| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
42,876 |
37,926 |
$18.51M |
| J9271 |
Injection, pembrolizumab, 1 mg |
2,295 |
1,653 |
$14.22M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
33,887 |
31,489 |
$8.65M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
36,566 |
33,792 |
$6.75M |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
20,589 |
18,865 |
$4.89M |
| J9306 |
Injection, pertuzumab, 1 mg |
895 |
631 |
$4.78M |
| J9355 |
Injection, trastuzumab, excludes biosimilar, 10 mg |
3,106 |
1,267 |
$4.09M |
| G0378 |
Hospital observation service, per hour |
50,920 |
19,726 |
$3.72M |
| 72125 |
Computed tomography, cervical spine; without contrast material |
8,096 |
7,297 |
$2.88M |
| J9035 |
Injection, bevacizumab, 10 mg |
1,118 |
452 |
$2.59M |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
33,845 |
11,891 |
$2.24M |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
18,967 |
17,379 |
$2.05M |
| 96361 |
Intravenous infusion, hydration; each additional hour |
42,528 |
28,534 |
$2.02M |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
26,125 |
13,854 |
$1.66M |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
7,840 |
7,142 |
$1.60M |
| J2505 |
Injection, pegfilgrastim, 6 mg |
647 |
425 |
$1.60M |
| J0897 |
Injection, denosumab, 1 mg |
1,593 |
1,368 |
$1.34M |
| 70450 |
Computed tomography, head or brain; without contrast material |
18,790 |
16,731 |
$1.18M |
| J9299 |
Injection, nivolumab, 1 mg |
388 |
225 |
$1.18M |
| J1439 |
Injection, ferric carboxymaltose, 1 mg |
2,079 |
1,261 |
$1.15M |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
29,449 |
20,795 |
$1.08M |
| C1713 |
Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) |
1,351 |
1,263 |
$985K |
| 70498 |
|
2,177 |
2,022 |
$841K |
| 72131 |
|
1,940 |
1,808 |
$841K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
4,680 |
2,233 |
$700K |
| Q5107 |
Injection, bevacizumab-awwb, biosimilar, (mvasi), 10 mg |
1,014 |
410 |
$663K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
452 |
409 |
$640K |
| 74174 |
|
745 |
685 |
$495K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
7,748 |
7,017 |
$474K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
41,149 |
34,256 |
$437K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
128,352 |
99,358 |
$377K |
| J1750 |
Injection, iron dextran, 50 mg |
1,937 |
1,241 |
$372K |
| J0185 |
Injection, aprepitant, 1 mg |
1,820 |
1,184 |
$366K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
19,244 |
11,001 |
$355K |
| 96416 |
|
1,765 |
961 |
$350K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
765 |
691 |
$346K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
4,555 |
4,346 |
$337K |
| J1756 |
Injection, iron sucrose, 1 mg |
10,833 |
3,573 |
$330K |
| 76801 |
|
1,628 |
1,470 |
$325K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
19,027 |
7,155 |
$314K |
| J1453 |
Injection, fosaprepitant, 1 mg |
4,292 |
2,611 |
$311K |
| J1561 |
Injection, immune globulin, (gamunex-c/gammaked), non-lyophilized (e.g., liquid), 500 mg |
435 |
128 |
$274K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
6,752 |
2,320 |
$264K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
565 |
525 |
$239K |
| Q5111 |
Injection, pegfilgrastim-cbqv (udenyca), biosimilar, 0.5 mg |
122 |
90 |
$239K |
| 76830 |
Ultrasound, transvaginal |
2,653 |
2,530 |
$234K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
24,183 |
19,780 |
