| Code | Description | Claims | Beneficiaries | Total Paid |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
329,724 |
313,099 |
$17.20M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
176,641 |
170,944 |
$11.27M |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
80,309 |
78,469 |
$6.52M |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
76,915 |
76,170 |
$6.39M |
| 99233 |
Prolong inpt eval add15 m |
88,073 |
29,360 |
$5.97M |
| 99244 |
Office or other outpatient consultation, moderate to high complexity |
42,090 |
41,513 |
$5.33M |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
57,319 |
56,806 |
$5.05M |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
35,599 |
35,128 |
$3.38M |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
59,181 |
30,569 |
$3.00M |
| 99243 |
|
32,832 |
32,501 |
$2.97M |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
28,217 |
27,789 |
$2.38M |
| 99215 |
Prolong outpt/office vis |
26,497 |
24,761 |
$2.34M |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
9,124 |
5,930 |
$1.83M |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
131,095 |
129,710 |
$1.64M |
| 99381 |
|
19,047 |
18,836 |
$1.64M |
| 99472 |
Subsequent inpatient pediatric critical care, per day, 2-5 years |
4,253 |
2,850 |
$1.60M |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
183,617 |
74,095 |
$1.48M |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
123,955 |
74,488 |
$1.28M |
| 99239 |
Hospital discharge day management, more than 30 minutes |
15,296 |
15,000 |
$1.27M |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
10,688 |
10,450 |
$1.23M |
| 95720 |
|
6,544 |
4,357 |
$1.05M |
| 99222 |
Initial hospital care, per day, moderate complexity |
8,762 |
8,678 |
$935K |
| 01922 |
|
4,200 |
4,093 |
$892K |
| 00170 |
Anesthesia for intraoral procedures, including biopsy |
5,524 |
5,434 |
$840K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
97,311 |
71,374 |
$836K |
| 99245 |
|
4,767 |
4,668 |
$825K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
6,667 |
6,465 |
$819K |
| 69436 |
Tympanostomy (requiring insertion of ventilating tube), general anesthesia |
6,966 |
4,256 |
$783K |
| 99255 |
|
4,031 |
3,935 |
$696K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
10,808 |
7,138 |
$641K |
| 99219 |
|
6,932 |
6,865 |
$606K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
7,224 |
6,132 |
$545K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
15,551 |
15,020 |
$513K |
| 87428 |
|
8,112 |
7,997 |
$502K |
| 99242 |
|
6,084 |
6,025 |
$411K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
3,354 |
3,199 |
$404K |
| 99217 |
|
7,009 |
6,944 |
$399K |
| 99205 |
Prolong outpt/office vis |
3,611 |
3,513 |
$378K |
| 99000 |
|
34,641 |
32,883 |
$369K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
4,405 |
4,253 |
$368K |
| 90461 |
|
50,683 |
42,904 |
$359K |
| 99383 |
|
3,407 |
3,370 |
$320K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
6,101 |
5,923 |
$318K |
| 80061 |
Lipid panel |
27,264 |
26,936 |
$297K |
| 90474 |
|
28,596 |
28,316 |
$294K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
9,446 |
9,334 |
$291K |
| 83655 |
|
25,072 |
24,739 |
$271K |
