| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
118,156 |
102,390 |
$5.29M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
88,339 |
82,356 |
$4.94M |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
23,586 |
20,544 |
$1.78M |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
20,084 |
19,715 |
$1.60M |
| 87428 |
|
30,936 |
29,615 |
$1.53M |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
104,014 |
45,794 |
$1.13M |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
12,655 |
12,432 |
$1.06M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
15,695 |
15,259 |
$960K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
19,668 |
19,095 |
$885K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
15,522 |
13,424 |
$576K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
6,584 |
6,470 |
$571K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
8,203 |
8,019 |
$444K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
31,303 |
29,797 |
$383K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
12,184 |
10,600 |
$371K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
4,633 |
4,186 |
$345K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
2,579 |
2,537 |
$291K |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
9,826 |
3,315 |
$253K |
| 01967 |
Neuraxial labor analgesia/anesthesia for planned vaginal delivery |
1,152 |
1,037 |
$236K |
| J0585 |
Injection, onabotulinumtoxina, 1 unit |
303 |
282 |
$227K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
5,411 |
5,329 |
$157K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
4,918 |
4,115 |
$144K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
1,500 |
1,266 |
$133K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
1,580 |
1,521 |
$117K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
1,809 |
1,729 |
$116K |
| 90461 |
|
27,717 |
23,438 |
$114K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
1,492 |
1,444 |
$109K |
| 99233 |
Prolong inpt eval add15 m |
4,373 |
1,621 |
$107K |
| 99429 |
|
3,176 |
3,118 |
$101K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
1,822 |
1,785 |
$99K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
2,783 |
2,707 |
$85K |
| 99215 |
Prolong outpt/office vis |
844 |
663 |
$84K |
| 70450 |
Computed tomography, head or brain; without contrast material |
4,411 |
4,197 |
$80K |
| 71045 |
Radiologic examination, chest; single view |
19,408 |
16,869 |
$77K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
9,456 |
8,269 |
$75K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
1,286 |
1,060 |
$71K |
| 99239 |
Hospital discharge day management, more than 30 minutes |
1,439 |
1,284 |
$70K |
| 90791 |
Psychiatric diagnostic evaluation |
649 |
615 |
$70K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
1,195 |
1,152 |
$69K |
| 71046 |
Radiologic examination, chest; 2 views |
5,498 |
5,343 |
$66K |
| 0002A |
|
2,597 |
2,567 |
$62K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
5,115 |
2,256 |
$58K |
| 0001A |
|
2,735 |
2,682 |
$57K |
| 99223 |
Prolong inpt eval add15 m |
690 |
662 |
$43K |
| 90832 |
Psychotherapy, 30 minutes with patient |
882 |
739 |
$43K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
3,207 |
2,968 |
$36K |
| 88307 |
|
576 |
564 |
$35K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
