| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| G0378 |
Hospital observation service, per hour |
8,788 |
7,391 |
$6.69M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
20,631 |
18,204 |
$6.43M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
19,084 |
17,392 |
$5.00M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
9,543 |
8,405 |
$1.71M |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
6,904 |
6,403 |
$1.20M |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
18,255 |
4,430 |
$908K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
1,033 |
984 |
$719K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
1,842 |
855 |
$639K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
11,252 |
2,815 |
$518K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
4,310 |
4,018 |
$378K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
17,720 |
15,180 |
$265K |
| 70450 |
Computed tomography, head or brain; without contrast material |
5,460 |
4,982 |
$215K |
| OP370 |
|
3,052 |
2,738 |
$213K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
4,592 |
3,964 |
$189K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
11,905 |
10,460 |
$170K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
181 |
179 |
$165K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
9,278 |
8,237 |
$163K |
| G0283 |
Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care |
3,158 |
924 |
$158K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
3,894 |
1,634 |
$147K |
| 92507 |
Treatment of speech, language, voice, communication, and/or auditory processing disorder |
1,545 |
376 |
$144K |
| OP710 |
|
1,967 |
1,787 |
$136K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
9,596 |
8,176 |
$132K |
| OP272 |
|
5,034 |
4,348 |
$118K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
33,543 |
26,382 |
$110K |
| 71046 |
Radiologic examination, chest; 2 views |
8,847 |
8,322 |
$109K |
| OP250 |
|
53,583 |
26,877 |
$106K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
1,763 |
1,634 |
$103K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
5,888 |
5,190 |
$101K |
| 80053 |
Comprehensive metabolic panel |
22,607 |
18,025 |
$97K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
747 |
681 |
$96K |
| 93017 |
|
198 |
196 |
$88K |
| 97010 |
|
10,543 |
2,728 |
$79K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
1,069 |
1,015 |
$73K |
| 93971 |
|
885 |
831 |
$72K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
83 |
83 |
$69K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
2,075 |
783 |
$68K |
| 36415 |
Collection of venous blood by venipuncture |
29,178 |
23,197 |
$65K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
1,978 |
1,887 |
$65K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
13,370 |
11,183 |
$64K |
| 0202U |
Oncology (prostate), multianalyte, gene expression profiling |
1,411 |
1,328 |
$62K |
| 97161 |
|
1,130 |
1,048 |
$58K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
938 |
877 |
$56K |
| 71045 |
Radiologic examination, chest; single view |
6,351 |
5,731 |
$53K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
2,431 |
2,246 |
$53K |
| 90791 |
Psychiatric diagnostic evaluation |
2,954 |
2,379 |
$50K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
5,273 |
3,897 |
$44K |
| 84484 |
|
12,314 |
9,608 |
$41K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
1,751 |
1,570 |
$40K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
90 |
84 |
$38K |
| 97162 |
|
898 |
812 |
$36K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
2,656 |
2,328 |
$34K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
1,145 |
1,083 |
$30K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
1,041 |
987 |
$27K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
95 |
94 |
$27K |
| 76830 |
Ultrasound, transvaginal |
701 |
680 |
$27K |
| 96376 |
|
2,795 |
2,103 |
$26K |
| 81003 |
|
7,675 |
6,932 |
$25K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
5,441 |
4,648 |
$25K |
| 80076 |
|
5,492 |
4,991 |
$25K |
| 95810 |
Polysomnography; sleep staging with 4 or more additional parameters |
12 |
12 |
$24K |
| 93970 |
|
196 |
191 |
$23K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
1,619 |
1,363 |
$22K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
1,135 |
906 |
$22K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
580 |
552 |
$18K |
| 73562 |
|
1,540 |
1,401 |
