| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| X4011 |
State-specific procedure code |
26,268 |
23,980 |
$7.00M |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
35,989 |
32,975 |
$3.01M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
19,863 |
18,608 |
$2.87M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
13,009 |
12,005 |
$2.63M |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
47,120 |
40,336 |
$1.70M |
| 80053 |
Comprehensive metabolic panel |
39,055 |
34,894 |
$1.50M |
| X4003 |
|
10,900 |
6,991 |
$1.32M |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
15,548 |
14,041 |
$787K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
2,222 |
1,993 |
$705K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
5,697 |
5,222 |
$571K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
3,192 |
2,991 |
$416K |
| 81003 |
|
5,614 |
4,296 |
$358K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
9,973 |
8,161 |
$355K |
| 71045 |
Radiologic examination, chest; single view |
7,090 |
6,429 |
$325K |
| 36902 |
|
658 |
600 |
$320K |
| 84484 |
|
12,298 |
8,638 |
$297K |
| J2426 |
Injection, paliperidone palmitate extended release (invega sustenna), 1 mg |
1,286 |
1,083 |
$264K |
| 81001 |
|
3,072 |
2,861 |
$244K |
| G0378 |
Hospital observation service, per hour |
733 |
624 |
$214K |
| X4006 |
|
229 |
181 |
$205K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
2,657 |
2,534 |
$179K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
1,394 |
1,221 |
$170K |
| 90791 |
Psychiatric diagnostic evaluation |
2,350 |
2,151 |
$165K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,587 |
3,253 |
$140K |
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
901 |
280 |
$137K |
| 70450 |
Computed tomography, head or brain; without contrast material |
1,584 |
1,418 |
$132K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
6,988 |
6,844 |
$128K |
| 81002 |
|
1,506 |
1,350 |
$122K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,512 |
1,370 |
$114K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
1,021 |
591 |
$109K |
| 81025 |
|
1,120 |
1,085 |
$101K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
1,130 |
1,064 |
$74K |
| 83690 |
|
1,646 |
1,514 |
$66K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
1,823 |
1,595 |
$56K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
2,033 |
1,977 |
$56K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
172 |
86 |
$55K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
899 |
772 |
$53K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
523 |
390 |
$52K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
1,312 |
1,136 |
$49K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
445 |
428 |
$47K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
209 |
196 |
$45K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
359 |
350 |
$42K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
291 |
276 |
$37K |
| C9803 |
Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
3,378 |
3,048 |
$33K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
1,722 |
1,674 |
$32K |
| 76818 |
|
552 |
330 |
$31K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
338 |
321 |
$26K |
| 59025 |
Fetal non-stress test |
90 |
82 |
$24K |
| 84702 |
|
95 |
88 |
$22K |
| J3490 |
Unclassified drugs |
3,529 |
1,987 |
$21K |
| Y7506 |
|
124 |
110 |
$21K |
| 87400 |
|
622 |
587 |
$19K |
| 87428 |
|
417 |
412 |
$16K |
| 71046 |
Radiologic examination, chest; 2 views |
222 |
202 |
$16K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
197 |
186 |
$14K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
197 |
186 |
$14K |
| 36415 |
Collection of venous blood by venipuncture |
422 |
374 |
$14K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
133 |
122 |
$14K |
| 86780 |
|
415 |
408 |
$13K |
| 84703 |
|
