| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
50,902 |
48,579 |
$8.19M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
21,906 |
20,875 |
$3.76M |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
22,658 |
18,688 |
$2.16M |
| H0012 |
Alcohol and/or drug services; sub-acute detoxification (residential addiction program outpatient) |
3,240 |
969 |
$1.27M |
| H0015 |
Alcohol and/or drug services; intensive outpatient (treatment program that operates at least 3 hours/day and at least 3 days/week and is based on an individualized treatment plan), including assessment, counseling; crisis intervention, and activity therapies or education |
9,930 |
1,259 |
$1.26M |
| 90791 |
Psychiatric diagnostic evaluation |
6,357 |
5,977 |
$536K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
20,973 |
14,930 |
$446K |
| 80053 |
Comprehensive metabolic panel |
29,717 |
26,868 |
$419K |
| H0005 |
Alcohol and/or drug services; group counseling by a clinician |
6,090 |
2,089 |
$356K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
1,842 |
1,725 |
$338K |
| C9803 |
Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
5,306 |
5,138 |
$314K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
511 |
480 |
$292K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
11,462 |
3,905 |
$285K |
| 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 |
1,693 |
1,502 |
$281K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
1,302 |
921 |
$250K |
| 80320 |
|
10,044 |
6,786 |
$183K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
34,137 |
23,855 |
$154K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
1,503 |
1,436 |
$107K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
796 |
760 |
$92K |
| 70450 |
Computed tomography, head or brain; without contrast material |
318 |
296 |
$81K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
5,145 |
4,895 |
$69K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
3,314 |
2,803 |
$66K |
| 80061 |
Lipid panel |
4,428 |
4,240 |
$63K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
3,867 |
3,508 |
$62K |
| 36415 |
Collection of venous blood by venipuncture |
45,719 |
28,907 |
$60K |
| 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 |
5,732 |
4,187 |
$60K |
| 73630 |
|
922 |
841 |
$59K |
| 90837 |
Psychotherapy, 53 minutes with patient |
613 |
404 |
$56K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
2,246 |
2,172 |
$52K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
4,056 |
3,930 |
$50K |
| G0378 |
Hospital observation service, per hour |
1,115 |
429 |
$47K |
| 82607 |
|
1,261 |
1,227 |
$44K |
| 11721 |
|
904 |
861 |
$40K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
224 |
202 |
$37K |
| 84484 |
|
4,714 |
4,138 |
$36K |
| 84443 |
Thyroid stimulating hormone (TSH) |
2,290 |
2,151 |
$35K |
| 99231 |
Subsequent hospital care, per day, straightforward or low complexity |
3,267 |
1,380 |
$34K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
155 |
150 |
$32K |
| 85027 |
|
2,993 |
2,734 |
$30K |
| 86481 |
|
251 |
245 |
$29K |
| 80076 |
|
1,535 |
666 |
$24K |
| 98941 |
Chiropractic manipulative treatment; spinal, 3-4 regions |
276 |
113 |
$24K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
219 |
72 |
$22K |
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
417 |
99 |
$22K |
| 85060 |
|
2,321 |
2,003 |
$21K |
| 90832 |
Psychotherapy, 30 minutes with patient |
189 |
163 |
$21K |
| J0592 |
Injection, buprenorphine hydrochloride, 0.1 mg |
1,021 |
440 |
$20K |
| G0397 |
Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and intervention, greater than 30 minutes |
564 |
515 |
$20K |
| 83540 |
|
1,115 |
1,082 |
$20K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
113 |
99 |
$20K |
| 82570 |
|
1,294 |
1,088 |
$20K |
| 88307 |
|
434 |
408 |
$19K |
| 83550 |
|
1,111 |
1,078 |
$17K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
40 |
40 |
$17K |
| 11056 |
|
49 |
44 |
$15K |
| 86803 |
|
198 |
197 |
$13K |
| 98940 |
|
275 |
144 |
$13K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
9,025 |
8,272 |
$12K |
| 82728 |
|
337 |
328 |
$12K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
39 |
38 |
$12K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
27 |
25 |
$11K |
| 84450 |
|
419 |
408 |
$9K |
| 87340 |
|
213 |
210 |
$9K |
| 83735 |
|
1,175 |
614 |
$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 |
1,530 |
1,344 |
$9K |
| 82043 |
|
745 |
730 |
$8K |
| 85610 |
|
1,188 |
874 |
$8K |
| 97810 |
|
162 |
74 |
$8K |
| 80349 |
|
538 |
334 |
$7K |
| 93017 |
|
160 |
138 |
$7K |
| 82075 |
|
273 |
172 |
$6K |
| 86677 |
|
263 |
253 |
$6K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
4,953 |
4,654 |
$6K |
| 84460 |
|
419 |
408 |
$6K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
203 |
189 |
$6K |
| 88304 |
|
787 |
763 |
$5K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
139 |
138 |
$5K |
| 81025 |
|
11,694 |
11,353 |
$5K |