$213K |
| 71046 |
Radiologic examination, chest; 2 views |
14,027 |
13,063 |
$211K |
| 71250 |
|
3,812 |
3,442 |
$211K |
| 36430 |
|
2,038 |
1,394 |
$193K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
1,358 |
1,257 |
$193K |
| Q5117 |
Injection, trastuzumab-anns, biosimilar, (kanjinti), 10 mg |
527 |
345 |
$192K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
7,749 |
7,571 |
$182K |
| J9395 |
Injection, fulvestrant, 25 mg |
398 |
313 |
$166K |
| 36591 |
|
11,574 |
7,179 |
$157K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
4,110 |
3,774 |
$151K |
| J9312 |
Injection, rituximab, 10 mg |
82 |
26 |
$147K |
| 94060 |
|
582 |
559 |
$145K |
| J0585 |
Injection, onabotulinumtoxina, 1 unit |
350 |
270 |
$129K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
11,741 |
5,435 |
$129K |
| J9217 |
Leuprolide acetate (for depot suspension), 7.5 mg |
392 |
373 |
$126K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
3,294 |
3,064 |
$122K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
45,714 |
26,687 |
$121K |
| 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 |
964 |
914 |
$120K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
2,234 |
2,110 |
$119K |
| 97161 |
|
7,922 |
7,332 |
$110K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
58,729 |
41,919 |
$110K |
| 76536 |
|
1,510 |
1,423 |
$108K |
| J9041 |
Injection, bortezomib, 0.1 mg |
337 |
64 |
$108K |
| 99205 |
Prolong outpt/office vis |
5,134 |
4,994 |
$106K |
| 99215 |
Prolong outpt/office vis |
7,730 |
6,676 |
$105K |
| 93970 |
|
3,301 |
3,046 |
$103K |
| Q5106 |
Injection, epoetin alfa-epbx, biosimilar, (retacrit) (for non-esrd use), 1000 units |
1,218 |
488 |
$100K |
| 72141 |
|
818 |
739 |
$100K |
| 72100 |
|
2,975 |
2,855 |
$100K |
| J9264 |
Injection, paclitaxel protein-bound particles, 1 mg |
80 |
24 |
$100K |
| 70491 |
|
203 |
190 |
$90K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
22,605 |
16,870 |
$90K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
11,188 |
8,068 |
$89K |
| 93976 |
|
1,210 |
1,161 |
$88K |
| J2506 |
Injection, pegfilgrastim, excludes biosimilar, 0.5 mg |
66 |
38 |
$86K |
| 96417 |
|
8,778 |
5,233 |
$85K |
| C1776 |
Joint device (implantable) |
64 |
56 |
$83K |
| 73030 |
|
4,388 |
4,017 |
$83K |
| 80053 |
Comprehensive metabolic panel |
74,516 |
54,525 |
$77K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
2,479 |
2,265 |
$72K |
| 99195 |
|
1,005 |
770 |
$71K |
| 93458 |
|
79 |
69 |
$70K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
1,723 |
1,605 |
$70K |
| 96415 |
|
7,007 |
4,322 |
$67K |
| 72050 |
|
426 |
411 |
$67K |
| 64483 |
|
139 |
131 |
$65K |
| 52332 |
|
27 |
27 |
$64K |
| J9310 |
Injection, rituximab, 100 mg |
51 |
25 |
$64K |
| 70496 |
|
1,953 |
1,800 |
$63K |
| J9358 |
Injection, fam-trastuzumab deruxtecan-nxki, 1 mg |
21 |
12 |
$63K |
| 73130 |
|
4,049 |
3,829 |
$63K |
| 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 |
10,623 |
9,469 |
$62K |
| 93971 |
|
4,502 |
4,163 |
$61K |
| 11045 |
|
262 |
132 |
$60K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
1,675 |
1,605 |
$57K |
| 52356 |
|
31 |
27 |
$52K |
| 10060 |
|
441 |
418 |
$50K |
| 76770 |
|
1,207 |
1,127 |
$50K |
| J2469 |
Injection, palonosetron hcl, 25 mcg |
3,555 |
1,914 |
$47K |
| 72040 |
|
1,146 |
1,081 |
$46K |
| 49083 |
|
146 |
88 |
$41K |
| 73560 |
|
1,644 |
1,495 |
$40K |
| 73110 |
|
2,656 |
2,480 |
$39K |
| 73562 |
|
4,375 |