1,622 |
902 |
$33K |
| 87807 |
|
3,239 |
3,119 |
$33K |
| 42820 |
Tonsillectomy and adenoidectomy; younger than age 12 |
156 |
138 |
$29K |
| 59430 |
|
329 |
308 |
$27K |
| 96131 |
|
313 |
293 |
$26K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
1,913 |
1,899 |
$26K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
370 |
366 |
$26K |
| 69436 |
Tympanostomy (requiring insertion of ventilating tube), general anesthesia |
192 |
168 |
$26K |
| 99460 |
|
344 |
337 |
$26K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
474 |
450 |
$24K |
| 90833 |
Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) |
733 |
566 |
$23K |
| 73630 |
|
1,362 |
1,027 |
$23K |
| 96130 |
|
341 |
328 |
$23K |
| 99442 |
|
761 |
754 |
$21K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
757 |
702 |
$21K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
403 |
129 |
$21K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
743 |
689 |
$20K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
2,027 |
2,012 |
$18K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
879 |
847 |
$18K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
306 |
303 |
$18K |
| 73110 |
|
660 |
584 |
$17K |
| 73610 |
|
762 |
713 |
$16K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
1,066 |
582 |
$16K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
123 |
55 |
$15K |
| 0071A |
|
359 |
355 |
$15K |
| 99423 |
|
490 |
157 |
$14K |
| 00170 |
Anesthesia for intraoral procedures, including biopsy |
87 |
81 |
$14K |
| 90960 |
End-stage renal disease related services monthly, for patients 20 years and older, with 4 or more face-to-face visits |
1,048 |
1,048 |
$14K |
| 81002 |
|
4,810 |
3,101 |
$14K |
| 88304 |
|
1,565 |
1,536 |
$13K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
306 |
297 |
$13K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
243 |
241 |
$13K |
| 74018 |
|
964 |
889 |
$12K |
| 0072A |
|
312 |
300 |
$12K |
| 73564 |
|
469 |
417 |
$12K |
| 96136 |
|
624 |
548 |
$12K |
| 90686 |
|
15,911 |
15,588 |
$12K |
| 73130 |
|
523 |
471 |
$11K |
| 76830 |
Ultrasound, transvaginal |
201 |
193 |
$11K |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
2,795 |
2,680 |
$10K |
| 99244 |
Office or other outpatient consultation, moderate to high complexity |
77 |
76 |
$10K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
4,738 |
3,697 |
$9K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
740 |
660 |
$9K |
| 76801 |
|
110 |
105 |
$9K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
163 |
147 |
$8K |
| 93000 |
|
938 |
908 |
$8K |
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
13 |
13 |
$7K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
1,939 |
1,872 |
$7K |
| 76770 |
|
290 |
285 |
$7K |
| 64615 |
|
91 |
89 |
$7K |
| 87800 |
|
202 |
189 |
$7K |
| 0004A |
|
562 |
555 |
$7K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
268 |
265 |
$6K |
| 0054A |
|
230 |
217 |
$6K |
| 80053 |
Comprehensive metabolic panel |
3,464 |
2,873 |
$6K |
| 86780 |
|
729 |
653 |
$5K |
| 92567 |
|
440 |
431 |
$5K |
| 76642 |
|
248 |
240 |
$5K |
| 96160 |
|
3,050 |
2,956 |
$5K |
| 59025 |
Fetal non-stress test |
161 |
103 |
$5K |
| 90715 |
|
235 |
227 |
$5K |
| 85610 |
|
2,794 |
1,565 |
$4K |
| 84443 |
Thyroid stimulating hormone (TSH) |
