| Code | Description | Claims | Beneficiaries | Total Paid |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
50,810 |
44,167 |
$2.26M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
41,253 |
34,708 |
$1.19M |
| 99223 |
Prolong inpt eval add15 m |
17,668 |
15,722 |
$820K |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
51,486 |
17,729 |
$769K |
| 99233 |
Prolong inpt eval add15 m |
23,112 |
9,633 |
$495K |
| 99222 |
Initial hospital care, per day, moderate complexity |
6,378 |
5,887 |
$242K |
| 99308 |
Subsequent nursing facility care, per day, straightforward |
17,586 |
14,103 |
$236K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
3,713 |
3,295 |
$174K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
4,971 |
2,117 |
$172K |
| 99239 |
Hospital discharge day management, more than 30 minutes |
6,592 |
5,746 |
$160K |
| 80053 |
Comprehensive metabolic panel |
12,976 |
11,763 |
$92K |
| 99309 |
Subsequent nursing facility care, per day, low to moderate complexity |
4,943 |
3,550 |
$67K |
| 99215 |
Prolong outpt/office vis |
1,201 |
1,031 |
$65K |
| 99231 |
Subsequent hospital care, per day, straightforward or low complexity |
6,279 |
3,095 |
$65K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
3,671 |
3,204 |
$63K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
950 |
883 |
$61K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
1,553 |
1,423 |
$61K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
11,688 |
10,514 |
$61K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,050 |
986 |
$61K |
| 99306 |
Prolong nursin fac eval 15m |
1,755 |
1,603 |
$60K |
| 95886 |
|
1,358 |
1,139 |
$55K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
842 |
779 |
$52K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
2,988 |
974 |
$52K |
| 80061 |
Lipid panel |
5,674 |
4,996 |
$46K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
2,753 |
2,232 |
$45K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,704 |
1,574 |
$44K |
| 99307 |
|
5,782 |
5,135 |
$42K |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
7,770 |
6,161 |
$42K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
701 |
657 |
$40K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
2,691 |
928 |
$40K |
| 95810 |
Polysomnography; sleep staging with 4 or more additional parameters |
237 |
211 |
$39K |
| 99205 |
Prolong outpt/office vis |
598 |
556 |
$39K |
| 92587 |
|
1,958 |
1,808 |
$36K |
| 20610 |
|
1,068 |
733 |
$32K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
510 |
476 |
$31K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
1,594 |
1,429 |
$30K |
| 90651 |
|
166 |
157 |
$30K |
| E0601 |
Continuous positive airway pressure (cpap) device |
688 |
635 |
$28K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
165 |
141 |
$26K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
414 |
285 |
$26K |
| 84443 |
Thyroid stimulating hormone (TSH) |
2,448 |
2,085 |
$26K |
| 99219 |
|
619 |
559 |
$21K |
| 86140 |
|
6,354 |
5,896 |
$21K |
| 93000 |
|
2,378 |
2,061 |
$20K |
| 99305 |
|
834 |
719 |
$18K |
| 99220 |
|
346 |
322 |
$18K |
| 90756 |
|
1,122 |
1,011 |
$17K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
372 |
332 |
$15K |
| 31231 |
|
237 |
218 |
$14K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
2,363 |
2,013 |