4,101 |
$38K |
| 72128 |
|
285 |
255 |
$38K |
| 73610 |
|
3,533 |
3,306 |
$37K |
| 96401 |
|
1,461 |
429 |
$37K |
| J0881 |
Injection, darbepoetin alfa, 1 microgram (non-esrd use) |
164 |
106 |
$36K |
| 73630 |
|
4,511 |
4,276 |
$35K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
42 |
39 |
$34K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
738 |
701 |
$34K |
| 96367 |
|
15,021 |
9,089 |
$31K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
252 |
225 |
$31K |
| M0243 |
Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring |
160 |
156 |
$31K |
| 58661 |
|
13 |
13 |
$30K |
| 72072 |
|
550 |
532 |
$30K |
| 93798 |
|
502 |
95 |
$29K |
| 73564 |
|
637 |
608 |
$29K |
| 45378 |
Colonoscopy, flexible; diagnostic, including collection of specimen(s) |
54 |
54 |
$29K |
| J9070 |
Cyclophosphamide, 100 mg |
316 |
164 |
$28K |
| 93975 |
|
114 |
106 |
$27K |
| 73080 |
|
1,356 |
1,278 |
$27K |
| 99244 |
Office or other outpatient consultation, moderate to high complexity |
3,207 |
2,900 |
$26K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
49,087 |
41,621 |
$26K |
| 97535 |
Self-care/home management training, each 15 minutes |
7,733 |
5,289 |
$26K |
| 73502 |
|
2,237 |
2,049 |
$25K |
| Q5130 |
Injection, pegfilgrastim-pbbk (fylnetra), biosimilar, 0.5 mg |
14 |
12 |
$25K |
| 96523 |
|
2,524 |
1,670 |
$25K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
57 |
55 |
$25K |
| 97162 |
|
2,714 |
2,334 |
$24K |
| 64615 |
|
248 |
226 |
$23K |
| 58558 |
|
27 |
25 |
$22K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
4,077 |
3,886 |
$22K |
| 77012 |
|
33 |
29 |
$22K |
| 58571 |
|
14 |
12 |
$21K |
| 76882 |
|
643 |
599 |
$21K |
| G0257 |
Unscheduled or emergency dialysis treatment for an esrd patient in a hospital outpatient department that is not certified as an esrd facility |
44 |
25 |
$20K |
| J3489 |
Injection, zoledronic acid, 1 mg |
969 |
867 |
$20K |
| 88185 |
|
13 |
13 |
$20K |
| Q5101 |
Injection, filgrastim-sndz, biosimilar, (zarxio), 1 microgram |
91 |
31 |
$18K |
| 70487 |
|
56 |
51 |
$18K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
48,772 |
39,411 |
$18K |
| 73590 |
|
2,320 |
2,184 |
$17K |
| 96376 |
|
23,183 |
13,386 |
$17K |
| 58662 |
|
12 |
12 |
$16K |
| 97165 |
|
2,955 |
2,609 |
$15K |
| 94618 |
|
188 |
177 |
$15K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
4,681 |
3,306 |
$14K |
| 74183 |
|
26 |
24 |
$13K |
| 71101 |
|
508 |
490 |
$13K |
| 72170 |
|
686 |
596 |
$13K |
| 76870 |
|
741 |
701 |
$13K |
| 73521 |
|
408 |
382 |
$12K |
| 74178 |
|
30 |
29 |
$12K |
| J0885 |
Injection, epoetin alfa, (for non-esrd use), 1000 units |
167 |
76 |
$11K |
| 74018 |
|
1,615 |
1,460 |
$11K |
| 99245 |
|
781 |
697 |
$10K |
| 73552 |
|
702 |
640 |
$10K |
| 45385 |
Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) |
34 |
32 |
$9K |
| 95819 |
|
92 |
85 |
$8K |
| 85027 |
|
36,333 |
21,862 |
$8K |
| 72114 |
|
56 |
55 |
$8K |
| J9190 |
Injection, fluorouracil, 500 mg |
5,758 |
1,632 |
$8K |
| 70486 |
|
2,601 |
2,417 |
$7K |
| 62323 |
|
27 |
27 |
$7K |
| 71045 |
Radiologic examination, chest; single view |
37,232 |
32,579 |
$6K |
| 72110 |
|
95 |
92 |
$6K |
| 73090 |
|
1,435 |
1,329 |
$6K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
2,342 |
2,187 |
$6K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
732 |
680 |
$6K |
| 73140 |
|
632 |
593 |
$6K |
| J2997 |
Injection, alteplase recombinant, 1 mg |
153 |
131 |
$6K |
