| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
9,319 |
8,251 |
$1.83M |
| Y7506 |
|
5,069 |
4,026 |
$1.73M |
| X4011 |
State-specific procedure code |
5,395 |
4,432 |
$1.29M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
9,178 |
8,132 |
$1.28M |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
27,420 |
23,269 |
$1.18M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
8,546 |
7,520 |
$861K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
26,597 |
22,916 |
$792K |
| 80053 |
Comprehensive metabolic panel |
23,457 |
20,287 |
$579K |
| X4003 |
|
7,266 |
5,920 |
$430K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
1,046 |
917 |
$372K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
3,974 |
3,514 |
$351K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
11,517 |
9,890 |
$344K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
7,573 |
6,498 |
$320K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
4,406 |
4,084 |
$276K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
6,009 |
3,065 |
$248K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
3,113 |
2,959 |
$239K |
| 42820 |
Tonsillectomy and adenoidectomy; younger than age 12 |
157 |
82 |
$219K |
| 71045 |
Radiologic examination, chest; single view |
10,918 |
9,655 |
$210K |
| 69436 |
Tympanostomy (requiring insertion of ventilating tube), general anesthesia |
482 |
274 |
$208K |
| 81001 |
|
11,265 |
8,739 |
$188K |
| 20610 |
|
2,485 |
1,435 |
$136K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
2,179 |
2,013 |
$128K |
| 81003 |
|
6,429 |
5,301 |
$127K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
2,040 |
1,885 |
$125K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
2,911 |
2,718 |
$109K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
7,982 |
7,611 |
$100K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
1,481 |
476 |
$90K |
| 84484 |
|
4,765 |
3,793 |
$84K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
2,502 |
2,067 |
$83K |
| 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 |
5,291 |
4,948 |
$77K |
| C9803 |
Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
9,409 |
8,671 |
$72K |
| 81025 |
|
1,224 |
1,142 |
$64K |
| 80306 |
|
2,076 |
1,795 |
$58K |
| 87081 |
|
4,479 |
4,308 |
$54K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
557 |
509 |
$53K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
240 |
125 |
$53K |
| 95811 |
|
198 |
115 |
$52K |
| 71046 |
Radiologic examination, chest; 2 views |
5,728 |
5,407 |
$52K |
| 70450 |
Computed tomography, head or brain; without contrast material |
1,453 |
1,345 |
$49K |
| A0427 |
Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) |
986 |
802 |
$46K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
1,413 |
1,246 |
$40K |
| 73630 |
|
2,670 |
2,152 |
$38K |
| 36415 |
Collection of venous blood by venipuncture |
8,058 |
6,712 |
$38K |
| 92557 |
|
838 |
700 |
$38K |
| A0425 |
Ground mileage, per statute mile |
1,437 |
1,136 |
$37K |
| 66984 |
Extracapsular cataract removal with insertion of intraocular lens prosthesis |
79 |
37 |
$36K |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
523 |
505 |
$32K |
| 85610 |
|
1,234 |
1,076 |
$32K |
| 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 |
471 |
420 |
$30K |
| 99215 |
Prolong outpt/office vis |
305 |
286 |
$27K |
| 83690 |
|
1,961 |
1,759 |
$25K |
| 80081 |
|
369 |
344 |
$22K |
| 36591 |
|
278 |
173 |
$22K |
| 83735 |
|
4,072 |
3,509 |
$22K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
1,369 |
193 |
$21K |
| 84443 |
Thyroid stimulating hormone (TSH) |
2,188 |
2,054 |
$21K |
| 95810 |
Polysomnography; sleep staging with 4 or more additional parameters |
74 |
40 |
$21K |
| 87088 |
|
768 |
694 |
$18K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
125 |
112 |
$18K |
| 83605 |
|
1,728 |
1,464 |
$18K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
857 |
823 |
$17K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
424 |
401 |
$16K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
374 |
358 |
$16K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
117 |
69 |
$15K |
| 0240U |
|
215 |
203 |
$15K |
| 92567 |
|
1,133 |
961 |
$15K |
| 62323 |
|
80 |
40 |
$13K |
| Y7507 |
|
85 |
60 |
$13K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
1,057 |
924 |
$13K |
| 45378 |
Colonoscopy, flexible; diagnostic, including collection of specimen(s) |
26 |
13 |
$12K |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
2,223 |
2,050 |
$11K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
1,471 |
1,393 |
$11K |
| 80061 |
Lipid panel |
1,460 |
1,388 |
$11K |
| 83880 |
|
427 |
358 |
$11K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
583 |
560 |
$11K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
376 |
334 |
$10K |
| X4006 |
|
33 |
27 |
$10K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
349 |
256 |
$10K |
| 76801 |
|
179 |
168 |
