| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
103,560 |
76,149 |
$5.04M |
| 96361 |
Intravenous infusion, hydration; each additional hour |
6,390 |
5,137 |
$1.55M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
10,484 |
9,087 |
$904K |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
12,274 |
10,738 |
$863K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
12,408 |
10,780 |
$830K |
| J0585 |
Injection, onabotulinumtoxina, 1 unit |
1,899 |
1,540 |
$660K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
5,306 |
4,814 |
$649K |
| 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 |
7,382 |
5,912 |
$535K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
2,398 |
2,222 |
$480K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
2,184 |
1,664 |
$450K |
| 70450 |
Computed tomography, head or brain; without contrast material |
3,800 |
3,389 |
$419K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
4,778 |
3,657 |
$391K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
1,100 |
1,045 |
$341K |
| 11043 |
|
1,828 |
899 |
$281K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
3,392 |
2,855 |
$277K |
| 80053 |
Comprehensive metabolic panel |
61,593 |
50,281 |
$273K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
3,926 |
2,247 |
$257K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
10,178 |
9,157 |
$251K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
2,508 |
2,252 |
$234K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
2,601 |
2,283 |
$224K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
1,339 |
1,227 |
$195K |
| 52000 |
|
536 |
502 |
$192K |
| G0378 |
Hospital observation service, per hour |
9,443 |
3,224 |
$178K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
5,530 |
4,429 |
$129K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
977 |
890 |
$116K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
1,216 |
630 |
$112K |
| 96415 |
|
1,049 |
708 |
$110K |
| 67028 |
Intravitreal injection of a pharmacologic agent |
1,004 |
879 |
$106K |
| 45385 |
Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) |
417 |
397 |
$101K |
| 76942 |
|
2,586 |
2,228 |
$100K |
| 20610 |
|
999 |
810 |
$99K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
713 |
645 |
$93K |
| 84443 |
Thyroid stimulating hormone (TSH) |
18,588 |
17,592 |
$92K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
13,052 |
11,465 |
$90K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
61,065 |
48,122 |
$86K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
3,896 |
2,451 |
$81K |
| 78815 |
Positron emission tomography (PET) for limited area imaging |
210 |
186 |
$76K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
517 |
470 |
$75K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
14,774 |
12,021 |
$62K |
| 93971 |
|
894 |
806 |
$62K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
5,785 |
5,096 |
$60K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
18,125 |
17,175 |
$56K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
