| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
13,718 |
11,535 |
$828K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
3,993 |
2,879 |
$423K |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
7,199 |
6,082 |
$340K |
| 80053 |
Comprehensive metabolic panel |
13,371 |
10,393 |
$255K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
6,921 |
2,421 |
$238K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
2,858 |
1,901 |
$171K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
2,520 |
2,216 |
$156K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
3,928 |
3,378 |
$154K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
20,395 |
13,822 |
$147K |
| 92507 |
Treatment of speech, language, voice, communication, and/or auditory processing disorder |
3,002 |
934 |
$129K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
7,386 |
5,762 |
$126K |
| 87637 |
Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV |
939 |
832 |
$111K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
2,556 |
2,160 |
$110K |
| 70450 |
Computed tomography, head or brain; without contrast material |
1,821 |
1,602 |
$103K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
1,677 |
1,451 |
$101K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
16,791 |
12,669 |
$82K |
| 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 |
2,127 |
1,720 |
$76K |
| 81025 |
|
2,851 |
2,440 |
$67K |
| G0378 |
Hospital observation service, per hour |
2,257 |
1,113 |
$67K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
852 |
722 |
$64K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
326 |
288 |
$55K |
| 97116 |
|
1,939 |
723 |
$52K |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
411 |
357 |
$51K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
5,697 |
1,901 |
$50K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
1,346 |
934 |
$47K |
| 81001 |
|
8,192 |
6,936 |
$36K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
3,306 |
2,805 |
$33K |
| U0004 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc, making use of high throughput technologies as described by cms-2020-01-r |
979 |
756 |
$32K |
| 85610 |
|
5,485 |
3,408 |
$32K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
965 |
780 |
$31K |
| 80061 |
Lipid panel |
3,189 |
2,900 |
$31K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
821 |
716 |
$30K |
| 84484 |
|
4,381 |
3,073 |
$29K |
| 84443 |
Thyroid stimulating hormone (TSH) |
2,617 |
2,317 |
$26K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
620 |
520 |
$26K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
965 |
780 |
$25K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
240 |
147 |
$25K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
559 |
484 |
$24K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
339 |
287 |
$23K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
1,162 |
443 |
$22K |
| 83605 |
|
1,624 |
1,333 |
$22K |
| 82962 |
|
2,330 |
1,406 |
$20K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
2,800 |
2,592 |
$19K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
788 |
718 |
$19K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
392 |
292 |
$18K |
| 87077 |
|
1,331 |
1,085 |
$18K |
| 87070 |
|
765 |
633 |
$15K |
| 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 |
400 |
341 |
$15K |
| 83880 |
|
845 |
730 |
$15K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
789 |
711 |
$15K |
| 83690 |
|
3,110 |
2,624 |
$15K |
| 85027 |
|
2,963 |
2,283 |
$14K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
7,271 |
6,003 |
$14K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
257 |
243 |
$14K |
| 80050 |
General health panel |
1,017 |
913 |
$13K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
2,310 |
592 |
$13K |
| 20610 |
|
827 |
589 |
$13K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
150 |
129 |
$13K |
| 83735 |
|
2,736 |
1,946 |
$11K |
| 87186 |
|
2,100 |
1,740 |
$11K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
364 |
302 |
$11K |
| 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 |
973 |
751 |
$10K |
| 71046 |
Radiologic examination, chest; 2 views |
2,840 |
2,467 |
$9K |
| 83874 |
|
1,698 |
1,424 |
