Psychiatric diagnostic evaluation |
1,774 |
1,563 |
$21K |
| 95910 |
|
155 |
154 |
$20K |
| 92567 |
|
3,395 |
3,258 |
$20K |
| 95813 |
|
59 |
54 |
$20K |
| 87077 |
|
4,875 |
4,467 |
$20K |
| 88112 |
|
599 |
564 |
$20K |
| 36415 |
Collection of venous blood by venipuncture |
99,039 |
80,262 |
$20K |
| 86200 |
|
2,211 |
2,147 |
$20K |
| 97165 |
|
250 |
236 |
$19K |
| A9585 |
Injection, gadobutrol, 0.1 ml |
11,287 |
10,504 |
$19K |
| J2704 |
Injection, propofol, 10 mg |
17,344 |
14,456 |
$19K |
| 95165 |
Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy, multiple dose vials |
369 |
173 |
$19K |
| 84550 |
|
19,220 |
14,830 |
$18K |
| 74018 |
|
1,549 |
1,363 |
$17K |
| 87040 |
|
1,999 |
1,734 |
$17K |
| 64635 |
|
54 |
51 |
$17K |
| 73080 |
|
1,585 |
1,410 |
$17K |
| 90662 |
|
2,728 |
2,647 |
$17K |
| 84165 |
|
3,491 |
3,351 |
$17K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
205 |
195 |
$16K |
| Q0138 |
Injection, ferumoxytol, for treatment of iron deficiency anemia, 1 mg (non-esrd use) |
52 |
37 |
$15K |
| 90677 |
|
649 |
626 |
$15K |
| 83721 |
|
2,667 |
2,604 |
$15K |
| 20553 |
|
88 |
83 |
$15K |
| 99443 |
|
507 |
438 |
$15K |
| 83921 |
|
1,225 |
1,186 |
$15K |
| ATP16 |
|
2,299 |
1,656 |
$15K |
| 87070 |
|
3,286 |
2,962 |
$15K |
| 20550 |
|
79 |
69 |
$15K |
| 88307 |
|
306 |
296 |
$14K |
| 77334 |
|
122 |
86 |
$14K |
| 76882 |
|
126 |
121 |
$14K |
| 76981 |
|
322 |
316 |
$14K |
| 87147 |
|
1,681 |
1,520 |
$14K |
| 85730 |
|
4,793 |
4,437 |
$14K |
| 99442 |
|
814 |
665 |
$14K |
| G0444 |
Annual depression screening, 5 to 15 minutes |
6,784 |
6,551 |
$14K |
| 84480 |
|
1,385 |
1,344 |
$13K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
13,831 |
11,617 |
$13K |
| 64494 |
|
76 |
52 |
$13K |
| 86334 |
|
1,193 |
1,162 |
$13K |
| J0690 |
Injection, cefazolin sodium, 500 mg |
6,628 |
5,472 |
$13K |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
8,400 |
6,921 |
$12K |
| 36591 |
|
3,466 |
2,113 |
$12K |
| 86431 |
|
2,890 |
2,803 |
$11K |
| 99441 |
|
189 |
178 |
$11K |
| 77062 |
|
123 |
122 |
$11K |
| 73564 |
|
1,645 |
1,540 |
$11K |
| 0004A |
|
472 |
442 |
$11K |
| 11721 |
|
765 |
708 |
$11K |
| 83883 |
|
971 |
906 |
$11K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
112 |
111 |
$10K |
| 84425 |
|
672 |
657 |
$10K |
| 90732 |
|
544 |
528 |
$10K |
| 82962 |
|
17,318 |
12,503 |
$10K |
| 86235 |
|
101 |
94 |
$10K |
| 94761 |
|
18,543 |
16,514 |
$10K |
| 88304 |
|
1,286 |
1,249 |
$9K |
| 95819 |
|
52 |
52 |
$9K |
| 87497 |
|
1,205 |
869 |
$9K |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
2,045 |
752 |
$9K |
| J1170 |
Injection, hydromorphone, up to 4 mg |
5,984 |
4,074 |
$9K |
| 82550 |
|
4,773 |
4,380 |
$9K |
| 86708 |
|
912 |
