| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
21,069 |
18,989 |
$5.76M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
18,737 |
16,396 |
$5.58M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
9,968 |
8,836 |
$3.68M |
| H0035 |
Mental health partial hospitalization, treatment, less than 24 hours |
7,066 |
1,005 |
$1.71M |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
6,416 |
6,103 |
$1.36M |
| G0378 |
Hospital observation service, per hour |
4,064 |
2,117 |
$966K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
16,147 |
15,030 |
$916K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
2,075 |
1,003 |
$900K |
| 90834 |
Psychotherapy, 45 minutes with patient |
16,291 |
7,948 |
$863K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
3,941 |
3,652 |
$793K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
24,078 |
6,332 |
$755K |
| 0202U |
Oncology (prostate), multianalyte, gene expression profiling |
6,353 |
5,877 |
$658K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
32,560 |
7,665 |
$536K |
| 70450 |
Computed tomography, head or brain; without contrast material |
5,206 |
4,581 |
$457K |
| H0019 |
Behavioral health; long-term residential (non-medical, non-acute care in a residential treatment program where stay is typically longer than 30 days), without room and board, per diem |
2,364 |
92 |
$416K |
| OP710 |
|
3,022 |
2,589 |
$397K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
2,047 |
1,868 |
$357K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
12,614 |
10,676 |
$353K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
2,069 |
1,813 |
$315K |
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
9,820 |
2,708 |
$294K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
6,532 |
5,324 |
$248K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
544 |
533 |
$235K |
| 87633 |
Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets |
1,488 |
1,454 |
$226K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,996 |
3,418 |
$221K |
| H2018 |
Psychosocial rehabilitation services, per diem |
1,066 |
41 |
$194K |
| 71045 |
Radiologic examination, chest; single view |
7,059 |
6,266 |
$176K |
| 80053 |
Comprehensive metabolic panel |
25,433 |
21,070 |
$174K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
7,581 |
6,764 |
$173K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
5,492 |
1,496 |
$166K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
8,585 |
7,623 |
$164K |
| 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 |
5,432 |
4,552 |
$162K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
9,422 |
2,554 |
$157K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
4,951 |
2,994 |
$156K |
| OP250 |
|
58,880 |
24,077 |
$149K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
8,294 |
5,673 |
$148K |
| 76830 |
Ultrasound, transvaginal |
1,044 |
996 |
$147K |
| 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 |
2,451 |
2,240 |
$145K |
| 71046 |
Radiologic examination, chest; 2 views |
4,568 |
4,241 |
$138K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
5,782 |
5,059 |
$134K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
1,117 |
1,078 |
$123K |
| 90791 |
Psychiatric diagnostic evaluation |
2,200 |
1,946 |
$122K |
| 97161 |
|
2,442 |
2,307 |
$121K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
28,276 |
22,907 |
$119K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
8,290 |
6,275 |
$117K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
221 |
210 |
$113K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
2,044 |
1,729 |
$113K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
2,560 |
2,108 |
$89K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
3,613 |
3,353 |
$88K |
| 36415 |
Collection of venous blood by venipuncture |
28,805 |
23,819 |
$86K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
480 |
453 |
$71K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
455 |
434 |
$68K |
| OP272 |
|
7,810 |
5,410 |
$63K |
| OP270 |
|
15,965 |
11,044 |
$60K |
| 90832 |
Psychotherapy, 30 minutes with patient |
1,394 |
831 |
$58K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
1,077 |
1,038 |
$50K |
| 84484 |
|
7,770 |
6,236 |
$50K |
| 97162 |
|
1,036 |
962 |
$45K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
701 |
635 |
$43K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
331 |
305 |
$43K |
| 73630 |
