| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
Emergency department visit for the evaluation and management, high severity |
17,615 |
14,731 |
$3.19M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
16,757 |
14,059 |
$2.19M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
7,129 |
6,045 |
$1.54M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
17,814 |
14,425 |
$705K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
6,130 |
5,053 |
$560K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
6,396 |
5,661 |
$424K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
6,850 |
5,819 |
$411K |
| G0378 |
Hospital observation service, per hour |
1,113 |
765 |
$393K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
9,815 |
7,529 |
$387K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
4,207 |
3,639 |
$341K |
| 30140 |
|
251 |
194 |
$326K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
3,231 |
1,941 |
$306K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
3,870 |
2,483 |
$304K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
9,032 |
2,203 |
$284K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
7,709 |
6,802 |
$271K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
1,677 |
1,471 |
$250K |
| 99215 |
Prolong outpt/office vis |
2,852 |
2,374 |
$244K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
6,222 |
5,354 |
$242K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
5,076 |
3,747 |
$224K |
| 71046 |
Radiologic examination, chest; 2 views |
5,185 |
4,486 |
$199K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
7,906 |
6,650 |
$183K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
1,764 |
1,534 |
$171K |
| 80053 |
Comprehensive metabolic panel |
26,590 |
20,845 |
$171K |
| 71045 |
Radiologic examination, chest; single view |
5,194 |
4,348 |
$158K |
| 30130 |
|
68 |
67 |
$151K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
1,521 |
1,320 |
$144K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
30,152 |
23,451 |
$137K |
| 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 |
2,134 |
1,928 |
$129K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
5,069 |
3,879 |
$127K |
| 86900 |
|
2,162 |
1,751 |
$127K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
400 |
370 |
$124K |
| 70450 |
Computed tomography, head or brain; without contrast material |
2,600 |
2,209 |
$108K |
| 73630 |
|
2,687 |
2,194 |
$103K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
3,821 |
3,453 |
$101K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
1,222 |
1,131 |
$95K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
2,027 |
1,336 |
$92K |
| 84443 |
Thyroid stimulating hormone (TSH) |
8,236 |
7,239 |
$82K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
6,546 |
5,321 |
$81K |
| 36415 |
Collection of venous blood by venipuncture |
26,347 |
20,031 |
$65K |
| 73562 |
|
1,645 |
1,400 |
$62K |
| 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 |
1,116 |
859 |
$62K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
1,264 |
1,134 |
$56K |
| 87634 |
|
1,025 |
911 |
$55K |
| 74018 |
|
1,242 |
1,034 |
$55K |
| 59025 |
Fetal non-stress test |
533 |
309 |
$52K |
| 83880 |
|
3,014 |
2,517 |
$51K |
| 86850 |
|
1,876 |
1,540 |
$50K |
| 80061 |
Lipid panel |
6,483 |
5,776 |
$50K |
| J3490 |
Unclassified drugs |
8,301 |
4,722 |
$46K |
| 73030 |
|
1,142 |
1,017 |
$40K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,117 |
1,022 |
$39K |
| 86901 |
|
2,152 |
1,754 |
$39K |
| 73610 |
|
927 |
814 |
$38K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,618 |
1,348 |
$36K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,855 |
1,189 |
$36K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
585 |
523 |
$34K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
6,200 |
5,582 |
$34K |
| 95810 |
Polysomnography; sleep staging with 4 or more additional parameters |
55 |
52 |
$33K |
| 81025 |
|
5,267 |
4,541 |
$30K |
| 73130 |
|
684 |
595 |
$28K |
| 69436 |
Tympanostomy (requiring insertion of ventilating tube), general anesthesia |
53 |
37 |
$28K |
| 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 |
1,446 |
1,300 |
$27K |
| 84439 |
|
4,458 |
3,949 |
$25K |
| 84484 |
|
4,373 |
3,108 |
$25K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
1,752 |
1,628 |
$22K |
| 73110 |
|
494 |
419 |
$21K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