$10K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
122 |
117 |
$9K |
| 86787 |
|
331 |
309 |
$9K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
311 |
298 |
$9K |
| 87807 |
|
734 |
710 |
$9K |
| 69210 |
|
369 |
288 |
$8K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
122 |
114 |
$8K |
| 11057 |
|
374 |
193 |
$8K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
108 |
102 |
$8K |
| 92507 |
Treatment of speech, language, voice, communication, and/or auditory processing disorder |
204 |
64 |
$7K |
| 31231 |
|
75 |
39 |
$7K |
| 95885 |
|
509 |
381 |
$7K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
132 |
125 |
$7K |
| 59025 |
Fetal non-stress test |
181 |
61 |
$7K |
| 87801 |
Infectious agent detection by nucleic acid; amplified probe, multiple organisms |
52 |
51 |
$7K |
| 31575 |
|
103 |
65 |
$7K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
1,357 |
1,256 |
$7K |
| 82550 |
|
769 |
677 |
$6K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
1,088 |
1,027 |
$6K |
| 82607 |
|
649 |
621 |
$6K |
| 80050 |
General health panel |
12 |
12 |
$5K |
| J3490 |
Unclassified drugs |
4,682 |
2,203 |
$5K |
| 82553 |
|
403 |
353 |
$5K |
| 86803 |
|
387 |
357 |
$5K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
63 |
25 |
$4K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
45 |
36 |
$4K |
| 95117 |
|
145 |
58 |
$4K |
| 92134 |
|
160 |
99 |
$3K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
64 |
59 |
$3K |
| 73110 |
|
424 |
368 |
$3K |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
137 |
62 |
$3K |
| 82951 |
|
68 |
68 |
$3K |
| 94060 |
|
135 |
123 |
$3K |
| 94727 |
|
227 |
208 |
$3K |
| 73030 |
|
487 |
429 |
$3K |
| 73610 |
|
438 |
391 |
$3K |
| 85730 |
|
553 |
483 |
$2K |
| 11721 |
|
1,514 |
854 |
$2K |
| 64615 |
|
20 |
12 |
$2K |
| 82728 |
|
271 |
262 |
$2K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
35 |
27 |
$2K |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
70 |
68 |
$2K |
| 74019 |
|
210 |
201 |
$2K |
| 73130 |
|
370 |
294 |
$2K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
43 |
41 |
$2K |
| 51798 |
|
91 |
89 |
$2K |
| 84439 |
|
393 |
377 |
$2K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
92 |
89 |
$2K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
77 |
65 |
$2K |
| 82565 |
|
118 |
103 |
$2K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
75 |
74 |
$2K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
57 |
56 |
$2K |
| 82962 |
|
16 |
12 |
$2K |
| J2704 |
Injection, propofol, 10 mg |
408 |
293 |
$2K |
| 92015 |
Determination of refractive state |
435 |
407 |
$2K |
| 84702 |
|
49 |
44 |
$2K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
66 |
62 |
$1K |
| 94729 |
|
238 |
221 |
$1K |
| 99309 |
Subsequent nursing facility care, per day, low to moderate complexity |
55 |
52 |
$1K |
| 90960 |
End-stage renal disease related services monthly, for patients 20 years and older, with 4 or more face-to-face visits |
24 |
24 |
$1K |
| 87070 |
|
247 |
228 |
$1K |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
226 |
213 |
$1K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
55 |
53 |
$896.70 |
| 92136 |
|
22 |
12 |
$889.80 |
| 92083 |
|
21 |
13 |
$869.89 |
| 86308 |
|
29 |
29 |
$828.27 |
| 83550 |
|
146 |
142 |
$791.46 |
| 83615 |
|
210 |
164 |
$780.67 |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
12 |
12 |
$733.08 |
| 83540 |
|
146 |
142 |
$585.10 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
99 |
86 |
$568.42 |
| 96367 |
|
19 |
14 |
$557.81 |
| A0429 |
Ambulance service, basic life support, emergency transport (bls-emergency) |
12 |
12 |
$552.42 |
| 82746 |
|
70 |
64 |
$539.23 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
68 |
57 |
$461.41 |
| 84252 |
|
36 |
33 |
$443.25 |
| 73562 |
|
60 |
51 |
$439.14 |
| 84145 |
|
33 |
29 |
$428.75 |
| 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 |
31 |
28 |
$403.00 |
| 84100 |
|
108 |
63 |
$388.30 |
| 85027 |
|
98 |
94 |
$355.64 |
| 84425 |
|
33 |
29 |
$344.53 |
| 95909 |
|
14 |
13 |
$332.86 |
| 82150 |
|
93 |
83 |
$280.36 |
| 73564 |
|
32 |
27 |
$262.73 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
49 |
43 |
$219.68 |
| 99358 |
Prolong nursin fac eval 15m |
19 |
17 |
$174.48 |
| 80069 |
|
60 |
46 |
$159.76 |
| J2360 |
Injection, orphenadrine citrate, up to 60 mg |
14 |
13 |
$157.00 |
| 86140 |
|
58 |
49 |
$119.03 |
| 84481 |
|
12 |
12 |
$112.87 |
| 72100 |
|
12 |
12 |
$96.28 |
| 86038 |
|
13 |
12 |
$81.61 |
| 99497 |
|
22 |
19 |
$77.24 |
| 86200 |
|
12 |
12 |
$75.75 |
| 86592 |
|
13 |
12 |
$37.60 |
| 82950 |
|
14 |
13 |
$32.97 |
| 87077 |
|
22 |
14 |
$32.30 |
| J7620 |
Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme |
15 |
13 |
$17.42 |
| 82570 |
|
12 |
12 |
$17.34 |
| 84156 |
|
12 |
12 |
$12.26 |
| 3074F |
|
134 |
132 |
$0.00 |
| 3075F |
|
16 |
14 |
$0.00 |
| G9920 |
Screening performed and negative |
254 |
228 |
$0.00 |
| 3078F |
|
259 |
236 |
$0.00 |