|
1,315 |
1,233 |
$42K |
| 73610 |
|
1,268 |
1,185 |
$41K |
| 96376 |
|
2,008 |
1,433 |
$41K |
| 85610 |
|
9,296 |
8,101 |
$39K |
| 81001 |
|
15,196 |
13,445 |
$38K |
| 93017 |
|
101 |
101 |
$37K |
| OP251 |
|
2,484 |
1,128 |
$37K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
453 |
430 |
$36K |
| 83880 |
|
2,424 |
2,093 |
$36K |
| 71250 |
|
265 |
215 |
$35K |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
1,589 |
1,552 |
$34K |
| 97803 |
|
650 |
584 |
$33K |
| 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 |
1,904 |
1,772 |
$32K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
183 |
170 |
$31K |
| 85730 |
|
8,592 |
7,565 |
$30K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
1,481 |
1,245 |
$29K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
194 |
131 |
$29K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
4,300 |
3,552 |
$28K |
| 84443 |
Thyroid stimulating hormone (TSH) |
3,025 |
2,745 |
$28K |
| 87631 |
|
467 |
463 |
$27K |
| 87581 |
|
1,488 |
1,455 |
$27K |
| 87040 |
|
2,428 |
2,192 |
$27K |
| 87486 |
|
1,487 |
1,454 |
$27K |
| 86850 |
|
2,620 |
2,263 |
$26K |
| 83605 |
|
3,273 |
2,875 |
$26K |
| 83735 |
|
6,392 |
5,260 |
$25K |
| 73562 |
|
720 |
679 |
$24K |
| 73030 |
|
788 |
715 |
$24K |
| 90833 |
Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) |
506 |
396 |
$24K |
| 84145 |
|
2,125 |
1,921 |
$23K |
| 80305 |
|
2,160 |
1,579 |
$22K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
110 |
108 |
$22K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
1,605 |
1,536 |
$21K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
614 |
512 |
$20K |
| 73130 |
|
759 |
714 |
$20K |
| 82962 |
|
4,823 |
3,156 |
$19K |
| 81025 |
|
9,021 |
8,270 |
$18K |
| 99215 |
Prolong outpt/office vis |
268 |
257 |
$18K |
| 86900 |
|
2,818 |
2,395 |
$18K |
| 93971 |
|
141 |
135 |
$18K |
| 83690 |
|
6,073 |
5,403 |
$18K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
283 |
274 |
$17K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
86 |
52 |
$16K |
| 86901 |
|
2,809 |
2,387 |
$16K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
2,861 |
2,581 |
$15K |
| OP370 |
|
321 |
270 |
$15K |
| 85027 |
|
1,996 |
1,615 |
$14K |
| 84702 |
|
2,499 |
2,224 |
$13K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
13 |
12 |
$11K |
| 0002A |
|
369 |
369 |
$11K |
| 97016 |
|
1,792 |
526 |
$11K |
| 87186 |
|
1,099 |
992 |
$10K |
| 0001A |
|
386 |
386 |
$10K |
| 87077 |
|
1,274 |
1,142 |
$10K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
502 |
393 |
$10K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
304 |
224 |
$10K |
| 82550 |
|
1,913 |
1,687 |
$9K |
| 73110 |
|
351 |
325 |
$9K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
4,989 |
4,383 |
$9K |
| 90675 |
|
44 |
15 |
$8K |
| 72100 |
|
255 |
251 |
$8K |
| 72131 |
|
31 |
26 |
$8K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
538 |
526 |
$7K |
| OP258 |
|
6,522 |
3,477 |
$7K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,125 |
1,108 |
$7K |
| 84100 |
|
1,732 |
1,479 |
$6K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
262 |
231 |
$6K |
| 90715 |
|
1,290 |
1,212 |
$6K |
| 88304 |
|
115 |
114 |
$6K |
| G1004 |
Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program |
9,909 |
6,778 |
$6K |
| 82077 |
|
1,102 |
907 |
$5K |
| 76801 |
|
33 |
32 |
$5K |
| 80076 |
|
1,032 |
893 |
$5K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
464 |
314 |
$5K |
| 80320 |
|
433 |
383 |
$4K |
| 80061 |
Lipid panel |
410 |
376 |
$4K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
14 |
13 |
$4K |
| J2704 |
Injection, propofol, 10 mg |
1,884 |
1,795 |
$4K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
1,299 |
1,116 |
$4K |
| 90375 |
|
15 |
13 |
$4K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,506 |
1,224 |
$4K |
| 12001 |
|
147 |
130 |
$4K |
| 85378 |
|
1,350 |
1,260 |
$4K |
| 86618 |
|
325 |
314 |
$4K |
| 0004A |
|
101 |
101 |
$3K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
251 |
241 |
$3K |
| 76536 |
|
30 |
28 |
$3K |
| J1170 |
Injection, hydromorphone, up to 4 mg |
862 |
654 |
$3K |
| 81003 |
|
1,119 |
1,042 |
$3K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
20 |
12 |
$3K |
| J2060 |
Injection, lorazepam, 2 mg |
991 |
736 |
$3K |
| 74018 |
|
113 |
101 |
$3K |
| A9575 |
Injection, gadoterate meglumine, 0.1 ml |
598 |
512 |
$3K |
| 80143 |
|
641 |
531 |
$3K |
| 70486 |
|
