| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| H0020 |
Alcohol and/or drug services; methadone administration and/or service (provision of the drug by a licensed program) |
984,362 |
58,853 |
$27.03M |
| G2067 |
Medication assisted treatment, methadone; weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing, if performed (provision of the services by a medicare-enrolled opioid treatment program) |
41,319 |
10,591 |
$8.51M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
30,842 |
29,205 |
$7.00M |
| 90832 |
Psychotherapy, 30 minutes with patient |
67,102 |
38,408 |
$6.68M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
31,159 |
29,588 |
$6.07M |
| G0378 |
Hospital observation service, per hour |
5,635 |
3,502 |
$5.68M |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
41,507 |
35,802 |
$4.46M |
| 96361 |
Intravenous infusion, hydration; each additional hour |
15,169 |
12,175 |
$1.78M |
| 36415 |
Collection of venous blood by venipuncture |
137,798 |
67,951 |
$1.05M |
| G0396 |
Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and brief intervention 15 to 30 minutes |
10,657 |
6,787 |
$1.03M |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
6,481 |
6,140 |
$983K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
37,210 |
31,580 |
$940K |
| 93976 |
|
2,628 |
2,548 |
$787K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
4,102 |
4,009 |
$751K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
20,581 |
19,203 |
$679K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
2,254 |
2,235 |
$677K |
| 70450 |
Computed tomography, head or brain; without contrast material |
3,208 |
3,142 |
$652K |
| 80053 |
Comprehensive metabolic panel |
53,454 |
47,763 |
$598K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
21,445 |
20,467 |
$585K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
3,301 |
3,173 |
$547K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
19,793 |
16,815 |
$536K |
| 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 |
12,022 |
10,089 |
$519K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
12,362 |
12,000 |
$443K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
1,566 |
1,544 |
$433K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
4,728 |
3,972 |
$425K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
19,880 |
19,337 |
$387K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
1,805 |
1,776 |
$362K |
| H0050 |
Alcohol and/or drug services, brief intervention, per 15 minutes |
7,691 |
4,604 |
$361K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
1,792 |
1,772 |
$360K |
| C1713 |
Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) |
575 |
472 |
$339K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
469 |
469 |
$328K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
8,246 |
7,191 |
$292K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
2,622 |
2,518 |
$280K |
| 76801 |
|
4,102 |
3,859 |
$257K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
2,146 |
2,033 |
$239K |
| H0005 |
Alcohol and/or drug services; group counseling by a clinician |
4,813 |
1,444 |
$239K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
20,750 |
16,721 |
$230K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
6,729 |
3,830 |
$224K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
7,915 |
7,857 |
$212K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
3,660 |
3,578 |
$195K |
| 87631 |
|
4,510 |
4,389 |
$168K |
| 86850 |
|
8,748 |
8,262 |
$162K |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