6,952 |
6,660 |
$53K |
| 80061 |
Lipid panel |
15,623 |
14,958 |
$52K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
2,603 |
2,366 |
$52K |
| 97161 |
|
1,660 |
1,451 |
$49K |
| 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 |
7,667 |
6,689 |
$49K |
| 96367 |
|
1,644 |
1,128 |
$42K |
| 92557 |
|
958 |
929 |
$42K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
6,296 |
5,582 |
$41K |
| J2469 |
Injection, palonosetron hcl, 25 mcg |
1,163 |
685 |
$41K |
| 82607 |
|
6,810 |
6,501 |
$40K |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
3,071 |
2,979 |
$40K |
| 93321 |
|
329 |
299 |
$39K |
| 82728 |
|
8,247 |
7,844 |
$39K |
| 86140 |
|
12,140 |
11,137 |
$38K |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
2,714 |
2,632 |
$37K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
2,014 |
1,000 |
$32K |
| 84484 |
|
9,193 |
5,993 |
$31K |
| 76830 |
Ultrasound, transvaginal |
426 |
410 |
$29K |
| 87536 |
|
1,120 |
1,055 |
$29K |
| 86780 |
|
3,663 |
3,497 |
$28K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
248 |
227 |
$28K |
| 83970 |
|
2,195 |
2,018 |
$25K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
18,039 |
14,613 |
$24K |
| 36415 |
Collection of venous blood by venipuncture |
41,972 |
31,397 |
$23K |
| 84439 |
|
3,634 |
3,424 |
$23K |
| 64615 |
|
144 |
130 |
$22K |
| 97165 |
|
739 |
669 |
$22K |
| 83880 |
|
3,611 |
3,208 |
$21K |
| J3490 |
Unclassified drugs |
27,211 |
9,786 |
$21K |
| 71046 |
Radiologic examination, chest; 2 views |
3,768 |
3,356 |
$20K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
358 |
350 |
$19K |
| 84403 |
|
2,090 |
1,971 |
$19K |
| 93017 |
|
418 |
365 |
$19K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
6,376 |
6,090 |
$18K |
| 83605 |
|
3,977 |
3,101 |
$18K |
| 85652 |
|
10,377 |
9,643 |
$18K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
279 |
244 |
$17K |
| 86803 |
|
5,439 |
5,136 |
$17K |
| 86301 |
|
2,393 |
1,651 |
$17K |
| 83550 |
|
6,247 |
5,923 |
$16K |
| 90686 |
|
1,648 |
1,567 |
$16K |
| 82784 |
|
2,909 |
2,181 |
$16K |
| 82570 |
|
5,970 |
5,343 |
$15K |
| 87637 |
Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV |
702 |
663 |
$15K |
| 87040 |
|
2,199 |
1,197 |
$14K |
| 86481 |
|
1,030 |
987 |
$14K |
| 83540 |
|
6,331 |
5,994 |
$14K |
| 88342 |
|
2,815 |
2,425 |
$14K |
| 11102 |
|
54 |
53 |
$14K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
2,420 |
2,311 |
$14K |
| 31579 |
|
51 |
51 |
$13K |
| 43248 |
|
28 |
24 |
$12K |
| 92202 |
|
1,219 |
1,143 |
$12K |
| 90715 |
|
834 |
809 |
$12K |
| 87088 |
|
9,468 |
8,375 |
$12K |
| 86480 |
|
891 |
852 |
$12K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
762 |
357 |
$12K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
6,983 |
6,284 |
$11K |
| 92134 |
|
2,623 |
2,404 |
$11K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
6,464 |
4,355 |
$10K |
| 86360 |
|
1,045 |
989 |
$10K |
| 51798 |
|
1,394 |
1,147 |
$10K |
| 87340 |
|
3,737 |
3,478 |
$10K |
| 81001 |
|
16,146 |
13,980 |
$10K |
| 80076 |
|
2,196 |
2,046 |
