| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
Emergency department visit for the evaluation and management, high severity |
14,535 |
13,013 |
$5.17M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
14,303 |
13,108 |
$4.31M |
| G0378 |
Hospital observation service, per hour |
3,012 |
2,613 |
$3.12M |
| S9480 |
Intensive outpatient psychiatric services, per diem |
1,445 |
1,350 |
$1.16M |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
1,201 |
720 |
$940K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
4,169 |
3,795 |
$874K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
4,147 |
3,953 |
$825K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
9,698 |
2,063 |
$582K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
6,877 |
5,410 |
$550K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
669 |
628 |
$544K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
2,828 |
1,977 |
$530K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
6,736 |
5,314 |
$522K |
| H0035 |
Mental health partial hospitalization, treatment, less than 24 hours |
2,514 |
230 |
$510K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
8,355 |
1,904 |
$457K |
| 92507 |
Treatment of speech, language, voice, communication, and/or auditory processing disorder |
4,037 |
1,054 |
$362K |
| 90832 |
Psychotherapy, 30 minutes with patient |
3,013 |
1,610 |
$334K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
2,769 |
2,605 |
$290K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
3,589 |
3,193 |
$266K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
11,052 |
9,657 |
$249K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
3,539 |
3,069 |
$233K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
7,331 |
6,365 |
$217K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,605 |
1,439 |
$217K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
4,864 |
3,427 |
$200K |
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
5,618 |
1,510 |
$195K |
| 70450 |
Computed tomography, head or brain; without contrast material |
3,678 |
3,362 |
$172K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
2,071 |
1,515 |
$167K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
5,099 |
3,605 |
$163K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,117 |
908 |
$153K |
| 80053 |
Comprehensive metabolic panel |
27,345 |
20,512 |
$150K |
| OP370 |
|
3,534 |
3,174 |
$122K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
567 |
519 |
$116K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
829 |
769 |
$114K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
29,956 |
22,116 |
$109K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
1,964 |
1,755 |
$109K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
1,270 |
1,220 |
$104K |
| OP250 |
|
40,109 |
17,955 |
$98K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
5,318 |
3,569 |
$97K |
| 92567 |
|
1,081 |
1,048 |
$90K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
4,332 |
3,856 |
$81K |
| 0202U |
Oncology (prostate), multianalyte, gene expression profiling |
2,360 |
2,267 |
$80K |
| OP710 |
|
1,816 |
1,664 |
$74K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
903 |
855 |
$70K |
| OP272 |
|
5,296 |
4,611 |
$66K |
| 71045 |
Radiologic examination, chest; single view |
6,675 |
6,107 |
$64K |
| 93971 |
|
354 |
336 |
$57K |
| 96367 |
|
335 |
253 |
$54K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
1,656 |
1,556 |
$54K |
| 36415 |
Collection of venous blood by venipuncture |
25,071 |
19,419 |