| 97116 |
|
4,822 |
3,193 |
$5K |
| 74019 |
|
362 |
345 |
$5K |
| 96411 |
|
2,595 |
1,634 |
$5K |
| 12002 |
|
510 |
486 |
$4K |
| 99243 |
|
361 |
344 |
$4K |
| 12001 |
|
676 |
645 |
$3K |
| C1781 |
Mesh (implantable) |
117 |
105 |
$3K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
8,364 |
7,941 |
$3K |
| 87206 |
|
207 |
123 |
$3K |
| 96402 |
|
2,296 |
1,974 |
$3K |
| 72146 |
|
16 |
16 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
381 |
308 |
$2K |
| 84484 |
|
43,027 |
27,605 |
$2K |
| 86850 |
|
6,496 |
5,499 |
$2K |
| 0202U |
Oncology (prostate), multianalyte, gene expression profiling |
88 |
84 |
$2K |
| 94669 |
|
56 |
25 |
$2K |
| C1769 |
Guide wire |
2,967 |
2,656 |
$2K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
3,777 |
3,424 |
$2K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
41,458 |
30,253 |
$2K |
| 95816 |
|
27 |
24 |
$2K |
| 73060 |
|
361 |
327 |
$2K |
| 93880 |
|
33 |
28 |
$2K |
| 73700 |
|
163 |
149 |
$2K |
| 88341 |
|
111 |
82 |
$2K |
| 96409 |
|
20 |
13 |
$2K |
| J0640 |
Injection, leucovorin calcium, per 50 mg |
3,353 |
1,509 |
$2K |
| 86923 |
|
1,581 |
846 |
$2K |
| 82962 |
|
43,408 |
16,294 |
$2K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
3,655 |
3,507 |
$2K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
30,483 |
18,321 |
$1K |
| 82803 |
|
2,301 |
1,979 |
$1K |
| 83735 |
|
32,595 |
20,682 |
$1K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
4,102 |
3,920 |
$1K |
| Q3014 |
Telehealth originating site facility fee |
2,449 |
2,079 |
$1K |
| J9171 |
Injection, docetaxel, 1 mg |
426 |
267 |
$1K |
| 97799 |
|
92 |
39 |
$1K |
| 92523 |
|
658 |
522 |
$1K |
| 85610 |
|
25,429 |
21,834 |
$1K |
| 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 |
1,737 |
1,377 |
$1K |
| 80306 |
|
15,725 |
14,343 |
$1K |
| 87040 |
|
12,748 |
6,518 |
$1K |
| 43235 |
|
13 |
13 |
$1K |
| 82248 |
|
22,249 |
19,491 |
$1K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
4,104 |
3,919 |
$1K |
| 94726 |
|
547 |
530 |
$1K |
| 77080 |
|
35 |
29 |
$1K |
| 83690 |
|
29,356 |
25,689 |
$1K |
| 81001 |
|
49,739 |
44,113 |
$1K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
34,172 |
30,478 |
$1K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
12,117 |
8,329 |
$1K |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
22,202 |
16,208 |
$970.71 |
| 87186 |
|
6,293 |
5,217 |
$966.31 |
| J9263 |
Injection, oxaliplatin, 0.5 mg |
1,800 |
671 |
$945.77 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
7,759 |
6,001 |
$942.94 |
| 0352U |
|
384 |
376 |
$908.26 |
| 80074 |
|
795 |
743 |
$906.00 |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
5,371 |
3,198 |
$837.34 |
| 72070 |
|
12 |
12 |
$813.18 |
| 84703 |
|
18,112 |
16,684 |
$756.16 |
| 74230 |
|
18 |
12 |
$711.78 |
| 84443 |
Thyroid stimulating hormone (TSH) |
6,211 |
5,551 |
$684.37 |
| 81025 |
|
8,764 |
8,288 |
$674.30 |
| 93017 |
|
512 |
463 |
$673.41 |
| 36415 |
Collection of venous blood by venipuncture |
35,165 |
24,573 |
$632.24 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
50,336 |
36,606 |
$570.15 |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
17,714 |
15,938 |
$551.90 |
| 86635 |
|
1,870 |
885 |
$539.97 |
| 87631 |
|
244 |
242 |
$528.16 |
| 0012A |
|
18 |
18 |
$521.10 |
| 17250 |
|
15 |
12 |
$512.66 |
| 74022 |
|
144 |
135 |
$489.14 |
| 90686 |
|
226 |
211 |
$446.58 |
| 85730 |
|
14,029 |
12,215 |
$412.98 |
| 36593 |
|
39 |
36 |