$9K |
| 85610 |
|
11,531 |
8,739 |
$9K |
| 82105 |
|
1,475 |
1,368 |
$9K |
| 93242 |
|
288 |
279 |
$9K |
| 11100 |
|
28 |
26 |
$9K |
| 82670 |
|
817 |
774 |
$9K |
| 83735 |
|
9,804 |
6,542 |
$8K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
7,968 |
6,644 |
$8K |
| 87205 |
|
5,507 |
4,713 |
$8K |
| 86706 |
|
3,253 |
2,995 |
$8K |
| 86038 |
|
2,172 |
2,017 |
$8K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
1,055 |
810 |
$7K |
| 87799 |
|
1,463 |
954 |
$7K |
| 85007 |
|
5,640 |
4,229 |
$7K |
| 43264 |
|
28 |
24 |
$7K |
| 31231 |
|
51 |
49 |
$7K |
| 80197 |
|
3,154 |
1,668 |
$7K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
196 |
192 |
$7K |
| 82746 |
|
2,349 |
2,214 |
$6K |
| 82947 |
|
19,700 |
9,880 |
$6K |
| 83516 |
|
1,987 |
1,477 |
$6K |
| J1453 |
Injection, fosaprepitant, 1 mg |
120 |
68 |
$6K |
| 71045 |
Radiologic examination, chest; single view |
6,983 |
5,966 |
$6K |
| 91010 |
|
50 |
43 |
$6K |
| 92567 |
|
1,065 |
1,027 |
$6K |
| G0103 |
Prostate cancer screening; prostate specific antigen test (psa) |
1,906 |
1,834 |
$6K |
| C1769 |
Guide wire |
3,485 |
2,843 |
$6K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
868 |
784 |
$6K |
| 86704 |
|
2,401 |
2,197 |
$6K |
| 92133 |
|
1,067 |
1,019 |
$6K |
| 87081 |
|
1,741 |
1,633 |
$6K |
| 95886 |
|
39 |
37 |
$6K |
| 93325 |
|
634 |
561 |
$6K |
| 93243 |
|
288 |
279 |
$5K |
| 86160 |
|
2,596 |
1,413 |
$5K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
10,949 |
9,449 |
$5K |
| 87077 |
|
4,878 |
3,434 |
$5K |
| 97802 |
|
214 |
189 |
$5K |
| 82043 |
|
3,642 |
3,483 |
$5K |
| 87070 |
|
3,062 |
2,553 |
$5K |
| 97535 |
Self-care/home management training, each 15 minutes |
479 |
279 |
$5K |
| 43235 |
|
13 |
13 |
$5K |
| 43237 |
|
13 |
12 |
$4K |
| 71250 |
|
142 |
117 |
$4K |
| 93296 |
|
478 |
454 |
$4K |
| 70496 |
|
46 |
39 |
$4K |
| 85379 |
|
978 |
913 |
$4K |
| 87186 |
|
4,519 |
3,674 |
$4K |
| 73030 |
|
901 |
747 |
$4K |
| 76882 |
|
56 |
51 |
$4K |
| 83690 |
|
7,509 |
6,504 |
$4K |
| 82565 |
|
7,473 |
6,332 |
$4K |
| 96127 |
|
86 |
75 |
$4K |
| 85027 |
|
5,909 |
4,326 |
$4K |
| 73630 |
|
1,085 |
897 |
$4K |
| 45378 |
Colonoscopy, flexible; diagnostic, including collection of specimen(s) |
12 |
12 |
$4K |
| 97116 |
|
348 |
241 |
$4K |
| 82550 |
|
2,167 |
1,848 |
$4K |
| 51600 |
|
40 |
39 |
$4K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
289 |
282 |
$4K |
| 76642 |
|
51 |
43 |
$3K |
| 70486 |
|
91 |
86 |
$3K |
| 86850 |
|
2,271 |
1,900 |
$3K |
| G0481 |
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; 8-14 drug class(es), including metabolite(s) if performed |
80 |
73 |
$3K |
| 87497 |
|
325 |
270 |
$3K |
| 86431 |
|
1,435 |
1,377 |
$3K |
| 94010 |
|
470 |
449 |
$3K |
| 84165 |
|
1,191 |
1,134 |
$3K |
| 87522 |
Neg quan hep c or qual rna |
236 |
221 |
$3K |
| 86900 |
|
2,848 |
1,989 |
$3K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
371 |
359 |
$3K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
305 |
271 |
$3K |
| 17110 |
|
50 |
49 |
$3K |
| 51729 |
|
26 |