$53K |
| 97010 |
|
6,593 |
1,536 |
$48K |
| 90791 |
Psychiatric diagnostic evaluation |
1,155 |
930 |
$45K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
566 |
535 |
$44K |
| 71046 |
Radiologic examination, chest; 2 views |
3,075 |
2,963 |
$42K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
1,189 |
1,139 |
$36K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,206 |
2,103 |
$35K |
| 76641 |
|
421 |
333 |
$34K |
| 84484 |
|
8,171 |
6,487 |
$30K |
| 77066 |
Tomosynthesis, mammo |
294 |
278 |
$30K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
700 |
638 |
$29K |
| 76830 |
Ultrasound, transvaginal |
558 |
524 |
$28K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
245 |
244 |
$26K |
| G0279 |
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) |
734 |
696 |
$24K |
| OP379 |
|
428 |
401 |
$23K |
| 76813 |
|
192 |
192 |
$19K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
624 |
548 |
$19K |
| OP259 |
|
3,165 |
2,357 |
$19K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
371 |
351 |
$18K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
207 |
198 |
$18K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
3,240 |
2,884 |
$17K |
| 90834 |
Psychotherapy, 45 minutes with patient |
460 |
218 |
$17K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
1,032 |
889 |
$17K |
| 97162 |
|
409 |
356 |
$16K |
| 93976 |
|
150 |
138 |
$16K |
| OP258 |
|
18,747 |
11,561 |
$16K |
| 96376 |
|
1,510 |
1,210 |
$16K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
1,491 |
1,273 |
$16K |
| 85610 |
|
3,632 |
3,255 |
$15K |
| G0008 |
Administration of influenza virus vaccine |
405 |
398 |
$15K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
637 |
598 |
$15K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
55 |
55 |
$14K |
| 97161 |
|
351 |
329 |
$13K |
| 99173 |
|
623 |
613 |
$13K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
868 |
808 |
$12K |
| 85730 |
|
3,030 |
2,757 |
$12K |
| OP278 |
|
13 |
13 |
$12K |
| 86885 |
|
1,850 |
1,592 |
$12K |
| 82077 |
|
3,451 |
2,677 |
$11K |
| 81003 |
|
6,555 |
6,047 |
$11K |
| 41899 |
Unlisted procedure, dentoalveolar structures |
28 |
27 |
$10K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
100 |
99 |
$10K |
| 64493 |
|
14 |
13 |
$10K |
| 81025 |
|
5,471 |
4,892 |
$10K |
| 82962 |
|
4,544 |
2,871 |
$9K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
79 |
79 |
$9K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
154 |
129 |
$9K |
| 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 |
649 |
507 |
$9K |
| 84443 |
Thyroid stimulating hormone (TSH) |
1,831 |
1,618 |
$9K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
1,511 |
1,254 |
$9K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
37 |
36 |
$9K |
| 87070 |
|
3,558 |
3,436 |
$9K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
3,344 |
3,074 |
$8K |
| 86901 |
|
2,288 |
1,911 |
$8K |
| 83690 |
|
4,822 |
4,246 |
$8K |
| 87040 |
|
858 |
747 |
$8K |
| 81001 |
|
7,064 |
6,246 |
$8K |
| 0012A |
|
297 |
297 |
$8K |
| 86900 |
|
2,254 |
1,904 |
$8K |
| 76642 |
|
112 |
109 |
$8K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
5,308 |
4,157 |
$7K |
| 0011A |
|
297 |
297 |
$7K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
1,633 |
1,466 |
$7K |
| 93970 |
|
28 |
28 |
$7K |
| 88304 |
|
430 |
377 |
$7K |
| 85027 |
|
1,032 |
881 |
$7K |
| OP279 |
|
505 |
411 |
$7K |
| J1170 |
Injection, hydromorphone, up to 4 mg |
1,231 |
838 |
$6K |
| 93017 |
|
13 |
13 |
$6K |
| 80061 |
Lipid panel |
948 |
886 |
$6K |
| J3490 |