21,999 |
20,138 |
$160K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
15,307 |
7,156 |
$149K |
| G0397 |
Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and intervention, greater than 30 minutes |
1,265 |
939 |
$146K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
1,873 |
1,864 |
$142K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
2,878 |
2,593 |
$134K |
| 84443 |
Thyroid stimulating hormone (TSH) |
17,288 |
17,024 |
$128K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
4,143 |
4,046 |
$120K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
10,240 |
6,315 |
$114K |
| 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 |
7,830 |
7,026 |
$114K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
1,461 |
1,194 |
$112K |
| 93970 |
|
458 |
452 |
$112K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
15,203 |
14,991 |
$110K |
| 81025 |
|
30,756 |
28,294 |
$106K |
| 80061 |
Lipid panel |
14,892 |
14,826 |
$101K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,314 |
1,279 |
$100K |
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
1,821 |
633 |
$97K |
| 87481 |
|
2,940 |
2,858 |
$93K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
24,173 |
18,147 |
$91K |
| 86900 |
|
9,078 |
8,414 |
$91K |
| J1439 |
Injection, ferric carboxymaltose, 1 mg |
298 |
189 |
$90K |
| 83880 |
|
4,438 |
4,124 |
$89K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
67,310 |
59,360 |
$85K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
1,513 |
1,512 |
$81K |
| 99460 |
|
1,657 |
1,656 |
$78K |
| 99201 |
|
689 |
686 |
$74K |
| 76830 |
Ultrasound, transvaginal |
2,772 |
2,748 |
$72K |
| 82607 |
|
7,037 |
6,987 |
$69K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
2,732 |
2,700 |
$68K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
3,350 |
2,989 |
$68K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
1,033 |
1,032 |
$68K |
| 87660 |
|
13,776 |
13,033 |
$65K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
1,514 |
1,502 |
$64K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
5,645 |
5,040 |
$64K |
| 10E0XZZ |
|
121 |
12 |
$61K |
| 99406 |
|
2,623 |
2,586 |
$59K |
| 90715 |
|
2,009 |
2,000 |
$53K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
16,608 |
15,712 |
$51K |
| H0001 |
Alcohol and/or drug assessment |
520 |
426 |
$51K |
| 84439 |
|
6,425 |
6,342 |
$48K |
| 59426 |
|
410 |
293 |
$48K |
| 92551 |
|
949 |
319 |
$46K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
1,628 |
537 |
$44K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
5,447 |
5,409 |
$42K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
17,547 |
16,079 |
$42K |
| 80076 |
|
5,923 |
5,649 |
$42K |
| 93975 |
|
110 |
105 |
$39K |
| 85027 |
|
13,989 |
12,146 |
$37K |
| 82746 |
|
4,112 |
4,084 |
$36K |
| 59425 |
|
420 |
347 |
$35K |
| G2023 |
Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
2,803 |
2,700 |
$35K |
| 81003 |
|
4,952 |
4,345 |
$35K |
| 76813 |
|
766 |
758 |
$34K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,845 |
2,726 |
$34K |
| 86701 |
|
3,946 |
3,901 |
$33K |
| 83655 |
|
2,646 |
2,636 |
$33K |
| 93971 |
|
644 |
637 |
$32K |
| 81001 |
|
30,474 |
28,502 |
$31K |
| 71046 |
Radiologic examination, chest; 2 views |
4,073 |
4,045 |
$31K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
1,960 |
1,918 |
$30K |
| 82728 |
|
3,164 |
3,117 |
$30K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
210 |
200 |
$29K |
| H0004 |
Behavioral health counseling and therapy, per 15 minutes |
598 |
381 |
$29K |
| 86803 |
|
4,457 |