$9K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
783 |
714 |
$9K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
70 |
63 |
$9K |
| 82550 |
|
1,933 |
1,576 |
$8K |
| 97535 |
Self-care/home management training, each 15 minutes |
354 |
181 |
$8K |
| 76830 |
Ultrasound, transvaginal |
164 |
148 |
$7K |
| 86140 |
|
1,911 |
1,488 |
$7K |
| 84439 |
|
637 |
559 |
$7K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
170 |
157 |
$7K |
| 88142 |
|
115 |
104 |
$7K |
| 36415 |
Collection of venous blood by venipuncture |
18,691 |
13,075 |
$6K |
| 80143 |
|
355 |
301 |
$6K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
107 |
88 |
$6K |
| 85379 |
|
839 |
738 |
$6K |
| 0002A |
|
453 |
312 |
$6K |
| 82553 |
|
1,685 |
1,412 |
$5K |
| 45385 |
Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) |
28 |
24 |
$5K |
| 82077 |
|
524 |
444 |
$5K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
4,788 |
3,608 |
$5K |
| 85007 |
|
1,050 |
801 |
$5K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
3,721 |
2,558 |
$5K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
2,645 |
1,524 |
$5K |
| 87210 |
|
191 |
164 |
$5K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
189 |
146 |
$5K |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
244 |
169 |
$5K |
| 0001A |
|
410 |
303 |
$5K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
123 |
108 |
$5K |
| 76642 |
|
144 |
112 |
$4K |
| C9803 |
Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
200 |
155 |
$4K |
| 87631 |
|
31 |
29 |
$4K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
104 |
83 |
$4K |
| 80179 |
|
350 |
297 |
$3K |
| 83655 |
|
132 |
122 |
$3K |
| 87081 |
|
102 |
98 |
$3K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
61 |
52 |
$3K |
| 62323 |
|
57 |
53 |
$3K |
| 84703 |
|
420 |
364 |
$3K |
| 86803 |
|
316 |
264 |
$3K |
| 80076 |
|
500 |
428 |
$3K |
| 82728 |
|
266 |
237 |
$3K |
| 43248 |
|
13 |
12 |
$3K |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
120 |
90 |
$2K |
| 85652 |
|
1,635 |
1,302 |
$2K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
117 |
103 |
$2K |
| 87205 |
|
961 |
783 |
$2K |
| 83540 |
|
363 |
329 |
$2K |
| 85018 |
|
525 |
473 |
$2K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
16 |
14 |
$2K |
| 90834 |
Psychotherapy, 45 minutes with patient |
703 |
492 |
$2K |
| 87075 |
|
422 |
355 |
$2K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
29 |
25 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
81 |
79 |
$2K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
3,781 |
2,833 |
$2K |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
103 |
45 |
$2K |
| 85730 |
|
507 |
440 |
$2K |
| 87563 |
|
58 |
46 |
$2K |
| 82607 |
|
151 |
142 |
$1K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
75 |
65 |
$1K |
| 72100 |
|
166 |
151 |
$1K |
| 83550 |
|
248 |
224 |
$1K |
| 91300 |
|
791 |
482 |
$1K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
30 |
25 |
$1K |
| 82043 |
|
184 |
170 |
$1K |
| 82803 |
|
75 |
62 |
$1K |
| 97533 |
|
66 |
25 |
$1K |
| 84100 |
|
346 |
201 |
$1K |
| 71045 |
Radiologic examination, chest; single view |
3,197 |
2,707 |
$1K |
| 97161 |
|
332 |
294 |
$972.31 |
| 74018 |
|
77 |
62 |
$737.92 |
| 82805 |
|
19 |
17 |
$698.68 |
| 87040 |
|
120 |
53 |
$679.24 |
| 77002 |
|
17 |
15 |
$671.47 |
| 93017 |
|
12 |
12 |
$614.95 |
| 71250 |
|
14 |
12 |
$529.12 |
| 93971 |
|
14 |
13 |
$468.45 |
| 90686 |
|
183 |
165 |
$404.22 |
| 73502 |
|
106 |
97 |
$403.40 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
21 |
12 |
$395.53 |
| 11720 |
|
60 |
57 |
$376.60 |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
46 |
45 |
$367.01 |
| 82465 |
|
14 |
13 |
$322.99 |
| 73562 |
|
253 |
209 |
$318.95 |
| 82746 |
|
31 |
24 |
$300.92 |
| 86592 |
|
12 |
12 |
$284.29 |
| G1004 |
Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program |
400 |
254 |
$249.92 |
| G0279 |
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) |
53 |
50 |
$221.12 |
| 87147 |
|
50 |
44 |
$188.70 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
2,009 |
1,792 |
$180.49 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
526 |
321 |
$174.52 |
| J7030 |
Infusion, normal saline solution , 1000 cc |
3,485 |
2,675 |
$131.19 |
| 84550 |
|
