| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
145,904 |
39,108 |
$22.40M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
63,099 |
57,418 |
$17.26M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
44,184 |
39,510 |
$14.49M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
26,330 |
23,720 |
$8.56M |
| G0378 |
Hospital observation service, per hour |
18,876 |
10,027 |
$6.44M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
74,855 |
69,953 |
$4.55M |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
25,418 |
23,574 |
$4.26M |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
6,237 |
6,052 |
$2.80M |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
8,958 |
8,608 |
$2.26M |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
4,454 |
4,303 |
$1.84M |
| OP272 |
|
32,058 |
20,568 |
$1.54M |
| A0427 |
Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) |
4,322 |
4,142 |
$1.48M |
| S9480 |
Intensive outpatient psychiatric services, per diem |
1,813 |
1,680 |
$1.45M |
| 95810 |
Polysomnography; sleep staging with 4 or more additional parameters |
1,612 |
1,585 |
$1.44M |
| 90837 |
Psychotherapy, 53 minutes with patient |
26,111 |
12,538 |
$1.36M |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
35,956 |
29,123 |
$1.30M |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
43,123 |
37,435 |
$1.27M |
| 70450 |
Computed tomography, head or brain; without contrast material |
10,638 |
9,942 |
$1.26M |
| OP251 |
|
123,779 |
89,950 |
$1.22M |
| 90832 |
Psychotherapy, 30 minutes with patient |
23,513 |
20,188 |
$1.22M |
| 59025 |
Fetal non-stress test |
6,430 |
3,675 |
$1.16M |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
36,477 |
24,892 |
$1.10M |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
115,214 |
90,744 |
$1.06M |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
9,655 |
9,211 |
$1.05M |
| 45378 |
Colonoscopy, flexible; diagnostic, including collection of specimen(s) |
2,427 |
2,370 |
$1.04M |
| 71046 |
Radiologic examination, chest; 2 views |
24,493 |
23,484 |
$993K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
3,243 |
3,138 |
$983K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
10,675 |
10,448 |
$947K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
9,115 |
5,256 |
$932K |
| 90834 |
Psychotherapy, 45 minutes with patient |
15,190 |
7,274 |
$913K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
19,608 |
15,448 |
$898K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
14,655 |
12,951 |
$828K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
40,137 |
30,553 |
$806K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
6,268 |
5,490 |
$778K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
11,042 |
9,287 |
$758K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
7,293 |
6,423 |
$712K |
| 80053 |
Comprehensive metabolic panel |
63,530 |
52,190 |
$692K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
7,118 |
6,571 |
$656K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
5,107 |
4,949 |
$596K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
4,276 |
2,286 |
$591K |
| 90791 |
Psychiatric diagnostic evaluation |
8,406 |
