| Code | Description | Claims | Beneficiaries | Total Paid |
| 99472 |
Subsequent inpatient pediatric critical care, per day, 2-5 years |
65,906 |
12,979 |
$21.73M |
| 99469 |
Subsequent inpatient neonatal critical care, per day, 28 days or younger |
15,525 |
4,178 |
$4.80M |
| 99479 |
Subsequent intensive care, per day, very low birth weight infant |
44,297 |
12,718 |
$4.58M |
| 99480 |
Subsequent intensive care, per day, low birth weight infant |
47,223 |
12,804 |
$4.45M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
65,491 |
45,853 |
$3.17M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
70,945 |
52,258 |
$2.64M |
| 99238 |
Hospital discharge day management, 30 minutes or less |
17,078 |
13,819 |
$966K |
| 90960 |
End-stage renal disease related services monthly, for patients 20 years and older, with 4 or more face-to-face visits |
17,654 |
12,443 |
$954K |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
43,390 |
13,246 |
$863K |
| 99460 |
|
12,281 |
9,940 |
$829K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
13,774 |
10,661 |
$753K |
| 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 |
8,871 |
6,157 |
$460K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
4,775 |
3,755 |
$449K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
9,157 |
6,993 |
$409K |
| 90961 |
|
7,285 |
4,963 |
$357K |
| 99233 |
Prolong inpt eval add15 m |
9,350 |
3,575 |
$354K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
4,849 |
3,705 |
$327K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
12,046 |
8,112 |
$289K |
| 36902 |
|
3,616 |
2,629 |
$289K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
6,667 |
4,553 |
$237K |
| 99477 |
|
791 |
620 |
$236K |
| 99462 |
|
5,661 |
3,793 |
$169K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,638 |
1,932 |
$167K |
| 90935 |
Hemodialysis procedure with single evaluation by a physician |
8,068 |
3,123 |
$158K |
| 31231 |
|
1,483 |
953 |
$150K |
| H0016 |
Alcohol and/or drug services; medical/somatic (medical intervention in ambulatory setting) |
844 |
570 |
$148K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
3,529 |
2,966 |
$144K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
2,257 |
1,679 |
$134K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,457 |
1,109 |
$112K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
5,562 |
3,968 |
$103K |
| 11750 |
|
831 |
585 |
$102K |
| 99205 |
Prolong outpt/office vis |
1,062 |
758 |
$101K |
| 11721 |
|
9,602 |
6,951 |
$101K |
| 73620 |
|
9,196 |
3,928 |
$99K |
| G2023 |
Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
6,450 |
4,736 |
$91K |
| 99222 |
Initial hospital care, per day, moderate complexity |
2,433 |
1,765 |
$86K |
| 99478 |
|
808 |
231 |
$86K |
| 99215 |
Prolong outpt/office vis |
1,300 |
679 |
$83K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
1,044 |
739 |
$81K |
| 92134 |
|
5,644 |
3,635 |
$76K |
| 90833 |
Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) |
2,909 |
1,803 |
$61K |
| 67028 |
Intravitreal injection of a pharmacologic agent |
1,345 |
745 |
$53K |
| H2010 |
Comprehensive medication services, per 15 minutes |
959 |
615 |
$51K |
| 11056 |
|
4,041 |
2,812 |
$51K |
| 81025 |
|
10,695 |
7,796 |
$50K |
| 99493 |
|
646 |
496 |
$47K |
| 88307 |
|
755 |
531 |
$46K |
| 59514 |
|
429 |
383 |
$46K |
| 99468 |
|
62 |
49 |
$44K |
| 96127 |
|
12,689 |
9,342 |
$43K |
| 90832 |
Psychotherapy, 30 minutes with patient |
1,780 |
1,221 |
$42K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
519 |
387 |
$42K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
3,302 |
2,387 |
$42K |
| 37248 |
|
235 |
150 |
$40K |
| 36512 |
|
1,053 |
599 |
$39K |
| 36907 |
|
524 |
