| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
18,117 |
16,900 |
$3.50M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
14,874 |
13,998 |
$2.61M |
| 96361 |
Intravenous infusion, hydration; each additional hour |
6,217 |
5,696 |
$1.84M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
8,418 |
7,886 |
$1.53M |
| 90834 |
Psychotherapy, 45 minutes with patient |
7,222 |
3,736 |
$905K |
| 70450 |
Computed tomography, head or brain; without contrast material |
2,549 |
2,502 |
$775K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
6,094 |
5,235 |
$746K |
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
11,213 |
1,940 |
$736K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
3,984 |
3,818 |
$734K |
| 80053 |
Comprehensive metabolic panel |
25,835 |
20,425 |
$548K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
1,865 |
1,833 |
$546K |
| 90832 |
Psychotherapy, 30 minutes with patient |
5,303 |
3,007 |
$537K |
| 92507 |
Treatment of speech, language, voice, communication, and/or auditory processing disorder |
3,728 |
1,240 |
$521K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
1,830 |
1,789 |
$402K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
1,500 |
1,402 |
$253K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
400 |
392 |
$245K |
| H0005 |
Alcohol and/or drug services; group counseling by a clinician |
3,123 |
608 |
$240K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
694 |
682 |
$220K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
8,811 |
4,589 |
$215K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,734 |
1,584 |
$198K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
4,476 |
4,282 |
$189K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,258 |
1,160 |
$179K |
| 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 |
1,862 |
1,484 |
$158K |
| 90791 |
Psychiatric diagnostic evaluation |
723 |
719 |
$143K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
1,705 |
515 |
$143K |
| G0378 |
Hospital observation service, per hour |
500 |
352 |
$84K |
| 87633 |
Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets |
1,128 |
1,112 |
$80K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
3,974 |
3,652 |
$77K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
9,710 |
6,928 |
$67K |
| 95810 |
Polysomnography; sleep staging with 4 or more additional parameters |
61 |
61 |
$56K |
| 86850 |
|
1,788 |
1,717 |
$55K |
| G0396 |
Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and brief intervention 15 to 30 minutes |
363 |
180 |
$48K |
| 86901 |
|
2,169 |
1,815 |
$46K |
| 86900 |
|
2,169 |
1,817 |
$44K |
| 87486 |
|
1,134 |
1,118 |
$43K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
124 |
120 |
$40K |
| 93976 |
|
103 |
102 |
$40K |
| 92550 |
|
416 |
416 |
$38K |
| 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 |
498 |
480 |
$38K |
| G0397 |
Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and intervention, greater than 30 minutes |
221 |
129 |
$37K |
| 36415 |
Collection of venous blood by venipuncture |
9,044 |
7,597 |
$32K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
2,039 |
1,869 |
$32K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
49 |
49 |
$27K |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
1,288 |
1,239 |
$27K |
| 12001 |
|
47 |
47 |
$26K |
| 87581 |
|
1,135 |
1,119 |
$22K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
565 |
548 |
$20K |
| 92567 |
|
239 |
239 |
$20K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
414 |
408 |
$19K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
221 |
215 |