| 99223 |
Prolong inpt eval add15 m |
1,929 |
1,877 |
$265K |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
29,935 |
28,324 |
$261K |
| 76820 |
|
7,337 |
4,323 |
$240K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
2,388 |
2,294 |
$238K |
| 99235 |
|
1,517 |
1,508 |
$235K |
| 42820 |
Tonsillectomy and adenoidectomy; younger than age 12 |
1,003 |
988 |
$234K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
1,547 |
1,507 |
$230K |
| 99460 |
|
2,759 |
2,735 |
$211K |
| 90833 |
Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) |
3,888 |
3,750 |
$197K |
| 64642 |
|
2,126 |
2,100 |
$182K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
3,097 |
3,067 |
$178K |
| 73100 |
|
6,539 |
5,334 |
$170K |
| 29085 |
|
2,193 |
1,949 |
$170K |
| 29705 |
|
3,381 |
3,255 |
$155K |
| 72082 |
|
3,203 |
3,095 |
$155K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
2,309 |
2,125 |
$149K |
| 73140 |
|
4,727 |
3,850 |
$141K |
| 97802 |
|
3,511 |
3,485 |
$140K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
9,415 |
9,122 |
$126K |
| 17110 |
|
2,218 |
2,167 |
$123K |
| 54161 |
|
915 |
900 |
$121K |
| 64643 |
|
1,550 |
1,534 |
$113K |
| 99254 |
|
851 |
836 |
$111K |
| 99140 |
|
1,434 |
1,400 |
$110K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
2,312 |
2,271 |
$102K |
| 99382 |
|
989 |
982 |
$92K |
| 85060 |
|
6,883 |
6,116 |
$89K |
| 29075 |
|
1,263 |
1,190 |
$87K |
| 76825 |
|
480 |
424 |
$83K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
973 |
963 |
$81K |
| 54150 |
|
913 |
905 |
$79K |
| 88342 |
|
2,209 |
2,119 |
$75K |
| 97803 |
|
2,542 |
2,489 |
$74K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
1,325 |
846 |
$73K |
| 73070 |
|
3,154 |
2,623 |
$73K |
| 77073 |
|
2,058 |
1,978 |
$69K |
| 96160 |
|
29,681 |
28,886 |
$66K |
| 00920 |
|
711 |
704 |
$64K |
| 44970 |
|
128 |
127 |
$63K |
| 87634 |
|
992 |
965 |
$60K |
| 29065 |
|
769 |
729 |
$59K |
| 99417 |
Prolong home eval add 15m |
3,290 |
2,614 |
$57K |
| 93303 |
Transthoracic echocardiography for congenital cardiac anomalies, follow-up or limited study |
443 |
415 |
$54K |
| 72081 |
|
1,632 |
1,596 |
$52K |
| 85018 |
|
36,237 |
35,715 |
$52K |
| 99471 |
|
62 |
62 |
$49K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
3,705 |
1,823 |
$49K |
| 99225 |
|
1,156 |
1,079 |
$48K |
| 73630 |
|
1,781 |
1,434 |
$47K |
| 99231 |
Subsequent hospital care, per day, straightforward or low complexity |
1,360 |
692 |
$46K |
| 93976 |
|
453 |
403 |
$46K |
| 99384 |
|
434 |
424 |
$43K |
| 42830 |
|
315 |
313 |
$43K |
| 00140 |
|
366 |
366 |
$42K |
| 0071A |
|
951 |
946 |
$40K |
| 88720 |
|
8,843 |
7,190 |
$39K |
| 99220 |
|
311 |
309 |
$38K |
| 96112 |
|
444 |
430 |
$38K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
706 |
694 |
$37K |
| 88108 |
|
2,036 |
1,735 |
$37K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
323 |
307 |
$37K |
| 00731 |
|
315 |
315 |
$35K |
| 73130 |
|
1,161 |
988 |
$34K |
| 0072A |
|
785 |
783 |
$33K |
| 88304 |
|
3,322 |
3,279 |
$33K |
| 95819 |
|
663 |
656 |
$30K |
| 73610 |
|
1,127 |
978 |
$30K |
| 54640 |
|
86 |
66 |
$29K |
| 00300 |
|
209 |
199 |
$29K |
| 95718 |
|
288 |
267 |
$28K |
| 93000 |
|
2,453 |
2,405 |
