| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
66,375 |
62,840 |
$10.56M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
40,136 |
37,740 |
$10.30M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
14,961 |
13,747 |
$3.80M |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
14,434 |
13,622 |
$2.28M |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
2,603 |
2,449 |
$1.53M |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
12,005 |
11,540 |
$1.16M |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
19,171 |
17,954 |
$653K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
25,493 |
22,182 |
$603K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
61,685 |
54,450 |
$432K |
| 80053 |
Comprehensive metabolic panel |
50,722 |
45,411 |
$417K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
14,729 |
12,504 |
$396K |
| 70450 |
Computed tomography, head or brain; without contrast material |
2,406 |
2,255 |
$372K |
| 71046 |
Radiologic examination, chest; 2 views |
8,942 |
8,519 |
$358K |
| J3490 |
Unclassified drugs |
102,987 |
43,348 |
$339K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
11,168 |
10,266 |
$321K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
13,760 |
10,684 |
$308K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
3,455 |
2,387 |
$252K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
3,767 |
2,182 |
$232K |
| 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 |
2,706 |
2,490 |
$193K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
2,068 |
1,874 |
$190K |
| Q0138 |
Injection, ferumoxytol, for treatment of iron deficiency anemia, 1 mg (non-esrd use) |
719 |
569 |
$181K |
| 81025 |
|
17,890 |
16,742 |
$153K |
| 0202U |
Oncology (prostate), multianalyte, gene expression profiling |
2,444 |
2,076 |
$151K |
| 71045 |
Radiologic examination, chest; single view |
6,226 |
5,838 |
$148K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
3,857 |
3,389 |
$147K |
| 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 |
2,445 |
2,063 |
$139K |
| 84484 |
|
15,571 |
12,766 |
$133K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
288 |
271 |
$128K |
| 81001 |
|
38,060 |
35,676 |
$128K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
791 |
733 |
$124K |
| 59025 |
Fetal non-stress test |
1,559 |
1,208 |
$102K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
724 |
684 |
$101K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
3,093 |
2,460 |
$99K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
2,570 |
2,432 |
$99K |
| 83690 |
|
13,514 |
12,709 |
$96K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
6,906 |
5,934 |
$93K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
11,126 |
10,531 |
$92K |
| 87637 |
Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV |
603 |
584 |
$88K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
3,694 |
3,411 |
$86K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
7,052 |
6,378 |
$81K |
| 36415 |
Collection of venous blood by venipuncture |
27,610 |
23,948 |
$59K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
6,392 |
5,802 |
$59K |
| 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 |
2,386 |
2,181 |
$54K |
| J7050 |
Infusion, normal saline solution, 250 cc |
11,986 |
4,851 |
$47K |
| 45385 |
Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) |
294 |
281 |
$44K |
| 66984 |
Extracapsular cataract removal with insertion of intraocular lens prosthesis |
532 |
495 |
$42K |
| 93458 |
|
56 |
54 |
$37K |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
5,299 |
4,873 |
$35K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
10,013 |
9,340 |
$30K |
| 83735 |
|
4,898 |
4,553 |
$30K |
| 82728 |
|
3,925 |
3,158 |
$29K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
2,036 |
1,986 |
$28K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
628 |
586 |
$22K |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
3,866 |
3,346 |
$19K |
| 83550 |
|
3,660 |
2,986 |
$17K |
| 83540 |
|
3,668 |
2,991 |
$13K |
| J2704 |
Injection, propofol, 10 mg |
3,189 |
2,894 |
$12K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
6,720 |
6,111 |
$12K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
1,681 |
1,599 |
$11K |
| 69436 |
Tympanostomy (requiring insertion of ventilating tube), general anesthesia |