394 |
367 |
$13K |
| 83880 |
|
232 |
206 |
$12K |
| 85610 |
|
196 |
169 |
$11K |
| 36591 |
|
195 |
99 |
$11K |
| 82947 |
|
126 |
124 |
$10K |
| 85730 |
|
89 |
84 |
$7K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
362 |
334 |
$7K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
36 |
26 |
$7K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
147 |
128 |
$7K |
| 96415 |
|
202 |
141 |
$6K |
| 83735 |
|
1,421 |
1,282 |
$6K |
| 64483 |
|
29 |
26 |
$6K |
| 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 |
492 |
482 |
$6K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
131 |
116 |
$5K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
801 |
642 |
$4K |
| 87081 |
|
429 |
427 |
$4K |
| 36832 |
|
12 |
12 |
$4K |
| 36901 |
|
13 |
12 |
$3K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
76 |
73 |
$3K |
| 86850 |
|
25 |
24 |
$3K |
| 82657 |
|
151 |
149 |
$3K |
| 76801 |
|
41 |
40 |
$2K |
| 86592 |
|
16 |
14 |
$2K |
| 80061 |
Lipid panel |
291 |
256 |
$2K |
| 86900 |
|
24 |
24 |
$2K |
| 80055 |
|
20 |
17 |
$2K |
| 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 |
457 |
450 |
$1K |
| 85379 |
|
14 |
12 |
$1K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
29 |
29 |
$1K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
259 |
226 |
$1K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
14 |
12 |
$1K |
| 0240U |
|
16 |
13 |
$1K |
| 83020 |
|
18 |
14 |
$1K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
13 |
13 |
$1K |
| 87899 |
|
87 |
85 |
$1K |
| 93985 |
|
15 |
13 |
$995.97 |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
46 |
33 |
$994.53 |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
17 |
12 |
$835.75 |
| 73630 |
|
15 |
12 |
$821.60 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
908 |
842 |
$718.30 |
| 86901 |
|
24 |
24 |
$697.63 |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
13 |
13 |
$483.82 |
| 93990 |
|
13 |
12 |
$389.43 |
| 84450 |
|
127 |
75 |
$381.58 |
| 84075 |
|
127 |
75 |
$381.58 |
| 82247 |
|
127 |
75 |
$370.06 |
| 82040 |
|
127 |
75 |
$365.18 |
| 82962 |
|
458 |
154 |
$320.14 |
| 83605 |
|
65 |
51 |
$300.21 |
| 82803 |
|
21 |
15 |
$271.05 |
| 84155 |
|
127 |
75 |
$270.20 |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
16 |
16 |
$230.52 |
| 87040 |
|
15 |
12 |
$152.85 |
| 84443 |
Thyroid stimulating hormone (TSH) |
18 |
14 |
$120.96 |
| 86803 |
|
38 |
38 |
$95.57 |
| 87210 |
|
15 |
15 |
$64.98 |
| 86696 |
|
26 |
26 |
$61.92 |
| 86694 |
|
26 |
26 |
$57.55 |
| 86695 |
|
26 |
26 |
$52.75 |
| J7050 |
Infusion, normal saline solution, 250 cc |
1,002 |
873 |
$48.65 |
| J1631 |
Injection, haloperidol decanoate, per 50 mg |
237 |
211 |
$35.81 |
| 87340 |
|
13 |
12 |
$34.88 |
| J2704 |
Injection, propofol, 10 mg |
325 |
242 |
$3.34 |
| J1644 |
Injection, heparin sodium, per 1000 units |
275 |
187 |
$2.45 |
| G1004 |
Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program |
89 |
64 |
$0.05 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
650 |
577 |
$0.00 |
| C1894 |
Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser |
972 |
887 |
$0.00 |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
42 |
38 |
$0.00 |
| C1887 |
Catheter, guiding (may include infusion/perfusion capability) |
157 |
153 |
$0.00 |
| J7030 |
Infusion, normal saline solution , 1000 cc |
14 |
14 |
$0.00 |
| 36600 |
|
18 |
15 |
$0.00 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
13 |
13 |
$0.00 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
343 |
318 |
$0.00 |
| C1725 |
Catheter, transluminal angioplasty, non-laser (may include guidance, infusion/perfusion capability) |
645 |
606 |
$0.00 |
| C1769 |
Guide wire |
673 |
629 |
$0.00 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
133 |
127 |
$0.00 |
| 36907 |
|
72 |
68 |
$0.00 |
| A9270 |
Non-covered item or service |
104 |
69 |
$0.00 |