8,141 |
$588K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
3,163 |
3,024 |
$588K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
4,495 |
4,232 |
$571K |
| 76830 |
Ultrasound, transvaginal |
4,899 |
4,748 |
$538K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
7,343 |
7,048 |
$530K |
| 71045 |
Radiologic examination, chest; single view |
19,131 |
17,470 |
$509K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
16,261 |
4,153 |
$482K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
6,741 |
2,666 |
$472K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
1,673 |
1,607 |
$467K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
2,127 |
2,046 |
$450K |
| 93458 |
|
388 |
357 |
$440K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
9,607 |
8,870 |
$440K |
| 76801 |
|
4,364 |
3,735 |
$433K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
30,193 |
24,622 |
$399K |
| A0428 |
Ambulance service, basic life support, non-emergency transport, (bls) |
11,453 |
5,853 |
$370K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
3,205 |
3,136 |
$358K |
| 77066 |
Tomosynthesis, mammo |
2,713 |
2,638 |
$354K |
| OP270 |
|
5,952 |
4,465 |
$349K |
| 88342 |
|
4,744 |
4,624 |
$347K |
| A0425 |
Ground mileage, per statute mile |
16,588 |
10,243 |
$337K |
| 71250 |
|
2,461 |
2,383 |
$323K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
19,381 |
17,565 |
$319K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
2,540 |
2,355 |
$318K |
| 93017 |
|
2,006 |
1,928 |
$309K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
5,805 |
5,381 |
$287K |
| 90847 |
Family psychotherapy with the patient present, 50 minutes |
5,711 |
4,572 |
$286K |
| 93970 |
|
1,383 |
1,321 |
$273K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
4,559 |
4,088 |
$273K |
| 45385 |
Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) |
717 |
696 |
$267K |
| 76642 |
|
3,216 |
3,118 |
$262K |
| 73630 |
|
5,833 |
5,584 |
$244K |
| 80305 |
|
15,520 |
12,348 |
$242K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
1,421 |
1,357 |
$239K |
| 80320 |
|
9,458 |
7,993 |
$231K |
| OP250 |
|
32,243 |
21,945 |
$222K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
1,030 |
1,005 |
$218K |
| 77080 |
|
2,830 |
2,748 |
$216K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
2,973 |
2,863 |
$216K |
| A0429 |
Ambulance service, basic life support, emergency transport (bls-emergency) |
1,104 |
1,032 |
$215K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
34,926 |
29,798 |
$214K |
| 87536 |
|
2,749 |
2,699 |
$200K |
| 84484 |
|
25,861 |
21,941 |
$190K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
6,710 |
6,507 |
$189K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
2,997 |
2,653 |
$188K |
| J1439 |
Injection, ferric carboxymaltose, 1 mg |
313 |
201 |
$186K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
5,555 |
5,343 |
$180K |
| 83880 |
|
10,313 |
9,493 |
$176K |
| 87631 |
|
4,047 |
3,749 |
$175K |
| 70486 |
|
1,188 |
1,142 |
$173K |
| 97802 |
|
3,375 |
2,689 |
$172K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
9,115 |
8,900 |
$171K |
| 76813 |
|
1,512 |
1,477 |
$170K |
| 86850 |
|
13,694 |
12,054 |
