| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| X4011 |
State-specific procedure code |
28,126 |
26,546 |
$13.44M |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
102,268 |
93,754 |
$7.68M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
17,314 |
16,338 |
$5.71M |
| X4003 |
|
47,475 |
42,909 |
$2.78M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
15,591 |
14,544 |
$2.38M |
| 81002 |
|
31,827 |
25,101 |
$1.99M |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
73,408 |
67,758 |
$1.79M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
7,002 |
6,607 |
$1.36M |
| X4006 |
|
1,372 |
1,143 |
$1.17M |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
16,922 |
15,656 |
$916K |
| 86900 |
|
9,300 |
8,443 |
$847K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
12,048 |
11,611 |
$792K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
12,051 |
11,613 |
$778K |
| 59025 |
Fetal non-stress test |
3,675 |
1,907 |
$764K |
| 80053 |
Comprehensive metabolic panel |
45,541 |
41,467 |
$756K |
| 85027 |
|
13,231 |
12,495 |
$737K |
| 86850 |
|
9,283 |
8,421 |
$732K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
4,500 |
4,221 |
$682K |
| 86901 |
|
9,291 |
8,432 |
$681K |
| 81025 |
|
9,473 |
9,057 |
$593K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
3,534 |
3,332 |
$555K |
| 86592 |
|
12,752 |
12,345 |
$548K |
| J2426 |
Injection, paliperidone palmitate extended release (invega sustenna), 1 mg |
853 |
736 |
$534K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
18,151 |
17,020 |
$512K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
4,454 |
4,021 |
$512K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
5,109 |
5,009 |
$499K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
5,785 |
5,286 |
$455K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
11,214 |
10,835 |
$452K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
7,278 |
6,929 |
$415K |
| Y7506 |
|
1,160 |
1,082 |
$400K |
| J3490 |
Unclassified drugs |
8,378 |
7,041 |
$399K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
9,166 |
8,302 |
$351K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
5,571 |
5,436 |
$334K |
| G0378 |
Hospital observation service, per hour |
3,254 |
2,861 |
$331K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
9,182 |
8,777 |
$325K |
| 71046 |
Radiologic examination, chest; 2 views |
6,762 |
6,291 |
$323K |
| 87801 |
Infectious agent detection by nucleic acid; amplified probe, multiple organisms |
2,832 |
2,773 |
$294K |
| 86787 |
|
3,766 |
3,659 |
$291K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
1,780 |
1,126 |
$269K |
| Y7507 |
|
1,278 |
1,157 |
$256K |
| 88142 |
|
2,453 |
2,421 |
$243K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
1,296 |
1,252 |
$238K |
| 83020 |
|
3,454 |
3,147 |
$234K |
| 81001 |
|
8,064 |
7,675 |
$229K |
| 87340 |
|
3,845 |
3,723 |
$223K |
| 36415 |
Collection of venous blood by venipuncture |
11,900 |
11,212 |
$221K |
| 86762 |
|
3,209 |
3,111 |
$208K |
| 86803 |
|
3,424 |
3,326 |
$196K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
20,514 |
20,043 |
$188K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
5,036 |
4,936 |
$188K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
921 |
897 |
$185K |
| 87536 |
|
2,117 |
2,001 |
$171K |
| 87081 |
|
2,004 |
1,950 |
$164K |
| 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 |
2,295 |
2,110 |
$162K |
| 82950 |
|
3,009 |
2,955 |
$158K |
| 84484 |
|
8,396 |
7,434 |
$156K |
| 76801 |
|
1,262 |
1,205 |
$140K |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
2,289 |
2,218 |
$138K |
| P9016 |
Red blood cells, leukocytes reduced, each unit |
491 |
431 |
$130K |
| 87077 |
|
1,991 |
1,899 |
$130K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
1,453 |
1,380 |
$121K |
| 84443 |
Thyroid stimulating hormone (TSH) |
6,258 |
6,021 |
$116K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
570 |
529 |
$115K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
5,427 |
4,097 |
$111K |
| 80061 |
Lipid panel |
7,413 |
7,227 |
$105K |
| G0472 |
Hepatitis c antibody screening, for individual at high risk and other covered indication(s) |
2,686 |
2,634 |
$94K |
| G0475 |
Hiv antigen/antibody, combination assay, screening |
