| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
149,869 |
140,383 |
$11.98M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
102,702 |
95,961 |
$9.93M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
47,919 |
44,400 |
$6.09M |
| 96361 |
Intravenous infusion, hydration; each additional hour |
20,694 |
18,767 |
$4.64M |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
78,606 |
24,391 |
$2.60M |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
26,978 |
25,724 |
$2.18M |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
16,023 |
15,385 |
$1.88M |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
15,636 |
14,671 |
$1.54M |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
13,208 |
10,175 |
$1.26M |
| 70450 |
Computed tomography, head or brain; without contrast material |
15,299 |
14,422 |
$1.25M |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
34,283 |
34,044 |
$1.13M |
| 95810 |
Polysomnography; sleep staging with 4 or more additional parameters |
1,505 |
1,466 |
$1.13M |
| 59025 |
Fetal non-stress test |
6,800 |
4,523 |
$1.04M |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
55,215 |
17,414 |
$1.01M |
| 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 |
36,689 |
33,543 |
$963K |
| 45378 |
Colonoscopy, flexible; diagnostic, including collection of specimen(s) |
1,162 |
1,123 |
$933K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
10,466 |
10,310 |
$913K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
34,057 |
11,606 |
$880K |
| S9485 |
Crisis intervention mental health services, per diem |
2,720 |
1,825 |
$861K |
| G0378 |
Hospital observation service, per hour |
17,303 |
11,245 |
$840K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
2,144 |
2,091 |
$804K |
| 45385 |
Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) |
917 |
893 |
$684K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
11,677 |
11,319 |
$651K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
57,196 |
54,778 |
$630K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
57,186 |
54,784 |
$630K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
5,426 |
5,217 |
$616K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
6,760 |
6,387 |
$607K |
| 87637 |
Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV |
5,888 |
5,588 |
$584K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
2,224 |
2,142 |
$574K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
216,054 |
188,484 |
$566K |
| 71046 |
Radiologic examination, chest; 2 views |
39,272 |
37,459 |
$528K |
| 97010 |
|
24,521 |
8,433 |
$515K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
3,565 |
2,855 |
$513K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
34,358 |
34,129 |
$481K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
6,514 |
6,337 |
$477K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
23,975 |
21,256 |
$461K |
| 76801 |
|
7,352 |
6,994 |
$454K |
| ATP14 |
|
54,146 |
46,885 |
$436K |
| 76830 |
Ultrasound, transvaginal |
8,645 |
8,507 |
$413K |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
4,523 |
4,268 |
$399K |
| 76642 |
|
7,449 |
7,219 |
$394K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
4,897 |
4,845 |
