| Code | Description | Claims | Beneficiaries | Total Paid |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
25,399 |
21,883 |
$5.22M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
27,482 |
24,386 |
$5.12M |
| 96361 |
Intravenous infusion, hydration; each additional hour |
14,036 |
11,115 |
$4.23M |
| 41899 |
Unlisted procedure, dentoalveolar structures |
1,456 |
1,286 |
$2.02M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
9,440 |
8,526 |
$2.02M |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
3,962 |
3,710 |
$1.99M |
| G0378 |
Hospital observation service, per hour |
7,306 |
5,875 |
$1.41M |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
1,575 |
1,502 |
$992K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
5,480 |
5,017 |
$964K |
| 70450 |
Computed tomography, head or brain; without contrast material |
5,792 |
5,112 |
$901K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
4,293 |
3,916 |
$674K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
1,860 |
1,676 |
$595K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
3,975 |
3,581 |
$492K |
| 45378 |
Colonoscopy, flexible; diagnostic, including collection of specimen(s) |
444 |
433 |
$430K |
| 59025 |
Fetal non-stress test |
2,214 |
1,675 |
$430K |
| 27447 |
|
40 |
40 |
$328K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
1,898 |
1,711 |
$302K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
1,239 |
1,162 |
$294K |
| G0379 |
Direct admission of patient for hospital observation care |
2,616 |
2,135 |
$286K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
1,492 |
884 |
$263K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
686 |
655 |
$246K |
| 45385 |
Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) |
646 |
625 |
$244K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
711 |
677 |
$237K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
3,270 |
3,118 |
$233K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
2,534 |
2,350 |
$225K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
1,730 |
1,629 |
$192K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
2,929 |
2,548 |
$190K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
3,369 |
2,643 |
$175K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
2,006 |
1,874 |
$169K |
| 36832 |
|
73 |
64 |
$159K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
967 |
919 |
$153K |
| 76830 |
Ultrasound, transvaginal |
1,579 |
1,477 |
$135K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
2,389 |
2,099 |
$128K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
709 |
645 |
$122K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
1,253 |
1,141 |
$107K |
| 80053 |
Comprehensive metabolic panel |
27,084 |
21,906 |
$96K |
| 93971 |
|
1,080 |
995 |
$94K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
519 |
498 |
$92K |
| 70496 |
|
376 |
365 |
$86K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
478 |
457 |
$85K |
| 97161 |
|
1,100 |
981 |
$85K |
| 93976 |
|
1,303 |
1,197 |
$83K |
| 62323 |
|
141 |
133 |
$71K |
| 87400 |
|
5,260 |
2,949 |
$60K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
12,641 |
9,582 |
$58K |
| 71046 |
Radiologic examination, chest; 2 views |
5,247 |
4,835 |
$57K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
117 |
102 |
$57K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
1,566 |
1,498 |
$55K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
313 |
299 |
$48K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
464 |
422 |
$46K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
744 |
712 |
$41K |