$18K |
| 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 |
665 |
573 |
$17K |
| 85610 |
|
6,026 |
5,233 |
$17K |
| 83690 |
|
9,020 |
7,891 |
$17K |
| 85730 |
|
4,687 |
4,210 |
$16K |
| J3490 |
Unclassified drugs |
2,218 |
1,797 |
$15K |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
2,526 |
2,060 |
$15K |
| 73630 |
|
1,520 |
1,428 |
$15K |
| 82962 |
|
6,571 |
4,129 |
$14K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
2,100 |
1,731 |
$14K |
| 83735 |
|
5,140 |
4,073 |
$13K |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
2,567 |
2,257 |
$13K |
| 84703 |
|
8,296 |
7,331 |
$13K |
| OP379 |
|
317 |
307 |
$13K |
| OP279 |
|
521 |
478 |
$13K |
| OP259 |
|
4,048 |
2,871 |
$13K |
| 80306 |
|
3,751 |
3,228 |
$12K |
| 83880 |
|
2,479 |
2,223 |
$12K |
| 82077 |
|
3,800 |
3,156 |
$12K |
| 84443 |
Thyroid stimulating hormone (TSH) |
2,572 |
2,315 |
$12K |
| 73130 |
|
1,191 |
1,111 |
$12K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
2,331 |
2,056 |
$12K |
| 73610 |
|
1,474 |
1,378 |
$12K |
| 73030 |
|
1,158 |
1,083 |
$11K |
| C1769 |
Guide wire |
616 |
432 |
$10K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
67 |
65 |
$9K |
| 0012A |
|
320 |
320 |
$9K |
| OP258 |
|
19,001 |
14,098 |
$9K |
| 81001 |
|
6,869 |
6,070 |
$8K |
| 0011A |
|
314 |
313 |
$8K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
332 |
290 |
$8K |
| 87070 |
|
2,080 |
1,962 |
$8K |
| 80061 |
Lipid panel |
1,648 |
1,484 |
$8K |
| 77065 |
Tomosynthesis, mammo |
125 |
113 |
$8K |
| J2060 |
Injection, lorazepam, 2 mg |
1,879 |
1,378 |
$7K |
| G0279 |
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) |
256 |
245 |
$7K |
| 90715 |
|
1,030 |
958 |
$7K |
| 93976 |
|
25 |
25 |
$7K |
| J1170 |
Injection, hydromorphone, up to 4 mg |
973 |
615 |
$7K |
| 80143 |
|
1,787 |
1,487 |
$7K |
| J3590 |
Unclassified biologics |
146 |
143 |
$6K |
| 84100 |
|
2,393 |
1,850 |
$6K |
| 71250 |
|
88 |
80 |
$6K |
| 86885 |
|
1,865 |
1,689 |
$6K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
59 |
51 |
$6K |
| 72100 |
|
700 |
646 |
$6K |
| 80179 |
|
1,764 |
1,473 |
$6K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
72 |
71 |
$5K |
| 85027 |
|
2,194 |
1,603 |
$5K |
| 0001A |
|
145 |
144 |
$5K |
| 85379 |
|
2,319 |
2,157 |
$5K |
| 83605 |
|
1,672 |
1,451 |
$5K |
| 96367 |
|
268 |
216 |
$5K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
2,682 |
2,418 |
$5K |
| 97116 |
|
552 |
350 |
$5K |
| 86901 |
|
2,052 |
1,778 |
$5K |
| 0002A |
|
131 |
131 |
$5K |
| 81025 |
|
2,001 |
1,883 |
$5K |
| 86900 |
|
2,046 |
1,778 |
$4K |
| 84702 |
|
1,847 |
1,704 |
$4K |
| 95800 |
|
14 |
13 |
$4K |
| C1894 |
Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser |
318 |
264 |
$4K |
| J2704 |
Injection, propofol, 10 mg |
2,934 |
2,434 |
$4K |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
1,859 |
1,467 |
$4K |
| 73110 |
|
414 |
383 |
$4K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
2,319 |
2,190 |
$4K |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
2,948 |
1,938 |
$4K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
8,311 |
6,825 |
$3K |
| OP270 |
|
2,377 |
2,131 |
$3K |
| 87040 |
|
295 |
263 |
$3K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
1,828 |
1,314 |
$3K |
| 82150 |
|
532 |
514 |
$3K |
| 76642 |
|
51 |
49 |
$3K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
6,787 |
5,441 |
$3K |
| 73502 |
|
368 |
329 |
$3K |
| A9502 |
Technetium tc-99m tetrofosmin, diagnostic, per study dose |
75 |
74 |
$2K |
| J0136 |
Injection, acetaminophen (b braun), not therapeutically equivalent to j0131, 10 mg |
1,803 |
1,542 |
$2K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
991 |
976 |
$2K |
| G1004 |
Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program |
530 |
397 |
$2K |
| 88313 |
|
315 |
280 |
$2K |
| 87088 |
|
394 |
383 |
$2K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
157 |
108 |
$2K |
| 72110 |
|
70 |
69 |
$2K |
| 74240 |
|
39 |
38 |
$2K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
2,027 |
1,786 |
$2K |
| J0690 |
Injection, cefazolin sodium, 500 mg |
1,014 |
794 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,191 |
1,037 |
$2K |
| 72040 |
|
219 |
209 |
$2K |
| 83789 |
|
424 |
384 |
$2K |
| 0004A |
|
43 |
43 |
$2K |
| 82550 |
|
1,118 |
964 |
$2K |
| 87205 |
|
174 |
152 |
$1K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
834 |
728 |
$1K |
| 88312 |
|
240 |