$18K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
91 |
83 |
$17K |
| 97803 |
|
255 |
187 |
$17K |
| 90833 |
Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) |
419 |
380 |
$16K |
| 83880 |
|
509 |
487 |
$16K |
| H2001 |
Rehabilitation program, per 1/2 day |
114 |
13 |
$15K |
| 76830 |
Ultrasound, transvaginal |
117 |
115 |
$14K |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
142 |
136 |
$14K |
| 92588 |
|
215 |
213 |
$13K |
| 97161 |
|
105 |
104 |
$13K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
28 |
13 |
$12K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
287 |
207 |
$12K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
565 |
548 |
$11K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
5,175 |
4,889 |
$10K |
| 0012A |
|
350 |
350 |
$10K |
| 92579 |
|
140 |
139 |
$10K |
| 71046 |
Radiologic examination, chest; 2 views |
1,719 |
1,679 |
$10K |
| 92557 |
|
155 |
154 |
$9K |
| C1713 |
Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) |
14 |
13 |
$8K |
| 80061 |
Lipid panel |
1,157 |
1,132 |
$8K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
11,217 |
10,175 |
$8K |
| S9480 |
Intensive outpatient psychiatric services, per diem |
54 |
12 |
$8K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
985 |
974 |
$8K |
| 86703 |
|
546 |
541 |
$8K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
4,000 |
3,629 |
$8K |
| 12011 |
|
13 |
13 |
$8K |
| 84443 |
Thyroid stimulating hormone (TSH) |
1,373 |
1,329 |
$7K |
| 85027 |
|
4,429 |
4,098 |
$7K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
45 |
43 |
$7K |
| 0011A |
|
327 |
324 |
$7K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
5,373 |
5,062 |
$7K |
| 92587 |
|
156 |
156 |
$7K |
| 29125 |
|
24 |
24 |
$7K |
| 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 |
578 |
524 |
$6K |
| 90715 |
|
282 |
282 |
$6K |
| 85610 |
|
3,020 |
2,789 |
$6K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
31 |
25 |
$5K |
| 93971 |
|
40 |
39 |
$5K |
| 83516 |
|
594 |
528 |
$4K |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
1,318 |
1,068 |
$4K |
| 85730 |
|
2,248 |
2,187 |
$4K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
17 |
12 |
$4K |
| 92526 |
|
25 |
12 |
$4K |
| 71045 |
Radiologic examination, chest; single view |
2,682 |
2,595 |
$3K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
116 |
111 |
$3K |
| 0002A |
|
74 |
74 |
$3K |
| 96379 |
|
101 |
101 |
$3K |
| 83735 |
|
1,447 |
1,223 |
$2K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
36 |
36 |
$2K |
| 86618 |
|
409 |
217 |
$2K |
| 73610 |
|
437 |
405 |
$2K |
| 99215 |
Prolong outpt/office vis |
15 |
15 |
$2K |
| 73562 |
|
323 |
318 |
$2K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
1,778 |
1,718 |
$2K |
| 85007 |
|
2,645 |
2,452 |
$2K |
| 82784 |
|
126 |
86 |
$2K |
| 73030 |
|
257 |
250 |
$2K |
| 81001 |
|
3,515 |
3,360 |
$2K |
| 86140 |
|
1,005 |
960 |
$1K |
| 81025 |
|
452 |
446 |
$1K |
| 84703 |
|
4,417 |
4,099 |
$1K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
50 |
12 |
$1K |
| 88304 |
|
19 |
13 |
$1K |
| 70486 |
|
13 |
13 |
$1K |
| 85651 |
|
966 |
942 |
$1K |
| 0031A |
|
30 |
30 |
$1K |
| 97010 |
|
65 |
27 |
$1K |
| 84439 |
|
157 |
150 |
$1K |
| 0001A |
|
74 |
74 |
$1K |
| 84484 |
|
2,525 |
2,269 |
$954.44 |
| 83690 |
|
2,794 |
2,601 |
$931.68 |
| 82962 |
|
177 |
131 |
$860.64 |
| 82947 |
|
2,290 |
1,276 |
$819.52 |
| 73630 |
|
261 |
254 |
$739.55 |
| 80320 |
|
2,855 |
2,588 |
$686.62 |
| G0108 |
Diabetes outpatient self-management training services, individual, per 30 minutes |
17 |
12 |
$662.62 |
| 86769 |
|
22 |
22 |
$599.41 |
| 83540 |
|
133 |
133 |