| 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 |
3,094 |
2,560 |
$39K |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
6,150 |
5,847 |
$34K |
| 76801 |
|
1,088 |
939 |
$30K |
| 97165 |
|
329 |
300 |
$29K |
| 87040 |
|
4,247 |
2,413 |
$28K |
| 76770 |
|
179 |
175 |
$25K |
| 71045 |
Radiologic examination, chest; single view |
11,192 |
9,771 |
$24K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
242 |
231 |
$24K |
| J3490 |
Unclassified drugs |
13,163 |
7,014 |
$21K |
| C1889 |
Implantable/insertable device, not otherwise classified |
456 |
442 |
$20K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
17,029 |
13,830 |
$19K |
| 93970 |
|
140 |
133 |
$17K |
| 87420 |
|
898 |
849 |
$17K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
940 |
862 |
$17K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
16,818 |
14,261 |
$17K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
35,272 |
27,938 |
$15K |
| 97162 |
|
138 |
133 |
$14K |
| 71250 |
|
224 |
216 |
$14K |
| 85379 |
|
2,876 |
2,647 |
$13K |
| 83880 |
|
2,249 |
1,912 |
$13K |
| 84484 |
|
11,702 |
9,370 |
$13K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
202 |
143 |
$13K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
940 |
809 |
$12K |
| 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 |
534 |
485 |
$11K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
423 |
193 |
$10K |
| 76536 |
|
79 |
78 |
$9K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
293 |
147 |
$9K |
| 77080 |
|
120 |
117 |
$9K |
| 97116 |
|
394 |
208 |
$9K |
| 36415 |
Collection of venous blood by venipuncture |
9,134 |
5,971 |
$8K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
1,861 |
1,637 |
$8K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
28 |
25 |
$8K |
| 72131 |
|
144 |
138 |
$7K |
| 70486 |
|
149 |
145 |
$7K |
| 73564 |
|
851 |
715 |
$7K |
| 85027 |
|
5,066 |
3,666 |
$6K |
| 93017 |
|
117 |
102 |
$6K |
| 84443 |
Thyroid stimulating hormone (TSH) |
2,286 |
2,068 |
$5K |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
2,941 |
2,299 |
$5K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
16,154 |
12,809 |
$5K |
| 80143 |
|
1,310 |
1,132 |
$5K |
| M0245 |
Intravenous infusion, bamlanivimab and etesevimab, includes infusion and post administration monitoring |
18 |
18 |
$5K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
10,401 |
5,964 |
$5K |
| 87081 |
|
5,767 |
5,128 |
$4K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
12,067 |
9,263 |
$4K |
| 73030 |
|
560 |
504 |
$4K |
| 92610 |
|
65 |
54 |
$4K |
| 73630 |
|
1,080 |
943 |
$4K |
| S0020 |
Injection, bupivicaine hydrochloride, 30 ml |
719 |
582 |
$4K |
| 73700 |
|
43 |
42 |
$4K |
| 84703 |
|
8,978 |
7,934 |
$4K |
| 81001 |
|
12,638 |
11,137 |
$3K |
| 70498 |
|
372 |
361 |
$3K |
| 76820 |
|
103 |
49 |
$3K |
| 80061 |
Lipid panel |
1,229 |
1,091 |
$3K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
128 |
37 |
$3K |
| 96376 |
|
5,973 |
3,440 |
$3K |
| 12001 |
|
16 |
13 |
$3K |
| 73610 |
|
809 |
734 |
$3K |
| 83735 |
|
4,518 |
3,206 |
$3K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
220 |
201 |
$3K |
| 82248 |
|
4,181 |
3,434 |
$3K |
| 85610 |
|
4,565 |
3,635 |
$3K |
| 80179 |
|
1,277 |
1,113 |
$3K |
| 74018 |
|
257 |
225 |
$3K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
1,411 |
1,264 |
$2K |
| 97166 |
|
28 |
28 |
$2K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
6,980 |
3,874 |
$2K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
5,637 |
4,929 |
$2K |
| 87430 |
|
5,400 |
5,117 |
$2K |
| 83690 |
|
10,101 |
8,721 |
$2K |
| 72110 |
|
70 |
69 |
$2K |