$27K |
| 99476 |
|
98 |
66 |
$26K |
| 95812 |
|
562 |
549 |
$26K |
| 99356 |
|
562 |
203 |
$26K |
| 96380 |
|
1,930 |
1,841 |
$25K |
| 73090 |
|
1,127 |
880 |
$25K |
| 99100 |
|
306 |
301 |
$25K |
| 00813 |
|
207 |
205 |
$24K |
| 99462 |
|
637 |
528 |
$24K |
| 73562 |
|
761 |
678 |
$23K |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
264 |
259 |
$22K |
| 90480 |
|
1,192 |
1,115 |
$22K |
| 73521 |
|
639 |
629 |
$21K |
| 99253 |
|
218 |
214 |
$21K |
| 76827 |
|
442 |
393 |
$20K |
| 54300 |
|
38 |
38 |
$20K |
| 31624 |
|
184 |
177 |
$20K |
| 72170 |
|
816 |
792 |
$18K |
| 16020 |
|
401 |
337 |
$17K |
| 73590 |
|
675 |
576 |
$17K |
| 99292 |
|
108 |
79 |
$15K |
| 95874 |
|
1,098 |
1,022 |
$14K |
| 93325 |
|
1,051 |
961 |
$14K |
| 73560 |
|
473 |
399 |
$13K |
| 93320 |
|
443 |
415 |
$13K |
| 88307 |
|
129 |
128 |
$11K |
| 60521 |
|
24 |
24 |
$11K |
| 99241 |
|
200 |
197 |
$9K |
| 95813 |
|
129 |
127 |
$9K |
| 00126 |
|
123 |
112 |
$9K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
1,087 |
1,068 |
$9K |
| 73564 |
|
256 |
232 |
$8K |
| 77072 |
|
548 |
537 |
$7K |
| 96381 |
|
451 |
446 |
$7K |
| 31575 |
|
136 |
126 |
$7K |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
1,006 |
929 |
$7K |
| 93597 |
|
25 |
25 |
$7K |
| 81003 |
|
3,376 |
3,252 |
$6K |
| 45100 |
|
27 |
26 |
$6K |
| 00840 |
|
42 |
25 |
$6K |
| 99358 |
Prolong nursin fac eval 15m |
96 |
91 |
$5K |
| 92567 |
|
463 |
457 |
$5K |
| 88341 |
|
59 |
51 |
$5K |
| 51798 |
|
594 |
577 |
$5K |
| 85097 |
|
116 |
106 |
$4K |
| 29799 |
|
336 |
272 |
$4K |
| 99418 |
Prolong nursin fac eval 15m |
75 |
41 |
$4K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
96 |
95 |
$4K |
| 69210 |
|
133 |
117 |
$3K |
| 99221 |
|
46 |
46 |
$3K |
| 90473 |
|
241 |
239 |
$3K |
| 99463 |
|
26 |
25 |
$3K |
| 94010 |
|
119 |
113 |
$3K |
| G2023 |
Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
245 |
242 |
$2K |
| 96450 |
|
38 |
24 |
$2K |
| 81002 |
|
753 |
742 |
$2K |
| 0111A |
|
49 |
49 |
$2K |
| 96040 |
|
54 |
54 |
$2K |
| 99201 |
|
86 |
74 |
$2K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
211 |
206 |
$2K |
| 92579 |
|
56 |
56 |
$2K |
| 59025 |
Fetal non-stress test |
56 |
32 |
$2K |
| 99443 |
|
38 |
37 |
$2K |
| 29405 |
|
28 |
27 |
$2K |
| 88313 |
|
151 |
149 |
$2K |
| 93790 |
|
130 |
128 |
$2K |
| 90677 |
|
16,958 |
16,770 |
$2K |
| Q4010 |
Cast supplies, short arm cast, adult (11 years +), fiberglass |
1,774 |
1,578 |
$2K |
| 87807 |
|
148 |
138 |
$2K |
| 29345 |
|
13 |
12 |
$1K |
| 99234 |
|
15 |
15 |
$1K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
13 |
13 |
$1K |
| 76818 |
|
21 |
16 |
$1K |
| 0112A |
|
30 |
30 |
$1K |
| 73552 |
|
41 |
37 |
$1K |
| 00400 |
|
17 |
13 |
$1K |
| 17250 |
|
43 |
29 |
$1K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
12 |
12 |
$1K |
| 73110 |
|
25 |
24 |
$880.96 |
| 94760 |
|
819 |
782 |
$865.22 |
| 93567 |
|
14 |
13 |
$803.20 |
| 94375 |
|
59 |
58 |
$788.17 |
| 51741 |
|
75 |
69 |
$757.25 |
| 69209 |
|
53 |
39 |
$739.27 |
| 93568 |
|
13 |
13 |
$672.92 |
| 91038 |
|
13 |
12 |
$622.94 |
| 99051 |
|
6,411 |
6,288 |
$615.76 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
40 |
39 |
$612.02 |
| 99151 |
|
27 |
26 |