799 |
663 |
$20K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
797 |
662 |
$20K |
| 20610 |
|
161 |
139 |
$20K |
| J8499 |
Prescription drug, oral, non chemotherapeutic, nos |
13,898 |
7,556 |
$19K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,894 |
1,547 |
$19K |
| 76642 |
|
429 |
395 |
$19K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
3,405 |
2,743 |
$19K |
| 81000 |
|
7,876 |
6,587 |
$18K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
3,550 |
3,013 |
$18K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
1,068 |
957 |
$18K |
| 90670 |
|
166 |
142 |
$18K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
301 |
277 |
$17K |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
875 |
825 |
$17K |
| 88342 |
|
189 |
144 |
$16K |
| 85027 |
|
3,618 |
2,966 |
$16K |
| 86803 |
|
2,042 |
1,905 |
$16K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
322 |
270 |
$15K |
| 72100 |
|
312 |
270 |
$14K |
| 83690 |
|
3,471 |
2,931 |
$14K |
| 88304 |
|
283 |
201 |
$12K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
433 |
150 |
$11K |
| 84702 |
|
1,180 |
831 |
$11K |
| 83735 |
|
3,628 |
2,652 |
$11K |
| 87186 |
|
2,080 |
1,594 |
$11K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
328 |
208 |
$11K |
| 87081 |
|
1,600 |
1,304 |
$10K |
| 90686 |
|
648 |
610 |
$10K |
| 87077 |
|
2,060 |
1,558 |
$10K |
| 74019 |
|
171 |
152 |
$10K |
| 97161 |
|
237 |
227 |
$9K |
| 87040 |
|
1,871 |
962 |
$9K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
432 |
389 |
$9K |
| 84466 |
|
1,262 |
1,156 |
$9K |
| 81003 |
|
5,529 |
4,787 |
$8K |
| 82728 |
|
1,008 |
915 |
$7K |
| M0243 |
Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring |
39 |
35 |
$7K |
| 85610 |
|
3,192 |
2,546 |
$7K |
| 83605 |
|
1,338 |
1,024 |
$6K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
636 |
235 |
$6K |
| 82607 |
|
772 |
714 |
$6K |
| 87807 |
|
551 |
491 |
$6K |
| 95811 |
|
14 |
12 |
$6K |
| 83540 |
|
1,672 |
1,513 |
$6K |
| 87088 |
|
1,314 |
1,119 |
$6K |
| 82962 |
|
2,453 |
1,881 |
$6K |
| 87070 |
|
1,017 |
827 |
$6K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
13 |
12 |
$5K |
| 82570 |
|
1,775 |
1,498 |
$5K |
| 87400 |
|
453 |
196 |
$4K |
| 86140 |
|
1,356 |
1,183 |
$4K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
900 |
480 |
$4K |
| 86703 |
|
392 |
361 |
$4K |
| 71250 |
|
134 |
123 |
$4K |
| J0561 |
Injection, penicillin g benzathine, 100,000 units |
54 |
40 |
$4K |
| 82950 |
|
1,126 |
1,005 |
$3K |
| 73502 |
|
115 |
102 |
$3K |
| 85730 |
|
1,004 |
836 |
$3K |
| 85651 |
|
1,176 |
1,024 |
$3K |
| 90651 |
|
18 |
15 |
$3K |
| 82043 |
|
1,071 |
966 |
$3K |
| 97162 |
|
100 |
92 |
$2K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
26 |
25 |
$2K |
| 76536 |
|
38 |
36 |
$2K |
| J8597 |
Antiemetic drug, oral, not otherwise specified |
1,034 |
921 |
$2K |
| 76770 |
|
43 |
38 |
$2K |
| 85379 |
|
421 |
345 |
$2K |
| 77065 |
Tomosynthesis, mammo |
36 |
26 |
$2K |
| 90734 |
|
35 |
28 |
$2K |
| 82550 |
|
447 |
357 |
$2K |
| 72040 |
|
40 |
38 |
$2K |
| 73080 |
|
26 |
25 |
$1K |
| 96367 |
|
51 |
37 |
$1K |
| 86738 |
|
99 |
87 |
$1K |
| 84550 |
|
364 |
285 |
$1K |
| 76801 |
|
16 |
12 |
$893.73 |
| 90732 |
|
13 |
13 |
$868.48 |
| 94760 |
|
800 |
571 |
$845.29 |
| 84156 |
|
346 |
229 |
$798.37 |
| 85007 |
|
368 |
278 |
$798.00 |
| 90656 |
|
58 |
56 |
$710.10 |
| 83615 |
|
189 |
145 |
$684.97 |
| 77080 |
|
12 |
12 |
$682.28 |
| 72110 |
|
13 |
12 |
$681.20 |
| J7030 |
Infusion, normal saline solution , 1000 cc |
3,670 |
2,958 |
$677.84 |
| 82553 |
|
62 |
51 |
$670.24 |
| 80179 |
|
58 |
51 |
$640.02 |
| 84153 |
|
86 |
81 |
$634.38 |
| 93971 |
|
17 |
16 |
$614.89 |
| 81001 |
|
278 |
215 |
$609.48 |
| 80076 |
|
79 |
59 |
$562.55 |
| 72125 |
Computed tomography, cervical spine; without contrast material |
25 |
25 |
$525.47 |
| 90661 |
|
16 |
16 |
$326.48 |
| 81002 |
|
136 |
123 |
$322.54 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
4,457 |
3,755 |
$307.92 |
| 87147 |
|
67 |
45 |
$307.55 |
| 84100 |
|
226 |
145 |
$300.27 |
| 86141 |
|
20 |
17 |
$286.90 |
| 82803 |
|
18 |
12 |
$281.99 |
| 80305 |
|
27 |
27 |
$272.16 |
| 96376 |
|
1,816 |
991 |
$268.02 |
| 0071A |
|
14 |
12 |
$258.82 |
| J0330 |
Injection, succinylcholine chloride, up to 20 mg |
1,217 |
948 |
$257.18 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
2,603 |
1,748 |
$251.57 |
| 82565 |
|
58 |
52 |