$410.05 |
| 83880 |
|
10,621 |
9,274 |
$403.27 |
| 85379 |
|
10,564 |
9,566 |
$391.64 |
| 88184 |
|
42 |
41 |
$388.30 |
| 0042T |
|
234 |
227 |
$381.00 |
| 90715 |
|
4,096 |
3,875 |
$377.32 |
| 97166 |
|
388 |
316 |
$373.73 |
| 87070 |
|
3,375 |
2,721 |
$363.12 |
| 80047 |
|
1,941 |
1,723 |
$360.70 |
| 87510 |
|
2,040 |
1,956 |
$359.11 |
| 87480 |
|
2,041 |
1,956 |
$359.03 |
| 87400 |
|
3,623 |
1,719 |
$357.09 |
| 83605 |
|
13,937 |
10,482 |
$345.48 |
| 86900 |
|
7,708 |
6,413 |
$336.79 |
| 0011A |
|
35 |
35 |
$327.20 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
24,291 |
16,282 |
$323.41 |
| 87660 |
|
2,041 |
1,956 |
$310.71 |
| 87634 |
|
80 |
77 |
$307.96 |
| 82330 |
|
2,188 |
1,881 |
$307.94 |
| 83615 |
|
1,150 |
806 |
$302.41 |
| 82550 |
|
7,501 |
6,035 |
$298.38 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
17,070 |
10,909 |
$284.75 |
| J7050 |
Infusion, normal saline solution, 250 cc |
8,829 |
3,943 |
$263.16 |
| 88307 |
|
517 |
421 |
$252.85 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
24,153 |
20,546 |
$249.62 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
4,631 |
4,321 |
$241.78 |
| 73120 |
|
14 |
14 |
$236.27 |
| J3370 |
Injection, vancomycin hcl, 500 mg |
7,072 |
3,175 |
$234.28 |
| 72220 |
|
13 |
13 |
$230.38 |
| J2785 |
Injection, regadenoson, 0.1 mg |
385 |
349 |
$226.36 |
| 84702 |
|
3,191 |
2,885 |
$225.35 |
| 84100 |
|
13,504 |
8,614 |
$218.93 |
| 90670 |
|
46 |
42 |
$209.57 |
| 82140 |
|
2,590 |
2,042 |
$206.01 |
| 97127 |
|
216 |
133 |
$203.86 |
| C9113 |
Injection, pantoprazole sodium, per vial |
5,029 |
3,162 |
$194.28 |
| 80076 |
|
1,545 |
1,387 |
$192.81 |
| J3420 |
Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg |
5,716 |
4,420 |
$189.82 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
23,079 |
17,710 |
$186.67 |
| 80061 |
Lipid panel |
3,129 |
2,811 |
$184.11 |
| 85007 |
|
3,923 |
2,830 |
$183.65 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
8,818 |
7,690 |
$178.85 |
| 86920 |
|
99 |
68 |
$178.27 |
| J2919 |
Injection, methylprednisolone sodium succinate, 5 mg |
499 |
355 |
$173.22 |
| 84439 |
|
1,164 |
1,041 |
$170.66 |
| 84132 |
|
5,690 |
4,334 |
$155.04 |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
485 |
460 |
$152.06 |
| 82728 |
|
1,881 |
1,478 |
$150.99 |
| 80051 |
|
992 |
882 |
$148.70 |
| 87077 |
|
7,855 |
6,167 |
$144.37 |
| J3490 |
Unclassified drugs |
2,325 |
1,752 |
$134.77 |
| J2060 |
Injection, lorazepam, 2 mg |
7,302 |
5,581 |
$133.99 |
| 80069 |
|
2,224 |
1,147 |
$120.55 |
| 94760 |
|
14,701 |
7,717 |
$114.13 |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
12,369 |
10,129 |
$111.91 |
| 82947 |
|
3,054 |
2,769 |
$111.37 |
| 82607 |
|
581 |
520 |
$95.32 |
| P9016 |
Red blood cells, leukocytes reduced, each unit |
648 |
492 |
$92.84 |
| 81003 |
|
3,035 |
2,720 |
$90.84 |
| 86901 |
|
7,950 |
6,636 |
$86.70 |
| 84295 |
|
1,119 |
1,002 |
$86.60 |
| 93922 |
|
13 |
12 |
$86.36 |
| 82565 |
|
1,359 |
1,218 |
$84.07 |
| 82435 |
|
956 |
885 |
$70.62 |
| 29580 |
|
23 |
12 |
$69.66 |
| 94729 |
|
565 |
545 |
$62.43 |
| 73600 |
|
15 |
12 |
$59.52 |
| J0360 |
Injection, hydralazine hcl, up to 20 mg |
4,810 |
3,187 |
$55.96 |
| 73565 |
|
15 |
13 |
$51.08 |
| 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 |
145 |
137 |
$50.00 |
| J1790 |
Injection, droperidol, up to 5 mg |
1,511 |
1,408 |
$49.39 |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
270 |
249 |
