| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 0202U |
Oncology (prostate), multianalyte, gene expression profiling |
19,087 |
18,421 |
$5.07M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
25,286 |
22,918 |
$3.53M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
42,613 |
39,832 |
$3.47M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
10,211 |
9,102 |
$1.08M |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
2,865 |
2,610 |
$761K |
| 70450 |
Computed tomography, head or brain; without contrast material |
3,193 |
2,704 |
$478K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
4,909 |
4,690 |
$403K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
5,082 |
4,529 |
$321K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
928 |
817 |
$199K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
4,191 |
3,772 |
$140K |
| G0378 |
Hospital observation service, per hour |
1,820 |
1,120 |
$127K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
471 |
428 |
$126K |
| 81220 |
CFTR (cystic fibrosis transmembrane conductance regulator) gene analysis; common variants |
213 |
200 |
$106K |
| 80053 |
Comprehensive metabolic panel |
22,251 |
19,657 |
$102K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
2,286 |
1,748 |
$97K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
1,469 |
1,326 |
$90K |
| 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 |
1,859 |
1,700 |
$89K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
1,091 |
1,014 |
$73K |
| 59025 |
Fetal non-stress test |
745 |
572 |
$72K |
| 71045 |
Radiologic examination, chest; single view |
10,641 |
9,508 |
$69K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
3,568 |
3,110 |
$68K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
635 |
516 |
$65K |
| 71046 |
Radiologic examination, chest; 2 views |
2,669 |
2,556 |
$64K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
1,509 |
1,238 |
$53K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
658 |
630 |
$43K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
1,432 |
1,304 |
$42K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
3,536 |
2,990 |
$42K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
113 |
105 |
$36K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
7,858 |
6,921 |
$35K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
6,672 |
6,131 |
$32K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
8,426 |
7,165 |
$31K |
| 92650 |
|
820 |
741 |
$30K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
82 |
73 |
$29K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
1,612 |
462 |
$26K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
25,378 |
22,028 |
$26K |
| 87637 |
Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV |
3,732 |
3,546 |
$26K |
| 74018 |
|
2,070 |
1,977 |
$25K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
770 |
564 |
$23K |
| 76830 |
Ultrasound, transvaginal |
350 |
334 |
$20K |
| 87507 |
|
284 |
271 |
$20K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
2,114 |
1,964 |
$19K |
| 81025 |
|
4,095 |
3,801 |
$19K |
| 92587 |
|
472 |
395 |
$18K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
215 |
208 |
$18K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
5,446 |
5,346 |
$17K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
258 |
253 |
$17K |
| 86850 |
|
1,697 |
1,509 |
$16K |
| 73610 |
|
781 |
722 |
$16K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
667 |
598 |
$16K |
| 76801 |
|
1,250 |
1,078 |
$15K |
| 82947 |
|
2,729 |
1,594 |
$12K |
| 81001 |
|
15,128 |
13,708 |
$11K |
| 87806 |
|
1,129 |
1,075 |
$11K |
| 73110 |
|
548 |
494 |
$11K |
| 73630 |
|
896 |
813 |
$11K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
138 |
102 |
$10K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
2,490 |
1,977 |
$10K |
| 93017 |
|
266 |
244 |