213 |
$1K |
| 87186 |
|
186 |
180 |
$1K |
| 76536 |
|
24 |
24 |
$1K |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
571 |
485 |
$1K |
| Q9966 |
Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml |
896 |
775 |
$1K |
| 77066 |
Tomosynthesis, mammo |
12 |
12 |
$1K |
| 73080 |
|
118 |
106 |
$1K |
| 80320 |
|
334 |
304 |
$1K |
| A9575 |
Injection, gadoterate meglumine, 0.1 ml |
326 |
279 |
$999.01 |
| J1630 |
Injection, haloperidol, up to 5 mg |
975 |
710 |
$920.76 |
| 74019 |
|
102 |
96 |
$781.91 |
| C9290 |
Injection, bupivacaine liposome, 1 mg |
13 |
12 |
$769.01 |
| 84145 |
|
108 |
90 |
$701.36 |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
450 |
382 |
$696.46 |
| 70486 |
|
24 |
24 |
$693.57 |
| J1644 |
Injection, heparin sodium, per 1000 units |
1,137 |
520 |
$655.30 |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
136 |
125 |
$627.45 |
| OP229 |
|
12 |
12 |
$615.96 |
| J3370 |
Injection, vancomycin hcl, 500 mg |
41 |
29 |
$601.58 |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
136 |
125 |
$596.87 |
| 87077 |
|
302 |
267 |
$588.06 |
| 86140 |
|
428 |
400 |
$569.45 |
| 87633 |
Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets |
26 |
26 |
$546.68 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
1,759 |
1,486 |
$528.07 |
| 0064A |
|
24 |
21 |
$505.90 |
| J3360 |
Injection, diazepam, up to 5 mg |
218 |
193 |
$485.14 |
| 72050 |
|
13 |
12 |
$456.22 |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
857 |
384 |
$391.63 |
| 82728 |
|
81 |
76 |
$390.35 |
| 88304 |
|
69 |
66 |
$370.46 |
| C9113 |
Injection, pantoprazole sodium, per vial |
611 |
413 |
$320.33 |
| 73090 |
|
28 |
25 |
$286.28 |
| 85378 |
|
123 |
122 |
$279.03 |
| 12001 |
|
28 |
28 |
$251.77 |
| 85651 |
|
206 |
182 |
$238.98 |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
227 |
179 |
$209.50 |
| 73140 |
|
24 |
24 |
$194.67 |
| 97535 |
Self-care/home management training, each 15 minutes |
60 |
50 |
$186.48 |
| 88311 |
|
39 |
39 |
$185.87 |
| A9585 |
Injection, gadobutrol, 0.1 ml |
39 |
36 |
$185.30 |
| 87999 |
|
72 |
72 |
$185.03 |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
16 |
15 |
$139.04 |
| J2919 |
Injection, methylprednisolone sodium succinate, 5 mg |
155 |
110 |
$136.51 |
| 82803 |
|
37 |
30 |
$134.98 |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
29 |
27 |
$132.80 |
| J0137 |
Injection, acetaminophen (hikma), not therapeutically equivalent to j0131, 10 mg |
121 |
101 |
$127.51 |
| 87420 |
|
67 |
65 |
$125.39 |
| 86618 |
|
12 |
12 |
$125.36 |
| 86308 |
|
78 |
78 |
$112.43 |
| J7030 |
Infusion, normal saline solution , 1000 cc |
99 |
59 |
$109.02 |
| 82607 |
|
65 |
52 |
$108.19 |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
19 |
19 |
$100.38 |
| 71100 |
|
12 |
12 |
$83.64 |
| 87486 |
|
26 |
26 |
$82.95 |
| 87581 |
|
26 |
26 |
$82.95 |
| 82248 |
|
50 |
50 |
$80.23 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
793 |
614 |
$72.73 |
| J1596 |
Injection, glycopyrrolate, 0.1 mg |
67 |
47 |
$71.53 |
| 99152 |
|
91 |
74 |
$61.24 |
| J2710 |
Injection, neostigmine methylsulfate, up to 0.5 mg |
136 |
125 |
$54.63 |
| J2470 |
Injection, pantoprazole sodium, 40 mg |
94 |
77 |
$51.85 |
| J3480 |
Injection, potassium chloride, per 2 meq |
21 |
13 |
$34.64 |
| 84439 |
|
43 |
37 |
$33.71 |
| 84480 |
|
24 |
24 |
$32.01 |
| 73590 |
|
55 |
51 |
$29.93 |
| J0360 |
Injection, hydralazine hcl, up to 20 mg |
51 |
32 |
$23.99 |
| J1815 |
Injection, insulin, per 5 units |
199 |
66 |
$15.00 |
| J8540 |
Dexamethasone, oral, 0.25 mg |
64 |
30 |
$14.26 |
| 82009 |
|
15 |
14 |
$11.48 |
| J2004 |
Injection, lidocaine hcl with epinephrine, 1 mg |
17 |
13 |
$8.46 |
| 84436 |
|
12 |
12 |
$8.37 |
| OP637 |
|
8,746 |
1,358 |
$8.00 |
| J7620 |
Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme |
129 |
93 |
$6.48 |
| 91301 |
|
539 |
515 |
$1.00 |
| G8978 |
Mobility: walking & moving around functional limitation, current status, at therapy episode outset and at reporting intervals |
14 |
13 |
$1.00 |
| G8979 |
Mobility: walking & moving around functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting |
28 |
26 |
$1.00 |
| 91300 |
|
255 |
234 |
$0.01 |
| 85008 |
|
32 |
28 |
$0.00 |
| 99153 |
Mod sedat endo service >5yrs |
29 |
25 |
$0.00 |
| J2543 |
Injection, piperacillin sodium/tazobactam sodium, 1 gram/0.125 grams (1.125 grams) |
16 |
12 |
$0.00 |
| 91306 |
|
20 |
17 |
$0.00 |