$563.24 |
| 0692T |
|
122 |
117 |
$507.83 |
| Q4012 |
Cast supplies, short arm cast, pediatric (0-10 years), fiberglass |
1,480 |
1,337 |
$498.00 |
| 90671 |
|
6,606 |
6,565 |
$497.62 |
| 62370 |
|
12 |
12 |
$445.23 |
| 11102 |
|
13 |
13 |
$399.37 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
65 |
61 |
$386.44 |
| G8431 |
Screening for depression is documented as being positive and a follow-up plan is documented |
50 |
49 |
$357.13 |
| 92551 |
|
970 |
947 |
$316.18 |
| 92504 |
|
42 |
39 |
$298.36 |
| 73620 |
|
13 |
13 |
$286.65 |
| 90710 |
|
12,090 |
11,967 |
$278.26 |
| 90670 |
|
47,203 |
46,623 |
$237.64 |
| 90619 |
|
8,943 |
8,815 |
$233.79 |
| Q4008 |
Cast supplies, long arm cast, pediatric (0-10 years), fiberglass |
371 |
357 |
$159.00 |
| 85045 |
|
41 |
39 |
$136.83 |
| 90621 |
|
833 |
824 |
$123.83 |
| G2211 |
Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established) |
250 |
246 |
$123.01 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
53 |
51 |
$74.77 |
| 82947 |
|
22 |
22 |
$74.25 |
| S3620 |
Newborn metabolic screening panel, includes test kit, postage and the laboratory tests specified by the state for inclusion in this panel (e.g., galactose; hemoglobin, electrophoresis; hydroxyprogesterone, 17-d; phenylalanine (pku); and thyroxine, total) |
2,514 |
2,482 |
$68.60 |
| 82272 |
|
16 |
15 |
$61.84 |
| 90686 |
|
62,599 |
62,066 |
$40.60 |
| Q4032 |
Cast supplies, long leg cast, pediatric (0-10 years), fiberglass |
152 |
71 |
$33.10 |
| 36415 |
Collection of venous blood by venipuncture |
11,310 |
10,804 |
$29.30 |
| 96161 |
|
642 |
626 |
$24.75 |
| 90656 |
|
9,538 |
9,528 |
$20.51 |
| 99070 |
|
74 |
73 |
$12.00 |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
51 |
43 |
$5.22 |
| 90697 |
|
18,119 |
17,929 |
$1.59 |
| 90381 |
|
1,081 |
1,069 |
$1.58 |
| 90380 |
|
690 |
686 |
$0.41 |
| 91321 |
|
830 |
809 |
$0.26 |
| 90651 |
|
19,088 |
18,832 |
$0.01 |
| 90660 |
|
109 |
107 |
$0.01 |
| 90633 |
|
33,151 |
32,808 |
$0.00 |
| 90648 |
|
8,175 |
8,105 |
$0.00 |
| 90734 |
|
3,775 |
3,685 |
$0.00 |
| 90685 |
|
139 |
138 |
$0.00 |
| 90715 |
|
4,813 |
4,732 |
$0.00 |
| 90700 |
|
10,414 |
10,332 |
$0.00 |
| A9286 |
Hygienic item or device, disposable or non-disposable, any type, each |
234 |
207 |
$0.00 |
| 90707 |
|
10,351 |
10,201 |
$0.00 |
| 99173 |
|
1,305 |
1,279 |
$0.00 |
| 90658 |
|
188 |
188 |
$0.00 |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
220 |
216 |
$0.00 |
| 90672 |
|
374 |
366 |
$0.00 |
| 99177 |
|
1,182 |
1,161 |
$0.00 |
| 91322 |
|
41 |
41 |
$0.00 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
178 |
176 |
$0.00 |
| 96004 |
|
14 |
14 |
$0.00 |
| 36416 |
|
63,431 |
62,164 |
$0.00 |
| 90698 |
|
35,798 |
35,382 |
$0.00 |
| 90688 |
|
1,788 |
1,777 |
$0.00 |
| 90744 |
|
18,775 |
18,562 |
$0.00 |
| 90716 |
|
10,433 |
10,284 |
$0.00 |
| 90696 |
|
7,877 |
7,779 |
$0.00 |
| 90680 |
|
46,790 |
46,262 |
$0.00 |
| 99024 |
|
8,216 |
5,986 |
$0.00 |
| 91307 |
|
1,071 |
1,016 |
$0.00 |
| J3535 |
Drug administered through a metered dose inhaler |
12 |
12 |
$0.00 |
| 90647 |
|
87 |
87 |
$0.00 |
| 94761 |
|
13 |
13 |
$0.00 |
| 90723 |
|
14 |
14 |
$0.00 |
| 96127 |
|
12 |
12 |
$0.00 |