26 |
$3K |
| 88304 |
|
865 |
824 |
$3K |
| 10060 |
|
12 |
12 |
$3K |
| 73564 |
|
376 |
277 |
$2K |
| 88341 |
|
925 |
722 |
$2K |
| 84550 |
|
1,619 |
1,518 |
$2K |
| 0124A |
|
199 |
190 |
$2K |
| 88112 |
|
515 |
436 |
$2K |
| 88307 |
|
236 |
203 |
$2K |
| 86200 |
|
1,061 |
1,011 |
$2K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
61 |
55 |
$2K |
| 82274 |
|
556 |
543 |
$2K |
| 84702 |
|
571 |
480 |
$2K |
| 82378 |
|
1,437 |
1,125 |
$2K |
| 84156 |
|
2,384 |
2,073 |
$2K |
| 88312 |
|
443 |
405 |
$2K |
| 72100 |
|
322 |
303 |
$2K |
| 94761 |
|
26,682 |
22,263 |
$2K |
| 0296T |
|
183 |
165 |
$2K |
| 84100 |
|
4,312 |
2,672 |
$2K |
| C9257 |
Injection, bevacizumab, 0.25 mg |
95 |
48 |
$2K |
| 74455 |
|
37 |
36 |
$2K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
7,553 |
5,664 |
$2K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
185 |
173 |
$2K |
| 74170 |
|
24 |
18 |
$2K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
358 |
337 |
$2K |
| J2704 |
Injection, propofol, 10 mg |
15,088 |
10,325 |
$2K |
| 73502 |
|
388 |
363 |
$2K |
| 0004A |
|
75 |
71 |
$2K |
| C1894 |
Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser |
2,014 |
1,595 |
$2K |
| 83001 |
|
170 |
163 |
$2K |
| 86364 |
|
440 |
420 |
$2K |
| 86901 |
|
2,906 |
2,030 |
$2K |
| 94729 |
|
349 |
334 |
$2K |
| 31575 |
|
12 |
12 |
$2K |
| 96417 |
|
1,168 |
651 |
$2K |
| 83615 |
|
1,357 |
1,186 |
$2K |
| 73610 |
|
417 |
356 |
$2K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
24 |
24 |
$2K |
| 95910 |
|
15 |
13 |
$2K |
| 85014 |
|
1,850 |
1,481 |
$1K |
| 73130 |
|
438 |
372 |
$1K |
| 91200 |
|
18 |
17 |
$1K |
| 93320 |
|
46 |
38 |
$1K |
| 0054A |
|
101 |
97 |
$1K |
| G0008 |
Administration of influenza virus vaccine |
1,192 |
1,120 |
$1K |
| 73110 |
|
336 |
274 |
$1K |
| 0297T |
|
183 |
165 |
$1K |
| 93351 |
|
31 |
31 |
$1K |
| 51728 |
|
14 |
13 |
$1K |
| 84703 |
|
1,429 |
1,328 |
$1K |
| 96523 |
|
29 |
24 |
$1K |
| 87563 |
|
204 |
184 |
$1K |
| 77077 |
|
177 |
124 |
$1K |
| 85730 |
|
2,218 |
1,979 |
$1K |
| 82248 |
|
336 |
316 |
$985.39 |
| 80051 |
|
595 |
381 |
$966.99 |
| 36591 |
|
726 |
641 |
$930.12 |
| 87808 |
|
445 |
431 |
$912.30 |
| 80069 |
|
288 |
215 |
$894.51 |
| 74330 |
|
16 |
13 |
$893.64 |
| J1610 |
Injection, glucagon hydrochloride, per 1 mg |
30 |
24 |
$878.36 |
| 92250 |
|
352 |
328 |
$854.89 |
| 84146 |
|
115 |
108 |
$850.86 |
| 82150 |
|
223 |
205 |
$848.99 |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
13 |
12 |
$817.45 |
| 83520 |
|
183 |
161 |
$763.90 |
| 81025 |
|
5,636 |
5,012 |
$763.14 |
| 81003 |
|
5,458 |
4,902 |
$756.54 |
| 83655 |
|
51 |
46 |
$755.19 |
| 72141 |
|
14 |
13 |
$751.40 |
| 96416 |
|
19 |
12 |
$750.64 |
| 94760 |
|
11,642 |
9,579 |
$740.89 |
| C1889 |
Implantable/insertable device, not otherwise classified |
264 |
218 |
$737.09 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
6,229 |
3,980 |
$726.71 |
| 73562 |
|
229 |
180 |
$707.92 |
| 70498 |
|
43 |
38 |
$706.64 |
| 87631 |
|
71 |
61 |
$649.93 |
| 96521 |
|
142 |
61 |
$631.64 |