Unclassified drugs |
1,194 |
918 |
$6K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
50 |
49 |
$6K |
| 83735 |
|
3,059 |
2,199 |
$6K |
| 90715 |
|
371 |
345 |
$6K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
2,822 |
2,115 |
$6K |
| S9484 |
Crisis intervention mental health services, per hour |
12 |
12 |
$5K |
| 0002A |
|
178 |
178 |
$5K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
3,932 |
3,820 |
$5K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
86 |
32 |
$5K |
| 73630 |
|
420 |
408 |
$5K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
70 |
67 |
$5K |
| 76801 |
|
87 |
81 |
$5K |
| 71250 |
|
42 |
41 |
$5K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
12 |
12 |
$5K |
| 72110 |
|
199 |
198 |
$4K |
| 0001A |
|
134 |
134 |
$4K |
| OP270 |
|
2,016 |
1,796 |
$4K |
| 83605 |
|
1,530 |
1,322 |
$4K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
1,940 |
1,888 |
$4K |
| 80143 |
|
1,434 |
1,221 |
$4K |
| 73610 |
|
387 |
370 |
$4K |
| 87088 |
|
994 |
959 |
$4K |
| 90670 |
|
205 |
181 |
$4K |
| 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 |
63 |
62 |
$4K |
| 80179 |
|
1,380 |
1,174 |
$4K |
| 77065 |
Tomosynthesis, mammo |
62 |
49 |
$4K |
| 97116 |
|
248 |
123 |
$4K |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
2,725 |
2,410 |
$3K |
| J2060 |
Injection, lorazepam, 2 mg |
2,090 |
1,366 |
$3K |
| 83880 |
|
711 |
648 |
$3K |
| C9290 |
Injection, bupivacaine liposome, 1 mg |
91 |
74 |
$3K |
| 90686 |
|
774 |
698 |
$3K |
| 0064A |
|
78 |
78 |
$3K |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
1,543 |
1,078 |
$3K |
| 80306 |
|
1,221 |
1,050 |
$3K |
| 73564 |
|
146 |
139 |
$2K |
| 0004A |
|
60 |
59 |
$2K |
| 73030 |
|
212 |
202 |
$2K |
| 0072A |
|
43 |
43 |
$2K |
| 99215 |
Prolong outpt/office vis |
12 |
12 |
$2K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
878 |
679 |
$2K |
| 83789 |
|
605 |
560 |
$2K |
| 0071A |
|
39 |
39 |
$2K |
| J2704 |
Injection, propofol, 10 mg |
2,721 |
2,400 |
$2K |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
1,676 |
1,428 |
$2K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
72 |
28 |
$2K |
| A9502 |
Technetium tc-99m tetrofosmin, diagnostic, per study dose |
12 |
12 |
$2K |
| 87633 |
Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets |
26 |
26 |
$2K |
| 87077 |
|
530 |
483 |
$2K |
| Q2038 |
Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (fluzone) |
134 |
133 |
$2K |
| 85379 |
|
1,070 |
976 |
$2K |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
1,939 |
1,209 |
$2K |
| 73130 |
|
160 |
147 |
$2K |
| A9575 |
Injection, gadoterate meglumine, 0.1 ml |
345 |
309 |
$2K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
722 |
651 |
$2K |
| 84703 |
|
1,052 |
948 |
$1K |
| 74018 |
|
162 |
155 |
$1K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
2,585 |
2,261 |
$1K |
| 80320 |
|
284 |
239 |
$1K |
| 84702 |
|
343 |
302 |
$1K |
| J0134 |
Injection, acetaminophen (fresenius kabi), not therapeutically equivalent to j0131, 10 mg |
742 |
597 |
$1K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
4,177 |
3,493 |
$1K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
89 |
88 |
$994.47 |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
89 |
88 |
$960.04 |
| 82607 |
|
58 |
53 |
$890.95 |
| 84145 |
|
286 |
257 |
$842.46 |
| 87999 |
|
378 |
362 |
$769.86 |
| 85651 |
|
145 |
138 |
$736.72 |
| 90697 |
|
14 |
13 |
$664.48 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
1,258 |
957 |
$596.38 |
| 97535 |
Self-care/home management training, each 15 minutes |