$14K |
| 90619 |
|
145 |
142 |
$13K |
| 90670 |
|
65 |
64 |
$13K |
| 99177 |
|
1,861 |
1,655 |
$13K |
| 92557 |
|
604 |
545 |
$12K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
903 |
811 |
$12K |
| 99217 |
|
532 |
482 |
$12K |
| 69210 |
|
1,608 |
1,294 |
$11K |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
2,132 |
1,785 |
$10K |
| 99221 |
|
314 |
304 |
$10K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
691 |
374 |
$9K |
| 11721 |
|
639 |
539 |
$8K |
| 93015 |
|
189 |
162 |
$8K |
| 17110 |
|
193 |
130 |
$8K |
| A9500 |
Technetium tc-99m sestamibi, diagnostic, per study dose |
77 |
69 |
$7K |
| 31575 |
|
177 |
158 |
$7K |
| 85652 |
|
3,763 |
3,521 |
$7K |
| 92567 |
|
853 |
751 |
$7K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
119 |
113 |
$6K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
483 |
448 |
$6K |
| 96127 |
|
1,710 |
1,551 |
$6K |
| 90674 |
|
402 |
362 |
$6K |
| 93970 |
|
218 |
207 |
$6K |
| A9502 |
Technetium tc-99m tetrofosmin, diagnostic, per study dose |
77 |
60 |
$6K |
| 82607 |
|
952 |
746 |
$6K |
| 36415 |
Collection of venous blood by venipuncture |
3,682 |
3,173 |
$6K |
| 36416 |
|
2,873 |
2,518 |
$6K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
83 |
73 |
$5K |
| 95811 |
|
25 |
25 |
$5K |
| 84439 |
|
834 |
687 |
$4K |
| 94060 |
|
343 |
287 |
$4K |
| 95816 |
|
132 |
120 |
$4K |
| 99051 |
|
207 |
187 |
$4K |
| 93971 |
|
169 |
158 |
$4K |
| 97161 |
|
80 |
75 |
$4K |
| 83655 |
|
455 |
420 |
$4K |
| 82962 |
|
1,990 |
1,707 |
$4K |
| 95912 |
|
31 |
29 |
$3K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
608 |
554 |
$3K |
| 90688 |
|
187 |
170 |
$3K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
67 |
65 |
$3K |
| 92551 |
|
508 |
488 |
$3K |
| 95911 |
|
30 |
27 |
$3K |
| 99236 |
Prolong inpt eval add15 m |
44 |
41 |
$3K |
| 94729 |
|
451 |
388 |
$3K |
| 84100 |
|
1,072 |
998 |
$3K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
215 |
76 |
$3K |
| 90686 |
|
159 |
157 |
$3K |
| 88312 |
|
45 |
41 |
$3K |
| 73630 |
|
189 |
150 |
$3K |
| 94726 |
|
418 |
359 |
$3K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
83 |
80 |
$3K |
| 99397 |
|
58 |
51 |
$3K |
| 99318 |
|
151 |
136 |
$2K |
| 93880 |
|
64 |
60 |
$2K |
| 93016 |
|
182 |
155 |
$2K |
| 83735 |
|
575 |
455 |
$2K |
| G0008 |
Administration of influenza virus vaccine |
345 |
307 |
$2K |
| L3000 |
Foot, insert, removable, molded to patient model, 'ucb' type, berkeley shell, each |
23 |
12 |
$2K |
| 81002 |
|
738 |
716 |
$2K |
| 85018 |
|
1,082 |
969 |
$2K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
96 |
81 |
$2K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
26 |
19 |
$2K |
| 85027 |
|
313 |
295 |
$2K |
| 0071A |
|
16 |
16 |
$2K |
| 95913 |
|
13 |
13 |
$2K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
16 |
12 |
$2K |
| 82043 |
|
395 |
331 |
$2K |
| 0001A |
|
19 |
19 |
$2K |
| 99173 |
|
617 |
597 |
$1K |
| 80076 |
|
279 |
269 |
$1K |
| 82570 |
|
409 |
343 |
$1K |
| 99407 |
|
89 |
78 |
$1K |
| 93018 |
|
182 |
155 |
$1K |
| G0182 |