$49.30 |
| 80320 |
|
11,174 |
9,966 |
$49.20 |
| 84145 |
|
1,687 |
1,420 |
$43.51 |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
14,889 |
7,508 |
$42.69 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
903 |
860 |
$40.35 |
| J2543 |
Injection, piperacillin sodium/tazobactam sodium, 1 gram/0.125 grams (1.125 grams) |
7,156 |
2,914 |
$37.55 |
| 87205 |
|
4,338 |
3,348 |
$36.96 |
| 88304 |
|
1,146 |
1,019 |
$36.79 |
| 85652 |
|
2,977 |
2,609 |
$34.58 |
| 80050 |
General health panel |
262 |
236 |
$34.37 |
| Q9956 |
Injection, octafluoropropane microspheres, per ml |
661 |
626 |
$30.52 |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
1,839 |
1,551 |
$29.24 |
| J1920 |
Injection, labetalol hydrochloride, 5 mg |
301 |
267 |
$27.58 |
| 82553 |
|
315 |
243 |
$25.98 |
| J2360 |
Injection, orphenadrine citrate, up to 60 mg |
1,370 |
1,299 |
$25.44 |
| C9803 |
Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
977 |
876 |
$22.83 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
3,915 |
2,910 |
$20.88 |
| 85014 |
|
3,293 |
2,636 |
$20.04 |
| J1644 |
Injection, heparin sodium, per 1000 units |
8,297 |
2,805 |
$19.58 |
| 36600 |
|
212 |
177 |
$18.16 |
| 86141 |
|
655 |
608 |
$17.90 |
| 82150 |
|
2,537 |
2,168 |
$17.88 |
| 87081 |
|
1,433 |
1,348 |
$17.82 |
| 83540 |
|
1,140 |
1,032 |
$15.47 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
7,776 |
6,501 |
$15.34 |
| J0171 |
Injection, adrenalin, epinephrine, 0.1 mg |
432 |
374 |
$13.82 |
| 87147 |
|
2,129 |
1,461 |
$13.31 |
| J2704 |
Injection, propofol, 10 mg |
12,639 |
10,844 |
$13.11 |
| J3480 |
Injection, potassium chloride, per 2 meq |
8,975 |
4,439 |
$11.56 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
11,386 |
10,110 |
$11.38 |
| J0295 |
Injection, ampicillin sodium/sulbactam sodium, per 1.5 gm |
763 |
334 |
$10.80 |
| 82010 |
|
416 |
366 |
$10.60 |
| 87075 |
|
1,833 |
1,528 |
$10.55 |
| A9270 |
Non-covered item or service |
49,601 |
6,509 |
$9.76 |
| J1626 |
Injection, granisetron hydrochloride, 100 mcg |
2,292 |
974 |
$9.56 |
| 86140 |
|
2,011 |
1,591 |
$9.42 |
| J0456 |
Injection, azithromycin, 500 mg |
443 |
268 |
$9.19 |
| 82274 |
|
103 |
99 |
$8.36 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
4,718 |
3,234 |
$7.49 |
| 82810 |
|
590 |
486 |
$7.33 |
| 86592 |
|
278 |
237 |
$6.45 |
| J3411 |
Injection, thiamine hcl, 100 mg |
2,186 |
1,353 |
$6.00 |
| J1815 |
Injection, insulin, per 5 units |
3,327 |
1,090 |
$5.54 |
| 85018 |
|
825 |
515 |
$4.98 |
| Q0162 |
Ondansetron 1 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen |
2,626 |
2,319 |
$3.61 |
| 70544 |
|
14 |
12 |
$3.54 |
| 81002 |
|
619 |
445 |
$3.54 |
| 99152 |
|
2,141 |
1,936 |
$3.08 |
| 82270 |
|
96 |
89 |
$3.06 |
| 99153 |
Mod sedat endo service >5yrs |
1,064 |
956 |
$2.38 |
| J2175 |
Injection, meperidine hydrochloride, per 100 mg |
2,112 |
1,898 |
$2.30 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
10,426 |
7,453 |
$1.96 |
| J2550 |
Injection, promethazine hcl, up to 50 mg |
1,641 |
1,192 |
$1.71 |
| J2920 |
Injection, methylprednisolone sodium succinate, up to 40 mg |
389 |
170 |
$1.50 |
| G1004 |
Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program |
5,841 |
3,761 |
$1.00 |
| 82310 |
|
314 |
263 |
$1.00 |
| J2370 |
Injection, phenylephrine hcl, up to 1 ml |
335 |
296 |
$0.00 |
| 84157 |
|
158 |
132 |
$0.00 |
| J1940 |
Injection, furosemide, up to 20 mg |
2,143 |
1,105 |
$0.00 |