25 |
24 |
$3K |
| 96367 |
|
147 |
104 |
$3K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
4,767 |
4,006 |
$3K |
| Q9966 |
Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml |
171 |
164 |
$3K |
| 80179 |
|
618 |
513 |
$3K |
| J3490 |
Unclassified drugs |
12,645 |
6,424 |
$3K |
| 97802 |
|
25 |
25 |
$3K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
5,668 |
4,814 |
$2K |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
1,185 |
914 |
$2K |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
351 |
325 |
$2K |
| OP279 |
|
1,624 |
1,368 |
$2K |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
243 |
219 |
$2K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
12 |
12 |
$2K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
105 |
100 |
$2K |
| 29125 |
|
71 |
59 |
$2K |
| G0283 |
Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care |
50 |
14 |
$2K |
| 76641 |
|
13 |
13 |
$2K |
| OP229 |
|
29 |
19 |
$1K |
| 97014 |
|
330 |
91 |
$1K |
| 77080 |
|
12 |
12 |
$1K |
| 93970 |
|
13 |
13 |
$1K |
| 72110 |
|
14 |
14 |
$1K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
1,884 |
1,570 |
$1K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
359 |
324 |
$1K |
| 73502 |
|
61 |
52 |
$1K |
| J1630 |
Injection, haloperidol, up to 5 mg |
162 |
119 |
$1K |
| 80164 |
|
59 |
48 |
$1K |
| 0012A |
|
30 |
30 |
$1K |
| 87070 |
|
118 |
115 |
$1K |
| 76642 |
|
14 |
13 |
$1K |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
1,092 |
807 |
$1K |
| C7901 |
Service for diagnosis, evaluation, or treatment of a mental health or substance use disorder, 30-60 minutes, provided remotely by hospital staff who are licensed to provided mental health services under applicable state law(s), when the patient is in their home, and there is no associated professional service |
80 |
48 |
$962.75 |
| 0011A |
|
25 |
25 |
$960.00 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
646 |
559 |
$774.15 |
| G0279 |
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) |
14 |
13 |
$731.19 |
| J0136 |
Injection, acetaminophen (b braun), not therapeutically equivalent to j0131, 10 mg |
314 |
284 |
$728.97 |
| 97165 |
|
13 |
13 |
$711.23 |
| 73080 |
|
28 |
28 |
$689.25 |
| 86140 |
|
528 |
419 |
$677.39 |
| 82553 |
|
40 |
40 |
$669.92 |
| 84439 |
|
134 |
129 |
$600.89 |
| 0072A |
|
15 |
15 |
$565.04 |
| 0071A |
|
14 |
14 |
$524.80 |
| 0031A |
|
16 |
16 |
$423.16 |
| 82728 |
|
44 |
43 |
$418.66 |
| A9585 |
Injection, gadobutrol, 0.1 ml |
27 |
26 |
$398.20 |
| 85055 |
|
21 |
12 |
$380.13 |
| 73590 |
|
14 |
13 |
$365.69 |
| 85652 |
|
415 |
323 |
$358.84 |
| J0134 |
Injection, acetaminophen (fresenius kabi), not therapeutically equivalent to j0131, 10 mg |
240 |
216 |
$355.41 |
| 0064A |
|
12 |
12 |
$324.17 |
| C7900 |
Service for diagnosis, evaluation, or treatment of a mental health or substance use disorder, 15-29 minutes, provided remotely by hospital staff who are licensed to provide mental health services under applicable state law(s), when the patient is in their home, and there is no associated professional service |
220 |
153 |
$319.00 |
| 73140 |
|
12 |
12 |
$243.88 |
| 97116 |
|
29 |
12 |
$204.54 |
| 97018 |
|
53 |
12 |
$197.40 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
91 |
76 |
$192.04 |
| 87081 |
|
18 |
18 |
$181.79 |
| OP278 |
|
12 |
12 |
$180.35 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
578 |
514 |
$171.44 |
| 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 |
591 |
537 |
$155.86 |
| C9113 |
Injection, pantoprazole sodium, per vial |
121 |
82 |
$148.92 |
| J2543 |
Injection, piperacillin sodium/tazobactam sodium, 1 gram/0.125 grams (1.125 grams) |
15 |
12 |
$142.28 |
| 83615 |
|
36 |
31 |
$137.85 |
| 29515 |
|
12 |
12 |
$105.65 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
45 |
39 |
$90.46 |
| 87430 |
|
19 |
19 |
$83.22 |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
105 |
65 |
$71.80 |
| 84481 |
|
17 |
12 |
$63.10 |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
87 |
74 |
$59.00 |
| OP255 |
|
116 |
63 |
$49.80 |
| 84703 |
|
12 |
12 |
$22.80 |
| J0137 |
Injection, acetaminophen (hikma), not therapeutically equivalent to j0131, 10 mg |
17 |
15 |
$19.12 |
| 87205 |
|
16 |
13 |
$11.24 |
| 82150 |
|
18 |
16 |
$10.35 |
| 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 |
31 |
28 |
$8.00 |
| J2003 |
Injection, lidocaine hydrochloride, 1 mg |
16 |
16 |
$7.06 |