862 |
$9K |
| 97162 |
|
158 |
152 |
$9K |
| 93225 |
|
123 |
121 |
$9K |
| 64405 |
|
29 |
26 |
$9K |
| 85014 |
|
6,273 |
5,774 |
$9K |
| 88341 |
|
386 |
334 |
$8K |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
4,014 |
3,170 |
$8K |
| M0247 |
Intravenous infusion, sotrovimab, includes infusion and post administration monitoring |
45 |
45 |
$8K |
| G0008 |
Administration of influenza virus vaccine |
4,071 |
3,934 |
$8K |
| 83718 |
|
1,335 |
1,314 |
$8K |
| 83520 |
|
556 |
526 |
$8K |
| 91301 |
|
2,540 |
2,389 |
$8K |
| 11104 |
|
13 |
12 |
$8K |
| 90670 |
|
276 |
259 |
$8K |
| 90480 |
|
353 |
350 |
$8K |
| 85018 |
|
3,271 |
2,818 |
$7K |
| C9803 |
Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
2,649 |
2,482 |
$7K |
| 83521 |
|
912 |
819 |
$7K |
| 82390 |
|
865 |
850 |
$7K |
| ATP03 |
|
9,275 |
7,846 |
$7K |
| 58300 |
|
24 |
24 |
$7K |
| 76870 |
|
41 |
40 |
$7K |
| J0881 |
Injection, darbepoetin alfa, 1 microgram (non-esrd use) |
46 |
36 |
$7K |
| 84460 |
|
5,610 |
5,345 |
$7K |
| 0054A |
|
191 |
186 |
$7K |
| 84450 |
|
4,853 |
4,630 |
$7K |
| 82150 |
|
1,213 |
1,146 |
$7K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
7,030 |
6,487 |
$6K |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
3,180 |
2,607 |
$6K |
| J0171 |
Injection, adrenalin, epinephrine, 0.1 mg |
2,332 |
2,089 |
$6K |
| 64636 |
|
107 |
51 |
$6K |
| 0124A |
|
245 |
236 |
$6K |
| 89051 |
|
1,830 |
995 |
$6K |
| 57454 |
|
14 |
14 |
$6K |
| 82040 |
|
4,082 |
3,788 |
$6K |
| 99201 |
|
38 |
38 |
$6K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
687 |
673 |
$5K |
| 86769 |
|
210 |
192 |
$5K |
| 97804 |
|
84 |
83 |
$5K |
| 0134A |
|
230 |
227 |
$5K |
| 87799 |
|
1,140 |
688 |
$5K |
| 90832 |
Psychotherapy, 30 minutes with patient |
1,840 |
1,578 |
$5K |
| 84156 |
|
3,431 |
3,124 |
$5K |
| 99205 |
Prolong outpt/office vis |
104 |
99 |
$5K |
| ATP11 |
|
2,062 |
1,839 |
$5K |
| 86812 |
|
230 |
228 |
$5K |
| ATP07 |
|
1,248 |
1,102 |
$5K |
| 84134 |
|
419 |
405 |
$5K |
| 82172 |
|
325 |
319 |
$4K |
| 81015 |
|
1,993 |
1,909 |
$4K |
| 77061 |
|
51 |
50 |
$4K |
| 74246 |
|
28 |
27 |
$4K |
| 84630 |
|
458 |
454 |
$4K |
| 83615 |
|
2,663 |
2,367 |
$4K |
| 86364 |
|
685 |
674 |
$4K |
| 86765 |
|
250 |
234 |
$4K |
| 82985 |
|
570 |
546 |
$4K |
| G0103 |
Prostate cancer screening; prostate specific antigen test (psa) |
3,145 |
3,111 |
$4K |
| 46600 |
|
69 |
66 |
$4K |
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
190 |
89 |
$4K |
| 82610 |
|
604 |
560 |
$4K |
| 82525 |
|
383 |
370 |
$4K |
| 51702 |
|
1,065 |
955 |
$4K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
2,367 |
1,693 |
$4K |
| 96376 |
|
1,688 |
1,423 |
$4K |
| 99406 |
|
312 |
290 |
$4K |
| 80164 |
|
1,541 |