33 |
27 |
$126.70 |
| 72040 |
|
14 |
14 |
$111.85 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
3,894 |
3,276 |
$106.12 |
| 90715 |
|
13 |
13 |
$96.44 |
| 87340 |
|
21 |
14 |
$87.48 |
| 86901 |
|
68 |
52 |
$84.30 |
| 86900 |
|
68 |
52 |
$84.30 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
821 |
640 |
$70.91 |
| 73610 |
|
123 |
98 |
$68.32 |
| 73630 |
|
114 |
106 |
$67.07 |
| 87088 |
|
24 |
24 |
$62.85 |
| 82150 |
|
17 |
13 |
$55.29 |
| 81002 |
|
25 |
15 |
$54.00 |
| G0008 |
Administration of influenza virus vaccine |
361 |
332 |
$51.65 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
1,998 |
1,690 |
$49.14 |
| 81003 |
|
66 |
56 |
$47.82 |
| 73030 |
|
15 |
12 |
$38.59 |
| Q3014 |
Telehealth originating site facility fee |
15 |
12 |
$37.96 |
| 84460 |
|
15 |
12 |
$36.22 |
| 73564 |
|
35 |
29 |
$28.22 |
| J3490 |
Unclassified drugs |
810 |
717 |
$20.88 |
| 98940 |
|
25 |
12 |
$20.79 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
29 |
26 |
$17.21 |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
1,210 |
700 |
$16.88 |
| 74022 |
|
29 |
27 |
$16.00 |
| 96376 |
|
332 |
236 |
$13.41 |
| P9603 |
Travel allowance one way in connection with medically necessary laboratory specimen collection drawn from home bound or nursing home bound patient; prorated miles actually travelled |
4,670 |
2,947 |
$11.66 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
3,791 |
2,861 |
$10.65 |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
2,200 |
1,746 |
$10.21 |
| J2704 |
Injection, propofol, 10 mg |
2,523 |
1,632 |
$8.72 |
| J7050 |
Infusion, normal saline solution, 250 cc |
422 |
301 |
$4.50 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
2,804 |
2,325 |
$3.77 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
617 |
427 |
$2.93 |
| J0330 |
Injection, succinylcholine chloride, up to 20 mg |
76 |
64 |
$2.43 |
| J1642 |
Injection, heparin sodium, (heparin lock flush), per 10 units |
245 |
115 |
$2.25 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
2,606 |
1,764 |
$1.49 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
2,113 |
1,754 |
$1.32 |
| J2175 |
Injection, meperidine hydrochloride, per 100 mg |
246 |
221 |
$1.07 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
2,838 |
2,171 |
$0.35 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
4,995 |
3,817 |
$0.35 |
| 90662 |
|
80 |
72 |
$0.33 |
| A9270 |
Non-covered item or service |
8,155 |
1,350 |
$0.26 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
622 |
481 |
$0.00 |
| Q0162 |
Ondansetron 1 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen |
468 |
401 |
$0.00 |
| G0515 |
Development of cognitive skills to improve attention, memory, problem solving (includes compensatory training), direct (one-on-one) patient contact, each 15 minutes |
338 |
135 |
$0.00 |
| A9585 |
Injection, gadobutrol, 0.1 ml |
225 |
192 |
$0.00 |
| J2060 |
Injection, lorazepam, 2 mg |
21 |
12 |
$0.00 |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
44 |
40 |
$0.00 |
| G8979 |
Mobility: walking & moving around functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting |
341 |
264 |
$0.00 |
| J8499 |
Prescription drug, oral, non chemotherapeutic, nos |
339 |
291 |
$0.00 |
| J1596 |
Injection, glycopyrrolate, 0.1 mg |
47 |
40 |
$0.00 |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
212 |
176 |
$0.00 |
| 88312 |
|
44 |
41 |
$0.00 |
| G8978 |
Mobility: walking & moving around functional limitation, current status, at therapy episode outset and at reporting intervals |
232 |
198 |
$0.00 |
| A0130 |
Non-emergency transportation: wheelchair van |
76 |
25 |
$0.00 |
| Q0163 |
Diphenhydramine hydrochloride, 50 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at time of chemotherapy treatment not to exceed a 48 hour dosage regimen |
12 |
12 |
$0.00 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
216 |
163 |
$0.00 |
| C9113 |
Injection, pantoprazole sodium, per vial |
21 |
12 |
$0.00 |
| C1713 |
Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) |
13 |
12 |
$0.00 |
| Q9966 |
Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml |
15 |
13 |
$0.00 |
| A9577 |
Injection, gadobenate dimeglumine (multihance), per ml |
12 |
12 |
$0.00 |