$393K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
596 |
586 |
$391K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
57,502 |
56,409 |
$387K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
5,750 |
5,425 |
$366K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,731 |
3,989 |
$365K |
| 97803 |
|
7,481 |
6,454 |
$333K |
| 93971 |
|
3,580 |
3,411 |
$329K |
| 86480 |
|
16,821 |
16,503 |
$325K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
2,212 |
1,856 |
$325K |
| 76770 |
|
3,612 |
3,547 |
$324K |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
7,724 |
2,833 |
$320K |
| 97161 |
|
7,013 |
6,735 |
$307K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
5,663 |
5,455 |
$302K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
29,780 |
29,268 |
$301K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
2,120 |
1,988 |
$287K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
136,746 |
133,971 |
$285K |
| G2023 |
Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
37,350 |
33,462 |
$280K |
| 95811 |
|
359 |
344 |
$276K |
| 76536 |
|
4,944 |
4,877 |
$273K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
4,530 |
4,465 |
$268K |
| 77080 |
|
6,200 |
6,122 |
$267K |
| 93017 |
|
5,001 |
4,814 |
$264K |
| 84443 |
Thyroid stimulating hormone (TSH) |
68,363 |
66,827 |
$258K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
12,761 |
4,723 |
$253K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
84,940 |
76,915 |
$249K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
10,377 |
9,414 |
$222K |
| 80053 |
Comprehensive metabolic panel |
199,432 |
179,536 |
$220K |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
52,947 |
46,073 |
$219K |
| 70496 |
|
1,782 |
1,675 |
$211K |
| 97162 |
|
5,664 |
5,532 |
$204K |
| 84484 |
|
30,540 |
24,948 |
$195K |
| 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 |
23,058 |
21,110 |
$185K |
| 80050 |
General health panel |
23,514 |
22,530 |
$182K |
| 86803 |
|
44,747 |
43,887 |
$176K |
| 76775 |
|
2,922 |
2,866 |
$175K |
| 72100 |
|
7,247 |
7,122 |
$152K |
| 76818 |
|
3,857 |
2,044 |
$149K |
| 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 |
7,798 |
6,954 |
$141K |
| 81513 |
|
2,382 |
2,291 |
$138K |
| 77066 |
Tomosynthesis, mammo |
5,781 |
5,680 |
$138K |
| 81001 |
|
112,588 |
103,617 |
$132K |
| G0279 |
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) |
5,206 |
5,033 |
$131K |
| 47562 |
|
46 |
45 |
$129K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
7,502 |
7,137 |
$126K |
| 87340 |
|
42,346 |
41,434 |
$125K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
51,012 |
44,324 |
$123K |
| 84702 |
|
18,330 |
14,198 |
$123K |
| 12001 |
|
1,150 |
1,100 |
$122K |
| 73030 |
|
7,369 |
6,777 |
$121K |
| 94060 |
|
1,676 |
1,648 |
$121K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
2,090 |
2,004 |
$121K |
| 82607 |
|
28,826 |
28,281 |
$118K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
3,810 |
3,333 |
$113K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
1,537 |
1,526 |
$112K |
| 97535 |
Self-care/home management training, each 15 minutes |
4,210 |
3,512 |
$112K |
| 99223 |
Prolong inpt eval add15 m |
919 |
899 |
$110K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,864 |
2,577 |
$109K |