553 |
511 |
$4K |
| 90837 |
Psychotherapy, 53 minutes with patient |
43 |
24 |
$4K |
| 99222 |
Initial hospital care, per day, moderate complexity |
91 |
88 |
$4K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
576 |
505 |
$3K |
| 95117 |
|
478 |
190 |
$3K |
| 80061 |
Lipid panel |
750 |
724 |
$3K |
| 0052A |
|
80 |
77 |
$3K |
| 90682 |
|
65 |
64 |
$3K |
| 0051A |
|
79 |
76 |
$3K |
| 86850 |
|
431 |
362 |
$3K |
| 96380 |
|
166 |
166 |
$3K |
| 99231 |
Subsequent hospital care, per day, straightforward or low complexity |
179 |
90 |
$3K |
| 90677 |
|
3,217 |
3,190 |
$3K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
53 |
53 |
$3K |
| 72100 |
|
111 |
108 |
$2K |
| J0561 |
Injection, penicillin g benzathine, 100,000 units |
14 |
13 |
$2K |
| 88342 |
|
150 |
149 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
256 |
242 |
$2K |
| 84439 |
|
460 |
430 |
$2K |
| 73030 |
|
134 |
124 |
$2K |
| 84481 |
|
289 |
278 |
$2K |
| 99221 |
|
25 |
23 |
$2K |
| 95819 |
|
50 |
42 |
$2K |
| 81025 |
|
248 |
243 |
$2K |
| 99443 |
|
27 |
27 |
$2K |
| 92015 |
Determination of refractive state |
164 |
159 |
$2K |
| 96116 |
|
32 |
32 |
$2K |
| 93271 |
|
12 |
12 |
$1K |
| 94729 |
|
47 |
44 |
$1K |
| 76820 |
|
43 |
34 |
$1K |
| 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 |
39 |
29 |
$1K |
| 99201 |
|
73 |
55 |
$1K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
136 |
133 |
$1K |
| 90656 |
|
1,637 |
1,637 |
$1K |
| 17110 |
|
14 |
14 |
$1K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
25 |
25 |
$960.42 |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
301 |
292 |
$959.33 |
| 86762 |
|
83 |
73 |
$947.57 |
| 81001 |
|
1,338 |
1,195 |
$945.49 |
| 94726 |
|
30 |
28 |
$907.97 |
| 96137 |
|
37 |
36 |
$905.48 |
| 90961 |
|
75 |
75 |
$872.43 |
| 88142 |
|
55 |
55 |
$841.81 |
| 90935 |
Hemodialysis procedure with single evaluation by a physician |
73 |
38 |
$825.38 |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
26 |
26 |
$807.32 |
| 90834 |
Psychotherapy, 45 minutes with patient |
18 |
13 |
$682.71 |
| 99407 |
|
32 |
25 |
$659.12 |
| 82728 |
|
68 |
59 |
$651.49 |
| 86803 |
|
66 |
58 |
$648.73 |
| 92557 |
|
26 |
26 |
$609.85 |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
12 |
12 |
$583.80 |
| 92134 |
|
36 |
36 |
$550.74 |
| 94618 |
|
27 |
26 |
$547.27 |
| 0003A |
|
38 |
38 |
$544.00 |
| 99462 |
|
13 |
12 |
$513.52 |
| 90480 |
|
16 |
16 |
$504.00 |
| 80050 |
General health panel |
19 |
17 |
$498.44 |
| 87340 |
|
304 |
296 |
$478.36 |
| G0279 |
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) |
28 |
28 |
$445.48 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
259 |
250 |
$420.98 |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
12 |
12 |
$417.77 |
| 87070 |
|
49 |
48 |
$379.88 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
26 |
25 |
$375.26 |
| 82043 |
|
203 |
199 |
$352.62 |
| 87150 |
|
14 |
13 |
$347.33 |
| 94060 |
|
12 |
12 |
$331.76 |
| 81000 |
|
234 |
222 |
$331.64 |
| 73080 |
|
13 |
12 |
$310.07 |
| 76536 |
|
13 |
13 |
$282.12 |
| 0012A |
|
67 |
67 |
$265.45 |
| 83516 |
|
32 |
15 |
$248.60 |
| 88302 |
|
30 |
29 |
$247.33 |
| 90671 |
|
491 |
489 |
$231.36 |
| 93272 |
|
12 |
12 |
$224.33 |
| 92551 |
|
57 |
51 |
$216.27 |
| 86900 |
|
85 |
75 |
$199.07 |
| 86901 |
|
84 |
74 |