| 86900 |
|
3,277 |
2,738 |
$2K |
| 86850 |
|
2,785 |
2,464 |
$2K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
9,120 |
8,033 |
$2K |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
5,924 |
5,444 |
$2K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
4,416 |
3,274 |
$2K |
| 83605 |
|
2,137 |
1,795 |
$1K |
| C1776 |
Joint device (implantable) |
133 |
131 |
$1K |
| 90715 |
|
56 |
55 |
$1K |
| 85730 |
|
3,174 |
2,659 |
$1K |
| 86140 |
|
1,150 |
1,034 |
$1K |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
1,150 |
879 |
$1K |
| 73502 |
|
114 |
105 |
$1K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
9,381 |
7,973 |
$1K |
| S0119 |
Ondansetron, oral, 4 mg (for circumstances falling under the medicare statute, use hcpcs q code) |
3,943 |
3,639 |
$1K |
| 73560 |
|
181 |
157 |
$1K |
| 81003 |
|
5,922 |
5,334 |
$1K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
5,605 |
4,397 |
$1K |
| 81025 |
|
3,522 |
3,220 |
$1K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
103 |
95 |
$1K |
| 84702 |
|
1,975 |
1,685 |
$1K |
| 73110 |
|
236 |
215 |
$1K |
| 73130 |
|
187 |
165 |
$889.53 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
197 |
182 |
$834.86 |
| 84100 |
|
1,876 |
1,416 |
$786.33 |
| 72100 |
|
40 |
37 |
$755.09 |
| 82607 |
|
155 |
145 |
$743.91 |
| 85652 |
|
1,035 |
937 |
$695.94 |
| J7050 |
Infusion, normal saline solution, 250 cc |
1,428 |
771 |
$687.71 |
| J1644 |
Injection, heparin sodium, per 1000 units |
1,718 |
884 |
$659.07 |
| 86901 |
|
3,276 |
2,738 |
$656.12 |
| 87077 |
|
2,268 |
1,944 |
$645.73 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
3,367 |
2,812 |
$584.37 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
2,747 |
1,768 |
$546.53 |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
1,019 |
868 |
$527.59 |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
370 |
356 |
$519.33 |
| 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 |
423 |
384 |
$504.11 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
5,779 |
4,226 |
$475.69 |
| 97535 |
Self-care/home management training, each 15 minutes |
21 |
15 |
$474.00 |
| 82550 |
|
636 |
550 |
$465.90 |
| S0028 |
Injection, famotidine, 20 mg |
2,072 |
1,641 |
$413.39 |
| 87070 |
|
621 |
553 |
$390.65 |
| J8540 |
Dexamethasone, oral, 0.25 mg |
53 |
44 |
$318.11 |
| 87186 |
|
1,928 |
1,538 |
$307.20 |
| 88307 |
|
237 |
150 |
$301.46 |
| A9585 |
Injection, gadobutrol, 0.1 ml |
914 |
844 |
$259.56 |
| 73590 |
|
73 |
65 |
$255.56 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
2,697 |
2,392 |
$207.99 |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
369 |
356 |
$190.13 |
| 84132 |
|
1,582 |
1,275 |
$167.09 |
| 94664 |
|
1,031 |
848 |
$158.85 |
| 74019 |
|
37 |
37 |
$122.16 |
| 85007 |
|
74 |
66 |
$115.50 |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
1,509 |
760 |
$110.50 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
1,952 |
1,533 |
$110.02 |
| J2704 |
Injection, propofol, 10 mg |
5,801 |
5,219 |
$103.56 |
| 73080 |
|
25 |
24 |
$94.95 |
| 88342 |
|
496 |
457 |
$62.80 |
| 84439 |
|
14 |
12 |
$61.70 |
| J2550 |
Injection, promethazine hcl, up to 50 mg |
405 |
192 |
$47.45 |
| A9502 |
Technetium tc-99m tetrofosmin, diagnostic, per study dose |
117 |
102 |
$44.16 |
| J2543 |
Injection, piperacillin sodium/tazobactam sodium, 1 gram/0.125 grams (1.125 grams) |
490 |
206 |
$37.80 |
| 88304 |
|
364 |
340 |
$36.62 |
| 96367 |
|
98 |
82 |
$31.05 |
| J7060 |
5% dextrose/water (500 ml = 1 unit) |
301 |
213 |
$30.48 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
737 |
645 |
$27.63 |
| J2710 |