406 |
$37K |
| 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 |
2,123 |
1,450 |
$37K |
| 80305 |
|
7,273 |
4,190 |
$32K |
| 59025 |
Fetal non-stress test |
1,596 |
1,175 |
$32K |
| 66984 |
Extracapsular cataract removal with insertion of intraocular lens prosthesis |
148 |
110 |
$31K |
| 99223 |
Prolong inpt eval add15 m |
758 |
567 |
$31K |
| 1159F |
|
114,591 |
87,360 |
$30K |
| 99231 |
Subsequent hospital care, per day, straightforward or low complexity |
1,925 |
734 |
$29K |
| 99490 |
Ccm add 20min |
1,942 |
1,436 |
$29K |
| 1160F |
|
51,140 |
41,555 |
$28K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
2,712 |
2,122 |
$28K |
| 36581 |
|
449 |
279 |
$27K |
| 90686 |
|
3,004 |
2,386 |
$27K |
| 36415 |
Collection of venous blood by venipuncture |
18,955 |
13,673 |
$26K |
| 36215 |
|
662 |
461 |
$26K |
| 99494 |
|
609 |
485 |
$25K |
| 92083 |
|
1,230 |
774 |
$24K |
| 99492 |
|
223 |
178 |
$22K |
| 95720 |
|
413 |
150 |
$22K |
| 11100 |
|
527 |
411 |
$22K |
| 88342 |
|
803 |
580 |
$22K |
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
1,237 |
888 |
$21K |
| 3008F |
|
79,243 |
59,690 |
$19K |
| 36901 |
|
312 |
235 |
$19K |
| 76937 |
|
7,107 |
4,875 |
$18K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
194 |
157 |
$15K |
| 11305 |
|
412 |
236 |
$14K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
1,491 |
1,098 |
$14K |
| 99152 |
|
3,021 |
2,189 |
$12K |
| 17110 |
|
186 |
156 |
$12K |
| 90962 |
|
327 |
220 |
$11K |
| 11755 |
|
228 |
152 |
$11K |
| 92133 |
|
653 |
467 |
$11K |
| L3000 |
Foot, insert, removable, molded to patient model, 'ucb' type, berkeley shell, each |
39 |
24 |
$10K |
| 88304 |
|
1,050 |
823 |
$9K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
457 |
235 |
$9K |
| 95718 |
|
167 |
115 |
$9K |
| 77001 |
|
1,140 |
701 |
$9K |
| 99463 |
|
116 |
104 |
$9K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
670 |
511 |
$9K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
273 |
254 |
$9K |
| 92136 |
|
389 |
299 |
$9K |
| 99464 |
|
121 |
98 |
$9K |
| 99484 |
|
277 |
241 |
$8K |
| 97597 |
|
624 |
390 |
$8K |
| 37252 |
|
83 |
41 |
$8K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
141 |
90 |
$8K |
| 90651 |
|
133 |
87 |
$8K |
| 95812 |
|
409 |
323 |
$8K |
| 90791 |
Psychiatric diagnostic evaluation |
106 |
91 |
$8K |
| L1902 |
Ankle orthosis, ankle gauntlet or similar, with or without joints, prefabricated, off-the-shelf |
271 |
128 |
$7K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
262 |
242 |
$7K |
| 92551 |
|
709 |
525 |
$6K |
| 95819 |
|
276 |
220 |
$6K |
| 36595 |
|
253 |
153 |
$6K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
1,428 |
902 |
$6K |
| J9035 |
Injection, bevacizumab, 10 mg |
375 |
197 |
$5K |
| 95816 |
|
287 |
232 |
$5K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
74 |
38 |
$5K |
| 87210 |
|
1,242 |
620 |
$5K |
| 43775 |
|
31 |
25 |
$5K |
| 80306 |
|
597 |
347 |
$5K |
| 75901 |
|
280 |
173 |
$5K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
164 |
138 |
$5K |
| 36589 |
|
102 |
78 |
$5K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
262 |
243 |
$4K |
| 80053 |
Comprehensive metabolic panel |
1,502 |
935 |
$4K |
| 11102 |
|
82 |
75 |
$4K |
| 92285 |
|
288 |
189 |
$4K |
| V2020 |
Frames, purchases |
293 |
271 |
$4K |
| 99217 |
|
66 |
56 |
$4K |
| 37253 |
|
81 |
41 |
$4K |
| 64455 |
|
235 |
77 |
$4K |
| 88341 |
|
103 |
66 |
$4K |
| 99219 |
|
35 |
32 |
$4K |
| 3079F |
|
13,076 |
9,620 |
$3K |
| 99234 |
|
29 |
22 |
$3K |
| 77014 |
|
396 |
14 |
$3K |
| 3074F |
|
30,536 |
22,255 |
$3K |
| 82962 |
|
2,277 |
1,467 |
$3K |
| J0178 |
Injection, aflibercept, 1 mg |
27 |
12 |
$3K |
| 92015 |
Determination of refractive state |
