| Code | Description | Claims | Beneficiaries | Total Paid |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
11,395 |
10,960 |
$1.82M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
9,000 |
8,788 |
$1.16M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
7,271 |
7,087 |
$1.04M |
| G0378 |
Hospital observation service, per hour |
673 |
625 |
$602K |
| 87637 |
Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV |
1,496 |
1,481 |
$103K |
| 80053 |
Comprehensive metabolic panel |
14,315 |
13,240 |
$98K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
846 |
825 |
$97K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
1,413 |
1,398 |
$95K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
5,795 |
5,520 |
$95K |
| 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 |
1,306 |
1,167 |
$72K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
17,891 |
16,055 |
$61K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
1,538 |
1,441 |
$59K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
412 |
405 |
$42K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
7,205 |
6,839 |
$41K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
295 |
286 |
$36K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
3,160 |
2,987 |
$34K |
| 70450 |
Computed tomography, head or brain; without contrast material |
812 |
771 |
$31K |
| 80050 |
General health panel |
632 |
618 |
$28K |
| 84484 |
|
3,949 |
3,540 |
$24K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
234 |
234 |
$23K |
| 80061 |
Lipid panel |
1,589 |
1,557 |
$23K |
| 84443 |
Thyroid stimulating hormone (TSH) |
1,017 |
972 |
$23K |
| 71045 |
Radiologic examination, chest; single view |
4,239 |
4,003 |
$20K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
339 |
325 |
$19K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
314 |
306 |
$18K |
| T1015 |
Clinic visit/encounter, all-inclusive |
452 |
161 |
$17K |
| 93976 |
|
281 |
267 |
$16K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
2,762 |
2,273 |
$15K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
1,438 |
1,337 |
$14K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
732 |
678 |
$13K |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
196 |
194 |
$13K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
240 |
234 |
$12K |
| 83880 |
|
612 |
560 |
$11K |
| 84703 |
|
1,527 |
1,478 |
$10K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
244 |
241 |
$9K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
115 |
113 |
$9K |
| 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 |
613 |
556 |
$9K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
59 |
59 |
$8K |
| 93971 |
|
161 |
153 |
$8K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
207 |
196 |
$8K |
| 83735 |
|
1,482 |
1,201 |
$8K |
| 81001 |
|
4,495 |
4,329 |
$7K |
| 82805 |
|
313 |
274 |
$7K |
| 0100U |
|
190 |
179 |
$7K |
| 71046 |
Radiologic examination, chest; 2 views |
634 |
624 |
$7K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
975 |
948 |
$7K |
| 76830 |
Ultrasound, transvaginal |
161 |
157 |
$7K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
1,020 |
835 |
$7K |
| 83690 |
|
2,286 |
2,180 |
$7K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
323 |
321 |
$7K |
| 0002A |
|
123 |
122 |
$6K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
321 |
319 |
$6K |
| 0225U |
|
33 |
33 |
$6K |
| 84702 |
|
490 |
434 |
$6K |
| 84439 |
|
582 |
556 |
$5K |
| 0001A |
|
124 |
124 |
$5K |
| 80299 |
|
243 |
232 |
$5K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
100 |
98 |
$5K |
| 70498 |
|
60 |
57 |
$5K |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
120 |
120 |
$5K |
| 70496 |
|
60 |
57 |
$5K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
841 |
783 |
$4K |
| 36415 |
Collection of venous blood by venipuncture |
5,144 |
4,427 |
$4K |
| 71250 |
|
83 |
80 |
$4K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
263 |
208 |
$4K |
| 84466 |
|
221 |
214 |
$4K |
| 12001 |
|
28 |
26 |
$4K |
| 85379 |
|
541 |
515 |
$3K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
214 |
204 |
$3K |
| 87633 |
Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets |
21 |
20 |
$3K |
| 82607 |
|
247 |
241 |
$3K |
| 87040 |
|
246 |
231 |
$3K |
| 83605 |
|
656 |
556 |
$3K |
| 84999 |
|
1,278 |
1,094 |
$3K |
| 85610 |
|
1,128 |
863 |
$3K |
| 84145 |
|
268 |
242 |
$3K |
| 85027 |
|
551 |
487 |
$3K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
87 |
83 |
$3K |
| 82728 |
|
213 |
203 |
$3K |
| 96376 |
|
401 |
327 |
$2K |
| 73610 |
|
219 |
205 |
$2K |
| 84153 |
|
76 |
75 |