| 84155 |
|
536 |
507 |
$586.84 |
| 51784 |
|
14 |
13 |
$574.94 |
| 93350 |
|
58 |
50 |
$562.28 |
| 86255 |
|
63 |
39 |
$556.17 |
| 87147 |
|
615 |
504 |
$537.92 |
| 84480 |
|
174 |
165 |
$536.05 |
| C1726 |
Catheter, balloon dilatation, non-vascular |
247 |
205 |
$520.05 |
| 84153 |
|
166 |
159 |
$509.34 |
| 99152 |
|
412 |
341 |
$467.05 |
| 87633 |
Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets |
54 |
46 |
$463.28 |
| 86807 |
|
47 |
39 |
$455.11 |
| 86812 |
|
27 |
26 |
$451.67 |
| 70491 |
|
13 |
12 |
$451.26 |
| 87075 |
|
1,033 |
870 |
$439.27 |
| C1725 |
Catheter, transluminal angioplasty, non-laser (may include guidance, infusion/perfusion capability) |
109 |
89 |
$417.65 |
| 87338 |
|
92 |
92 |
$411.29 |
| 84436 |
|
145 |
134 |
$390.15 |
| 74220 |
|
42 |
38 |
$388.34 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
11,515 |
9,420 |
$388.05 |
| 84460 |
|
291 |
277 |
$378.05 |
| 86225 |
|
153 |
146 |
$372.26 |
| J1644 |
Injection, heparin sodium, per 1000 units |
10,485 |
4,073 |
$367.93 |
| 87506 |
|
14 |
13 |
$367.86 |
| C1887 |
Catheter, guiding (may include infusion/perfusion capability) |
268 |
195 |
$361.64 |
| 86003 |
|
61 |
53 |
$351.63 |
| G2066 |
Interrogation device evaluation(s), (remote) up to 30 days; implantable cardiovascular physiologic monitor system, implantable loop recorder system, or subcutaneous cardiac rhythm monitor system, remote data acquisition(s), receipt of transmissions and technician review, technical support and distribution of results |
37 |
36 |
$349.93 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
144 |
140 |
$349.12 |
| 84425 |
|
78 |
73 |
$331.69 |
| 83993 |
|
42 |
40 |
$326.91 |
| 86708 |
|
151 |
148 |
$323.23 |
| C2617 |
Stent, non-coronary, temporary, without delivery system |
306 |
258 |
$322.07 |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
39 |
39 |
$316.46 |
| 95004 |
Percutaneous tests with allergenic extracts, immediate type reaction |
245 |
241 |
$309.05 |
| 86359 |
|
93 |
88 |
$305.99 |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
31 |
26 |
$300.44 |
| 83883 |
|
43 |
26 |
$300.37 |
| 84132 |
|
2,021 |
1,525 |
$281.07 |
| 86769 |
|
75 |
73 |
$271.79 |
| 87206 |
|
396 |
254 |
$265.30 |
| 96376 |
|
2,933 |
2,194 |
$257.74 |
| A6021 |
Collagen dressing, sterile, size 16 sq. in. or less, each |
1,190 |
708 |
$255.40 |
| 82805 |
|
531 |
434 |
$247.36 |
| 87046 |
|
115 |
109 |
$238.94 |
| 11721 |
|
28 |
26 |
$236.99 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
6,660 |
5,668 |
$235.13 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
5,219 |
3,931 |
$226.98 |
| 99153 |
Mod sedat endo service >5yrs |
94 |
70 |
$222.26 |
| 84520 |
|
522 |
330 |
$221.38 |
| C1729 |
Catheter, drainage |
968 |
780 |
$213.50 |
| 72040 |
|
29 |
26 |
$211.29 |
| 51741 |
|
81 |
79 |
$203.38 |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
265 |
231 |
$200.04 |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
30 |
27 |
$195.48 |
| M0220 |
