| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
385,656 |
347,770 |
$36.55M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
23,697 |
21,569 |
$5.27M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
19,757 |
18,503 |
$2.74M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
5,071 |
4,537 |
$2.13M |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
29,780 |
28,929 |
$1.20M |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
9,987 |
9,011 |
$1.20M |
| 92507 |
Treatment of speech, language, voice, communication, and/or auditory processing disorder |
19,239 |
6,551 |
$1.20M |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
12,428 |
11,524 |
$976K |
| 41874 |
|
456 |
362 |
$937K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
10,343 |
10,148 |
$824K |
| 20610 |
|
4,533 |
3,650 |
$764K |
| 93303 |
Transthoracic echocardiography for congenital cardiac anomalies, follow-up or limited study |
2,002 |
1,681 |
$693K |
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
10,110 |
1,490 |
$660K |
| D7311 |
|
653 |
468 |
$583K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
1,022 |
862 |
$560K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
8,959 |
8,739 |
$559K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
6,783 |
6,661 |
$531K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
1,739 |
1,487 |
$491K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
12,020 |
11,804 |
$481K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
6,796 |
6,074 |
$323K |
| 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 |
5,072 |
4,439 |
$306K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
3,039 |
2,992 |
$278K |
| G0378 |
Hospital observation service, per hour |
4,194 |
1,778 |
$273K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
4,910 |
1,759 |
$218K |
| 71045 |
Radiologic examination, chest; single view |
3,885 |
3,547 |
$202K |
| 90834 |
Psychotherapy, 45 minutes with patient |
2,713 |
1,816 |
$201K |
| G0330 |
Facility services for dental rehabilitation procedure(s) performed on a patient who requires monitored anesthesia (e.g., general, intravenous sedation (monitored anesthesia care) and use of an operating room |
146 |
138 |
$175K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
4,968 |
4,445 |
$171K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
1,051 |
615 |
$170K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
600 |
336 |
$150K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
3,987 |
943 |
$130K |
| 95911 |
|
328 |
309 |
$111K |
| 69436 |
Tympanostomy (requiring insertion of ventilating tube), general anesthesia |
112 |
108 |
$101K |
| 95250 |
|
1,243 |
1,100 |
$83K |
| 95117 |
|
2,741 |
1,347 |
$80K |
| 90686 |
|
6,925 |
6,608 |
$77K |
| 71046 |
Radiologic examination, chest; 2 views |
1,269 |
1,166 |
$71K |
| D2930 |
Prefabricated stainless steel crown - primary tooth |
179 |
83 |
$68K |
| C9803 |
Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
6,163 |
5,711 |
$68K |
| 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 |
3,739 |
3,358 |
$63K |
| 80061 |
Lipid panel |
5,330 |
4,981 |
$62K |
| D7230 |
|
245 |
54 |
$62K |
| 92587 |
|
273 |
249 |
$60K |
| 36415 |
Collection of venous blood by venipuncture |
65,715 |
57,117 |
$48K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
2,692 |
2,361 |
$39K |
| 95909 |
|
207 |
197 |
$37K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
105 |
96 |
$37K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