$196.43 |
| 69210 |
|
13 |
13 |
$193.71 |
| 0011A |
|
77 |
77 |
$193.53 |
| 93296 |
|
29 |
29 |
$170.80 |
| J1040 |
Injection, methylprednisolone acetate, 80 mg |
43 |
39 |
$144.67 |
| 73502 |
|
15 |
12 |
$143.92 |
| 0202U |
Oncology (prostate), multianalyte, gene expression profiling |
79 |
78 |
$126.00 |
| 82947 |
|
52 |
44 |
$124.65 |
| 93297 |
|
12 |
12 |
$119.78 |
| G2066 |
Interrogation device evaluation(s), (remote) up to 30 days; implantable cardiovascular physiologic monitor system, implantable loop recorder system, or subcutaneous cardiac rhythm monitor system, remote data acquisition(s), receipt of transmissions and technician review, technical support and distribution of results |
13 |
13 |
$115.10 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
66 |
65 |
$95.36 |
| 80069 |
|
65 |
62 |
$64.08 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
23 |
15 |
$61.74 |
| 90672 |
|
380 |
361 |
$57.26 |
| 83970 |
|
24 |
24 |
$38.52 |
| 85027 |
|
1,467 |
1,195 |
$37.98 |
| 82570 |
|
37 |
36 |
$35.49 |
| 83880 |
|
14 |
14 |
$35.20 |
| 80305 |
|
69 |
66 |
$27.59 |
| 84156 |
|
36 |
36 |
$25.13 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
32 |
30 |
$20.94 |
| 87040 |
|
191 |
166 |
$18.20 |
| G2211 |
Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established) |
53 |
51 |
$13.61 |
| 99152 |
|
17 |
14 |
$9.83 |
| 77080 |
|
64 |
64 |
$7.75 |
| 86592 |
|
2,031 |
1,990 |
$7.54 |
| 84703 |
|
73 |
70 |
$6.64 |
| 85018 |
|
2,133 |
2,064 |
$4.18 |
| 85014 |
|
2,108 |
2,043 |
$4.18 |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
25 |
25 |
$4.00 |
| 82962 |
|
1,641 |
616 |
$3.00 |
| 83690 |
|
93 |
90 |
$1.22 |
| 91305 |
|
40 |
40 |
$0.03 |
| 90723 |
|
6,590 |
6,503 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
5,175 |
4,441 |
$0.00 |
| 90647 |
|
2,596 |
2,560 |
$0.00 |
| 90651 |
|
670 |
654 |
$0.00 |
| 90697 |
|
438 |
434 |
$0.00 |
| 90716 |
|
63 |
62 |
$0.00 |
| 96127 |
|
733 |
671 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
197 |
197 |
$0.00 |
| 90680 |
|
407 |
398 |
$0.00 |
| 99024 |
|
56 |
48 |
$0.00 |
| 90620 |
|
60 |
60 |
$0.00 |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
414 |
411 |
$0.00 |
| 90698 |
|
316 |
311 |
$0.00 |
| 90660 |
|
40 |
40 |
$0.00 |
| 90381 |
|
38 |
38 |
$0.00 |
| 90696 |
|
38 |
37 |
$0.00 |
| 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 |
37 |
37 |
$0.00 |
| 90619 |
|
12 |
12 |
$0.00 |
| 83735 |
|
35 |
24 |
$0.00 |
| 99441 |
|
31 |
31 |
$0.00 |
| 82607 |
|
15 |
15 |
$0.00 |
| 97804 |
|
12 |
12 |
$0.00 |
| 80048 |
Basic metabolic panel (calcium, ionized) |
17 |
12 |
$0.00 |
| 90670 |
|
9,302 |
9,117 |
$0.00 |
| 90633 |
|
2,788 |
2,725 |
$0.00 |
| 90681 |
|
2,543 |
2,515 |
$0.00 |
| 90648 |
|
5,451 |
5,388 |
$0.00 |
| 85007 |
|
343 |
247 |
$0.00 |
| 90710 |
|
1,247 |
1,206 |
$0.00 |
| 90734 |
|
433 |
415 |
$0.00 |
| 82247 |
|
782 |
317 |
$0.00 |
| 90700 |
|
76 |
76 |
$0.00 |
| 90707 |
|
64 |
63 |
$0.00 |
| 91300 |
|
44 |
44 |
$0.00 |
| 99177 |
|
69 |
69 |
$0.00 |
| 99173 |
|
31 |
31 |
$0.00 |
| 90662 |
|
28 |
28 |
$0.00 |
| G0179 |
Physician or allowed practitioner re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and allowed practitioners to affirm the initial implementation of the plan of care |
24 |
24 |
$0.00 |
| 90380 |
|
12 |
12 |
$0.00 |