1,413 |
$3K |
| J1815 |
Injection, insulin, per 5 units |
1,139 |
405 |
$3K |
| 96910 |
|
75 |
12 |
$3K |
| ATP18 |
|
1,610 |
1,422 |
$3K |
| 93226 |
|
52 |
52 |
$3K |
| 98967 |
|
56 |
48 |
$3K |
| 86355 |
|
281 |
267 |
$3K |
| 87427 |
|
144 |
139 |
$3K |
| G0145 |
Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system and manual rescreening under physician supervision |
704 |
690 |
$3K |
| 87517 |
|
122 |
117 |
$3K |
| 82533 |
|
241 |
222 |
$3K |
| 86255 |
|
339 |
310 |
$3K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
20,967 |
18,932 |
$3K |
| 83090 |
|
208 |
207 |
$3K |
| 84590 |
|
311 |
309 |
$3K |
| M0222 |
Intravenous injection, bebtelovimab, includes injection and post administration monitoring |
26 |
26 |
$3K |
| J2060 |
Injection, lorazepam, 2 mg |
2,780 |
1,983 |
$3K |
| 86225 |
|
356 |
336 |
$3K |
| 84207 |
|
124 |
123 |
$3K |
| 86695 |
|
117 |
114 |
$3K |
| 86787 |
|
199 |
180 |
$3K |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
3,985 |
3,243 |
$3K |
| 72202 |
|
82 |
82 |
$3K |
| 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 |
1,375 |
1,250 |
$3K |
| 70498 |
|
113 |
103 |
$3K |
| 81002 |
|
1,757 |
1,552 |
$2K |
| C1769 |
Guide wire |
1,500 |
1,378 |
$2K |
| 86696 |
|
104 |
102 |
$2K |
| 92285 |
|
438 |
414 |
$2K |
| 84446 |
|
220 |
214 |
$2K |
| 86381 |
|
129 |
125 |
$2K |
| 87486 |
|
86 |
82 |
$2K |
| 87581 |
|
86 |
82 |
$2K |
| 83037 |
|
614 |
603 |
$2K |
| 91300 |
|
1,758 |
1,594 |
$2K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
59 |
58 |
$2K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
13 |
12 |
$2K |
| ATP09 |
|
493 |
377 |
$2K |
| 0003A |
|
136 |
135 |
$2K |
| 86735 |
|
70 |
68 |
$2K |
| 86147 |
|
41 |
41 |
$2K |
| 94760 |
|
12,421 |
11,174 |
$2K |
| 0296T |
|
43 |
42 |
$2K |
| 93880 |
|
53 |
51 |
$2K |
| Q9965 |
Low osmolar contrast material, 100-199 mg/ml iodine concentration, per ml |
4,249 |
4,032 |
$2K |
| 90656 |
|
121 |
120 |
$2K |
| 93299 |
|
25 |
25 |
$2K |
| 86762 |
|
71 |
68 |
$2K |
| J1630 |
Injection, haloperidol, up to 5 mg |
1,376 |
1,134 |
$2K |
| 76942 |
|
377 |
352 |
$2K |
| 86376 |
|
94 |
93 |
$2K |
| 73590 |
|
517 |
439 |
$2K |
| G0101 |
Cervical or vaginal cancer screening; pelvic and clinical breast examination |
608 |
582 |
$1K |
| J1040 |
Injection, methylprednisolone acetate, 80 mg |
4,129 |
3,932 |
$1K |
| 87046 |
|
143 |
139 |
$1K |
| 73140 |
|
219 |
213 |
$1K |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
20,513 |
17,438 |
$1K |
| J2795 |
Injection, ropivacaine hydrochloride, 1 mg |
9,095 |
6,466 |
$1K |
| J7050 |
Infusion, normal saline solution, 250 cc |
404 |
385 |
$1K |
| 82103 |
|
131 |
125 |
$1K |
| 90746 |
|
25 |
25 |
$1K |
| 92250 |
|
128 |
125 |
$1K |