Injection, tixagevimab and cilgavimab, for the pre-exposure prophylaxis only, for certain adults and pediatric individuals (12 years of age and older weighing at least 40kg) with no known sars-cov-2 exposure, who either have moderate to severely compromised immune systems or for whom vaccination with any available covid-19 vaccine is not recommended due to a history of severe adverse reaction to a covid-19 vaccine(s) and/or covid-19 vaccine component(s), includes injection and post administration monitoring |
72 |
65 |
$189.46 |
| 97162 |
|
14 |
12 |
$174.17 |
| 82785 |
|
24 |
24 |
$166.31 |
| 87181 |
|
255 |
218 |
$156.06 |
| 86762 |
|
29 |
26 |
$142.94 |
| 90670 |
|
12 |
12 |
$133.96 |
| 92226 |
|
406 |
213 |
$131.23 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
8,661 |
6,403 |
$127.77 |
| 85018 |
|
187 |
138 |
$124.26 |
| 85651 |
|
76 |
69 |
$123.71 |
| J2310 |
Injection, naloxone hydrochloride, per 1 mg |
14 |
12 |
$120.24 |
| 88173 |
|
104 |
83 |
$118.92 |
| 90732 |
|
30 |
29 |
$117.80 |
| 80050 |
General health panel |
78 |
77 |
$116.95 |
| A9585 |
Injection, gadobutrol, 0.1 ml |
1,683 |
1,496 |
$114.21 |
| 90656 |
|
33 |
31 |
$113.16 |
| 83010 |
|
38 |
36 |
$111.80 |
| 90662 |
|
280 |
268 |
$109.84 |
| 87106 |
|
76 |
63 |
$107.16 |
| 86705 |
|
40 |
39 |
$92.98 |
| 89051 |
|
28 |
25 |
$81.32 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
2,436 |
1,746 |
$80.21 |
| 84481 |
|
13 |
13 |
$77.08 |
| 73560 |
|
38 |
26 |
$76.30 |
| 87324 |
|
28 |
26 |
$64.47 |
| 73501 |
|
14 |
14 |
$56.55 |
| 87015 |
|
65 |
37 |
$56.46 |
| 88313 |
|
59 |
50 |
$56.39 |
| 86765 |
|
13 |
13 |
$56.01 |
| 74328 |
|
13 |
12 |
$53.23 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
4,431 |
3,582 |
$50.17 |
| 92285 |
|
13 |
12 |
$42.04 |
| J0171 |
Injection, adrenalin, epinephrine, 0.1 mg |
715 |
596 |
$41.84 |
| 90694 |
|
154 |
144 |
$39.14 |
| 86787 |
|
20 |
15 |
$38.05 |
| 51797 |
|
40 |
39 |
$32.68 |
| 36592 |
|
98 |
69 |
$32.59 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
1,573 |
1,167 |
$30.95 |
| J1030 |
Injection, methylprednisolone acetate, 40 mg |
217 |
204 |
$29.99 |
| A9552 |
Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries |
169 |
151 |
$29.41 |
| 0099U |
|
69 |
63 |
$27.25 |
| 86039 |
|
13 |
12 |
$27.08 |
| 82977 |
|
13 |
12 |
$25.32 |
| J1040 |
Injection, methylprednisolone acetate, 80 mg |
415 |
391 |
$24.97 |
| 84450 |
|
15 |
13 |
$24.60 |
| J3590 |
Unclassified biologics |
146 |
28 |
$24.54 |
| 92083 |
|
12 |
12 |
$24.49 |
| 87102 |
|
47 |
40 |
$24.47 |
| 86235 |
|
19 |
13 |
$22.44 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
2,157 |
1,453 |
$21.96 |
| J1956 |
Injection, levofloxacin, 250 mg |
419 |
318 |
$21.75 |
| J3370 |
Injection, vancomycin hcl, 500 mg |
1,828 |
955 |
$20.50 |
| J1630 |
Injection, haloperidol, up to 5 mg |
3,771 |
3,187 |
$20.41 |
| J7030 |
Infusion, normal saline solution , 1000 cc |
2,789 |
2,470 |
$16.75 |
| J1815 |
Injection, insulin, per 5 units |
4,116 |
1,399 |
$15.94 |
| 85045 |
|
28 |
26 |
$15.93 |
| J2060 |
Injection, lorazepam, 2 mg |
1,901 |
