| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
Emergency department visit for the evaluation and management, high severity |
50,778 |
46,719 |
$11.63M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
60,377 |
56,321 |
$10.75M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
21,268 |
19,619 |
$5.37M |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
12,999 |
12,098 |
$2.04M |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
10,867 |
10,254 |
$1.19M |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
29,564 |
26,681 |
$859K |
| 41899 |
Unlisted procedure, dentoalveolar structures |
464 |
438 |
$739K |
| 70450 |
Computed tomography, head or brain; without contrast material |
3,327 |
3,070 |
$732K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
963 |
911 |
$695K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
9,795 |
8,779 |
$539K |
| 71045 |
Radiologic examination, chest; single view |
14,107 |
13,011 |
$523K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
16,140 |
14,830 |
$508K |
| 80053 |
Comprehensive metabolic panel |
60,617 |
54,634 |
$499K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
13,039 |
11,434 |
$489K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
66,116 |
58,877 |
$447K |
| J3490 |
Unclassified drugs |
109,161 |
42,188 |
$432K |
| 71046 |
Radiologic examination, chest; 2 views |
5,223 |
4,895 |
$418K |
| 66984 |
Extracapsular cataract removal with insertion of intraocular lens prosthesis |
1,669 |
1,548 |
$361K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
2,796 |
1,729 |
$355K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
3,729 |
2,165 |
$301K |
| 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 |
2,696 |
2,399 |
$178K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
12,026 |
9,972 |
$178K |
| 81001 |
|
49,496 |
45,517 |
$177K |
| 81025 |
|
21,220 |
19,495 |
$170K |
| 87631 |
|
2,064 |
2,013 |
$167K |
| 36415 |
Collection of venous blood by venipuncture |
68,741 |
59,331 |
$144K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
4,949 |
4,171 |
$133K |
| 84484 |
|
17,187 |
14,080 |
$127K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
1,742 |
557 |
$118K |
| 69436 |
Tympanostomy (requiring insertion of ventilating tube), general anesthesia |
196 |
191 |
$109K |
| 83690 |
|
16,589 |
15,294 |
$108K |
| 0202U |
Oncology (prostate), multianalyte, gene expression profiling |
1,626 |
1,399 |
$107K |
| 42820 |
Tonsillectomy and adenoidectomy; younger than age 12 |
112 |
109 |
$107K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
205 |
186 |
$105K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
11,746 |
10,889 |
$102K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
2,206 |
1,969 |
$102K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
1,656 |
1,590 |
$89K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
2,702 |
2,556 |
$84K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
984 |
890 |
$72K |
| 77412 |
|
562 |
48 |
$72K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
724 |
665 |
$65K |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
5,170 |
4,740 |
$58K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
303 |
272 |
$55K |
| 77336 |
|
721 |
260 |
$52K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
3,004 |
2,800 |
$52K |
| 87637 |
Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV |
360 |
326 |
$51K |
| 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 |
2,502 |
2,211 |
$49K |
| 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 |
1,013 |
911 |
$40K |
| J7050 |
Infusion, normal saline solution, 250 cc |
6,543 |
3,095 |
$35K |
| 83735 |
|
6,166 |
5,631 |
$35K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
3,164 |
2,686 |
$33K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
990 |
893 |
$32K |
| G0378 |
Hospital observation service, per hour |
548 |
386 |
$29K |
| 93798 |
|
350 |
66 |
$24K |
| 77417 |
|
778 |
277 |
$23K |
| 88304 |
|
290 |
284 |
$23K |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
3,518 |
3,261 |
$23K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
6,868 |
6,353 |
$22K |
| 99201 |
|
388 |
329 |
$22K |
| 83880 |
|
669 |
609 |
$20K |
| 87400 |
|
677 |
611 |
$15K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
471 |
436 |
$15K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
471 |
436 |
$15K |
| V2632 |
Posterior chamber intraocular lens |
1,413 |
1,301 |
$15K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
43 |
40 |
$13K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