4,429 |
$28K |
| 59025 |
Fetal non-stress test |
1,267 |
1,078 |
$28K |
| 86762 |
|
2,794 |
2,763 |
$26K |
| 84702 |
|
5,854 |
4,917 |
$26K |
| 86901 |
|
1,952 |
1,646 |
$25K |
| 90686 |
|
1,550 |
1,378 |
$25K |
| 97161 |
|
528 |
528 |
$25K |
| J1756 |
Injection, iron sucrose, 1 mg |
383 |
193 |
$24K |
| 10060 |
|
99 |
96 |
$23K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
482 |
480 |
$23K |
| 90837 |
Psychotherapy, 53 minutes with patient |
189 |
99 |
$23K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
13,384 |
11,027 |
$22K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
377 |
376 |
$21K |
| 99000 |
|
1,364 |
1,319 |
$21K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
367 |
359 |
$19K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
1,506 |
1,505 |
$19K |
| 87563 |
|
1,142 |
1,125 |
$19K |
| 87340 |
|
2,736 |
2,722 |
$18K |
| 71045 |
Radiologic examination, chest; single view |
10,841 |
10,224 |
$18K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
6,855 |
6,743 |
$18K |
| 85610 |
|
12,364 |
10,695 |
$17K |
| 99441 |
|
637 |
601 |
$17K |
| 82803 |
|
1,892 |
1,624 |
$17K |
| 86780 |
|
2,029 |
1,994 |
$17K |
| 76641 |
|
516 |
515 |
$16K |
| 83021 |
|
1,394 |
1,383 |
$16K |
| 82043 |
|
3,152 |
3,118 |
$14K |
| 72131 |
|
105 |
105 |
$14K |
| 87081 |
|
4,477 |
4,403 |
$14K |
| 58558 |
|
14 |
14 |
$14K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
65 |
64 |
$13K |
| 83550 |
|
3,435 |
3,403 |
$13K |
| 88307 |
|
186 |
178 |
$13K |
| 76820 |
|
915 |
593 |
$13K |
| 87077 |
|
4,583 |
4,075 |
$12K |
| 81220 |
CFTR (cystic fibrosis transmembrane conductance regulator) gene analysis; common variants |
41 |
41 |
$12K |
| 81002 |
|
12,246 |
8,152 |
$12K |
| 81513 |
|
3,267 |
3,165 |
$12K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
216 |
216 |
$12K |
| 99462 |
|
542 |
446 |
$12K |
| 83735 |
|
8,788 |
6,865 |
$11K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
220 |
220 |
$11K |
| 86480 |
|
214 |
213 |
$11K |
| 99442 |
|
293 |
281 |
$11K |
| 90656 |
|
849 |
732 |
$10K |
| 86769 |
|
300 |
300 |
$10K |
| 84153 |
|
543 |
542 |
$10K |
| 96376 |
|
4,998 |
2,544 |
$9K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
1,124 |
942 |
$9K |
| 93017 |
|
352 |
347 |
$9K |
| 85730 |
|
9,624 |
9,183 |
$9K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
87 |
87 |
$9K |
| 87522 |
Neg quan hep c or qual rna |
207 |
206 |
$8K |
| 82951 |
|
1,880 |
1,141 |
$8K |
| 90791 |
Psychiatric diagnostic evaluation |
62 |
48 |
$8K |
| 76821 |
|
371 |
211 |
$8K |
| 12001 |
|
24 |
24 |
$8K |
| 82948 |
|
8,730 |
4,482 |
$8K |
| 87186 |
|
3,737 |
3,363 |
$8K |
| 82955 |
|
1,288 |
1,282 |
$7K |
| 83013 |
|
136 |
136 |
$7K |
| 86706 |
|
1,129 |
1,123 |
$7K |
| 86787 |
|
1,525 |
1,504 |
$7K |
| 83001 |
|
485 |
479 |
$7K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
59 |
59 |
$7K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
675 |
341 |
$7K |
| 86140 |
|
2,581 |
2,184 |
$6K |
| 83970 |
|
215 |
213 |
$6K |
| 87480 |
|
1,713 |
1,689 |
$6K |
| 87510 |
|
1,712 |
1,688 |
$6K |
| 87070 |
|
1,617 |
1,534 |
$6K |
| 90651 |
|
245 |
237 |
$6K |
| 92567 |
|
167 |
55 |
$5K |
| 90658 |
|
484 |
480 |
$5K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
2,810 |
2,398 |
$5K |
| 90834 |
Psychotherapy, 45 minutes with patient |
70 |
48 |
$5K |
| 90714 |
|
269 |
267 |
$5K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
104 |
102 |
$4K |
| 87902 |
|
16 |
14 |
$4K |
| 90746 |
|
129 |
129 |
$4K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