52 |
32 |
$11K |
| 87081 |
|
1,607 |
1,568 |
$11K |
| 96367 |
|
364 |
214 |
$11K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
303 |
291 |
$10K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
244 |
239 |
$10K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
294 |
261 |
$9K |
| 85610 |
|
2,779 |
2,580 |
$8K |
| J1439 |
Injection, ferric carboxymaltose, 1 mg |
107 |
70 |
$7K |
| 96417 |
|
173 |
121 |
$7K |
| M0243 |
Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring |
22 |
21 |
$6K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
161 |
149 |
$6K |
| 84443 |
Thyroid stimulating hormone (TSH) |
458 |
396 |
$5K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
237 |
168 |
$5K |
| V2632 |
Posterior chamber intraocular lens |
450 |
419 |
$5K |
| 82553 |
|
663 |
639 |
$4K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
2,303 |
1,353 |
$4K |
| 85027 |
|
907 |
816 |
$3K |
| 83605 |
|
486 |
450 |
$3K |
| C1887 |
Catheter, guiding (may include infusion/perfusion capability) |
148 |
136 |
$3K |
| C1894 |
Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser |
220 |
208 |
$3K |
| J2916 |
Injection, sodium ferric gluconate complex in sucrose injection, 12.5 mg |
196 |
134 |
$3K |
| 82550 |
|
850 |
817 |
$3K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
14 |
12 |
$3K |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
1,033 |
914 |
$3K |
| 85730 |
|
718 |
679 |
$3K |
| 36591 |
|
146 |
101 |
$3K |
| 71250 |
|
46 |
25 |
$2K |
| 87070 |
|
478 |
415 |
$2K |
| J8597 |
Antiemetic drug, oral, not otherwise specified |
363 |
335 |
$2K |
| 87040 |
|
179 |
145 |
$2K |
| 93303 |
Transthoracic echocardiography for congenital cardiac anomalies, follow-up or limited study |
26 |
25 |
$2K |
| 96415 |
|
79 |
50 |
$2K |
| 82962 |
|
834 |
666 |
$2K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
51 |
48 |
$2K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
51 |
48 |
$2K |
| 93320 |
|
26 |
25 |
$2K |
| 80061 |
Lipid panel |
250 |
238 |
$2K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
1,175 |
1,025 |
$2K |
| 83880 |
|
68 |
66 |
$1K |
| 93325 |
|
26 |
25 |
$1K |
| 99152 |
|
65 |
62 |
$1K |
| C1760 |
Closure device, vascular (implantable/insertable) |
73 |
69 |
$1K |
| 82378 |
|
129 |
85 |
$1K |
| 87420 |
|
69 |
68 |
$971.04 |
| 87205 |
|
337 |
294 |
$854.49 |
| C1769 |
Guide wire |
16 |
16 |
$844.55 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
936 |
874 |
$785.18 |
| 86850 |
|
102 |
64 |
$738.16 |
| 81003 |
|
310 |
303 |
$677.60 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
861 |
794 |
$585.36 |
| Q5106 |
Injection, epoetin alfa-epbx, biosimilar, (retacrit) (for non-esrd use), 1000 units |
45 |
26 |
$577.82 |
| 88304 |
|
12 |
12 |
$537.68 |
| 00126 |
|
24 |
14 |
$500.49 |
| 84439 |
|
93 |
76 |
$434.42 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
44 |
39 |
$429.63 |
| A9270 |
Non-covered item or service |
14,726 |
6,187 |
$380.48 |
| 85379 |
|
42 |
40 |
$343.84 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
59 |
54 |
$340.80 |
| 84702 |
|
30 |
28 |
$335.70 |
| 83655 |
|
18 |
16 |
$322.88 |
| J0171 |
Injection, adrenalin, epinephrine, 0.1 mg |
517 |
486 |
$300.58 |
| J8540 |
Dexamethasone, oral, 0.25 mg |
237 |
164 |
$289.15 |
| G0378 |
Hospital observation service, per hour |
19 |
12 |
$261.18 |
| 87186 |
|
39 |
37 |
$251.17 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
66 |
65 |
$241.84 |
| 86901 |
|
105 |
66 |
$214.15 |
| 86900 |
|
104 |
66 |
$214.15 |
| J2003 |
Injection, lidocaine hydrochloride, 1 mg |
65 |
65 |
$167.06 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
80 |
75 |
$165.17 |
| 87210 |
|
27 |
26 |
$157.34 |
| 82948 |
|
45 |
35 |
$136.33 |
| 85007 |
|
42 |
41 |
$115.83 |
| 82607 |
|
14 |
13 |
$110.33 |
| 90686 |
|
60 |
55 |
$100.05 |
| 83921 |
|
12 |
12 |
$82.04 |
| J1644 |
Injection, heparin sodium, per 1000 units |
46 |
41 |
$48.22 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
22 |
12 |
$42.59 |
| 85018 |
|
13 |
12 |
$34.58 |
| 81002 |
|
12 |
12 |
$31.90 |
| 85651 |
|
13 |
12 |
$26.52 |
| J1642 |
Injection, heparin sodium, (heparin lock flush), per 10 units |
137 |
60 |
$2.30 |
| Q0244 |
Injection, casirivimab and imdevimab, 1200 mg |
17 |
16 |
$0.27 |