$10K |
| 86901 |
|
2,241 |
2,005 |
$8K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
165 |
134 |
$8K |
| 69436 |
Tympanostomy (requiring insertion of ventilating tube), general anesthesia |
25 |
24 |
$8K |
| 73130 |
|
562 |
498 |
$8K |
| 73562 |
|
558 |
485 |
$8K |
| 76377 |
|
835 |
663 |
$7K |
| 81003 |
|
3,639 |
3,389 |
$7K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
202 |
191 |
$7K |
| J2704 |
Injection, propofol, 10 mg |
1,015 |
684 |
$7K |
| 93971 |
|
490 |
434 |
$7K |
| 73080 |
|
347 |
315 |
$7K |
| 0225U |
|
646 |
623 |
$6K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
1,317 |
1,231 |
$6K |
| 72131 |
|
62 |
55 |
$6K |
| 84484 |
|
4,598 |
3,441 |
$6K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
107 |
86 |
$6K |
| 87070 |
|
660 |
590 |
$6K |
| 73030 |
|
585 |
514 |
$6K |
| 84702 |
|
1,842 |
1,493 |
$6K |
| 01999 |
|
1,548 |
1,453 |
$6K |
| 80050 |
General health panel |
259 |
248 |
$5K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
1,237 |
999 |
$5K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
2,174 |
1,990 |
$5K |
| 80061 |
Lipid panel |
1,216 |
1,135 |
$5K |
| J0690 |
Injection, cefazolin sodium, 500 mg |
300 |
226 |
$4K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
108 |
106 |
$4K |
| J1170 |
Injection, hydromorphone, up to 4 mg |
232 |
161 |
$4K |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
945 |
797 |
$4K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
4,480 |
3,731 |
$4K |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
1,497 |
1,269 |
$4K |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
1,171 |
1,122 |
$3K |
| 96376 |
|
835 |
583 |
$3K |
| 84443 |
Thyroid stimulating hormone (TSH) |
1,454 |
1,345 |
$3K |
| 73564 |
|
285 |
245 |
$3K |
| 97161 |
|
47 |
42 |
$3K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
287 |
276 |
$3K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
101 |
80 |
$3K |
| 72100 |
|
320 |
298 |
$3K |
| 88304 |
|
64 |
50 |
$3K |
| 36415 |
Collection of venous blood by venipuncture |
1,296 |
949 |
$3K |
| 71250 |
|
69 |
55 |
$3K |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
1,783 |
1,595 |
$3K |
| 73090 |
|
173 |
155 |
$3K |
| 72110 |
|
41 |
35 |
$2K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
116 |
107 |
$2K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
33 |
14 |
$2K |
| 73140 |
|
110 |
108 |
$2K |
| 87420 |
|
15 |
14 |
$2K |
| 86317 |
|
159 |
153 |
$2K |
| 84703 |
|
5,869 |
5,372 |
$2K |
| 86140 |
|
2,455 |
2,273 |
$2K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
4,438 |
3,455 |
$2K |
| G1010 |
Clinical decision support mechanism stanson, as defined by the medicare appropriate use criteria program |
781 |
386 |
$2K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
476 |
398 |
$2K |
| 82951 |
|
332 |
327 |
$2K |
| 83690 |
|
4,828 |
4,339 |
$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 |
247 |
183 |
$1K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
1,116 |
1,042 |
$1K |
| 85610 |
|
3,526 |
3,005 |
$1K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
186 |
63 |
$1K |
| 85730 |
|
2,806 |
2,434 |
$1K |
| 86803 |
|
836 |
785 |
$1K |
| 70491 |
|
30 |
30 |
$1K |
| 84439 |
|
1,086 |
1,022 |
$1K |
| 85018 |
|
458 |
425 |
$1K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
1,495 |
1,404 |
$1K |
| 87340 |
|
999 |
946 |
$1K |
| 86592 |
|
503 |
474 |
$945.96 |
| 0002A |
|
74 |
68 |
$925.61 |
| 73502 |
|
160 |
131 |
$910.22 |
| 10060 |
|
14 |
12 |
$763.60 |
| 87077 |
|
1,958 |
1,666 |
$746.86 |
| 73590 |
|
120 |
107 |
$683.14 |
| 82728 |
|
354 |
331 |
$647.68 |
| 0001A |
|
72 |
68 |
$634.61 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
2,584 |
2,257 |
$625.03 |
| 93970 |
|
19 |
16 |
$617.29 |
| 87186 |
|
1,790 |
1,545 |
$577.01 |
| 86900 |
|
2,249 |
2,006 |
$567.37 |
| 86762 |
|
448 |