| 71045 |
Radiologic examination, chest; single view |
3,640 |
3,446 |
$5K |
| 88311 |
|
680 |
635 |
$5K |
| 84436 |
|
421 |
381 |
$4K |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
278 |
89 |
$4K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
192 |
189 |
$4K |
| 97811 |
|
162 |
74 |
$4K |
| 73610 |
|
49 |
46 |
$3K |
| 81001 |
|
11,659 |
11,261 |
$3K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
12 |
12 |
$3K |
| 0002A |
|
101 |
92 |
$3K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
329 |
122 |
$3K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
4,075 |
3,949 |
$3K |
| 0001A |
|
106 |
100 |
$3K |
| 73564 |
|
26 |
25 |
$3K |
| 80354 |
|
231 |
121 |
$3K |
| 86850 |
|
123 |
116 |
$3K |
| 84439 |
|
60 |
41 |
$3K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
156 |
147 |
$2K |
| 86900 |
|
136 |
128 |
$2K |
| 84479 |
|
351 |
323 |
$2K |
| 81003 |
|
4,609 |
4,417 |
$2K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
10,152 |
9,042 |
$2K |
| 80359 |
|
112 |
75 |
$2K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
17 |
13 |
$1K |
| 87071 |
|
414 |
403 |
$1K |
| 86140 |
|
76 |
75 |
$1K |
| 87073 |
|
53 |
51 |
$1K |
| 99222 |
Initial hospital care, per day, moderate complexity |
44 |
39 |
$1K |
| 82550 |
|
1,094 |
1,008 |
$1K |
| 72050 |
|
13 |
13 |
$1K |
| G0008 |
Administration of influenza virus vaccine |
317 |
297 |
$1K |
| 90714 |
|
49 |
48 |
$1K |
| 86901 |
|
136 |
128 |
$1K |
| 72110 |
|
25 |
24 |
$869.83 |
| 82248 |
|
38 |
26 |
$728.12 |
| 99406 |
|
19 |
18 |
$695.70 |
| 87660 |
|
50 |
50 |
$635.72 |
| 73562 |
|
12 |
12 |
$569.71 |
| 86780 |
|
27 |
25 |
$548.14 |
| 0031A |
|
20 |
18 |
$497.51 |
| 87510 |
|
36 |
36 |
$492.14 |
| 82948 |
|
743 |
599 |
$375.36 |
| 96375 |
Therapeutic injection; each additional sequential IV push |
1,572 |
1,154 |
$361.46 |
| 85651 |
|
95 |
92 |
$351.50 |
| 85730 |
|
54 |
54 |
$342.77 |
| 90686 |
|
100 |
86 |
$330.58 |
| 84703 |
|
211 |
206 |
$291.78 |
| Q2038 |
Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (fluzone) |
47 |
44 |
$286.75 |
| 71046 |
Radiologic examination, chest; 2 views |
656 |
618 |
$259.47 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
2,402 |
1,172 |
$239.59 |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
28 |
26 |
$236.34 |
| 86762 |
|
27 |
25 |
$214.98 |
| 80069 |
|
14 |
12 |
$198.12 |
| Q0111 |
Wet mounts, including preparations of vaginal, cervical or skin specimens |
34 |
34 |
$175.69 |
| 80164 |
|
12 |
12 |
$154.16 |
| 87077 |
|
129 |
121 |
$149.60 |
| G0123 |
Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, screening by cytotechnologist under physician supervision |
12 |
12 |
$134.37 |
| J7030 |
Infusion, normal saline solution , 1000 cc |
3,044 |
2,867 |
$131.65 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
5,410 |
5,089 |
$94.79 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
42 |
41 |
$94.10 |
| 88300 |
|
38 |
37 |
$83.10 |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
18 |
13 |
$81.61 |
| 84153 |
|
20 |
18 |
$80.55 |
| 85379 |
|
73 |
72 |
$78.17 |
| 83690 |
|
740 |
698 |
$63.19 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
508 |
494 |
$57.55 |
| 99153 |
Mod sedat endo service >5yrs |
313 |
299 |
$48.06 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
2,541 |
2,474 |
$26.06 |
| 82150 |
|
176 |
172 |
$22.96 |
| J2360 |
Injection, orphenadrine citrate, up to 60 mg |
25 |
25 |
$21.12 |
| J1040 |
Injection, methylprednisolone acetate, 80 mg |
220 |
190 |
$17.24 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
1,705 |
1,560 |
$12.43 |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
61 |
61 |
$10.98 |
| J1644 |
Injection, heparin sodium, per 1000 units |
114 |
39 |
$9.48 |
| G0500 |
Moderate sedation services provided by the same physician or other qualified health care professional performing a gastrointestinal endoscopic service that sedation supports, requiring the presence of an independent trained observer to assist in the monitoring of the patient's level of consciousness and physiological status; initial 15 minutes of intra-service time; patient age 5 years or older (additional time may be reported with 99153, as appropriate) |
12 |
12 |
$8.49 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
388 |
369 |
$0.97 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
254 |
234 |
$0.90 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
225 |
206 |
$0.89 |
| J2175 |
Injection, meperidine hydrochloride, per 100 mg |
98 |
93 |
$0.45 |
| 99152 |
|
511 |
482 |
$0.00 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
74 |
66 |
$0.00 |
| 73030 |
|
30 |
28 |
$0.00 |
| 73130 |
|
26 |
25 |
$0.00 |
| J2785 |
Injection, regadenoson, 0.1 mg |
27 |
25 |
$0.00 |
| 87480 |
|
36 |
36 |
$0.00 |
| A9500 |
Technetium tc-99m sestamibi, diagnostic, per study dose |
12 |
12 |
$0.00 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
14 |
13 |
$0.00 |