478 |
458 |
$37K |
| H0035 |
Mental health partial hospitalization, treatment, less than 24 hours |
429 |
62 |
$37K |
| 11056 |
|
690 |
651 |
$35K |
| 95004 |
Percutaneous tests with allergenic extracts, immediate type reaction |
509 |
496 |
$34K |
| D7140 |
Extraction, erupted tooth or exposed root |
173 |
29 |
$34K |
| D1351 |
Sealant - per tooth |
75 |
27 |
$34K |
| J0585 |
Injection, onabotulinumtoxina, 1 unit |
100 |
55 |
$33K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
850 |
741 |
$33K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
319 |
296 |
$31K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
114 |
112 |
$31K |
| 80053 |
Comprehensive metabolic panel |
47,769 |
41,721 |
$30K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
2,690 |
2,359 |
$29K |
| 62323 |
|
88 |
81 |
$29K |
| G2023 |
Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
1,570 |
1,388 |
$28K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
38 |
37 |
$26K |
| 84443 |
Thyroid stimulating hormone (TSH) |
9,197 |
8,453 |
$26K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
168 |
130 |
$26K |
| 92557 |
|
523 |
491 |
$25K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
517 |
497 |
$25K |
| 43249 |
|
27 |
25 |
$24K |
| 11721 |
|
3,337 |
3,150 |
$24K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
5,294 |
4,884 |
$23K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
270 |
267 |
$23K |
| 45385 |
Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) |
58 |
52 |
$19K |
| 87637 |
Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV |
173 |
166 |
$18K |
| 92588 |
|
116 |
75 |
$17K |
| 70450 |
Computed tomography, head or brain; without contrast material |
84 |
77 |
$16K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
395 |
388 |
$16K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
43,877 |
38,405 |
$15K |
| 0202U |
Oncology (prostate), multianalyte, gene expression profiling |
44 |
40 |
$15K |
| G0379 |
Direct admission of patient for hospital observation care |
13 |
12 |
$15K |
| 90670 |
|
2,380 |
2,314 |
$14K |
| 87081 |
|
19,009 |
17,999 |
$12K |
| 90651 |
|
195 |
189 |
$12K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
6,412 |
5,952 |
$10K |
| 90837 |
Psychotherapy, 53 minutes with patient |
366 |
270 |
$9K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
39 |
37 |
$9K |
| D7310 |
|
16 |
12 |
$8K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
14,619 |
13,077 |
$8K |
| 86900 |
|
391 |
332 |
$8K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
61 |
59 |
$8K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
1,698 |
1,467 |
$8K |
| 83655 |
|
2,865 |
2,698 |
$8K |
| J7324 |
Hyaluronan or derivative, orthovisc, for intra-articular injection, per dose |
52 |
26 |
$7K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
71 |
65 |
$7K |
| 86780 |
|
529 |
461 |
$7K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
66 |
65 |
$6K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
35,582 |
34,697 |
$6K |
| 90791 |
Psychiatric diagnostic evaluation |
106 |
100 |
$5K |
| 73562 |
|
746 |
690 |
$5K |
| A0425 |
Ground mileage, per statute mile |
2,738 |
2,109 |
$5K |
| 11057 |
|
79 |
79 |
$5K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
121 |
99 |
$5K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
7,270 |
6,778 |
$5K |
| 73630 |
|
331 |
245 |
$5K |
| 85027 |
|
5,991 |
5,477 |
$5K |
| 82728 |
|
1,538 |
1,400 |
$4K |
| 90847 |
Family psychotherapy with the patient present, 50 minutes |