$168K |
| 84443 |
Thyroid stimulating hormone (TSH) |
12,821 |
12,103 |
$167K |
| 96376 |
|
4,336 |
3,285 |
$166K |
| 73560 |
|
4,441 |
4,273 |
$163K |
| 72110 |
|
2,314 |
2,257 |
$161K |
| 77065 |
Tomosynthesis, mammo |
2,281 |
2,135 |
$161K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
6,712 |
6,510 |
$161K |
| 95811 |
|
190 |
190 |
$159K |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
8,176 |
7,569 |
$143K |
| 58558 |
|
98 |
98 |
$143K |
| 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 |
3,483 |
2,871 |
$139K |
| 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 |
3,597 |
3,393 |
$138K |
| J1756 |
Injection, iron sucrose, 1 mg |
1,108 |
315 |
$124K |
| 64483 |
|
185 |
183 |
$124K |
| 73030 |
|
3,194 |
3,054 |
$121K |
| 73610 |
|
3,662 |
3,508 |
$119K |
| 93971 |
|
669 |
635 |
$116K |
| 84702 |
|
12,128 |
10,571 |
$116K |
| 80061 |
Lipid panel |
10,544 |
10,148 |
$114K |
| G0283 |
Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care |
3,718 |
1,044 |
$113K |
| 80330 |
|
3,637 |
3,370 |
$108K |
| C9803 |
Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
10,357 |
9,519 |
$107K |
| 86900 |
|
13,867 |
12,156 |
$103K |
| 73130 |
|
2,935 |
2,807 |
$102K |
| 59050 |
|
866 |
760 |
$101K |
| 36415 |
Collection of venous blood by venipuncture |
16,409 |
13,363 |
$100K |
| 80076 |
|
19,447 |
17,948 |
$92K |
| 76820 |
|
1,603 |
832 |
$90K |
| 80051 |
|
16,948 |
15,788 |
$90K |
| 86901 |
|
13,881 |
12,164 |
$89K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
4,352 |
4,200 |
$88K |
| OP259 |
|
5,915 |
4,742 |
$88K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
14,188 |
12,481 |
$86K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
3,354 |
2,729 |
$85K |
| 76536 |
|
845 |
828 |
$82K |
| J2469 |
Injection, palonosetron hcl, 25 mcg |
1,197 |
635 |
$82K |
| 86703 |
|
4,669 |
4,540 |
$81K |
| 86360 |
|
1,908 |
1,883 |
$80K |
| 83735 |
|
17,946 |
13,936 |
$78K |
| 76000 |
|
1,386 |
1,337 |
$77K |
| 92507 |
Treatment of speech, language, voice, communication, and/or auditory processing disorder |
752 |
270 |
$76K |
| 90671 |
|
930 |
906 |
$75K |
| 85610 |
|
19,304 |
17,368 |
$74K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
370 |
347 |
$74K |
| 86480 |
|
1,621 |
1,587 |
$73K |
| 76775 |
|
999 |
972 |
$72K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
5,248 |
5,138 |
$70K |
| 96523 |
|
1,331 |
894 |
$70K |
| T2034 |
Crisis intervention, waiver; per diem |
78 |
78 |
$67K |
| 96367 |
|
985 |
516 |
$65K |
| 82728 |
|
8,351 |
7,556 |
$62K |
| 97162 |
|
1,561 |
1,473 |
$62K |
| 83690 |
|
18,220 |
16,713 |
$61K |
| 85730 |
|
16,342 |
15,082 |
$61K |
| 82947 |
|
16,933 |
15,742 |
$61K |
| 87070 |
|
7,245 |
7,068 |
$61K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
5,016 |
4,750 |
$59K |
| 90846 |
Family psychotherapy without the patient present, 50 minutes |
1,148 |
930 |
$58K |
| J0897 |
Injection, denosumab, 1 mg |
99 |
87 |
$57K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
1,400 |
471 |
$56K |
| 82607 |
|
7,230 |
6,701 |
$55K |
| 78815 |
Positron emission tomography (PET) for limited area imaging |
67 |
66 |
$53K |
| OP258 |
|
5,584 |
3,981 |
$53K |