| J1756 |
Injection, iron sucrose, 1 mg |
28 |
13 |
$1K |
| G0476 |
Infectious agent detection by nucleic acid (dna or rna); human papillomavirus (hpv), high-risk types (e.g., 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68) for cervical cancer screening, must be performed in addition to pap test |
540 |
532 |
$1K |
| 87269 |
|
69 |
66 |
$1K |
| 72131 |
|
38 |
32 |
$1K |
| 87045 |
|
142 |
138 |
$1K |
| 86146 |
|
25 |
25 |
$1K |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
1,706 |
1,070 |
$1K |
| 80178 |
|
434 |
393 |
$1K |
| 82378 |
|
183 |
173 |
$1K |
| 82947 |
|
309 |
307 |
$1K |
| ATP04 |
|
455 |
397 |
$1K |
| 86800 |
|
65 |
65 |
$1K |
| 86356 |
|
49 |
45 |
$992.04 |
| ATP10 |
|
401 |
316 |
$959.51 |
| 87272 |
|
69 |
66 |
$932.74 |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
377 |
263 |
$863.69 |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
13 |
13 |
$818.60 |
| G0009 |
Administration of pneumococcal vaccine |
790 |
778 |
$798.13 |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
500 |
433 |
$782.11 |
| 51705 |
|
60 |
58 |
$775.97 |
| J3420 |
Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg |
2,255 |
1,878 |
$734.38 |
| J1071 |
Injection, testosterone cypionate, 1 mg |
501 |
235 |
$728.32 |
| 86015 |
|
100 |
95 |
$715.07 |
| 96417 |
|
64 |
38 |
$712.07 |
| 73522 |
|
13 |
13 |
$708.66 |
| 87075 |
|
161 |
131 |
$698.01 |
| 86003 |
|
12 |
12 |
$671.70 |
| 86617 |
|
13 |
13 |
$650.87 |
| 82785 |
|
52 |
50 |
$636.59 |
| J1030 |
Injection, methylprednisolone acetate, 40 mg |
741 |
719 |
$634.48 |
| 99152 |
|
2,214 |
2,021 |
$615.30 |
| 88173 |
|
14 |
12 |
$612.83 |
| 86666 |
|
13 |
12 |
$586.05 |
| 82805 |
|
42 |
29 |
$555.84 |
| 88185 |
|
12 |
12 |
$544.76 |
| 72070 |
|
26 |
25 |
$542.64 |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
274 |
260 |
$534.60 |
| 97116 |
|
74 |
43 |
$525.16 |
| 82977 |
|
168 |
166 |
$507.30 |
| C9399 |
Unclassified drugs or biologicals |
103 |
94 |
$505.96 |
| 83021 |
|
32 |
31 |
$484.12 |
| 86036 |
|
43 |
39 |
$476.50 |
| A4216 |
Sterile water, saline and/or dextrose, diluent/flush, 10 ml |
5,566 |
4,221 |
$466.42 |
| 99492 |
|
133 |
132 |
$463.21 |
| 86328 |
|
16 |
12 |
$461.62 |
| 86359 |
|
25 |
25 |
$458.41 |
| 86357 |
|
25 |
25 |
$458.41 |
| 99153 |
Mod sedat endo service >5yrs |
205 |
189 |
$457.97 |
| ATP02 |
|
188 |
151 |
$418.26 |
| 82948 |
|
73 |
67 |
$417.24 |
| G0328 |
Colorectal cancer screening; fecal occult blood test, immunoassay, 1-3 simultaneous |
1,204 |
1,183 |
$406.47 |
| 69209 |
|
13 |
12 |
$395.49 |
| J1720 |
Injection, hydrocortisone sodium succinate, up to 100 mg |
1,016 |
802 |
$381.92 |
| 82310 |
|
568 |
529 |
$367.85 |
| 0013A |
|
99 |
99 |
$366.96 |