4,890 |
4,815 |
$89K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
1,125 |
1,053 |
$85K |
| 76820 |
|
478 |
277 |
$83K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
912 |
850 |
$81K |
| 84156 |
|
2,093 |
1,929 |
$81K |
| 82962 |
|
5,778 |
5,222 |
$79K |
| 82728 |
|
2,839 |
2,776 |
$78K |
| 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 |
1,461 |
1,369 |
$77K |
| 82570 |
|
5,363 |
5,149 |
$77K |
| 90870 |
|
449 |
223 |
$73K |
| 70450 |
Computed tomography, head or brain; without contrast material |
1,133 |
1,041 |
$71K |
| 80081 |
|
307 |
299 |
$64K |
| 86920 |
|
483 |
405 |
$57K |
| 86922 |
|
500 |
420 |
$57K |
| 36430 |
|
405 |
363 |
$56K |
| 76830 |
Ultrasound, transvaginal |
494 |
483 |
$56K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
2,981 |
2,891 |
$54K |
| 0202U |
Oncology (prostate), multianalyte, gene expression profiling |
156 |
150 |
$54K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
1,368 |
1,278 |
$53K |
| Y7510 |
|
75 |
61 |
$48K |
| 86361 |
|
1,046 |
974 |
$47K |
| 66984 |
Extracapsular cataract removal with insertion of intraocular lens prosthesis |
41 |
41 |
$38K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
698 |
538 |
$37K |
| 71045 |
Radiologic examination, chest; single view |
1,074 |
992 |
$37K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
387 |
376 |
$35K |
| 73630 |
|
802 |
699 |
$34K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
318 |
285 |
$33K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
565 |
441 |
$31K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
1,297 |
1,098 |
$30K |
| 73610 |
|
588 |
550 |
$26K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
396 |
374 |
$26K |
| Q3014 |
Telehealth originating site facility fee |
1,948 |
1,919 |
$24K |
| 85610 |
|
5,713 |
3,738 |
$24K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,238 |
1,081 |
$22K |
| 90480 |
|
1,072 |
1,060 |
$21K |
| 73030 |
|
631 |
563 |
$20K |
| 73564 |
|
497 |
395 |
$19K |
| 0054A |
|
676 |
641 |
$19K |
| 87631 |
|
138 |
138 |
$18K |
| 81003 |
|
7,041 |
6,373 |
$18K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
99 |
62 |
$18K |
| 83550 |
|
1,862 |
1,815 |
$18K |
| 0124A |
|
673 |
644 |
$17K |
| 82607 |
|
1,345 |
1,319 |
$17K |
| 83540 |
|
2,032 |
1,982 |
$16K |
| 83690 |
|
1,371 |
1,311 |
$16K |
| 82043 |
|
3,086 |
3,019 |
$14K |
| 81511 |
|
78 |
75 |
$13K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
174 |
162 |
$11K |
| J1631 |
Injection, haloperidol decanoate, per 50 mg |
1,794 |
1,350 |
$11K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
442 |
333 |
$10K |
| 83880 |
|
375 |
354 |
$10K |
| 84439 |
|
961 |
930 |
$9K |
| 86902 |
|
121 |
98 |
$9K |
| 73130 |
|
168 |
133 |
$9K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
61 |
52 |
$9K |
| 83735 |
|
1,714 |
1,532 |
$8K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
157 |
147 |
$8K |
| 83605 |
|
594 |
545 |
$8K |
| 82077 |
|
618 |
593 |
$7K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
14 |
12 |
$7K |
| 87184 |
|
232 |
225 |
$7K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
49 |
47 |
$7K |
| G0123 |
Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, screening by cytotechnologist under physician supervision |
1,513 |
1,456 |
$6K |
| 90732 |
|
122 |
122 |
$6K |
| P3000 |
Screening papanicolaou smear, cervical or vaginal, up to three smears, by technician under physician supervision |
95 |
94 |
$6K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
124 |
122 |
$6K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
109 |
103 |
$6K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
61 |
51 |
$5K |
| 73552 |
|
117 |
108 |
$5K |
| 36591 |
|
75 |
51 |
$5K |
| 0004A |
|
144 |
144 |
$5K |
| 86481 |
|
57 |
54 |
$5K |
| 72100 |
|
67 |
66 |
$4K |
| 84702 |
|
166 |
139 |
$4K |
| 90715 |
|
134 |
132 |
$4K |
| 20610 |
|
26 |
25 |
$4K |
| 73590 |
|
67 |
60 |
$4K |
| 84550 |
|
148 |
127 |
$4K |
| 86706 |
|
393 |
384 |
$4K |
| 85660 |
|
613 |
549 |
$4K |
| 85730 |
|
419 |
375 |
$4K |
| 87040 |
|
189 |
183 |
$3K |
| 82746 |
|
163 |
159 |
$3K |
| 86704 |
|
248 |
244 |
$3K |
| 87633 |
Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets |
16 |
14 |
$3K |
| 73560 |
|