$246.82 |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
57 |
49 |
$227.32 |
| 82150 |
|
46 |
36 |
$206.60 |
| 96127 |
|
16 |
16 |
$200.00 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
6,567 |
4,950 |
$190.08 |
| 00170 |
Anesthesia for intraoral procedures, including biopsy |
150 |
125 |
$177.51 |
| J2704 |
Injection, propofol, 10 mg |
3,721 |
3,048 |
$176.40 |
| J2175 |
Injection, meperidine hydrochloride, per 100 mg |
2,234 |
1,676 |
$147.00 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
3,054 |
2,443 |
$140.48 |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
4,233 |
3,066 |
$139.84 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
1,898 |
1,349 |
$128.28 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
3,409 |
2,853 |
$110.10 |
| 82746 |
|
16 |
12 |
$109.17 |
| 84520 |
|
31 |
26 |
$92.19 |
| 82248 |
|
18 |
12 |
$75.94 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
4,930 |
3,924 |
$72.85 |
| 82272 |
|
26 |
25 |
$71.33 |
| Q3014 |
Telehealth originating site facility fee |
13 |
12 |
$58.63 |
| 80069 |
|
15 |
13 |
$58.55 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
842 |
612 |
$42.11 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
2,532 |
1,986 |
$35.89 |
| 85018 |
|
17 |
14 |
$23.59 |
| G0008 |
Administration of influenza virus vaccine |
54 |
54 |
$21.49 |
| A4216 |
Sterile water, saline and/or dextrose, diluent/flush, 10 ml |
382 |
216 |
$13.60 |
| J2550 |
Injection, promethazine hcl, up to 50 mg |
942 |
599 |
$10.50 |
| J7620 |
Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme |
364 |
254 |
$10.05 |
| J2272 |
Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg |
603 |
503 |
$7.88 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
320 |
256 |
$7.64 |
| J2919 |
Injection, methylprednisolone sodium succinate, 5 mg |
29 |
24 |
$6.75 |
| S0028 |
Injection, famotidine, 20 mg |
21 |
13 |
$4.62 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
387 |
327 |
$2.76 |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
204 |
165 |
$2.50 |
| 80347 |
|
214 |
190 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
57 |
53 |
$0.00 |
| 90461 |
|
670 |
604 |
$0.00 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
431 |
356 |
$0.00 |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
42 |
36 |
$0.00 |
| 80364 |
|
214 |
190 |
$0.00 |
| J1171 |
Injection, hydromorphone, 0.1 mg |
45 |
35 |
$0.00 |
| 80355 |
|
214 |
190 |
$0.00 |
| 00731 |
|
40 |
37 |
$0.00 |
| J0702 |
Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg |
20 |
13 |
$0.00 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
234 |
208 |
$0.00 |
| J7510 |
Prednisolone oral, per 5 mg |
84 |
63 |
$0.00 |
| 90715 |
|
93 |
84 |
$0.00 |
| 90648 |
|
56 |
48 |
$0.00 |
| 90714 |
|
52 |
49 |
$0.00 |
| 80326 |
|
214 |
190 |
$0.00 |
| J0134 |
Injection, acetaminophen (fresenius kabi), not therapeutically equivalent to j0131, 10 mg |
25 |
24 |
$0.00 |
| 90633 |
|
16 |
13 |
$0.00 |
| J7070 |
Infusion, d5w, 1000 cc |
60 |
29 |
$0.00 |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
16 |
12 |
$0.00 |
| 77061 |
|
33 |
25 |
$0.00 |
| J2360 |
Injection, orphenadrine citrate, up to 60 mg |
103 |
81 |
$0.00 |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
1,094 |
1,016 |
$0.00 |
| 94761 |
|
1,518 |
974 |
$0.00 |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
193 |
177 |
$0.00 |
| A9698 |
Non-radioactive contrast imaging material, not otherwise classified, per study |
765 |
546 |
$0.00 |
| J1940 |
Injection, furosemide, up to 20 mg |
60 |
41 |
$0.00 |
| J1815 |
Injection, insulin, per 5 units |
27 |
13 |
$0.00 |
| J7050 |
Infusion, normal saline solution, 250 cc |
454 |
283 |
$0.00 |
| J3420 |
Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg |
138 |
113 |
$0.00 |
| 90474 |
|
19 |
13 |
$0.00 |
| J2060 |
Injection, lorazepam, 2 mg |
114 |
80 |
$0.00 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
13 |
12 |
$0.00 |
| J2003 |
Injection, lidocaine hydrochloride, 1 mg |
71 |
67 |
$0.00 |
| 80320 |
|
35 |
28 |
$0.00 |
| A9585 |
Injection, gadobutrol, 0.1 ml |
42 |
37 |
$0.00 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
14 |
14 |
$0.00 |
| 90723 |
|
36 |
31 |
$0.00 |
| 80329 |
|
13 |
12 |
$0.00 |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
20 |
17 |
$0.00 |
| J1040 |
Injection, methylprednisolone acetate, 80 mg |
16 |
12 |
$0.00 |
| 00160 |
|
12 |
12 |
$0.00 |