Physician supervision of a patient under a medicare-approved hospice (patient not present) requiring complex and multidisciplinary care modalities involving regular physician development and/or revision of care plans, review of subsequent reports of patient status, review of laboratory and other studies, communication (including telephone calls) with other health care professionals involved in the patient's care, integration of new information into the medical treatment plan and/or adjustment of medical therapy, within a calendar month, 30 minutes or more |
150 |
139 |
$1K |
| 84460 |
|
250 |
242 |
$1K |
| 84450 |
|
249 |
241 |
$1K |
| 82565 |
|
222 |
216 |
$1K |
| 90734 |
|
16 |
15 |
$1K |
| 97150 |
Therapeutic procedure(s), group (2 or more individuals) |
119 |
55 |
$1K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
121 |
95 |
$1K |
| 11043 |
|
23 |
12 |
$991.02 |
| 86235 |
|
12 |
12 |
$880.20 |
| 84520 |
|
226 |
219 |
$865.83 |
| 99218 |
|
33 |
33 |
$822.97 |
| 20605 |
|
28 |
17 |
$813.00 |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
33 |
29 |
$784.56 |
| 99334 |
|
84 |
76 |
$780.66 |
| 84550 |
|
290 |
238 |
$766.70 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
32 |
29 |
$708.58 |
| 97802 |
|
511 |
476 |
$687.21 |
| 99188 |
|
44 |
36 |
$671.73 |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
17 |
16 |
$649.80 |
| 92015 |
Determination of refractive state |
40 |
37 |
$612.41 |
| 86160 |
|
40 |
39 |
$549.25 |
| A7037 |
Tubing used with positive airway pressure device |
86 |
76 |
$545.68 |
| 99326 |
|
23 |
19 |
$540.26 |
| 90661 |
|
69 |
63 |
$513.00 |
| 96375 |
Therapeutic injection; each additional sequential IV push |
63 |
39 |
$512.73 |
| 0011A |
|
16 |
15 |
$474.76 |
| 0012A |
|
14 |
14 |
$458.20 |
| L4360 |
Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
21 |
13 |
$454.88 |
| 96415 |
|
15 |
12 |
$440.79 |
| 90715 |
|
14 |
13 |
$436.36 |
| A7035 |
Headgear used with positive airway pressure device |
48 |
42 |
$420.62 |
| 81001 |
|
204 |
185 |
$415.81 |
| 98925 |
|
64 |
56 |
$412.92 |
| 88304 |
|
15 |
12 |
$395.79 |
| 99442 |
|
28 |
27 |
$393.27 |
| 29580 |
|
16 |
12 |
$384.22 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
123 |
100 |
$374.79 |
| 90633 |
|
14 |
12 |
$350.00 |
| 86200 |
|
43 |
36 |
$322.19 |
| 93356 |
|
13 |
13 |
$301.73 |
| 81015 |
|
147 |
106 |
$295.87 |
| 99226 |
|
19 |
12 |
$290.10 |
| A5500 |
For diabetics only, fitting (including follow-up), custom preparation and supply of off-the-shelf depth-inlay shoe manufactured to accommodate multi-density insert(s), per shoe |
23 |
12 |
$270.66 |
| 99225 |
|
15 |
12 |
$240.32 |
| A7030 |
Full face mask used with positive airway pressure device, each |
15 |
13 |
$232.02 |
| 83037 |
|
38 |
37 |
$219.42 |
| 99336 |
|
29 |
25 |
$189.41 |
| 94010 |
|
16 |
13 |
$188.13 |
| 98926 |
|
31 |
25 |
$185.87 |
| 99401 |
|
34 |
34 |
$183.47 |
| 99406 |
|
52 |
48 |
$180.30 |
| 77001 |
|
28 |
24 |
$170.59 |
| 82728 |
|
16 |
13 |
$155.79 |
| 76937 |
|
26 |
24 |
$148.37 |
| 82040 |
|
27 |
26 |
$134.39 |
| 99224 |
|
15 |
15 |
$130.14 |
| A7038 |
Filter, disposable, used with positive airway pressure device |
153 |
125 |
$121.76 |
| 94016 |
|
15 |
12 |
$115.72 |
| A7031 |
Face mask interface, replacement for full face mask, each |
15 |
13 |
$104.80 |
| 82310 |
|
123 |
106 |
$102.69 |
| 83550 |
|
16 |
13 |
$100.02 |
| 86225 |
|
12 |
12 |
$96.43 |
| 86226 |
|
12 |
12 |
$84.87 |
| 86038 |
|
12 |
12 |
$84.78 |
| 0399T |
|
13 |
13 |
$84.15 |
| J7050 |
Infusion, normal saline solution, 250 cc |
280 |
199 |
$80.92 |