| 97161 |
|
1,495 |
1,438 |
$52K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
8,731 |
8,401 |
$51K |
| 81002 |
|
24,592 |
14,526 |
$51K |
| 82565 |
|
16,723 |
15,566 |
$50K |
| 97010 |
|
5,191 |
1,653 |
$49K |
| 73502 |
|
1,439 |
1,359 |
$49K |
| 96417 |
|
440 |
257 |
$49K |
| 90461 |
|
3,110 |
3,072 |
$49K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
5,954 |
5,653 |
$48K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
2,478 |
2,432 |
$48K |
| 87088 |
|
13,772 |
12,917 |
$48K |
| 81001 |
|
20,803 |
19,526 |
$47K |
| 47562 |
|
25 |
25 |
$47K |
| 72050 |
|
686 |
679 |
$46K |
| 84439 |
|
6,591 |
6,287 |
$46K |
| 74018 |
|
1,317 |
1,220 |
$46K |
| 84520 |
|
16,617 |
15,443 |
$45K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
2,794 |
1,437 |
$45K |
| 83605 |
|
4,981 |
4,571 |
$45K |
| 77412 |
|
123 |
12 |
$44K |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
3,630 |
3,303 |
$44K |
| 97164 |
|
1,423 |
1,331 |
$44K |
| 73110 |
|
1,344 |
1,290 |
$43K |
| Q5106 |
Injection, epoetin alfa-epbx, biosimilar, (retacrit) (for non-esrd use), 1000 units |
161 |
77 |
$42K |
| 82542 |
|
1,500 |
1,056 |
$42K |
| 29580 |
|
1,140 |
415 |
$41K |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
2,390 |
2,186 |
$41K |
| 84100 |
|
10,612 |
8,494 |
$41K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
1,243 |
1,182 |
$41K |
| 70498 |
|
242 |
232 |
$41K |
| 85014 |
|
15,323 |
14,163 |
$40K |
| 88142 |
|
2,348 |
2,336 |
$40K |
| 87040 |
|
3,364 |
3,082 |
$38K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
573 |
530 |
$38K |
| 90723 |
|
2,879 |
2,821 |
$37K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
2,340 |
2,282 |
$37K |
| 72131 |
|
397 |
361 |
$37K |
| 84480 |
|
3,224 |
3,093 |
$35K |
| 11045 |
|
316 |
127 |
$35K |
| 90670 |
|
3,401 |
3,320 |
$35K |
| 82746 |
|
6,059 |
5,595 |
$34K |
| 88304 |
|
902 |
886 |
$34K |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
4,836 |
3,671 |
$34K |
| 82550 |
|
6,661 |
5,755 |
$34K |
| 86803 |
|
2,296 |
2,220 |
$34K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
844 |
843 |
$34K |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
1,161 |
1,156 |
$34K |
| A9500 |
Technetium tc-99m sestamibi, diagnostic, per study dose |
520 |
516 |
$33K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
1,802 |
837 |
$33K |
| 76818 |
|
291 |
184 |
$32K |
| 95782 |
|
32 |
32 |
$32K |
| G0279 |
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) |
1,438 |
1,320 |
$32K |
| 95816 |
|
173 |
172 |
$31K |
| 82378 |
|
2,194 |
1,813 |
$30K |
| 83550 |
|
8,268 |
7,482 |
$30K |
| 94664 |
|
1,133 |
1,061 |
$29K |
| 77334 |
|
49 |
36 |
$28K |
| 86922 |
|
999 |
800 |
$28K |
| 96415 |
|
225 |
161 |
$26K |
| 87340 |
|
3,542 |
3,426 |
$26K |
| 70496 |
|
156 |
150 |
$26K |
| J0690 |
Injection, cefazolin sodium, 500 mg |
3,399 |
2,943 |
$26K |
| 87186 |
|
3,177 |
3,020 |
$26K |
| J2785 |
Injection, regadenoson, 0.1 mg |
681 |
630 |
$26K |
| 64484 |
|
74 |
74 |
$25K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
478 |
335 |
$25K |
| 81420 |
Fetal chromosomal aneuploidy genomic sequence analysis panel |
126 |
125 |
$24K |
| 12001 |
|
498 |
468 |