422 |
$548.97 |
| 97150 |
Therapeutic procedure(s), group (2 or more individuals) |
34 |
12 |
$507.21 |
| 85027 |
|
1,161 |
975 |
$452.39 |
| 72040 |
|
24 |
24 |
$440.48 |
| 0071A |
|
16 |
16 |
$433.79 |
| 86787 |
|
495 |
468 |
$397.26 |
| 80076 |
|
146 |
132 |
$383.08 |
| 87040 |
|
2,464 |
1,806 |
$369.18 |
| 83735 |
|
1,808 |
1,518 |
$365.44 |
| 12011 |
|
14 |
12 |
$360.18 |
| 82247 |
|
196 |
116 |
$345.38 |
| 87205 |
|
286 |
250 |
$325.71 |
| 83880 |
|
1,343 |
1,159 |
$322.64 |
| 84156 |
|
126 |
95 |
$322.20 |
| 82565 |
|
257 |
222 |
$300.77 |
| 85007 |
|
183 |
160 |
$298.45 |
| 82248 |
|
350 |
284 |
$295.85 |
| 87581 |
|
13 |
13 |
$286.37 |
| 85379 |
|
639 |
587 |
$261.73 |
| J2785 |
Injection, regadenoson, 0.1 mg |
65 |
56 |
$247.88 |
| 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 |
15 |
14 |
$240.44 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
295 |
229 |
$238.26 |
| J1644 |
Injection, heparin sodium, per 1000 units |
202 |
91 |
$237.64 |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
357 |
312 |
$237.64 |
| 87210 |
|
1,174 |
1,096 |
$236.17 |
| J7050 |
Infusion, normal saline solution, 250 cc |
1,076 |
790 |
$215.12 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
350 |
298 |
$205.24 |
| 90715 |
|
333 |
299 |
$201.17 |
| C1751 |
Catheter, infusion, inserted peripherally, centrally or midline (other than hemodialysis) |
19 |
13 |
$188.29 |
| 0012A |
|
34 |
31 |
$170.34 |
| 83605 |
|
1,559 |
1,228 |
$164.73 |
| 82105 |
|
25 |
25 |
$160.81 |
| 82607 |
|
169 |
159 |
$152.48 |
| 12001 |
|
14 |
12 |
$149.07 |
| J2060 |
Injection, lorazepam, 2 mg |
233 |
181 |
$148.85 |
| 82077 |
|
436 |
364 |
$104.93 |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
53 |
53 |
$104.37 |
| 71101 |
|
31 |
30 |
$101.68 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
284 |
259 |
$85.52 |
| 82570 |
|
261 |
201 |
$81.40 |
| 86780 |
|
177 |
164 |
$70.02 |
| 87801 |
Infectious agent detection by nucleic acid; amplified probe, multiple organisms |
13 |
13 |
$67.32 |
| 87481 |
|
12 |
12 |
$67.32 |
| 83655 |
|
108 |
104 |
$63.18 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
1,649 |
1,373 |
$51.05 |
| 82550 |
|
302 |
242 |
$48.02 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
1,792 |
1,413 |
$47.23 |
| J2550 |
Injection, promethazine hcl, up to 50 mg |
34 |
28 |
$40.51 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
70 |
37 |
$38.08 |
| A9575 |
Injection, gadoterate meglumine, 0.1 ml |
49 |
44 |
$34.63 |
| 87341 |
|
118 |
109 |
$23.12 |
| 83540 |
|
326 |
304 |
$22.96 |
| 85652 |
|
571 |
517 |
$18.41 |
| 85014 |
|
496 |
461 |
$18.04 |
| 84466 |
|
241 |
228 |
$15.98 |
| 83550 |
|
56 |
51 |
$12.21 |
| 80074 |
|
12 |
12 |
$12.02 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
85 |
74 |
$10.22 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
503 |
419 |
$6.72 |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
2,475 |
1,459 |
$3.39 |
| 82952 |
|
154 |
151 |
$2.95 |
| 82274 |
|
54 |
49 |
$1.58 |
| A9500 |
Technetium tc-99m sestamibi, diagnostic, per study dose |
79 |
70 |
$0.00 |
| J2360 |
Injection, orphenadrine citrate, up to 60 mg |
445 |
399 |
$0.00 |
| 87486 |
|
13 |
13 |
$0.00 |
| 74019 |
|
42 |
42 |
$0.00 |
| J1790 |
Injection, droperidol, up to 5 mg |
27 |
25 |
$0.00 |
| J2543 |
Injection, piperacillin sodium/tazobactam sodium, 1 gram/0.125 grams (1.125 grams) |
76 |
50 |
$0.00 |
| 87081 |
|
69 |
68 |
$0.00 |
| 82746 |
|
26 |
25 |
$0.00 |
| J1815 |
Injection, insulin, per 5 units |
38 |
12 |
$0.00 |
| C9113 |
Injection, pantoprazole sodium, per vial |
218 |
182 |
$0.00 |
| 99152 |
|
72 |
67 |
$0.00 |
| 29125 |
|
26 |
26 |
$0.00 |
| J7510 |
Prednisolone oral, per 5 mg |
63 |
59 |
$0.00 |
| 86038 |
|
14 |
14 |
$0.00 |
| 84100 |
|
32 |
26 |
$0.00 |
| 82805 |
|
12 |
12 |
$0.00 |
| 84145 |
|
12 |
12 |
$0.00 |