28 |
25 |
$3K |
| 99460 |
|
32 |
32 |
$3K |
| 0052A |
|
84 |
77 |
$3K |
| 99231 |
Subsequent hospital care, per day, straightforward or low complexity |
64 |
57 |
$3K |
| 0051A |
|
74 |
72 |
$2K |
| 71250 |
|
26 |
24 |
$2K |
| 82248 |
|
198 |
191 |
$2K |
| 82803 |
|
104 |
87 |
$2K |
| 0002A |
|
55 |
54 |
$2K |
| 62323 |
|
13 |
12 |
$2K |
| 72082 |
|
26 |
26 |
$2K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
222 |
204 |
$1K |
| 0001A |
|
38 |
38 |
$1K |
| 0053A |
|
36 |
35 |
$1K |
| 31575 |
|
68 |
59 |
$1K |
| 73562 |
|
29 |
26 |
$1K |
| 85652 |
|
350 |
333 |
$948.79 |
| 88313 |
|
18 |
14 |
$925.69 |
| 72170 |
|
13 |
13 |
$893.35 |
| J3370 |
Injection, vancomycin hcl, 500 mg |
87 |
85 |
$876.69 |
| 86140 |
|
288 |
266 |
$833.18 |
| 80197 |
|
207 |
154 |
$796.81 |
| 83615 |
|
489 |
353 |
$771.98 |
| 80050 |
General health panel |
29 |
28 |
$757.49 |
| 77066 |
Tomosynthesis, mammo |
13 |
13 |
$708.36 |
| 88307 |
|
12 |
12 |
$588.64 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
142 |
129 |
$514.59 |
| 77001 |
|
14 |
13 |
$479.22 |
| 80076 |
|
48 |
44 |
$463.39 |
| J0330 |
Injection, succinylcholine chloride, up to 20 mg |
18 |
17 |
$463.11 |
| J2704 |
Injection, propofol, 10 mg |
32 |
29 |
$450.36 |
| 82784 |
|
58 |
33 |
$449.61 |
| 0121A |
|
30 |
28 |
$427.37 |
| 82010 |
|
64 |
59 |
$412.51 |
| 87210 |
|
12 |
12 |
$409.64 |
| 84100 |
|
140 |
126 |
$392.01 |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
32 |
24 |
$384.00 |
| 87497 |
|
23 |
12 |
$380.70 |
| 86038 |
|
31 |
26 |
$363.40 |
| 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 |
229 |
204 |
$332.00 |
| J1644 |
Injection, heparin sodium, per 1000 units |
48 |
41 |
$319.71 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
218 |
192 |
$300.30 |
| 87522 |
Neg quan hep c or qual rna |
12 |
12 |
$298.64 |
| G0279 |
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) |
56 |
54 |
$294.15 |
| 80069 |
|
50 |
49 |
$292.08 |
| 82330 |
|
14 |
12 |
$283.50 |
| 90677 |
|
149 |
149 |
$275.08 |
| J0692 |
Injection, cefepime hydrochloride, 500 mg |
27 |
27 |
$251.34 |
| J2370 |
Injection, phenylephrine hcl, up to 1 ml |
31 |
31 |
$238.66 |
| 84403 |
|
28 |
27 |
$232.30 |
| 84146 |
|
14 |
14 |
$219.85 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
60 |
54 |
$204.87 |
| G0008 |
Administration of influenza virus vaccine |
1,056 |
1,050 |
$204.13 |
| 87070 |
|
43 |
42 |
$193.03 |
| 58100 |
|
12 |
12 |
$173.39 |
| 86160 |
|
16 |
12 |
$171.76 |
| 84153 |
|
28 |
27 |
$165.50 |
| 83883 |
|
22 |
14 |
$165.48 |
| 83970 |
|
15 |
15 |
$165.10 |
| 84165 |
|
29 |
25 |
$161.24 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
37 |
33 |
$148.18 |
| 82378 |
|
15 |
12 |
$148.08 |
| 83521 |
|
15 |
12 |
$129.05 |
| 91320 |
|
425 |
421 |
$124.15 |
| 87205 |
|
30 |
29 |
$119.59 |
| 82105 |
|
14 |
12 |
$105.02 |
| 76937 |
|
17 |
15 |
$103.55 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
162 |
147 |
$102.80 |
| 90662 |
|
597 |
589 |
$92.88 |
| J7140 |
|
13 |
12 |
$87.50 |
| J0171 |
Injection, adrenalin, epinephrine, 0.1 mg |
25 |
25 |
$68.88 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
14 |
14 |
$55.50 |
| 86923 |
|
35 |
27 |
$50.83 |
| J2060 |
Injection, lorazepam, 2 mg |
12 |
12 |
$41.86 |
| J1940 |
Injection, furosemide, up to 20 mg |
14 |
14 |
$39.87 |
| 90686 |
|
710 |
698 |
$17.75 |
| 82951 |
|
12 |
12 |
$10.29 |
| J1642 |
Injection, heparin sodium, (heparin lock flush), per 10 units |
12 |
12 |
$0.45 |
| J0697 |
Injection, sterile cefuroxime sodium, per 750 mg |
12 |
12 |
$0.05 |
| 96376 |
|
492 |
380 |
$0.00 |
| G0009 |
Administration of pneumococcal vaccine |
207 |
206 |
$0.00 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
59 |
39 |
$0.00 |
| 90656 |
|
87 |
86 |
$0.00 |
| 93320 |
|
12 |
12 |
$0.00 |
| 51798 |
|
14 |
12 |
$0.00 |
| 0000 |
|
17 |
13 |
$0.00 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
39 |
39 |
$0.00 |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
31 |
31 |
$0.00 |
| V2632 |
Posterior chamber intraocular lens |
13 |
12 |
$0.00 |
| 93325 |
|
12 |
12 |
$0.00 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
12 |
12 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
17 |
17 |
$0.00 |
| 92504 |
|
16 |
13 |
$0.00 |