$23K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
1,672 |
1,549 |
$23K |
| 81003 |
|
10,854 |
10,290 |
$23K |
| 73080 |
|
827 |
788 |
$23K |
| 73590 |
|
737 |
689 |
$22K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
52 |
52 |
$22K |
| OP710 |
|
139 |
110 |
$22K |
| 90935 |
Hemodialysis procedure with single evaluation by a physician |
519 |
290 |
$22K |
| 83540 |
|
8,425 |
7,633 |
$22K |
| OP370 |
|
317 |
280 |
$21K |
| 82951 |
|
3,013 |
2,798 |
$21K |
| J1630 |
Injection, haloperidol, up to 5 mg |
1,249 |
1,044 |
$20K |
| 86580 |
|
1,920 |
1,853 |
$20K |
| 72100 |
|
627 |
614 |
$19K |
| 93975 |
|
85 |
79 |
$19K |
| 77062 |
|
756 |
747 |
$19K |
| 85378 |
|
3,878 |
3,692 |
$18K |
| 72170 |
|
633 |
576 |
$18K |
| 88307 |
|
161 |
158 |
$17K |
| 83615 |
|
3,411 |
3,255 |
$17K |
| 82105 |
|
1,638 |
1,579 |
$17K |
| A9502 |
Technetium tc-99m tetrofosmin, diagnostic, per study dose |
859 |
703 |
$17K |
| 80329 |
|
2,356 |
2,161 |
$17K |
| 66984 |
Extracapsular cataract removal with insertion of intraocular lens prosthesis |
29 |
27 |
$17K |
| J1815 |
Injection, insulin, per 5 units |
1,246 |
777 |
$16K |
| OP271 |
|
5,214 |
5,027 |
$16K |
| 86592 |
|
7,774 |
7,557 |
$15K |
| 0002A |
|
535 |
531 |
$15K |
| 82677 |
|
520 |
515 |
$14K |
| 36430 |
|
146 |
119 |
$14K |
| 83020 |
|
2,179 |
2,146 |
$14K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
762 |
756 |
$13K |
| 81025 |
|
3,139 |
3,032 |
$13K |
| 93880 |
|
87 |
87 |
$13K |
| 87320 |
|
956 |
947 |
$12K |
| C1713 |
Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) |
13 |
12 |
$12K |
| 84153 |
|
758 |
699 |
$12K |
| 12011 |
|
240 |
231 |
$12K |
| 73140 |
|
391 |
376 |
$12K |
| 19083 |
|
27 |
24 |
$11K |
| 86704 |
|
513 |
489 |
$11K |
| 82803 |
|
1,055 |
959 |
$11K |
| 86706 |
|
545 |
529 |
$11K |
| 86677 |
|
1,835 |
1,818 |
$10K |
| 83874 |
|
550 |
383 |
$10K |
| 84703 |
|
2,586 |
2,466 |
$10K |
| 86870 |
|
158 |
143 |
$10K |
| 82248 |
|
1,483 |
1,193 |
$10K |
| 82553 |
|
694 |
469 |
$10K |
| 90681 |
|
2,840 |
2,787 |
$9K |
| 70491 |
|
60 |
53 |
$9K |
| 76641 |
|
73 |
68 |
$9K |
| 71100 |
|
335 |
322 |
$9K |
| A6251 |
Specialty absorptive dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
6,461 |
2,257 |
$9K |
| 90714 |
|
1,699 |
1,604 |
$9K |
| 74021 |
|
226 |
221 |
$9K |
| 96161 |
|
685 |
648 |
$9K |
| 90380 |
|
41 |
39 |
$9K |
| 0001A |
|
496 |
493 |
$9K |
| 86762 |
|
2,217 |
2,172 |
$9K |
| C8929 |
Transthoracic echocardiography with contrast, or without contrast followed by with contrast, real-time with image documentation (2d), includes m-mode recording, when performed, complete, with spectral doppler echocardiography, and with color flow doppler echocardiography |
55 |
54 |
$9K |
| 90647 |
|
2,694 |
2,632 |
$8K |
| 80164 |
|
817 |
740 |
$8K |
| J1644 |
Injection, heparin sodium, per 1000 units |
368 |
327 |
$8K |
| J2710 |
Injection, neostigmine methylsulfate, up to 0.5 mg |
551 |
535 |
$8K |
| 72074 |
|
222 |
214 |
$8K |
| J2060 |
Injection, lorazepam, 2 mg |
1,650 |
1,330 |
$8K |
| 77336 |
|
94 |
39 |
$8K |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
3,405 |
1,498 |
$8K |
| 90686 |
|
1,317 |
1,280 |
$7K |
| 77061 |
|
427 |
395 |