64 |
64 |
$4K |
| 85652 |
|
2,872 |
2,555 |
$4K |
| 86038 |
|
807 |
768 |
$4K |
| 36430 |
|
16 |
12 |
$4K |
| 96127 |
|
92 |
55 |
$4K |
| 84156 |
|
1,641 |
1,430 |
$3K |
| 84146 |
|
252 |
246 |
$3K |
| P9016 |
Red blood cells, leukocytes reduced, each unit |
16 |
12 |
$3K |
| 96367 |
|
83 |
70 |
$3K |
| 99173 |
|
401 |
317 |
$3K |
| 82105 |
|
576 |
569 |
$3K |
| 83690 |
|
14,013 |
12,955 |
$3K |
| J1170 |
Injection, hydromorphone, up to 4 mg |
4,713 |
3,436 |
$3K |
| G0103 |
Prostate cancer screening; prostate specific antigen test (psa) |
349 |
347 |
$3K |
| 87210 |
|
916 |
891 |
$3K |
| 73630 |
|
1,013 |
991 |
$3K |
| 90734 |
|
193 |
188 |
$3K |
| 82570 |
|
731 |
686 |
$3K |
| 73030 |
|
619 |
603 |
$2K |
| 73562 |
|
614 |
599 |
$2K |
| 90674 |
|
225 |
225 |
$2K |
| 84550 |
|
767 |
730 |
$2K |
| 83540 |
|
569 |
566 |
$2K |
| 93041 |
|
1,574 |
1,546 |
$2K |
| 84134 |
|
375 |
340 |
$2K |
| 98967 |
|
32 |
32 |
$2K |
| 86376 |
|
167 |
165 |
$2K |
| H0002 |
Behavioral health screening to determine eligibility for admission to treatment program |
12 |
12 |
$2K |
| 82150 |
|
5,960 |
5,668 |
$2K |
| 72100 |
|
289 |
288 |
$2K |
| P9604 |
Travel allowance one way in connection with medically necessary laboratory specimen collection drawn from home bound or nursing home bound patient; prorated trip charge |
334 |
289 |
$2K |
| 87205 |
|
1,359 |
1,308 |
$2K |
| 83921 |
|
95 |
95 |
$2K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
7,038 |
6,028 |
$2K |
| 85379 |
|
3,195 |
3,093 |
$2K |
| 84484 |
|
13,060 |
8,110 |
$2K |
| 88342 |
|
42 |
41 |
$2K |
| 29125 |
|
13 |
13 |
$2K |
| 90670 |
|
105 |
104 |
$2K |
| 82784 |
|
169 |
108 |
$2K |
| 99443 |
|
61 |
58 |
$2K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
242 |
126 |
$2K |
| 70496 |
|
12 |
12 |
$2K |
| 82550 |
|
1,834 |
1,725 |
$2K |
| 73130 |
|
656 |
640 |
$2K |
| 84100 |
|
520 |
438 |
$2K |
| 85007 |
|
2,559 |
2,254 |
$2K |
| 88304 |
|
354 |
350 |
$2K |
| 90685 |
|
132 |
127 |
$2K |
| 70486 |
|
38 |
38 |
$1K |
| 98968 |
|
23 |
22 |
$1K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
12,062 |
10,332 |
$1K |
| 73610 |
|
634 |
619 |
$1K |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
47 |
47 |
$1K |
| 72110 |
|
181 |
181 |
$1K |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
10,214 |
9,029 |
$1K |
| 81015 |
|
2,379 |
2,251 |
$1K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
899 |
897 |
$1K |
| 86431 |
|
277 |
268 |
$1K |
| 87040 |
|
3,178 |
1,678 |
$1K |
| 82950 |
|
264 |
263 |
$1K |
| 87075 |
|
539 |
531 |
$1K |
| 82310 |
|
605 |
588 |
$1K |
| 83002 |
|
80 |
80 |
$1K |
| 86765 |
|
98 |
97 |
$1K |
| J3490 |
Unclassified drugs |
2,860 |
2,135 |
$1K |
| 84480 |
|
187 |
184 |
$1K |
| 90619 |
|
54 |
14 |
$1K |
| J7050 |
Infusion, normal saline solution, 250 cc |
2,135 |
1,445 |
$1K |
| 82947 |
|
569 |
547 |
$1K |
| 90633 |
|
86 |
81 |
$910.89 |
| 84403 |
|
42 |
38 |
$879.03 |
| 76828 |
|
44 |
25 |
$855.81 |
| 76818 |
|
42 |
38 |
$840.30 |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
30 |
30 |
$814.89 |
| 90672 |
|
45 |
45 |
$803.25 |
| 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 |
58 |
55 |
$795.71 |
| 86580 |
|
148 |
139 |
$733.44 |
| 99464 |
|
24 |
24 |
$692.80 |
| 92586 |
|
13 |
13 |
$643.51 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
13,339 |
12,117 |
$639.81 |
| 99385 |
|
14 |
14 |
$610.44 |
| 90677 |
|
13 |
13 |
$571.30 |
| 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) |
323 |
317 |
$570.98 |
| J1815 |
Injection, insulin, per 5 units |
274 |
216 |
$557.36 |