| 93976 |
|
1,580 |
1,541 |
$109K |
| 77065 |
Tomosynthesis, mammo |
3,805 |
3,652 |
$108K |
| 87536 |
|
4,324 |
4,197 |
$106K |
| 99233 |
Prolong inpt eval add15 m |
1,506 |
707 |
$106K |
| 73562 |
|
6,913 |
6,543 |
$101K |
| 96415 |
|
583 |
535 |
$96K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
29,583 |
27,140 |
$95K |
| ATP17 |
|
14,548 |
13,950 |
$93K |
| 76870 |
|
1,589 |
1,527 |
$93K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
2,154 |
1,553 |
$88K |
| 83655 |
|
22,769 |
22,644 |
$88K |
| 83880 |
|
9,263 |
8,438 |
$87K |
| 71250 |
|
1,652 |
1,620 |
$86K |
| 71045 |
Radiologic examination, chest; single view |
12,163 |
11,161 |
$86K |
| 82728 |
|
20,158 |
19,684 |
$85K |
| 83690 |
|
27,788 |
25,588 |
$83K |
| 74240 |
|
988 |
982 |
$82K |
| 87481 |
|
3,367 |
2,317 |
$81K |
| 99239 |
Hospital discharge day management, more than 30 minutes |
1,083 |
1,058 |
$80K |
| ATP08 |
|
15,034 |
13,105 |
$80K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
10,515 |
10,136 |
$78K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
1,980 |
1,808 |
$76K |
| 92507 |
Treatment of speech, language, voice, communication, and/or auditory processing disorder |
717 |
243 |
$75K |
| J1745 |
Injection, infliximab, excludes biosimilar, 10 mg |
221 |
211 |
$74K |
| 86850 |
|
17,414 |
16,480 |
$74K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
7,419 |
6,998 |
$73K |
| 99222 |
Initial hospital care, per day, moderate complexity |
716 |
697 |
$73K |
| 0002A |
|
3,715 |
3,609 |
$73K |
| 84466 |
|
18,466 |
18,029 |
$72K |
| 81025 |
|
19,450 |
18,389 |
$71K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
5,399 |
5,118 |
$68K |
| 80061 |
Lipid panel |
101,372 |
99,250 |
$68K |
| 87563 |
|
3,284 |
3,177 |
$67K |
| 74178 |
|
718 |
704 |
$67K |
| 85027 |
|
39,341 |
37,472 |
$67K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,396 |
1,255 |
$64K |
| 80074 |
|
4,460 |
4,328 |
$64K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
20,609 |
18,600 |
$64K |
| 0001A |
|
4,930 |
4,647 |
$63K |
| 84703 |
|
19,842 |
18,989 |
$63K |
| 94727 |
|
1,462 |
1,437 |
$63K |
| 77062 |
|
2,198 |
2,161 |
$62K |
| 87186 |
|
17,699 |
16,660 |
$62K |
| 84153 |
|
14,708 |
14,364 |
$61K |
| 84439 |
|
22,520 |
21,921 |
$61K |
| 83021 |
|
7,561 |
7,385 |
$60K |
| 82948 |
|
27,340 |
14,688 |
$59K |
| 83970 |
|
5,079 |
4,938 |
$58K |
| 74018 |
|
3,123 |
2,998 |
$57K |
| 73610 |
|
5,951 |
5,453 |
$56K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
7,261 |
6,931 |
$56K |
| 86592 |
|
43,102 |
42,224 |
$56K |
| 83735 |
|
21,849 |
18,592 |
$55K |
| 86706 |
|
17,489 |
17,156 |
$53K |
| 97166 |
|
976 |
941 |
$53K |
| 73130 |
|
5,372 |
4,640 |
$52K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
2,004 |
1,915 |
$52K |
| 73630 |
|
5,546 |
5,148 |
$52K |
| 12002 |
|
413 |
398 |
$50K |
| 87040 |
|
8,589 |
6,768 |
$50K |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
16,979 |
14,156 |
$50K |
| 87081 |
|
18,874 |
18,375 |
$49K |
| 99221 |
|
612 |
580 |
$47K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
870 |
840 |
$47K |
| ATP03 |
|
9,298 |
8,910 |
$47K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
660 |
605 |
$46K |
| 87338 |
|
8,193 |
8,085 |