$7K |
| 86336 |
|
496 |
491 |
$7K |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
2,518 |
2,051 |
$7K |
| 82465 |
|
1,830 |
1,802 |
$7K |
| 82009 |
|
2,378 |
2,194 |
$7K |
| 96402 |
|
65 |
62 |
$7K |
| 87634 |
|
212 |
211 |
$7K |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
4,901 |
4,347 |
$7K |
| OP720 |
|
47 |
38 |
$7K |
| 76870 |
|
71 |
70 |
$7K |
| 87110 |
|
463 |
459 |
$6K |
| J1245 |
Injection, dipyridamole, per 10 mg |
76 |
76 |
$6K |
| A0434 |
Specialty care transport (sct) |
20 |
13 |
$6K |
| G2023 |
Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
418 |
401 |
$6K |
| J1170 |
Injection, hydromorphone, up to 4 mg |
2,541 |
2,078 |
$6K |
| 96411 |
|
39 |
26 |
$6K |
| A4649 |
Surgical supply; miscellaneous |
1,155 |
488 |
$6K |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
5,289 |
4,793 |
$6K |
| 86701 |
|
762 |
732 |
$6K |
| 87205 |
|
1,526 |
1,442 |
$6K |
| 85044 |
|
1,362 |
1,154 |
$5K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
388 |
216 |
$5K |
| 93923 |
|
39 |
39 |
$5K |
| 10060 |
|
103 |
97 |
$5K |
| 36600 |
|
427 |
384 |
$5K |
| 72084 |
|
40 |
40 |
$5K |
| C9113 |
Injection, pantoprazole sodium, per vial |
1,533 |
894 |
$5K |
| 73090 |
|
169 |
159 |
$5K |
| 97116 |
|
287 |
133 |
$4K |
| 82247 |
|
947 |
768 |
$4K |
| 74183 |
|
12 |
12 |
$4K |
| 86140 |
|
1,888 |
1,816 |
$4K |
| G0121 |
Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk |
26 |
26 |
$4K |
| 84163 |
|
262 |
262 |
$4K |
| 85651 |
|
2,270 |
2,193 |
$4K |
| 82043 |
|
1,098 |
1,082 |
$4K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
142 |
126 |
$4K |
| J0330 |
Injection, succinylcholine chloride, up to 20 mg |
1,546 |
1,350 |
$4K |
| M0243 |
Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring |
63 |
62 |
$3K |
| A9552 |
Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries |
61 |
54 |
$3K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
73 |
73 |
$3K |
| 0011A |
|
108 |
107 |
$3K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
226 |
221 |
$3K |
| 93325 |
|
13 |
13 |
$3K |
| 73562 |
|
71 |
68 |
$3K |
| 76821 |
|
40 |
27 |
$3K |
| 86300 |
|
266 |
225 |
$3K |
| 83970 |
|
180 |
171 |
$3K |
| 0012A |
|
94 |
93 |
$3K |
| J0280 |
Injection, aminophyllin, up to 250 mg |
263 |
263 |
$3K |
| G0379 |
Direct admission of patient for hospital observation care |
64 |
56 |
$3K |
| 90677 |
|
24 |
24 |
$3K |
| 83930 |
|
717 |
659 |
$3K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
121 |
120 |
$2K |
| G0008 |
Administration of influenza virus vaccine |
248 |
243 |
$2K |
| 87400 |
|
208 |
205 |
$2K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
798 |
728 |
$2K |
| J3420 |
Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg |
1,472 |
890 |
$2K |
| 90474 |
|
259 |
259 |
$2K |
| 82570 |
|
873 |
788 |
$2K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
190 |
185 |
$2K |
| A6196 |
Alginate or other fiber gelling dressing, wound cover, sterile, pad size 16 sq. in. or less, each dressing |
547 |
263 |
$2K |
| G8978 |
Mobility: walking & moving around functional limitation, current status, at therapy episode outset and at reporting intervals |
83 |
79 |
$2K |
| 87075 |
|