$568.25 |
| 87469 |
|
15 |
15 |
$552.99 |
| 81003 |
|
2,796 |
2,693 |
$512.09 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
834 |
816 |
$509.58 |
| 84466 |
|
50 |
50 |
$478.19 |
| P9604 |
Travel allowance one way in connection with medically necessary laboratory specimen collection drawn from home bound or nursing home bound patient; prorated trip charge |
406 |
262 |
$464.92 |
| 82728 |
|
37 |
37 |
$459.31 |
| 83605 |
|
784 |
698 |
$445.40 |
| 87899 |
|
267 |
262 |
$419.74 |
| 72020 |
|
319 |
312 |
$381.18 |
| 73110 |
|
57 |
51 |
$371.22 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
3,562 |
3,138 |
$370.88 |
| 72100 |
|
52 |
52 |
$321.25 |
| 73130 |
|
70 |
69 |
$301.17 |
| 94799 |
|
18 |
16 |
$299.06 |
| 84100 |
|
156 |
134 |
$278.50 |
| 82150 |
|
639 |
607 |
$247.23 |
| 82550 |
|
234 |
206 |
$217.29 |
| 85379 |
|
364 |
354 |
$217.05 |
| 82570 |
|
43 |
37 |
$204.54 |
| 96376 |
|
315 |
273 |
$204.49 |
| 87070 |
|
96 |
87 |
$190.45 |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
24 |
24 |
$159.04 |
| 82607 |
|
12 |
12 |
$130.74 |
| 87040 |
|
314 |
246 |
$120.92 |
| 87186 |
|
64 |
55 |
$116.61 |
| 73560 |
|
25 |
24 |
$112.16 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
3,058 |
2,856 |
$110.83 |
| 87430 |
|
1,106 |
1,084 |
$105.48 |
| 83550 |
|
65 |
65 |
$104.06 |
| 74018 |
|
38 |
37 |
$102.70 |
| 86364 |
|
14 |
14 |
$99.81 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
597 |
311 |
$94.40 |
| 83789 |
|
113 |
99 |
$91.36 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
695 |
625 |
$82.43 |
| 87081 |
|
1,018 |
1,006 |
$79.61 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
185 |
181 |
$70.84 |
| J1630 |
Injection, haloperidol, up to 5 mg |
140 |
125 |
$65.22 |
| 82077 |
|
458 |
407 |
$63.68 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
561 |
527 |
$59.17 |
| 84702 |
|
26 |
24 |
$49.42 |
| J2060 |
Injection, lorazepam, 2 mg |
403 |
363 |
$46.31 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
250 |
228 |
$38.52 |
| J3535 |
Drug administered through a metered dose inhaler |
12 |
12 |
$37.16 |
| 95806 |
|
12 |
12 |
$34.38 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
181 |
171 |
$34.35 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
124 |
118 |
$31.05 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
623 |
563 |
$30.67 |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
714 |
678 |
$27.13 |
| 87420 |
|
99 |
99 |
$25.72 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
756 |
745 |
$18.16 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
1,578 |
1,493 |
$18.01 |
| 80143 |
|
102 |
98 |
$17.13 |
| 87205 |
|
14 |
14 |
$13.60 |
| J2704 |
Injection, propofol, 10 mg |
992 |
975 |
$9.86 |
| 87254 |
|
182 |
179 |
$9.74 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
12 |
12 |
$6.75 |
| J0134 |
Injection, acetaminophen (fresenius kabi), not therapeutically equivalent to j0131, 10 mg |
371 |
363 |
$4.68 |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
46 |
44 |
$3.42 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
440 |
432 |
$2.05 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
466 |
456 |
$0.60 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
143 |
142 |
$0.00 |
| 84145 |
|
27 |
24 |
$0.00 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
129 |
122 |
$0.00 |
| 80329 |
|
288 |
183 |
$0.00 |
| 87807 |
|
19 |
18 |
$0.00 |
| 87015 |
|
12 |
12 |
$0.00 |
| J7611 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, concentrated form, 1 mg |
19 |
12 |
$0.00 |
| J2003 |
Injection, lidocaine hydrochloride, 1 mg |
13 |
13 |
$0.00 |