$46K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
61,346 |
55,457 |
$45K |
| 86762 |
|
7,873 |
7,736 |
$45K |
| 82746 |
|
10,684 |
10,457 |
$45K |
| 82570 |
|
35,836 |
34,358 |
$44K |
| 90715 |
|
3,212 |
3,045 |
$44K |
| 83605 |
|
8,777 |
7,141 |
$42K |
| 77061 |
|
1,282 |
1,249 |
$42K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
2,983 |
1,913 |
$41K |
| 82043 |
|
34,819 |
34,117 |
$41K |
| C9803 |
Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
10,643 |
9,464 |
$40K |
| 83540 |
|
20,028 |
19,540 |
$39K |
| 70491 |
|
319 |
295 |
$38K |
| 73501 |
|
2,470 |
2,407 |
$38K |
| 85610 |
|
27,790 |
23,122 |
$37K |
| 85730 |
|
15,118 |
13,912 |
$37K |
| 43235 |
|
55 |
51 |
$36K |
| 76882 |
|
705 |
656 |
$36K |
| 12011 |
|
408 |
392 |
$36K |
| 99219 |
|
687 |
604 |
$35K |
| 87070 |
|
9,793 |
9,278 |
$34K |
| 94729 |
|
1,559 |
1,534 |
$34K |
| 80055 |
|
905 |
872 |
$33K |
| 72050 |
|
934 |
922 |
$32K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
40,581 |
33,268 |
$32K |
| 73110 |
|
3,180 |
2,975 |
$32K |
| 88342 |
|
2,858 |
2,755 |
$31K |
| 86780 |
|
9,814 |
9,708 |
$31K |
| ATP15 |
|
4,897 |
4,281 |
$31K |
| J2704 |
Injection, propofol, 10 mg |
18,790 |
17,345 |
$30K |
| G0399 |
Home sleep test (hst) with type iii portable monitor, unattended; minimum of 4 channels: 2 respiratory movement/airflow, 1 ecg/heart rate and 1 oxygen saturation |
199 |
154 |
$30K |
| 87522 |
Neg quan hep c or qual rna |
2,827 |
2,749 |
$29K |
| 73560 |
|
2,526 |
1,653 |
$29K |
| 86900 |
|
19,193 |
17,826 |
$29K |
| 71271 |
|
661 |
654 |
$28K |
| 97802 |
|
1,078 |
1,049 |
$28K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
25,956 |
22,270 |
$27K |
| 86140 |
|
13,891 |
12,830 |
$26K |
| 85379 |
|
6,425 |
6,097 |
$26K |
| 84403 |
|
3,231 |
3,170 |
$26K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
11,201 |
10,323 |
$26K |
| 86901 |
|
19,206 |
17,842 |
$25K |
| 87590 |
|
8,151 |
7,968 |
$25K |
| 84146 |
|
4,405 |
4,306 |
$24K |
| 84112 |
|
415 |
381 |
$24K |
| 84144 |
|
2,791 |
2,604 |
$24K |
| 36902 |
|
42 |
40 |
$23K |
| 86787 |
|
3,234 |
3,139 |
$23K |
| 95806 |
|
86 |
86 |
$23K |
| 87490 |
|
8,154 |
7,971 |
$23K |
| 10060 |
|
210 |
200 |
$22K |
| 86360 |
|
1,487 |
1,452 |
$22K |
| 95816 |
|
455 |
426 |
$21K |
| 99217 |
|
398 |
396 |
$21K |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
4,580 |
2,118 |
$21K |
| 82652 |
|
1,500 |
1,467 |
$21K |
| 70486 |
|
543 |
518 |
$21K |
| 97163 |
|
565 |
546 |
$20K |
| 84425 |
|
2,484 |
2,449 |
$19K |
| 93016 |
|
1,655 |
1,646 |
$19K |
| 84154 |
|
4,461 |
4,363 |
$19K |
| 83001 |
|
3,272 |
3,223 |
$18K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
13,038 |
11,952 |
$18K |
| 86038 |
|
6,001 |
5,809 |
$18K |
| 87807 |
|
3,609 |
3,380 |
$18K |
| 70498 |
|
1,331 |
1,241 |
$18K |
| 85007 |
|
10,891 |
9,802 |
$17K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
11,634 |
10,784 |
$17K |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
13,335 |
12,620 |
$17K |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
4,092 |
3,915 |
$16K |
| 99231 |
Subsequent hospital care, per day, straightforward or low complexity |
533 |
346 |
$16K |
| 99220 |
|
256 |
247 |
$16K |
| 93970 |
|
290 |
267 |
$16K |
| 97113 |
|
608 |
173 |