255 |
237 |
$1K |
| 29125 |
|
33 |
33 |
$1K |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
260 |
258 |
$1K |
| 86769 |
|
52 |
52 |
$1K |
| 83883 |
|
247 |
223 |
$1K |
| 73060 |
|
44 |
41 |
$1K |
| 85384 |
|
220 |
212 |
$1K |
| 84550 |
|
454 |
427 |
$1K |
| Q9963 |
High osmolar contrast material, 350-399 mg/ml iodine concentration, per ml |
12 |
12 |
$1K |
| M0247 |
Intravenous infusion, sotrovimab, includes infusion and post administration monitoring |
16 |
12 |
$1K |
| OP229 |
|
25 |
16 |
$1K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
65 |
64 |
$1K |
| 97803 |
|
17 |
17 |
$1K |
| 76881 |
|
12 |
12 |
$1K |
| G8979 |
Mobility: walking & moving around functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting |
44 |
41 |
$1K |
| 84202 |
|
161 |
152 |
$1K |
| 29130 |
|
28 |
28 |
$976.53 |
| 82962 |
|
330 |
285 |
$950.88 |
| P9040 |
Red blood cells, leukocytes reduced, irradiated, each unit |
12 |
12 |
$920.18 |
| 73552 |
|
42 |
41 |
$802.46 |
| 83655 |
|
161 |
152 |
$796.03 |
| 90633 |
|
787 |
765 |
$795.69 |
| 80179 |
|
105 |
92 |
$774.90 |
| A6021 |
Collagen dressing, sterile, size 16 sq. in. or less, each |
628 |
332 |
$766.90 |
| 90673 |
|
13 |
13 |
$724.90 |
| J0702 |
Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg |
19 |
12 |
$721.36 |
| 0031A |
|
40 |
40 |
$711.44 |
| 12002 |
|
16 |
13 |
$688.18 |
| J2916 |
Injection, sodium ferric gluconate complex in sucrose injection, 12.5 mg |
130 |
42 |
$683.03 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
118 |
113 |
$680.07 |
| 90685 |
|
1,089 |
1,085 |
$667.30 |
| 84155 |
|
414 |
401 |
$661.04 |
| 0003A |
|
24 |
23 |
$655.12 |
| 80143 |
|
105 |
93 |
$646.79 |
| 82150 |
|
200 |
190 |
$636.01 |
| 90715 |
|
16 |
16 |
$629.01 |
| 90662 |
|
42 |
36 |
$617.30 |
| J2370 |
Injection, phenylephrine hcl, up to 1 ml |
353 |
320 |
$588.78 |
| 90658 |
|
65 |
65 |
$585.38 |
| 85027 |
|
191 |
159 |
$557.09 |
| 90656 |
|
62 |
62 |
$519.20 |
| A6222 |
Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
175 |
92 |
$517.96 |
| J2704 |
Injection, propofol, 10 mg |
263 |
254 |
$517.93 |
| 73522 |
|
14 |
13 |
$482.47 |
| 82805 |
|
15 |
13 |
$480.89 |
| G0499 |
Hepatitis b screening in non-pregnant, high risk individual includes hepatitis b surface antigen (hbsag), antibodies to hbsag (anti-hbs) and antibodies to hepatitis b core antigen (anti-hbc), and is followed by a neutralizing confirmatory test, when performed, only for an initially reactive hbsag result |
97 |
78 |
$477.79 |
| 88311 |
|
24 |
24 |
$470.93 |
| A9270 |
Non-covered item or service |
200 |
108 |
$445.86 |
| 86709 |
|
97 |
92 |
$414.16 |
| 90716 |
|
170 |
164 |
$407.66 |
| 84403 |
|
15 |
14 |
$393.27 |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
12 |
12 |
$387.44 |
| 80074 |
|
12 |
12 |
$363.18 |
| 86694 |
|
19 |
19 |
$360.19 |
| 86705 |
|
55 |
54 |
$358.27 |
| 29515 |
|
12 |
12 |
$334.66 |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
23 |
22 |
$330.56 |
| J2920 |
Injection, methylprednisolone sodium succinate, up to 40 mg |
147 |
72 |
$280.76 |
| 84402 |
|
12 |
12 |
$262.59 |
| J2003 |
Injection, lidocaine hydrochloride, 1 mg |
232 |
219 |
$252.00 |
| J2919 |