258 |
201 |
$4K |
| 70320 |
|
33 |
26 |
$4K |
| 90723 |
|
1,191 |
1,165 |
$3K |
| 0071A |
|
71 |
71 |
$3K |
| A0428 |
Ambulance service, basic life support, non-emergency transport, (bls) |
947 |
728 |
$3K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
3,696 |
2,719 |
$3K |
| 83550 |
|
1,000 |
924 |
$2K |
| 97161 |
|
55 |
53 |
$2K |
| 0072A |
|
62 |
61 |
$2K |
| 92567 |
|
2,502 |
2,322 |
$2K |
| 84481 |
|
372 |
339 |
$2K |
| 59025 |
Fetal non-stress test |
23 |
12 |
$2K |
| 73564 |
|
263 |
241 |
$2K |
| 77336 |
|
30 |
13 |
$2K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
1,988 |
1,755 |
$2K |
| 83540 |
|
1,004 |
928 |
$2K |
| 64615 |
|
17 |
15 |
$2K |
| 51798 |
|
1,351 |
1,167 |
$2K |
| 92579 |
|
167 |
140 |
$2K |
| 87070 |
|
1,811 |
1,701 |
$2K |
| 84484 |
|
3,699 |
2,701 |
$2K |
| 84439 |
|
593 |
546 |
$1K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
522 |
458 |
$1K |
| 76801 |
|
15 |
12 |
$1K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
8,748 |
7,193 |
$1K |
| 84703 |
|
655 |
582 |
$1K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
15,369 |
15,058 |
$1K |
| 20552 |
|
23 |
14 |
$956.77 |
| A0427 |
Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) |
135 |
119 |
$935.09 |
| 76830 |
Ultrasound, transvaginal |
14 |
12 |
$879.17 |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
19 |
16 |
$768.88 |
| 84144 |
|
43 |
26 |
$720.50 |
| 73030 |
|
48 |
44 |
$714.39 |
| 73130 |
|
14 |
12 |
$683.50 |
| 80305 |
|
1,053 |
905 |
$666.86 |
| 82950 |
|
112 |
102 |
$636.53 |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
33 |
14 |
$633.02 |
| 93320 |
|
2,007 |
1,683 |
$629.00 |
| 76536 |
|
204 |
188 |
$610.14 |
| 73100 |
|
14 |
12 |
$587.64 |
| 80048 |
Basic metabolic panel (calcium, ionized) |
1,251 |
1,143 |
$488.03 |
| A0429 |
Ambulance service, basic life support, emergency transport (bls-emergency) |
90 |
64 |
$411.63 |
| 87633 |
Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets |
470 |
431 |
$404.28 |
| 87210 |
|
730 |
656 |
$377.20 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
36 |
34 |
$372.97 |
| 80055 |
|
13 |
12 |
$327.64 |
| 83735 |
|
2,193 |
2,024 |
$325.72 |
| 81003 |
|
5,768 |
5,124 |
$295.71 |
| 94762 |
|
160 |
65 |
$294.30 |
| 94010 |
|
469 |
443 |
$291.67 |
| 99173 |
|
13 |
12 |
$266.00 |
| 90677 |
|
42 |
42 |
$262.23 |
| 93017 |
|
41 |
40 |
$252.82 |
| 82607 |
|
106 |
103 |
$225.71 |
| Q3014 |
Telehealth originating site facility fee |
79 |
68 |
$206.56 |
| 84403 |
|
29 |
26 |
$200.05 |
| 85007 |
|
353 |
311 |
$181.09 |
| 85046 |
|
52 |
48 |
$180.60 |
| 82043 |
|
79 |
75 |
$161.47 |
| 81025 |
|
160 |
151 |
$152.40 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
946 |
792 |
$135.40 |
| 97542 |
|
12 |
12 |
$133.16 |
| 88720 |
|
15 |
13 |
$131.22 |
| 85018 |
|
260 |
250 |
$96.33 |
| 90656 |
|
13 |
13 |
$79.56 |
| 83690 |
|
2,995 |
2,683 |
$77.92 |
| 96127 |
|
208 |
204 |
$70.94 |
| 83605 |
|
4,242 |
3,697 |
$66.06 |
| 87400 |
|
122 |
108 |
$62.36 |
| 86140 |
|
8,080 |
7,288 |
$47.59 |
| 81001 |
|
5,232 |
4,741 |
$42.64 |
| 94761 |
|
3,729 |
3,059 |
$36.30 |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
501 |
449 |
$34.04 |
| 87581 |
|
499 |
447 |
$34.04 |
| 87486 |
|
499 |
447 |
$34.04 |
| 87186 |
|
25 |
25 |
$33.88 |
| 86762 |
|
116 |
105 |
$27.61 |
| 87807 |
|
725 |
705 |
$25.15 |
| 90647 |
|
1,125 |
1,090 |
$20.91 |
| 87340 |
|
118 |
107 |
$19.82 |
| J7030 |
Infusion, normal saline solution , 1000 cc |
8,951 |
7,606 |