6,911 |
6,372 |
$13K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
231 |
206 |
$11K |
| Q0138 |
Injection, ferumoxytol, for treatment of iron deficiency anemia, 1 mg (non-esrd use) |
26 |
16 |
$10K |
| J1097 |
Phenylephrine 10.16 mg/ml and ketorolac 2.88 mg/ml ophthalmic irrigation solution, 1 ml |
182 |
177 |
$10K |
| 86003 |
|
83 |
79 |
$9K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
1,113 |
1,000 |
$8K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
281 |
268 |
$8K |
| 85610 |
|
2,796 |
2,568 |
$8K |
| 0071A |
|
140 |
119 |
$8K |
| 59050 |
|
120 |
108 |
$8K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
242 |
222 |
$8K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
51 |
43 |
$7K |
| 0072A |
|
113 |
105 |
$7K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
13 |
12 |
$7K |
| 87430 |
|
458 |
442 |
$6K |
| 80061 |
Lipid panel |
271 |
249 |
$6K |
| 82962 |
|
2,387 |
1,774 |
$5K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
116 |
101 |
$5K |
| J2704 |
Injection, propofol, 10 mg |
2,147 |
1,834 |
$5K |
| 0001A |
|
85 |
78 |
$5K |
| 11043 |
|
88 |
60 |
$5K |
| 84681 |
|
185 |
174 |
$5K |
| 0064A |
|
96 |
90 |
$4K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
1,378 |
1,311 |
$4K |
| 59025 |
Fetal non-stress test |
32 |
27 |
$4K |
| 83525 |
|
230 |
211 |
$4K |
| 84439 |
|
272 |
252 |
$4K |
| 84443 |
Thyroid stimulating hormone (TSH) |
166 |
159 |
$4K |
| A9270 |
Non-covered item or service |
29,617 |
13,468 |
$4K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
2,365 |
2,184 |
$3K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
13 |
12 |
$3K |
| 82728 |
|
411 |
381 |
$3K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
300 |
198 |
$3K |
| 0002A |
|
58 |
52 |
$3K |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
776 |
694 |
$3K |
| C9290 |
Injection, bupivacaine liposome, 1 mg |
29 |
28 |
$3K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
238 |
220 |
$3K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
29 |
24 |
$3K |
| 66982 |
|
13 |
12 |
$2K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
55 |
54 |
$2K |
| J0171 |
Injection, adrenalin, epinephrine, 0.1 mg |
1,413 |
1,303 |
$2K |
| 83540 |
|
543 |
505 |
$2K |
| 87081 |
|
319 |
308 |
$2K |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
1,968 |
1,814 |
$2K |
| J8540 |
Dexamethasone, oral, 0.25 mg |
803 |
485 |
$2K |
| G0239 |
Therapeutic procedures to improve respiratory function or increase strength or endurance of respiratory muscles, two or more individuals (includes monitoring) |
185 |
36 |
$2K |
| 74019 |
|
28 |
27 |
$2K |
| J0690 |
Injection, cefazolin sodium, 500 mg |
434 |
411 |
$2K |
| 82785 |
|
92 |
88 |
$2K |
| 0004A |
|
29 |
28 |
$2K |
| 83550 |
|
283 |
275 |
$2K |
| 84466 |
|
192 |
173 |
$2K |
| 85730 |
|
358 |
326 |
$1K |
| 84702 |
|
124 |
113 |
$1K |
| 85027 |
|
294 |
215 |
$1K |
| J8597 |
Antiemetic drug, oral, not otherwise specified |
241 |
230 |
$1K |
| 83605 |
|
116 |
97 |
$915.01 |
| 87210 |
|
176 |
164 |
$861.89 |
| 97161 |
|
15 |
13 |
$814.15 |
| 87186 |
|
84 |
75 |
$728.83 |
| J7121 |
5% dextrose in lactated ringers infusion, up to 1000 cc |
64 |
51 |
$679.46 |
| 81015 |
|
182 |
173 |
$635.75 |
| 82565 |
|
223 |
177 |
$601.54 |
| 87077 |
|
55 |
50 |
$553.30 |
| J7510 |
Prednisolone oral, per 5 mg |
187 |
160 |
$500.29 |
| 97803 |
|
27 |
24 |
$464.81 |
| 87040 |
|
26 |
25 |
$348.68 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
121 |
113 |
$344.31 |
| 84146 |
|
13 |
13 |
$304.32 |
| 84100 |
|
101 |
91 |
$294.76 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
261 |
243 |
$285.97 |
| 82948 |
|
90 |
52 |
$250.86 |
| 82784 |
|
24 |
24 |
$243.62 |
| C1729 |
Catheter, drainage |
59 |
58 |
$213.09 |
| 87420 |
|
14 |
14 |
$199.92 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
38 |
38 |
$166.83 |
| 86900 |
|
37 |
24 |
$107.22 |
| J7620 |
Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme |
29 |
28 |
$98.58 |
| 86901 |
|
37 |
24 |
$90.72 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
29 |
27 |
$67.37 |
| C9447 |
Injection, phenylephrine and ketorolac, 4 ml vial |
141 |
133 |
$62.47 |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
14 |
14 |
$45.66 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
29 |
28 |
$42.70 |
| J2003 |
Injection, lidocaine hydrochloride, 1 mg |
50 |
46 |
$42.30 |
| 86334 |
|
13 |
13 |
$41.15 |
| 84165 |
|
13 |
13 |
$19.71 |
| 91307 |
|
253 |
204 |
$5.57 |
| 91300 |
|
245 |
216 |
$4.92 |
| 91306 |
|
96 |
90 |
$1.68 |
| 84999 |
|
13 |
13 |
$0.00 |