Injection, methylprednisolone sodium succinate, 5 mg |
142 |
109 |
$247.56 |
| 90707 |
|
179 |
173 |
$243.39 |
| 85379 |
|
35 |
34 |
$234.77 |
| A6197 |
Alginate or other fiber gelling dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., each dressing |
52 |
27 |
$191.31 |
| 15853 |
|
63 |
55 |
$188.44 |
| 86335 |
|
12 |
12 |
$186.35 |
| 82652 |
|
16 |
15 |
$184.06 |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
41 |
38 |
$183.02 |
| 85007 |
|
68 |
66 |
$177.71 |
| 90697 |
|
670 |
653 |
$176.00 |
| A4311 |
Insertion tray without drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.) |
160 |
137 |
$170.66 |
| 86320 |
|
17 |
15 |
$166.43 |
| 96127 |
|
13 |
13 |
$164.47 |
| 87045 |
|
24 |
24 |
$158.69 |
| J2274 |
Injection, morphine sulfate, preservative-free for epidural or intrathecal use, 10 mg |
117 |
110 |
$150.30 |
| A4452 |
Tape, waterproof, per 18 square inches |
22 |
16 |
$143.61 |
| J0171 |
Injection, adrenalin, epinephrine, 0.1 mg |
13 |
13 |
$141.69 |
| 83001 |
|
13 |
13 |
$140.13 |
| 84165 |
|
55 |
55 |
$135.43 |
| G0103 |
Prostate cancer screening; prostate specific antigen test (psa) |
12 |
12 |
$130.12 |
| 80178 |
|
24 |
24 |
$127.89 |
| 82575 |
|
25 |
25 |
$124.36 |
| 82270 |
|
64 |
60 |
$110.79 |
| 82952 |
|
37 |
37 |
$110.57 |
| 87081 |
|
41 |
38 |
$108.74 |
| 90710 |
|
61 |
60 |
$101.97 |
| G0009 |
Administration of pneumococcal vaccine |
24 |
24 |
$97.19 |
| 86317 |
|
15 |
14 |
$76.26 |
| 90700 |
|
104 |
104 |
$70.54 |
| 82140 |
|
55 |
43 |
$66.27 |
| 84436 |
|
30 |
27 |
$63.25 |
| V2632 |
Posterior chamber intraocular lens |
14 |
13 |
$62.37 |
| 85652 |
|
39 |
37 |
$60.11 |
| OP252 |
|
101 |
92 |
$56.47 |
| J0134 |
Injection, acetaminophen (fresenius kabi), not therapeutically equivalent to j0131, 10 mg |
84 |
70 |
$51.35 |
| J2371 |
Injection, phenylephrine hydrochloride, 20 micrograms |
164 |
151 |
$49.28 |
| J1171 |
Injection, hydromorphone, 0.1 mg |
46 |
32 |
$48.38 |
| 90689 |
|
36 |
36 |
$48.23 |
| J3370 |
Injection, vancomycin hcl, 500 mg |
78 |
49 |
$46.67 |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
17 |
12 |
$38.49 |
| 85045 |
|
13 |
12 |
$34.99 |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
13 |
13 |
$27.24 |
| J2004 |
Injection, lidocaine hcl with epinephrine, 1 mg |
18 |
18 |
$25.83 |
| J0360 |
Injection, hydralazine hcl, up to 20 mg |
25 |
13 |
$25.45 |
| 82310 |
|
26 |
26 |
$23.87 |
| J2471 |
Injection, pantoprazole (hikma), not therapeutically equivalent to j2470, 40 mg |
13 |
13 |
$22.65 |
| 84300 |
|
12 |
12 |
$21.12 |
| 36410 |
|
13 |
12 |
$20.28 |
| J1596 |
Injection, glycopyrrolate, 0.1 mg |
25 |
12 |
$14.50 |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
18 |
15 |
$14.38 |
| OP637 |
|
196 |
112 |
$11.81 |
| 84479 |
|
17 |
14 |
$10.68 |
| J1631 |
Injection, haloperidol decanoate, per 50 mg |
31 |
30 |
$6.89 |
| 91300 |
|
30 |
29 |
$3.00 |
| J2426 |
Injection, paliperidone palmitate extended release (invega sustenna), 1 mg |
69 |
65 |
$0.12 |
| J0401 |
Injection, aripiprazole (abilify maintena), 1 mg |
44 |
42 |
$0.11 |
| J0688 |
Injection, cefazolin sodium (hikma), not therapeutically equivalent to j0690, 500 mg |
50 |
50 |
$0.00 |