$15K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
19,397 |
16,895 |
$14K |
| 86704 |
|
2,756 |
2,659 |
$14K |
| 82747 |
|
2,259 |
2,243 |
$14K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
670 |
611 |
$14K |
| 85652 |
|
16,102 |
15,151 |
$13K |
| 82274 |
|
3,034 |
2,942 |
$13K |
| ATP18 |
|
2,290 |
2,138 |
$13K |
| 73080 |
|
1,378 |
1,281 |
$13K |
| ATP11 |
|
2,442 |
2,311 |
$13K |
| 72072 |
|
426 |
422 |
$12K |
| 83002 |
|
2,217 |
2,182 |
$12K |
| 88304 |
|
3,526 |
3,434 |
$12K |
| G0297 |
Low dose ct scan (ldct) for lung cancer screening |
190 |
188 |
$12K |
| J1170 |
Injection, hydromorphone, up to 4 mg |
6,439 |
4,893 |
$12K |
| 72040 |
|
521 |
512 |
$12K |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
5,369 |
5,077 |
$11K |
| 76857 |
|
220 |
216 |
$11K |
| 85018 |
|
14,837 |
14,564 |
$11K |
| 0012A |
|
618 |
609 |
$11K |
| 86618 |
|
2,186 |
2,129 |
$11K |
| 87328 |
|
3,880 |
3,793 |
$11K |
| 82784 |
|
2,481 |
2,410 |
$11K |
| 82670 |
|
1,262 |
1,239 |
$11K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
29,969 |
28,312 |
$11K |
| 87529 |
|
785 |
755 |
$11K |
| 87517 |
|
787 |
758 |
$11K |
| 88142 |
|
4,158 |
3,978 |
$10K |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
11,505 |
9,042 |
$10K |
| 87205 |
|
6,420 |
5,972 |
$10K |
| J0690 |
Injection, cefazolin sodium, 500 mg |
6,700 |
5,749 |
$10K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
131 |
131 |
$10K |
| A9500 |
Technetium tc-99m sestamibi, diagnostic, per study dose |
1,869 |
1,789 |
$10K |
| 0011A |
|
912 |
858 |
$10K |
| 84156 |
|
7,015 |
6,250 |
$9K |
| 87329 |
|
3,570 |
3,491 |
$9K |
| 87088 |
|
3,322 |
3,156 |
$9K |
| 64415 |
|
43 |
42 |
$9K |
| 86765 |
|
1,678 |
1,632 |
$9K |
| 96376 |
|
4,145 |
3,724 |
$9K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
6,944 |
5,301 |
$8K |
| 73140 |
|
903 |
869 |
$8K |
| 83516 |
|
1,861 |
1,819 |
$8K |
| 82803 |
|
585 |
494 |
$8K |
| 87046 |
|
1,352 |
1,308 |
$8K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
3,668 |
3,303 |
$7K |
| 82565 |
|
8,676 |
8,345 |
$7K |
| 82270 |
|
7,942 |
7,803 |
$7K |
| 82951 |
|
1,658 |
1,642 |
$7K |
| 36415 |
Collection of venous blood by venipuncture |
70,118 |
59,853 |
$7K |
| 97035 |
|
516 |
209 |
$7K |
| 85014 |
|
8,552 |
8,334 |
$7K |
| 82947 |
|
6,648 |
6,528 |
$7K |
| J1644 |
Injection, heparin sodium, per 1000 units |
4,433 |
2,995 |
$7K |
| 86708 |
|
1,860 |
1,810 |
$7K |
| 80076 |
|
13,325 |
12,856 |
$7K |
| ATP02 |
|
1,739 |
1,616 |
$6K |
| 84481 |
|
1,055 |
1,019 |
$6K |
| 86617 |
|
1,092 |
1,049 |
$6K |
| 87210 |
|
3,067 |
2,886 |
$6K |
| 84270 |
|
758 |
738 |
$6K |
| 86431 |
|
4,213 |
4,109 |
$6K |
| 86735 |
|
1,091 |
1,067 |
$6K |
| 73590 |
|
910 |
812 |
$6K |
| 82950 |
|
2,426 |
2,409 |
$6K |
| ATP07 |
|
1,144 |
1,081 |
$6K |
| 96367 |
|
92 |
83 |
$6K |
| 71100 |
|
248 |
240 |
$6K |
| 70360 |
|
225 |
224 |
$6K |
| 86603 |
|
2,483 |
2,444 |
$6K |
| 72170 |
|
304 |
279 |
$5K |
| ATP10 |
|
1,217 |
1,139 |
$5K |
| 74241 |
|
250 |
250 |
$5K |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
7,698 |
6,511 |
$5K |
| 93880 |
|
80 |
79 |
$5K |
| J7050 |
Infusion, normal saline solution, 250 cc |
3,109 |
2,812 |
$5K |
| 82150 |
|
1,844 |
1,789 |
$5K |
| 87634 |
|
79 |
79 |