| 83540 |
|
16 |
13 |
$73.93 |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
16 |
13 |
$66.00 |
| 85610 |
|
18 |
16 |
$41.69 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
17 |
13 |
$36.45 |
| J2919 |
Injection, methylprednisolone sodium succinate, 5 mg |
20 |
12 |
$22.06 |
| 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) |
636 |
524 |
$14.00 |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
546 |
501 |
$11.20 |
| G0270 |
Medical nutrition therapy; reassessment and subsequent intervention(s) following second referral in same year for change in diagnosis, medical condition or treatment regimen (including additional hours needed for renal disease), individual, face to face with the patient, each 15 minutes |
570 |
525 |
$10.92 |
| J7620 |
Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme |
17 |
13 |
$1.07 |
| 91301 |
|
35 |
34 |
$0.28 |
| 91300 |
|
27 |
22 |
$0.27 |
| 91307 |
|
21 |
18 |
$0.18 |
| 3008F |
|
27,462 |
23,943 |
$0.00 |
| 3079F |
|
4,922 |
4,427 |
$0.00 |
| 3044F |
|
1,023 |
784 |
$0.00 |
| G8420 |
Bmi is documented within normal parameters and no follow-up plan is required |
4,247 |
3,703 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
3,897 |
3,523 |
$0.00 |
| 3075F |
|
3,438 |
3,101 |
$0.00 |
| 3074F |
|
12,224 |
10,638 |
$0.00 |
| 2000F |
|
955 |
792 |
$0.00 |
| 3080F |
|
997 |
900 |
$0.00 |
| 3017F |
|
398 |
333 |
$0.00 |
| 1125F |
|
174 |
133 |
$0.00 |
| 1170F |
|
289 |
229 |
$0.00 |
| 1126F |
|
332 |
266 |
$0.00 |
| 3072F |
|
62 |
52 |
$0.00 |
| 99024 |
|
70 |
51 |
$0.00 |
| G9226 |
Foot examination performed (includes examination through visual inspection, sensory exam with 10-g monofilament plus testing any one of the following: vibration using 128-hz tuning fork, pinprick sensation, ankle reflexes, or vibration perception threshold, and pulse exam; report when all of the 3 components are completed) |
231 |
198 |
$0.00 |
| 1157F |
|
17 |
15 |
$0.00 |
| 3014F |
|
135 |
121 |
$0.00 |
| 3061F |
|
44 |
41 |
$0.00 |
| 1123F |
|
56 |
46 |
$0.00 |
| 94760 |
|
40 |
31 |
$0.00 |
| 4010F |
|
18 |
14 |
$0.00 |
| 3078F |
|
12,800 |
11,058 |
$0.00 |
| 3725F |
|
3,624 |
3,211 |
$0.00 |
| 1159F |
|
1,291 |
1,105 |
$0.00 |
| 1124F |
|
147 |
122 |
$0.00 |
| 3077F |
|
2,987 |
2,649 |
$0.00 |
| G8483 |
Influenza immunization was not administered for reasons documented by clinician (e.g., patient allergy or other medical reasons, patient declined or other patient reasons, vaccine not available or other system reasons) |
545 |
491 |
$0.00 |
| G8417 |
Bmi is documented above normal parameters and a follow-up plan is documented |
17,765 |
15,780 |
$0.00 |
| 1160F |
|
1,621 |
1,385 |
$0.00 |
| 1494F |
|
258 |
207 |
$0.00 |
| 1100F |
|
562 |
505 |
$0.00 |
| 2028F |
|
329 |
299 |
$0.00 |
| 3288F |
|
774 |
675 |
$0.00 |
| G8482 |
Influenza immunization administered or previously received |
215 |
185 |
$0.00 |
| G8431 |
Screening for depression is documented as being positive and a follow-up plan is documented |
174 |
153 |
$0.00 |
| 3045F |
|
140 |
116 |
$0.00 |
| 90461 |
|
106 |
99 |
$0.00 |
| G9920 |
Screening performed and negative |
48 |
46 |
$0.00 |
| 4004F |
|
25 |
21 |
$0.00 |
| G8427 |
Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications |
25 |
22 |
$0.00 |
| 3755F |
|
12 |
12 |
$0.00 |