$18.66 |
| 82785 |
|
12 |
12 |
$13.17 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
3,748 |
3,198 |
$12.00 |
| 85610 |
|
5,265 |
4,709 |
$10.38 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
4,743 |
4,054 |
$9.17 |
| 84145 |
|
975 |
883 |
$8.48 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
2,069 |
1,913 |
$8.00 |
| 87077 |
|
13 |
13 |
$7.91 |
| 83615 |
|
61 |
51 |
$7.08 |
| G0008 |
Administration of influenza virus vaccine |
62 |
62 |
$6.54 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
7,381 |
6,781 |
$0.42 |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
635 |
520 |
$0.12 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
4,614 |
3,708 |
$0.10 |
| J2704 |
Injection, propofol, 10 mg |
693 |
588 |
$0.09 |
| 90785 |
|
971 |
724 |
$0.00 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
1,444 |
1,218 |
$0.00 |
| 93325 |
|
2,007 |
1,683 |
$0.00 |
| 99152 |
|
1,209 |
1,021 |
$0.00 |
| 90633 |
|
316 |
300 |
$0.00 |
| 90648 |
|
242 |
242 |
$0.00 |
| 90833 |
Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) |
50 |
44 |
$0.00 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
53 |
40 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
66 |
66 |
$0.00 |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
25 |
13 |
$0.00 |
| 81002 |
|
38 |
37 |
$0.00 |
| 90681 |
|
37 |
37 |
$0.00 |
| 80179 |
|
37 |
35 |
$0.00 |
| A4649 |
Surgical supply; miscellaneous |
41 |
38 |
$0.00 |
| 90710 |
|
39 |
38 |
$0.00 |
| 90715 |
|
28 |
28 |
$0.00 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
138 |
119 |
$0.00 |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
31 |
28 |
$0.00 |
| 94664 |
|
30 |
25 |
$0.00 |
| 88312 |
|
30 |
29 |
$0.00 |
| J1644 |
Injection, heparin sodium, per 1000 units |
13 |
12 |
$0.00 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
14 |
14 |
$0.00 |
| C1894 |
Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser |
12 |
12 |
$0.00 |
| 87280 |
|
121 |
116 |
$0.00 |
| 90474 |
|
4,312 |
4,217 |
$0.00 |
| 95885 |
|
284 |
224 |
$0.00 |
| 36416 |
|
4,125 |
3,722 |
$0.00 |
| 90680 |
|
804 |
781 |
$0.00 |
| 85730 |
|
1,365 |
1,214 |
$0.00 |
| 86901 |
|
391 |
332 |
$0.00 |
| 86850 |
|
362 |
308 |
$0.00 |
| J2175 |
Injection, meperidine hydrochloride, per 100 mg |
64 |
55 |
$0.00 |
| 80320 |
|
20 |
17 |
$0.00 |
| 99153 |
Mod sedat endo service >5yrs |
790 |
662 |
$0.00 |
| 95886 |
|
666 |
568 |
$0.00 |
| 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 |
1,659 |
1,415 |
$0.00 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
184 |
172 |
$0.00 |
| J1040 |
Injection, methylprednisolone acetate, 80 mg |
323 |
278 |
$0.00 |
| 88342 |
|
568 |
474 |
$0.00 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
151 |
132 |
$0.00 |
| J1030 |
Injection, methylprednisolone acetate, 40 mg |
193 |
166 |
$0.00 |
| 87040 |
|
334 |
176 |
$0.00 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
91 |
79 |
$0.00 |
| 82150 |
|
96 |
92 |
$0.00 |
| 86803 |
|
48 |
42 |
$0.00 |
| 83880 |
|
32 |
30 |
$0.00 |
| 85379 |
|
109 |
97 |
$0.00 |
| C1726 |
Catheter, balloon dilatation, non-vascular |
41 |
38 |
$0.00 |
| A9500 |
Technetium tc-99m sestamibi, diagnostic, per study dose |
38 |
37 |
$0.00 |
| C1769 |
Guide wire |
12 |
12 |
$0.00 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
34 |
26 |
$0.00 |
| J2785 |
Injection, regadenoson, 0.1 mg |
13 |
12 |
$0.00 |
| 80329 |
|
19 |
17 |
$0.00 |
| 90696 |
|
39 |
38 |
$0.00 |
| 82550 |
|
15 |
14 |
$0.00 |
| 85652 |
|
17 |
15 |
$0.00 |