$4K |
| 87045 |
|
1,333 |
1,291 |
$4K |
| 84436 |
|
2,067 |
2,040 |
$4K |
| 86804 |
|
1,901 |
1,870 |
$4K |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
1,680 |
1,324 |
$4K |
| 87147 |
|
2,029 |
1,962 |
$4K |
| 73090 |
|
322 |
300 |
$4K |
| 0031A |
|
227 |
199 |
$4K |
| A9270 |
Non-covered item or service |
31,908 |
16,135 |
$4K |
| 83498 |
|
248 |
241 |
$4K |
| ATP04 |
|
873 |
833 |
$4K |
| 82550 |
|
5,120 |
4,753 |
$4K |
| 84520 |
|
5,235 |
5,001 |
$4K |
| G0121 |
Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk |
13 |
12 |
$3K |
| 86696 |
|
517 |
501 |
$3K |
| 93242 |
|
1,220 |
1,199 |
$3K |
| 86200 |
|
877 |
847 |
$3K |
| 84450 |
|
5,596 |
5,310 |
$3K |
| 72082 |
|
51 |
51 |
$3K |
| 82627 |
|
312 |
304 |
$3K |
| 82955 |
|
1,173 |
1,161 |
$3K |
| ATP09 |
|
552 |
484 |
$3K |
| 84460 |
|
5,863 |
5,657 |
$3K |
| 84165 |
|
1,163 |
1,135 |
$3K |
| 95819 |
|
26 |
26 |
$3K |
| J1569 |
Injection, immune globulin, (gammagard liquid), non-lyophilized, (e.g., liquid), 500 mg |
19 |
12 |
$3K |
| 97022 |
|
98 |
30 |
$3K |
| 97116 |
|
237 |
116 |
$3K |
| 84100 |
|
6,539 |
5,281 |
$3K |
| 76820 |
|
85 |
58 |
$3K |
| 88141 |
|
1,045 |
1,014 |
$3K |
| 86039 |
|
683 |
662 |
$2K |
| J3370 |
Injection, vancomycin hcl, 500 mg |
1,866 |
1,094 |
$2K |
| 86695 |
|
525 |
487 |
$2K |
| 73521 |
|
115 |
114 |
$2K |
| 84145 |
|
2,643 |
2,360 |
$2K |
| 86141 |
|
547 |
510 |
$2K |
| 84550 |
|
4,407 |
4,186 |
$2K |
| 99218 |
|
28 |
28 |
$2K |
| 86361 |
|
667 |
657 |
$2K |
| 82952 |
|
1,421 |
1,405 |
$2K |
| J2060 |
Injection, lorazepam, 2 mg |
4,041 |
3,193 |
$2K |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
301 |
224 |
$2K |
| 86376 |
|
425 |
416 |
$2K |
| 86309 |
|
517 |
493 |
$2K |
| J1815 |
Injection, insulin, per 5 units |
265 |
153 |
$2K |
| 82247 |
|
1,509 |
1,155 |
$2K |
| 85046 |
|
722 |
666 |
$2K |
| 72131 |
|
36 |
36 |
$2K |
| 73060 |
|
101 |
95 |
$2K |
| 83993 |
|
125 |
122 |
$2K |
| 80164 |
|
308 |
274 |
$2K |
| 76937 |
|
161 |
154 |
$2K |
| ATP16 |
|
189 |
164 |
$1K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
31 |
31 |
$1K |
| 82105 |
|
324 |
318 |
$1K |
| 86225 |
|
210 |
203 |
$1K |
| J3490 |
Unclassified drugs |
2,204 |
1,768 |
$1K |
| 99225 |
|
22 |
12 |
$1K |
| 82010 |
|
276 |
247 |
$1K |
| 74220 |
|
74 |
74 |
$1K |
| 86235 |
|
90 |
82 |
$1K |
| 87902 |
|
137 |
136 |
$1K |
| J2274 |
Injection, morphine sulfate, preservative-free for epidural or intrathecal use, 10 mg |
216 |
205 |
$1K |
| 83718 |
|
1,488 |
1,473 |
$1K |
| 86147 |
|
24 |
24 |
$1K |
| 83721 |
|
1,031 |
1,026 |
$1K |
| 82977 |
|
2,270 |
2,174 |
$1K |
| 82330 |
|
165 |
160 |
$1K |
| 72070 |
|
54 |
53 |
$1K |
| 82248 |
|
2,257 |
1,964 |
$1K |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
5,149 |
4,922 |
$1K |
| J2795 |
Injection, ropivacaine hydrochloride, 1 mg |
294 |
279 |
$996.46 |
| 84630 |
|
151 |
146 |
$987.03 |
| 88307 |
|
144 |
139 |
$983.93 |
| 93225 |
|
120 |
118 |
$982.05 |
| 85660 |
|
375 |
369 |
$962.60 |
| 86334 |
|
159 |
155 |
$911.00 |
| 88341 |
|
168 |
157 |
$903.03 |
| 82465 |
|
2,168 |
2,143 |
$884.30 |
| 87209 |
|
148 |
140 |
$875.09 |
| 99442 |
|
60 |
60 |
$848.11 |
| 86707 |
|
560 |
553 |
$830.08 |
| A0425 |
Ground mileage, per statute mile |
27 |