| 86735 |
|
79 |
78 |
$550.81 |
| 90660 |
|
50 |
24 |
$537.76 |
| 99239 |
Hospital discharge day management, more than 30 minutes |
15 |
14 |
$525.22 |
| 86141 |
|
65 |
64 |
$521.30 |
| 83605 |
|
3,715 |
3,292 |
$510.20 |
| 73564 |
|
232 |
232 |
$499.91 |
| 86317 |
|
210 |
210 |
$470.67 |
| 74018 |
|
405 |
401 |
$439.88 |
| J3420 |
Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg |
771 |
615 |
$421.98 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
3,794 |
3,385 |
$414.10 |
| 93000 |
|
28 |
28 |
$408.93 |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
29 |
14 |
$396.22 |
| C9803 |
Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
1,014 |
839 |
$393.88 |
| 84481 |
|
44 |
44 |
$359.21 |
| 82565 |
|
256 |
253 |
$356.78 |
| 72050 |
|
43 |
43 |
$345.54 |
| 86800 |
|
31 |
29 |
$329.25 |
| 74019 |
|
331 |
321 |
$305.99 |
| 80074 |
|
25 |
25 |
$272.67 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
4,448 |
4,257 |
$269.13 |
| 84402 |
|
14 |
14 |
$254.70 |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
2,040 |
1,244 |
$246.63 |
| C9113 |
Injection, pantoprazole sodium, per vial |
2,880 |
2,061 |
$244.85 |
| 84460 |
|
201 |
197 |
$240.87 |
| 90710 |
|
16 |
16 |
$232.05 |
| 90648 |
|
38 |
38 |
$232.05 |
| 85018 |
|
176 |
165 |
$228.88 |
| 82670 |
|
12 |
12 |
$223.52 |
| 80348 |
|
274 |
271 |
$220.16 |
| 83615 |
|
75 |
57 |
$213.74 |
| 76000 |
|
12 |
12 |
$210.47 |
| 90723 |
|
12 |
12 |
$196.35 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
2,469 |
2,038 |
$192.90 |
| 82785 |
|
20 |
12 |
$189.45 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
3,366 |
2,982 |
$184.17 |
| J2704 |
Injection, propofol, 10 mg |
3,733 |
3,663 |
$183.11 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
1,457 |
1,354 |
$168.41 |
| 90696 |
|
12 |
12 |
$160.65 |
| J7121 |
5% dextrose in lactated ringers infusion, up to 1000 cc |
831 |
710 |
$155.12 |
| 85460 |
|
12 |
12 |
$152.08 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
3,595 |
3,539 |
$147.52 |
| 84144 |
|
14 |
13 |
$146.44 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
3,748 |
3,693 |
$129.37 |
| J1644 |
Injection, heparin sodium, per 1000 units |
2,181 |
1,385 |
$129.19 |
| 87285 |
|
149 |
148 |
$127.15 |
| 90744 |
|
12 |
12 |
$124.95 |
| 87590 |
|
864 |
849 |
$120.63 |
| 84145 |
|
80 |
78 |
$120.61 |
| 82247 |
|
124 |
119 |
$115.22 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
823 |
778 |
$110.87 |
| 86308 |
|
223 |
217 |
$108.38 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
3,490 |
2,936 |
$105.35 |
| 72040 |
|
79 |
79 |
$103.78 |
| 97116 |
|
16 |
12 |
$101.72 |
| A9579 |
Injection, gadolinium-based magnetic resonance contrast agent, not otherwise specified (nos), per ml |
12 |
12 |
$99.42 |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
1,040 |
913 |
$93.85 |
| 87147 |
|
151 |
147 |
$92.94 |
| 73502 |
|
51 |
51 |
$80.62 |
| Q9969 |
Tc-99m from non-highly enriched uranium source, full cost recovery add-on, per study dose |
12 |
12 |
$80.34 |
| 85014 |
|
55 |
51 |
$77.70 |
| 86403 |
|
44 |
42 |
$77.58 |
| 94760 |
|
289 |
209 |
$71.66 |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
14 |
13 |
$67.42 |
| 80050 |
General health panel |
24 |
24 |
$66.84 |
| 86336 |
|
13 |
13 |
$66.30 |
| 80320 |
|
488 |
456 |
$65.90 |
| 84520 |
|
86 |
84 |
$55.30 |
| 84155 |
|
124 |
122 |
$54.27 |
| J7060 |
5% dextrose/water (500 ml = 1 unit) |
187 |
160 |
$52.03 |
| 82040 |
|
99 |
96 |
$46.90 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
1,221 |
1,136 |
$43.89 |