Injection, neostigmine methylsulfate, up to 0.5 mg |
157 |
141 |
$24.56 |
| 87205 |
|
220 |
194 |
$23.14 |
| J7999 |
Compounded drug, not otherwise classified |
608 |
576 |
$20.44 |
| 85014 |
|
123 |
89 |
$20.02 |
| J2060 |
Injection, lorazepam, 2 mg |
286 |
228 |
$18.94 |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
548 |
443 |
$18.17 |
| C1769 |
Guide wire |
237 |
218 |
$14.99 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
78 |
66 |
$13.98 |
| 87210 |
|
38 |
37 |
$13.67 |
| 85018 |
|
124 |
90 |
$10.02 |
| C9113 |
Injection, pantoprazole sodium, per vial |
506 |
280 |
$9.80 |
| J7042 |
5% dextrose/normal saline (500 ml = 1 unit) |
106 |
60 |
$7.91 |
| J7620 |
Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme |
65 |
52 |
$7.48 |
| J7644 |
Ipratropium bromide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per milligram |
58 |
52 |
$6.49 |
| A9575 |
Injection, gadoterate meglumine, 0.1 ml |
551 |
532 |
$4.67 |
| J0360 |
Injection, hydralazine hcl, up to 20 mg |
105 |
83 |
$4.11 |
| J7510 |
Prednisolone oral, per 5 mg |
13 |
12 |
$2.40 |
| J0330 |
Injection, succinylcholine chloride, up to 20 mg |
337 |
320 |
$1.92 |
| 82570 |
|
14 |
12 |
$1.04 |
| J1596 |
Injection, glycopyrrolate, 0.1 mg |
749 |
714 |
$0.34 |
| Q9969 |
Tc-99m from non-highly enriched uranium source, full cost recovery add-on, per study dose |
59 |
50 |
$0.15 |
| G1004 |
Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program |
1,705 |
1,290 |
$0.01 |
| J0688 |
Injection, cefazolin sodium (hikma), not therapeutically equivalent to j0690, 500 mg |
1,018 |
893 |
$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 |
89 |
58 |
$0.00 |
| J3370 |
Injection, vancomycin hcl, 500 mg |
446 |
303 |
$0.00 |
| J0670 |
Injection, mepivacaine hydrochloride, per 10 ml |
25 |
25 |
$0.00 |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
222 |
187 |
$0.00 |
| Q9966 |
Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml |
526 |
336 |
$0.00 |
| J0171 |
Injection, adrenalin, epinephrine, 0.1 mg |
30 |
27 |
$0.00 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
118 |
114 |
$0.00 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
25 |
25 |
$0.00 |
| C1713 |
Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) |
14 |
12 |
$0.00 |
| J2919 |
Injection, methylprednisolone sodium succinate, 5 mg |
56 |
46 |
$0.00 |
| J1171 |
Injection, hydromorphone, 0.1 mg |
135 |
88 |
$0.00 |
| G8978 |
Mobility: walking & moving around functional limitation, current status, at therapy episode outset and at reporting intervals |
71 |
44 |
$0.00 |
| 84550 |
|
15 |
12 |
$0.00 |
| 82805 |
|
13 |
13 |
$0.00 |
| 83540 |
|
13 |
13 |
$0.00 |
| J2370 |
Injection, phenylephrine hcl, up to 1 ml |
17 |
14 |
$0.00 |
| C9290 |
Injection, bupivacaine liposome, 1 mg |
240 |
233 |
$0.00 |
| 73060 |
|
15 |
14 |
$0.00 |
| J3535 |
Drug administered through a metered dose inhaler |
122 |
117 |
$0.00 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
470 |
405 |
$0.00 |
| 86308 |
|
13 |
13 |
$0.00 |
| 88341 |
|
23 |
14 |
$0.00 |
| J3480 |
Injection, potassium chloride, per 2 meq |
136 |
74 |
$0.00 |
| J8597 |
Antiemetic drug, oral, not otherwise specified |
28 |
25 |
$0.00 |
| J2471 |
Injection, pantoprazole (hikma), not therapeutically equivalent to j2470, 40 mg |
89 |
58 |
$0.00 |
| C1781 |
Mesh (implantable) |
54 |
52 |
$0.00 |
| J2371 |
Injection, phenylephrine hydrochloride, 20 micrograms |
15 |
14 |
$0.00 |
| J3411 |
Injection, thiamine hcl, 100 mg |
140 |
98 |
$0.00 |
| 83550 |
|
12 |
12 |
$0.00 |
| C1726 |
Catheter, balloon dilatation, non-vascular |
12 |
12 |
$0.00 |