24 |
$824.85 |
| 73565 |
|
222 |
221 |
$817.81 |
| C9113 |
Injection, pantoprazole sodium, per vial |
2,440 |
1,676 |
$800.61 |
| 83525 |
|
301 |
298 |
$790.74 |
| 73700 |
|
14 |
12 |
$788.12 |
| 99441 |
|
88 |
88 |
$713.37 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
5,629 |
4,980 |
$697.68 |
| 82040 |
|
1,496 |
1,411 |
$681.88 |
| J2785 |
Injection, regadenoson, 0.1 mg |
743 |
698 |
$680.78 |
| J2543 |
Injection, piperacillin sodium/tazobactam sodium, 1 gram/0.125 grams (1.125 grams) |
211 |
113 |
$675.90 |
| 83520 |
|
213 |
205 |
$673.53 |
| 85041 |
|
565 |
554 |
$648.64 |
| 93308 |
|
25 |
25 |
$629.66 |
| 83615 |
|
1,273 |
1,165 |
$570.61 |
| 86226 |
|
116 |
113 |
$554.59 |
| 93246 |
|
210 |
197 |
$540.67 |
| 99072 |
|
12 |
12 |
$517.53 |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
69 |
68 |
$504.29 |
| 86682 |
|
50 |
49 |
$493.21 |
| 86255 |
|
179 |
176 |
$473.45 |
| 86709 |
|
357 |
352 |
$471.95 |
| 97165 |
|
27 |
27 |
$470.96 |
| 84590 |
|
60 |
56 |
$460.80 |
| J1630 |
Injection, haloperidol, up to 5 mg |
1,356 |
1,076 |
$452.84 |
| 87177 |
|
148 |
140 |
$430.91 |
| 86215 |
|
365 |
361 |
$425.51 |
| 80178 |
|
131 |
116 |
$420.60 |
| 83020 |
|
43 |
43 |
$408.60 |
| 86161 |
|
82 |
70 |
$400.36 |
| 86622 |
|
95 |
94 |
$395.19 |
| 82533 |
|
62 |
56 |
$388.66 |
| 82525 |
|
44 |
41 |
$372.19 |
| 84080 |
|
53 |
51 |
$365.08 |
| 84480 |
|
69 |
68 |
$352.68 |
| 29515 |
|
13 |
12 |
$349.83 |
| 86705 |
|
166 |
159 |
$342.62 |
| A9502 |
Technetium tc-99m tetrofosmin, diagnostic, per study dose |
241 |
234 |
$311.86 |
| U0001 |
Cdc 2019 novel coronavirus (2019-ncov) real-time rt-pcr diagnostic panel |
192 |
187 |
$303.62 |
| 77072 |
|
12 |
12 |
$297.12 |
| 29125 |
|
28 |
26 |
$278.67 |
| J2916 |
Injection, sodium ferric gluconate complex in sucrose injection, 12.5 mg |
1,434 |
437 |
$270.36 |
| 72110 |
|
61 |
61 |
$261.95 |
| J0171 |
Injection, adrenalin, epinephrine, 0.1 mg |
159 |
144 |
$259.78 |
| 86316 |
|
28 |
28 |
$256.90 |
| 82272 |
|
121 |
117 |
$245.28 |
| 86768 |
|
59 |
58 |
$237.67 |
| 74175 |
|
14 |
14 |
$232.48 |
| C1769 |
Guide wire |
2,210 |
2,023 |
$219.46 |
| 86800 |
|
60 |
57 |
$211.41 |
| 80069 |
|
230 |
212 |
$198.42 |
| 86256 |
|
204 |
201 |
$187.02 |
| 83883 |
|
70 |
67 |
$184.37 |
| 93226 |
|
106 |
104 |
$176.44 |
| 83921 |
|
158 |
155 |
$172.34 |
| J1596 |
Injection, glycopyrrolate, 0.1 mg |
36 |
36 |
$170.00 |
| 73552 |
|
16 |
13 |
$164.11 |
| 86382 |
|
67 |
66 |
$159.20 |
| 74022 |
|
12 |
12 |
$155.71 |
| J0694 |
Injection, cefoxitin sodium, 1 gm |
29 |
16 |
$146.78 |
| 84155 |
|
212 |
209 |
$136.73 |
| 82140 |
|
17 |
15 |
$135.27 |
| 86341 |
|
17 |
14 |
$124.74 |
| J0295 |
Injection, ampicillin sodium/sulbactam sodium, per 1.5 gm |
343 |
185 |
$120.79 |
| 87799 |
|
14 |
14 |
$117.21 |
| 86337 |
|
14 |
13 |
$113.28 |
| 93018 |
|
30 |
29 |
$112.30 |
| 86335 |
|
37 |
37 |
$110.90 |
| 86308 |
|
83 |
81 |
$96.41 |
| 85384 |
|
31 |
25 |
$94.65 |
| 84166 |
|
13 |
12 |
$94.38 |
| 84075 |
|
134 |
126 |
$90.84 |
| J0702 |
Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg |
16 |
12 |
$88.10 |
| 71101 |
|
12 |
12 |
$86.30 |
| 80051 |
|
99 |
89 |
$73.83 |
| J2370 |
Injection, phenylephrine hcl, up to 1 ml |
1,727 |
1,663 |
$72.02 |