| 85045 |
|
233 |
210 |
$351.51 |
| 85705 |
|
42 |
42 |
$345.58 |
| 83020 |
|
32 |
31 |
$345.02 |
| 85613 |
|
42 |
42 |
$343.62 |
| 84481 |
|
14 |
14 |
$339.14 |
| ATP13 |
|
195 |
175 |
$326.70 |
| J8540 |
Dexamethasone, oral, 0.25 mg |
791 |
413 |
$313.04 |
| 92136 |
|
120 |
109 |
$302.90 |
| 84520 |
|
819 |
766 |
$281.69 |
| 84132 |
|
390 |
276 |
$274.14 |
| 82627 |
|
13 |
12 |
$265.28 |
| A9552 |
Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries |
1,222 |
1,131 |
$257.17 |
| 86317 |
|
16 |
16 |
$237.96 |
| 93298 |
|
12 |
12 |
$237.05 |
| 86304 |
|
42 |
36 |
$235.95 |
| 87015 |
|
58 |
54 |
$225.07 |
| ATP20 |
|
72 |
54 |
$223.82 |
| 73090 |
|
62 |
50 |
$218.26 |
| 86709 |
|
12 |
12 |
$205.77 |
| G2066 |
Interrogation device evaluation(s), (remote) up to 30 days; implantable cardiovascular physiologic monitor system, implantable loop recorder system, or subcutaneous cardiac rhythm monitor system, remote data acquisition(s), receipt of transmissions and technician review, technical support and distribution of results |
12 |
12 |
$186.59 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
276 |
221 |
$186.30 |
| 85652 |
|
100 |
96 |
$160.45 |
| 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 |
2,437 |
1,828 |
$153.68 |
| 88312 |
|
14 |
13 |
$151.72 |
| 88313 |
|
54 |
52 |
$142.41 |
| 87338 |
|
14 |
14 |
$140.89 |
| 87207 |
|
13 |
13 |
$140.65 |
| 86308 |
|
25 |
25 |
$137.94 |
| 86711 |
|
32 |
29 |
$134.10 |
| ATP19 |
|
77 |
61 |
$125.51 |
| 87324 |
|
12 |
12 |
$120.34 |
| 87449 |
|
12 |
12 |
$120.34 |
| J3489 |
Injection, zoledronic acid, 1 mg |
13 |
13 |
$111.89 |
| 82077 |
|
59 |
52 |
$110.06 |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
319 |
196 |
$100.80 |
| 91306 |
|
228 |
225 |
$95.52 |
| 88184 |
|
12 |
12 |
$92.82 |
| J2370 |
Injection, phenylephrine hcl, up to 1 ml |
3,655 |
3,100 |
$74.17 |
| 72170 |
|
74 |
66 |
$73.55 |
| 85004 |
|
165 |
136 |
$73.37 |
| 86360 |
|
13 |
13 |
$70.95 |
| 80069 |
|
91 |
79 |
$70.69 |
| 73552 |
|
96 |
87 |
$69.04 |
| 80175 |
|
30 |
29 |
$54.68 |
| 99493 |
|
271 |
270 |
$52.68 |
| 72156 |
|
13 |
12 |
$44.82 |
| 71101 |
|
13 |
13 |
$35.10 |
| 73060 |
|
50 |
41 |
$28.49 |
| J1020 |
Injection, methylprednisolone acetate, 20 mg |
69 |
67 |
$15.25 |
| 80156 |
|
25 |
25 |
$15.03 |
| 80185 |
|
12 |
12 |
$13.67 |
| G0500 |
Moderate sedation services provided by the same physician or other qualified health care professional performing a gastrointestinal endoscopic service that sedation supports, requiring the presence of an independent trained observer to assist in the monitoring of the patient's level of consciousness and physiological status; initial 15 minutes of intra-service time; patient age 5 years or older (additional time may be reported with 99153, as appropriate) |