58 |
25 |
$549.86 |
| Q9966 |
Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml |
62 |
60 |
$543.09 |
| 84439 |
|
107 |
107 |
$541.35 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
246 |
179 |
$534.99 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
18 |
18 |
$486.43 |
| 82728 |
|
88 |
74 |
$469.62 |
| 87420 |
|
246 |
239 |
$461.50 |
| 76536 |
|
12 |
12 |
$457.48 |
| 86140 |
|
342 |
301 |
$448.91 |
| G1004 |
Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program |
385 |
268 |
$420.50 |
| 72052 |
|
13 |
13 |
$415.24 |
| 87186 |
|
131 |
127 |
$406.87 |
| 84100 |
|
694 |
552 |
$381.59 |
| 82550 |
|
289 |
260 |
$368.72 |
| J1642 |
Injection, heparin sodium, (heparin lock flush), per 10 units |
510 |
211 |
$364.75 |
| 90677 |
|
132 |
124 |
$355.01 |
| 90656 |
|
165 |
161 |
$344.92 |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
334 |
274 |
$334.10 |
| 73562 |
|
25 |
24 |
$311.07 |
| J2919 |
Injection, methylprednisolone sodium succinate, 5 mg |
144 |
81 |
$264.13 |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
263 |
202 |
$256.29 |
| 82248 |
|
44 |
40 |
$245.73 |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
27 |
26 |
$227.79 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
214 |
186 |
$225.01 |
| 87486 |
|
26 |
26 |
$224.83 |
| 87581 |
|
26 |
26 |
$224.83 |
| J0295 |
Injection, ampicillin sodium/sulbactam sodium, per 1.5 gm |
660 |
204 |
$212.90 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
740 |
569 |
$204.25 |
| 85652 |
|
219 |
193 |
$174.75 |
| 72040 |
|
15 |
15 |
$170.71 |
| J7030 |
Infusion, normal saline solution , 1000 cc |
147 |
81 |
$153.49 |
| J0136 |
Injection, acetaminophen (b braun), not therapeutically equivalent to j0131, 10 mg |
258 |
209 |
$148.63 |
| 90681 |
|
28 |
25 |
$145.25 |
| 83550 |
|
43 |
41 |
$144.58 |
| 82247 |
|
33 |
26 |
$133.55 |
| A9585 |
Injection, gadobutrol, 0.1 ml |
43 |
39 |
$129.65 |
| 73502 |
|
13 |
12 |
$127.88 |
| 87147 |
|
94 |
94 |
$122.52 |
| J0689 |
Injection, cefazolin sodium (baxter), not therapeutically equivalent to j0690, 500 mg |
79 |
44 |
$104.91 |
| J3360 |
Injection, diazepam, up to 5 mg |
34 |
26 |
$76.77 |
| C9113 |
Injection, pantoprazole sodium, per vial |
274 |
172 |
$76.40 |
| J7620 |
Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme |
96 |
78 |
$73.97 |
| J1630 |
Injection, haloperidol, up to 5 mg |
151 |
112 |
$67.60 |
| J0360 |
Injection, hydralazine hcl, up to 20 mg |
95 |
65 |
$55.99 |
| 87205 |
|
47 |
40 |
$55.81 |
| 83540 |
|
31 |
29 |
$39.46 |
| J2272 |
Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg |
60 |
46 |
$34.90 |
| V2632 |
Posterior chamber intraocular lens |
44 |
36 |
$33.89 |
| 85378 |
|
25 |
25 |
$29.50 |
| 88300 |
|
28 |
27 |
$21.73 |
| J2004 |
Injection, lidocaine hcl with epinephrine, 1 mg |
17 |
17 |
$12.86 |
| 73110 |
|
13 |
12 |
$12.50 |
| J0171 |
Injection, adrenalin, epinephrine, 0.1 mg |
121 |
96 |
$9.67 |
| J1596 |
Injection, glycopyrrolate, 0.1 mg |
30 |
26 |
$8.39 |
| J3480 |
Injection, potassium chloride, per 2 meq |
20 |
14 |
$8.21 |
| 86308 |
|
29 |
29 |
$6.00 |
| J2710 |
Injection, neostigmine methylsulfate, up to 0.5 mg |
14 |
12 |
$5.16 |
| OP637 |
|
9,759 |
1,193 |
$4.21 |
| 85008 |
|
15 |
14 |
$1.20 |
| 81002 |
|
16 |
15 |
$1.00 |
| J1171 |
Injection, hydromorphone, 0.1 mg |
18 |
14 |
$0.66 |
| 91300 |
|
252 |
233 |
$0.01 |
| 91301 |
|
497 |
477 |
$0.00 |
| 91306 |
|
47 |
47 |
$0.00 |
| 91307 |
|
36 |
32 |
$0.00 |
| J1815 |
Injection, insulin, per 5 units |
42 |
14 |
$0.00 |