| J9045 |
Injection, carboplatin, 50 mg |
2,828 |
1,856 |
$0.00 |
| 80329 |
|
5,280 |
3,412 |
$0.00 |
| J0330 |
Injection, succinylcholine chloride, up to 20 mg |
1,620 |
1,501 |
$0.00 |
| J9267 |
Injection, paclitaxel, 1 mg |
3,718 |
1,663 |
$0.00 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
3,274 |
2,165 |
$0.00 |
| G8987 |
Self care functional limitation, current status, at therapy episode outset and at reporting intervals |
415 |
320 |
$0.00 |
| 87015 |
|
445 |
305 |
$0.00 |
| J7042 |
5% dextrose/normal saline (500 ml = 1 unit) |
526 |
327 |
$0.00 |
| A9585 |
Injection, gadobutrol, 0.1 ml |
1,215 |
1,104 |
$0.00 |
| 83050 |
|
364 |
304 |
$0.00 |
| 99407 |
|
556 |
491 |
$0.00 |
| J1642 |
Injection, heparin sodium, (heparin lock flush), per 10 units |
7,867 |
3,372 |
$0.00 |
| 87116 |
|
123 |
93 |
$0.00 |
| 83550 |
|
1,099 |
1,000 |
$0.00 |
| 88342 |
|
995 |
900 |
$0.00 |
| J7060 |
5% dextrose/water (500 ml = 1 unit) |
695 |
239 |
$0.00 |
| C2617 |
Stent, non-coronary, temporary, without delivery system |
226 |
195 |
$0.00 |
| J0500 |
Injection, dicyclomine hcl, up to 20 mg |
220 |
202 |
$0.00 |
| J1630 |
Injection, haloperidol, up to 5 mg |
625 |
513 |
$0.00 |
| 87807 |
|
113 |
112 |
$0.00 |
| 73620 |
|
28 |
27 |
$0.00 |
| 82746 |
|
172 |
168 |
$0.00 |
| 96377 |
|
302 |
201 |
$0.00 |
| G8988 |
Self care functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting |
418 |
320 |
$0.00 |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
733 |
696 |
$0.00 |
| J2795 |
Injection, ropivacaine hydrochloride, 1 mg |
639 |
563 |
$0.00 |
| 76377 |
|
82 |
73 |
$0.00 |
| J0461 |
Injection, atropine sulfate, 0.01 mg |
18 |
12 |
$0.00 |
| J8540 |
Dexamethasone, oral, 0.25 mg |
3,309 |
1,644 |
$0.00 |
| J2373 |
Injection, phenylephrine hydrochloride (immphentiv), 20 micrograms |
55 |
29 |
$0.00 |
| 87493 |
|
60 |
51 |
$0.00 |
| 88311 |
|
25 |
25 |
$0.00 |
| G8980 |
Mobility: walking & moving around functional limitation, discharge status, at discharge from therapy or to end reporting |
309 |
257 |
$0.00 |
| 96368 |
|
828 |
502 |
$0.00 |
| C1755 |
Catheter, intraspinal |
54 |
53 |
$0.00 |
| 84300 |
|
89 |
82 |
$0.00 |
| J2470 |
Injection, pantoprazole sodium, 40 mg |
269 |
201 |
$0.00 |
| 87088 |
|
51 |
50 |
$0.00 |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
71 |
65 |
$0.00 |
| J0610 |
Injection, calcium gluconate (fresenius kabi), per 10 ml |
15 |
12 |
$0.00 |
| 36410 |
|
84 |
70 |
$0.00 |
| Q0240 |
Injection, casirivimab and imdevimab, 600 mg |
44 |
34 |
$0.00 |
| 77001 |
|
56 |
54 |
$0.00 |
| J2371 |
Injection, phenylephrine hydrochloride, 20 micrograms |
281 |
223 |
$0.00 |
| J2305 |
Injection, nitroglycerin, 5 mg |
13 |
12 |
$0.00 |
| 88108 |
|
75 |
62 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
38 |
34 |
$0.00 |
| 87046 |
|
30 |
26 |
$0.00 |
| 91301 |
|
47 |
47 |
$0.00 |
| 29581 |
|
22 |
14 |
$0.00 |
| 86885 |
|
13 |
13 |
$0.00 |
| 74420 |
|
18 |
15 |
$0.00 |
| J9049 |
Injection, bortezomib (hospira), not therapeutically equivalent to j9041, 0.1 mg |
30 |
12 |
$0.00 |
| 94644 |
|
13 |
13 |
$0.00 |
| 87449 |
|
48 |
25 |
$0.00 |
| 90632 |
|
43 |
39 |
$0.00 |
| 64484 |
|
14 |
13 |
$0.00 |
| 95886 |
|
13 |
12 |
$0.00 |
| 82784 |
|
31 |
13 |
$0.00 |
| 64488 |
|
16 |
12 |
$0.00 |
| 87102 |
|
421 |
309 |
$0.00 |
| 87899 |
|
25 |
12 |
$0.00 |
| C1894 |
Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser |
1,892 |
1,720 |
$0.00 |