758 |
746 |
$13.20 |
| Q9966 |
Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml |
461 |
436 |
$11.81 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
403 |
353 |
$7.70 |
| J1171 |
Injection, hydromorphone, 0.1 mg |
62 |
33 |
$5.04 |
| J1010 |
Injection, methylprednisolone acetate, 1 mg |
256 |
235 |
$1.91 |
| J7060 |
5% dextrose/water (500 ml = 1 unit) |
49 |
25 |
$1.31 |
| J0670 |
Injection, mepivacaine hydrochloride, per 10 ml |
16 |
14 |
$0.00 |
| G8978 |
Mobility: walking & moving around functional limitation, current status, at therapy episode outset and at reporting intervals |
324 |
303 |
$0.00 |
| G8979 |
Mobility: walking & moving around functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting |
388 |
351 |
$0.00 |
| J1596 |
Injection, glycopyrrolate, 0.1 mg |
62 |
55 |
$0.00 |
| G1004 |
Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program |
8,935 |
6,791 |
$0.00 |
| G8985 |
Carrying, moving and handling objects, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting |
98 |
91 |
$0.00 |
| 91313 |
|
67 |
67 |
$0.00 |
| J3370 |
Injection, vancomycin hcl, 500 mg |
144 |
67 |
$0.00 |
| 51741 |
|
17 |
15 |
$0.00 |
| Q9957 |
Injection, perflutren lipid microspheres, per ml |
92 |
88 |
$0.00 |
| 76514 |
|
12 |
12 |
$0.00 |
| G8984 |
Carrying, moving & handling objects functional limitation, current status, at therapy episode outset and at reporting intervals |
59 |
57 |
$0.00 |
| 92020 |
|
16 |
15 |
$0.00 |
| C1780 |
Lens, intraocular (new technology) |
110 |
104 |
$0.00 |
| C1894 |
Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser |
28 |
25 |
$0.00 |
| C9113 |
Injection, pantoprazole sodium, per vial |
22 |
13 |
$0.00 |
| 91312 |
|
83 |
83 |
$0.00 |
| 90837 |
Psychotherapy, 53 minutes with patient |
19 |
15 |
$0.00 |
| 94664 |
|
28 |
25 |
$0.00 |
| 99397 |
|
12 |
12 |
$0.00 |
| 82523 |
|
12 |
12 |
$0.00 |
| J2785 |
Injection, regadenoson, 0.1 mg |
100 |
88 |
$0.00 |
| A9500 |
Technetium tc-99m sestamibi, diagnostic, per study dose |
190 |
170 |
$0.00 |
| V2632 |
Posterior chamber intraocular lens |
473 |
404 |
$0.00 |
| G0442 |
Annual alcohol misuse screening, 5 to 15 minutes |
55 |
55 |
$0.00 |
| G8980 |
Mobility: walking & moving around functional limitation, discharge status, at discharge from therapy or to end reporting |
52 |
50 |
$0.00 |
| 91305 |
|
55 |
53 |
$0.00 |
| J2003 |
Injection, lidocaine hydrochloride, 1 mg |
14 |
13 |
$0.00 |
| 80177 |
|
13 |
12 |
$0.00 |
| C1773 |
Retrieval device, insertable (used to retrieve fractured medical devices) |
25 |
25 |
$0.00 |
| C1726 |
Catheter, balloon dilatation, non-vascular |
12 |
12 |
$0.00 |