| 84132 |
|
130 |
122 |
$70.95 |
| 86665 |
|
12 |
12 |
$64.00 |
| 87184 |
|
14 |
14 |
$63.99 |
| 87341 |
|
39 |
39 |
$63.96 |
| 82310 |
|
81 |
77 |
$58.68 |
| 86160 |
|
16 |
12 |
$55.33 |
| 83519 |
|
32 |
31 |
$54.36 |
| 80197 |
|
27 |
26 |
$52.64 |
| 84479 |
|
12 |
12 |
$51.39 |
| 81050 |
|
49 |
49 |
$44.70 |
| 86738 |
|
28 |
27 |
$44.35 |
| 82677 |
|
29 |
29 |
$44.10 |
| 87427 |
|
17 |
12 |
$42.24 |
| 82378 |
|
27 |
27 |
$40.63 |
| 87512 |
|
14 |
14 |
$38.09 |
| 87625 |
|
115 |
111 |
$37.42 |
| 90686 |
|
25 |
25 |
$34.39 |
| 80320 |
|
345 |
314 |
$33.48 |
| 86788 |
|
29 |
28 |
$29.44 |
| 86664 |
|
12 |
12 |
$26.98 |
| J0330 |
Injection, succinylcholine chloride, up to 20 mg |
923 |
871 |
$26.88 |
| 84207 |
|
18 |
12 |
$23.07 |
| 87102 |
|
27 |
27 |
$23.01 |
| J2710 |
Injection, neostigmine methylsulfate, up to 0.5 mg |
315 |
304 |
$12.09 |
| 87493 |
|
40 |
40 |
$7.83 |
| 87150 |
|
60 |
57 |
$7.02 |
| 88300 |
|
15 |
13 |
$6.59 |
| 86381 |
|
97 |
92 |
$5.09 |
| C1894 |
Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser |
963 |
899 |
$1.68 |
| C1713 |
Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) |
521 |
486 |
$1.30 |
| J0744 |
Injection, ciprofloxacin for intravenous infusion, 200 mg |
94 |
81 |
$0.77 |
| C1751 |
Catheter, infusion, inserted peripherally, centrally or midline (other than hemodialysis) |
364 |
347 |
$0.00 |
| G8978 |
Mobility: walking & moving around functional limitation, current status, at therapy episode outset and at reporting intervals |
219 |
213 |
$0.00 |
| 91300 |
|
3,218 |
2,565 |
$0.00 |
| 86015 |
|
197 |
187 |
$0.00 |
| G8985 |
Carrying, moving and handling objects, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting |
26 |
24 |
$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 |
268 |
255 |
$0.00 |
| J2919 |
Injection, methylprednisolone sodium succinate, 5 mg |
126 |
77 |
$0.00 |
| J1171 |
Injection, hydromorphone, 0.1 mg |
84 |
55 |
$0.00 |
| 88313 |
|
14 |
12 |
$0.00 |
| G0328 |
Colorectal cancer screening; fecal occult blood test, immunoassay, 1-3 simultaneous |
440 |
439 |
$0.00 |
| 91301 |
|
478 |
446 |
$0.00 |
| G8987 |
Self care functional limitation, current status, at therapy episode outset and at reporting intervals |
97 |
88 |
$0.00 |
| C1725 |
Catheter, transluminal angioplasty, non-laser (may include guidance, infusion/perfusion capability) |
392 |
363 |
$0.00 |
| 99406 |
|
43 |
40 |
$0.00 |
| J7042 |
5% dextrose/normal saline (500 ml = 1 unit) |
214 |
120 |
$0.00 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
647 |
560 |
$0.00 |
| 91303 |
|
112 |
89 |
$0.00 |
| G8988 |
Self care functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting |
137 |
122 |
$0.00 |
| J2470 |
Injection, pantoprazole sodium, 40 mg |
98 |
64 |
$0.00 |
| J8540 |
Dexamethasone, oral, 0.25 mg |
135 |
128 |
$0.00 |
| G8982 |
Changing & maintaining body position functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting |
15 |
13 |
$0.00 |
| J1836 |
Injection, metronidazole, 10 mg |
27 |
15 |
$0.00 |
| 94760 |
|
13 |
12 |
$0.00 |
| 83010 |
|
17 |
17 |
$0.00 |
| G8981 |
Changing & maintaining body position functional limitation, current status, at therapy episode outset and at reporting intervals |
14 |
13 |
$0.00 |