583 |
394 |
$3K |
| 90670 |
|
1,716 |
1,378 |
$3K |
| 93886 |
|
296 |
52 |
$3K |
| 99173 |
|
765 |
590 |
$2K |
| 3078F |
|
25,671 |
18,580 |
$2K |
| 36905 |
|
15 |
12 |
$2K |
| 99201 |
|
85 |
63 |
$2K |
| 90834 |
Psychotherapy, 45 minutes with patient |
72 |
46 |
$2K |
| 0011A |
|
94 |
50 |
$2K |
| 88313 |
|
184 |
103 |
$2K |
| 99254 |
|
14 |
12 |
$2K |
| U0001 |
Cdc 2019 novel coronavirus (2019-ncov) real-time rt-pcr diagnostic panel |
69 |
60 |
$2K |
| 99442 |
|
111 |
71 |
$2K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
40 |
37 |
$2K |
| 3077F |
|
4,551 |
3,290 |
$2K |
| 3075F |
|
5,441 |
3,957 |
$2K |
| 92557 |
|
80 |
68 |
$2K |
| 92002 |
|
45 |
36 |
$2K |
| 90715 |
|
60 |
40 |
$2K |
| 31575 |
|
27 |
24 |
$1K |
| 92567 |
|
171 |
136 |
$1K |
| 90966 |
|
99 |
88 |
$1K |
| 11055 |
|
155 |
118 |
$1K |
| 90656 |
|
192 |
130 |
$1K |
| 99401 |
|
147 |
122 |
$1K |
| 3080F |
|
2,344 |
1,711 |
$1K |
| 90837 |
Psychotherapy, 53 minutes with patient |
32 |
28 |
$1K |
| 92020 |
|
151 |
94 |
$1K |
| 11057 |
|
46 |
42 |
$983.87 |
| 99221 |
|
51 |
40 |
$914.96 |
| 85045 |
|
798 |
486 |
$884.92 |
| 99443 |
|
82 |
32 |
$852.21 |
| 92025 |
|
97 |
57 |
$845.29 |
| 99239 |
Hospital discharge day management, more than 30 minutes |
17 |
17 |
$836.86 |
| 99153 |
Mod sedat endo service >5yrs |
332 |
247 |
$777.66 |
| 11104 |
|
13 |
12 |
$773.08 |
| 96900 |
|
48 |
24 |
$761.10 |
| 90836 |
|
36 |
25 |
$747.53 |
| 88312 |
|
29 |
25 |
$733.62 |
| 76512 |
|
58 |
29 |
$714.01 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
288 |
148 |
$668.94 |
| 92250 |
|
72 |
39 |
$609.04 |
| 99487 |
Ccm add 20min |
12 |
12 |
$599.03 |
| 90682 |
|
33 |
15 |
$587.70 |
| 99439 |
|
29 |
24 |
$561.58 |
| 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) |
275 |
180 |
$542.87 |
| 99459 |
|
39 |
32 |
$532.81 |
| 11900 |
|
19 |
15 |
$460.39 |
| 75710 |
|
65 |
49 |
$418.71 |
| 77336 |
|
75 |
12 |
$364.36 |
| 76513 |
|
19 |
14 |
$363.20 |
| 99441 |
|
40 |
33 |
$353.57 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
26 |
13 |
$349.24 |
| 76514 |
|
92 |
55 |
$338.89 |
| 83986 |
|
263 |
180 |
$336.41 |
| 81002 |
|
157 |
120 |
$299.58 |
| 90970 |
|
182 |
44 |
$227.24 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
1,380 |
689 |
$221.66 |
| 90785 |
|
41 |
25 |
$198.14 |
| 96161 |
|
54 |
36 |
$185.38 |
| 90461 |
|
4,585 |
3,642 |
$181.50 |
| 85018 |
|
124 |
62 |
$120.92 |
| 90723 |
|
223 |
181 |
$104.67 |
| 11101 |
|
21 |
12 |
$82.60 |
| 99421 |
|
26 |
19 |
$71.92 |
| 81003 |
|
43 |
26 |
$57.48 |
| 90662 |
|
21 |
12 |
$53.34 |
| 0500F |
|
50 |
40 |
$40.19 |
| 99024 |
|
739 |
411 |
$20.78 |
| 0502F |
|
12,243 |
8,827 |
$10.00 |
| G0008 |
Administration of influenza virus vaccine |
50 |
45 |
$4.64 |
| 1026F |
|
17,159 |
11,347 |
$1.11 |
| 90680 |
|
237 |
195 |
$0.05 |
| 0503F |
|
16 |
12 |
$0.05 |
| 1126F |
|
25,187 |
18,261 |
$0.04 |
| 90633 |
|
164 |
121 |
$0.00 |
| 90648 |
|
150 |
113 |
$0.00 |
| M1016 |
Female patients unable to bear children |
748 |
582 |
$0.00 |
| 3046F |
|
83 |
72 |
$0.00 |
| G9500 |
Radiation exposure indices documented in final report for procedure using fluoroscopy |
128 |
120 |
$0.00 |
| 90713 |
|
46 |
38 |
$0.00 |
| 90700 |
|
100 |
77 |
$0.00 |
| 3725F |
|
37 |
29 |
$0.00 |
| 1125F |
|
3,187 |
2,153 |
$0.00 |
| 3044F |
|
818 |
683 |
$0.00 |
| 90698 |
|
88 |
68 |
$0.00 |
| 3048F |
|
50 |
39 |
$0.00 |
| 99000 |
|
148 |
97 |
$0.00 |
| 99002 |
|
39 |
24 |
$0.00 |
| G0410 |
Group psychotherapy other than of a multiple-family group, in a partial hospitalization or intensive outpatient setting, approximately 45 to 50 minutes |
80 |
41 |
$0.00 |
| 90697 |
|
29 |
25 |
$0.00 |
| 90647 |
|
19 |
16 |
$0.00 |