| 90461 |
|
299 |
289 |
$38.06 |
| 82010 |
|
775 |
681 |
$37.71 |
| 87076 |
|
22 |
15 |
$35.16 |
| Q0144 |
Azithromycin dihydrate, oral, capsules/powder, 1 gram |
74 |
69 |
$33.04 |
| 74022 |
|
78 |
78 |
$31.20 |
| J2175 |
Injection, meperidine hydrochloride, per 100 mg |
546 |
540 |
$30.75 |
| 73110 |
|
49 |
49 |
$29.08 |
| 84132 |
|
87 |
82 |
$25.15 |
| J1790 |
Injection, droperidol, up to 5 mg |
505 |
431 |
$23.59 |
| 80177 |
|
16 |
13 |
$21.22 |
| J2800 |
Injection, methocarbamol, up to 10 ml |
475 |
474 |
$18.68 |
| J2272 |
Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg |
251 |
198 |
$17.84 |
| J2060 |
Injection, lorazepam, 2 mg |
859 |
730 |
$11.27 |
| 80354 |
|
16 |
16 |
$10.75 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
1,446 |
1,276 |
$8.02 |
| 82272 |
|
20 |
17 |
$7.94 |
| J0132 |
Injection, acetylcysteine, 100 mg |
203 |
194 |
$7.20 |
| A9270 |
Non-covered item or service |
18,046 |
14,216 |
$7.18 |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
37 |
36 |
$6.09 |
| 73590 |
|
12 |
12 |
$6.00 |
| J3480 |
Injection, potassium chloride, per 2 meq |
132 |
92 |
$5.80 |
| 82374 |
|
40 |
38 |
$4.88 |
| 84295 |
|
40 |
38 |
$4.81 |
| 82435 |
|
40 |
38 |
$4.60 |
| J1956 |
Injection, levofloxacin, 250 mg |
27 |
24 |
$3.90 |
| J7620 |
Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme |
50 |
34 |
$1.30 |
| J2920 |
Injection, methylprednisolone sodium succinate, up to 40 mg |
27 |
14 |
$1.29 |
| 84075 |
|
41 |
39 |
$1.04 |
| 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 |
58 |
56 |
$0.94 |
| 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 |
48 |
43 |
$0.24 |
| 99080 |
|
3,496 |
3,351 |
$0.00 |
| 99152 |
|
85 |
85 |
$0.00 |
| 3078F |
|
3,040 |
2,964 |
$0.00 |
| 3077F |
|
577 |
553 |
$0.00 |
| J2919 |
Injection, methylprednisolone sodium succinate, 5 mg |
139 |
104 |
$0.00 |
| J0689 |
Injection, cefazolin sodium (baxter), not therapeutically equivalent to j0690, 500 mg |
68 |
66 |
$0.00 |
| J1171 |
Injection, hydromorphone, 0.1 mg |
151 |
120 |
$0.00 |
| J1596 |
Injection, glycopyrrolate, 0.1 mg |
73 |
73 |
$0.00 |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
123 |
116 |
$0.00 |
| G0500 |
Moderate sedation services provided by the same physician or other qualified health care professional performing a gastrointestinal endoscopic service that sedation supports, requiring the presence of an independent trained observer to assist in the monitoring of the patient's level of consciousness and physiological status; initial 15 minutes of intra-service time; patient age 5 years or older (additional time may be reported with 99153, as appropriate) |
24 |
24 |
$0.00 |
| 3074F |
|
3,687 |
3,587 |
$0.00 |
| 3079F |
|
1,140 |
1,116 |
$0.00 |
| J1836 |
Injection, metronidazole, 10 mg |
109 |
82 |
$0.00 |
| J2370 |
Injection, phenylephrine hcl, up to 1 ml |
27 |
27 |
$0.00 |
| J2470 |
Injection, pantoprazole sodium, 40 mg |
159 |
122 |
$0.00 |
| 3075F |
|
191 |
190 |
$0.00 |
| J2371 |
Injection, phenylephrine hydrochloride, 20 micrograms |
145 |
145 |
$0.00 |
| 3080F |
|
165 |
155 |
$0.00 |
| 99153 |
Mod sedat endo service >5yrs |
14 |
14 |
$0.00 |
| S2900 |
Surgical techniques requiring use of robotic surgical system (list separately in addition to code for primary procedure) |
24 |
24 |
$0.00 |
| 1034F |
|
14 |
13 |
$0.00 |
| J0360 |
Injection, hydralazine hcl, up to 20 mg |
15 |
13 |
$0.00 |
| J0330 |
Injection, succinylcholine chloride, up to 20 mg |
12 |
12 |
$0.00 |
| J8540 |
Dexamethasone, oral, 0.25 mg |
18 |
12 |
$0.00 |