$2K |
| 0202U |
Oncology (prostate), multianalyte, gene expression profiling |
14 |
12 |
$2K |
| 80076 |
|
239 |
227 |
$2K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
295 |
268 |
$2K |
| 83540 |
|
228 |
223 |
$2K |
| 85730 |
|
505 |
466 |
$2K |
| 82043 |
|
211 |
205 |
$2K |
| 87631 |
|
16 |
16 |
$2K |
| 82570 |
|
234 |
226 |
$2K |
| 73030 |
|
188 |
172 |
$2K |
| 73630 |
|
268 |
253 |
$2K |
| 72100 |
|
95 |
92 |
$2K |
| 87186 |
|
315 |
296 |
$2K |
| 86850 |
|
294 |
278 |
$2K |
| 73130 |
|
214 |
201 |
$2K |
| 81003 |
|
839 |
792 |
$2K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
55 |
55 |
$2K |
| 82550 |
|
378 |
336 |
$2K |
| 73502 |
|
117 |
111 |
$1K |
| 73562 |
|
135 |
129 |
$1K |
| 76642 |
|
39 |
31 |
$1K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
38 |
37 |
$1K |
| 80320 |
|
171 |
159 |
$1K |
| 86803 |
|
53 |
53 |
$1K |
| 77065 |
Tomosynthesis, mammo |
17 |
15 |
$1K |
| 88342 |
|
54 |
51 |
$1K |
| 87481 |
|
27 |
26 |
$1K |
| 81025 |
|
462 |
454 |
$1K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
5,851 |
4,358 |
$1K |
| 86618 |
|
43 |
43 |
$995.91 |
| 93017 |
|
28 |
27 |
$877.69 |
| 77066 |
Tomosynthesis, mammo |
12 |
12 |
$824.18 |
| 86140 |
|
319 |
297 |
$819.23 |
| 86900 |
|
301 |
283 |
$796.93 |
| 86901 |
|
299 |
281 |
$787.84 |
| 87081 |
|
194 |
190 |
$778.67 |
| 87077 |
|
237 |
224 |
$773.48 |
| 84100 |
|
153 |
114 |
$734.29 |
| 82962 |
|
584 |
424 |
$713.12 |
| 85652 |
|
281 |
263 |
$701.68 |
| 96367 |
|
58 |
51 |
$698.04 |
| 73110 |
|
92 |
87 |
$662.24 |
| 82553 |
|
183 |
178 |
$660.53 |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
35 |
34 |
$651.37 |
| 70486 |
|
14 |
14 |
$591.72 |
| J2704 |
Injection, propofol, 10 mg |
1,774 |
1,391 |
$482.67 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
1,398 |
951 |
$479.65 |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
13 |
13 |
$475.65 |
| J3490 |
Unclassified drugs |
1,944 |
1,342 |
$432.77 |
| 82565 |
|
65 |
60 |
$419.59 |
| 80349 |
|
49 |
48 |
$399.40 |
| 76870 |
|
15 |
13 |
$355.96 |
| 82746 |
|
33 |
33 |
$340.13 |
| 87486 |
|
21 |
20 |
$310.60 |
| 84550 |
|
46 |
40 |
$274.58 |
| 80329 |
|
61 |
58 |
$264.21 |
| 74018 |
|
18 |
15 |
$234.02 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
4,089 |
2,357 |
$225.64 |
| 87205 |
|
57 |
55 |
$223.36 |
| 90715 |
|
82 |
82 |
$213.32 |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
1,853 |
1,346 |
$191.13 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
65 |
63 |
$173.05 |
| 87070 |
|
27 |
26 |
$171.58 |
| 73560 |
|
18 |
17 |
$161.78 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
528 |
339 |
$153.87 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
195 |
130 |
$142.84 |
| 87147 |
|
58 |
56 |
$135.97 |
| 84436 |
|
12 |
12 |
$134.08 |
| 87088 |
|
26 |
25 |
$120.48 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
3,592 |
2,656 |
$114.99 |
| 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 |
12 |
12 |
$110.41 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
44 |
40 |
$106.35 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
1,583 |
1,131 |
$101.62 |
| 73590 |
|
14 |
13 |
$99.00 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
336 |
239 |
$74.23 |
| 82248 |
|
13 |
12 |
$71.43 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
1,017 |
827 |
$70.92 |
| 87581 |
|
18 |
17 |
$62.04 |
| 82947 |
|
13 |
13 |
$55.86 |
| 97162 |
|
14 |
13 |
$38.00 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
19 |
12 |
$35.54 |
| J1815 |
Injection, insulin, per 5 units |
139 |
40 |
$33.46 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
934 |
753 |
$30.66 |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
147 |
105 |
$29.11 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
526 |
418 |
$24.58 |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
45 |
28 |
$16.71 |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
72 |
36 |
$12.79 |
| A9270 |
Non-covered item or service |
17,829 |
8,557 |
$9.09 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
42 |
37 |
$6.50 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
76 |
51 |
$5.24 |
| J2060 |
Injection, lorazepam, 2 mg |
19 |
13 |
$4.59 |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
16 |
12 |
$4.23 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
118 |
98 |
$0.47 |
| G1004 |
Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program |
1,571 |
1,359 |
$0.10 |
| J7999 |
Compounded drug, not otherwise classified |
29 |
12 |
$0.00 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
14 |
13 |
$0.00 |
| 90686 |
|
13 |
12 |
$0.00 |