| J9201 |
Injection, gemcitabine hydrochloride, not otherwise specified, 200 mg |
290 |
74 |
$0.00 |
| A9575 |
Injection, gadoterate meglumine, 0.1 ml |
755 |
696 |
$0.00 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
94 |
92 |
$0.00 |
| J1953 |
Injection, levetiracetam, 10 mg |
428 |
298 |
$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 |
1,120 |
882 |
$0.00 |
| J2710 |
Injection, neostigmine methylsulfate, up to 0.5 mg |
140 |
130 |
$0.00 |
| 96549 |
|
1,256 |
689 |
$0.00 |
| 80202 |
|
218 |
186 |
$0.00 |
| 86709 |
|
140 |
128 |
$0.00 |
| J9000 |
Injection, doxorubicin hydrochloride, 10 mg |
416 |
264 |
$0.00 |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
3,955 |
2,117 |
$0.00 |
| 82374 |
|
45 |
44 |
$0.00 |
| Q9966 |
Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml |
823 |
732 |
$0.00 |
| A9502 |
Technetium tc-99m tetrofosmin, diagnostic, per study dose |
481 |
410 |
$0.00 |
| 82272 |
|
152 |
145 |
$0.00 |
| 85347 |
|
23 |
13 |
$0.00 |
| Q9957 |
Injection, perflutren lipid microspheres, per ml |
354 |
333 |
$0.00 |
| C1760 |
Closure device, vascular (implantable/insertable) |
26 |
26 |
$0.00 |
| J1956 |
Injection, levofloxacin, 250 mg |
475 |
269 |
$0.00 |
| 89051 |
|
201 |
139 |
$0.00 |
| C1729 |
Catheter, drainage |
310 |
289 |
$0.00 |
| Q0163 |
Diphenhydramine hydrochloride, 50 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at time of chemotherapy treatment not to exceed a 48 hour dosage regimen |
1,595 |
1,121 |
$0.00 |
| 84520 |
|
1,070 |
958 |
$0.00 |
| J9206 |
Injection, irinotecan, 20 mg |
73 |
25 |
$0.00 |
| J9060 |
Injection, cisplatin, powder or solution, 10 mg |
543 |
211 |
$0.00 |
| G8978 |
Mobility: walking & moving around functional limitation, current status, at therapy episode outset and at reporting intervals |
1,085 |
853 |
$0.00 |
| 87045 |
|
27 |
26 |
$0.00 |
| J1171 |
Injection, hydromorphone, 0.1 mg |
67 |
54 |
$0.00 |
| P9021 |
Red blood cells, each unit |
656 |
545 |
$0.00 |
| J0692 |
Injection, cefepime hydrochloride, 500 mg |
880 |
336 |
$0.00 |
| 93325 |
|
13 |
12 |
$0.00 |
| J3371 |
Injection, vancomycin hcl (mylan), not therapeutically equivalent to j3370, 500 mg |
72 |
53 |
$0.00 |
| 82375 |
|
453 |
358 |
$0.00 |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
503 |
423 |
$0.00 |
| 92610 |
|
54 |
50 |
$0.00 |
| 87799 |
|
18 |
12 |
$0.00 |
| G8996 |
Swallowing functional limitation, current status at therapy episode outset and at reporting intervals |
54 |
37 |
$0.00 |
| Q0244 |
Injection, casirivimab and imdevimab, 1200 mg |
141 |
96 |
$0.00 |
| 83721 |
|
19 |
16 |
$0.00 |
| 12011 |
|
45 |
43 |
$0.00 |
| C1758 |
Catheter, ureteral |
107 |
87 |
$0.00 |
| 64447 |
|
15 |
14 |
$0.00 |
| 29125 |
|
71 |
67 |
$0.00 |
| 93321 |
|
13 |
12 |
$0.00 |
| M0239 |
Intravenous infusion, bamlanivimab-xxxx, includes infusion and post administration monitoring |
28 |
27 |
$0.00 |
| 84550 |
|
53 |
39 |
$0.00 |
| 76937 |
|
12 |
12 |
$0.00 |
| G8997 |
Swallowing functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting |
57 |
37 |
$0.00 |
| 97129 |
|
85 |
55 |
$0.00 |
| Q0239 |
Injection, bamlanivimab-xxxx, 700 mg |
28 |
27 |
$0.00 |
| 85384 |
|
15 |
13 |
$0.00 |
| 82570 |
|
13 |
12 |
$0.00 |
| C1751 |
Catheter, infusion, inserted peripherally, centrally or midline (other than hemodialysis) |
31 |
26 |
$0.00 |
| 86328 |
|
19 |
15 |
$0.00 |
| 87076 |
|
21 |
12 |
$0.00 |
| 90714 |
|
13 |
12 |
$0.00 |