1,379 |
$15.87 |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
428 |
306 |
$14.39 |
| 82310 |
|
14 |
12 |
$13.80 |
| J8499 |
Prescription drug, oral, non chemotherapeutic, nos |
874 |
387 |
$12.83 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
486 |
444 |
$12.14 |
| J3480 |
Injection, potassium chloride, per 2 meq |
127 |
81 |
$12.12 |
| 87184 |
|
33 |
25 |
$9.63 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
109 |
89 |
$7.09 |
| 36416 |
|
76 |
69 |
$6.86 |
| G0279 |
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) |
29 |
27 |
$5.23 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
1,519 |
1,115 |
$5.02 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
972 |
714 |
$4.78 |
| J1010 |
Injection, methylprednisolone acetate, 1 mg |
107 |
102 |
$3.84 |
| J2370 |
Injection, phenylephrine hcl, up to 1 ml |
196 |
155 |
$2.70 |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
1,448 |
344 |
$2.61 |
| J0689 |
Injection, cefazolin sodium (baxter), not therapeutically equivalent to j0690, 500 mg |
838 |
748 |
$2.20 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
557 |
308 |
$1.01 |
| 95874 |
|
140 |
127 |
$0.84 |
| 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 |
576 |
414 |
$0.64 |
| J2272 |
Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg |
33 |
26 |
$0.07 |
| 91300 |
|
112 |
92 |
$0.00 |
| 0202U |
Oncology (prostate), multianalyte, gene expression profiling |
45 |
41 |
$0.00 |
| C1713 |
Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) |
13 |
13 |
$0.00 |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
118 |
111 |
$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 |
81 |
72 |
$0.00 |
| J0640 |
Injection, leucovorin calcium, per 50 mg |
144 |
85 |
$0.00 |
| C9113 |
Injection, pantoprazole sodium, per vial |
156 |
89 |
$0.00 |
| J9190 |
Injection, fluorouracil, 500 mg |
164 |
98 |
$0.00 |
| C1760 |
Closure device, vascular (implantable/insertable) |
17 |
12 |
$0.00 |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
387 |
338 |
$0.00 |
| A6210 |
Foam dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing |
15 |
12 |
$0.00 |
| A6212 |
Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing |
61 |
38 |
$0.00 |
| 93356 |
|
12 |
12 |
$0.00 |
| G8978 |
Mobility: walking & moving around functional limitation, current status, at therapy episode outset and at reporting intervals |
80 |
72 |
$0.00 |
| 51701 |
|
16 |
12 |
$0.00 |
| J1171 |
Injection, hydromorphone, 0.1 mg |
119 |
82 |
$0.00 |
| C1758 |
Catheter, ureteral |
14 |
14 |
$0.00 |
| 76000 |
|
17 |
15 |
$0.00 |
| 90653 |
|
17 |
17 |
$0.00 |
| 96411 |
|
106 |
61 |
$0.00 |
| J3535 |
Drug administered through a metered dose inhaler |
67 |
56 |
$0.00 |
| 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 |
279 |
105 |
$0.00 |
| G0009 |
Administration of pneumococcal vaccine |
26 |
25 |
$0.00 |
| J3420 |
Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg |
92 |
77 |
$0.00 |
| J7999 |
Compounded drug, not otherwise classified |
340 |
300 |
$0.00 |
| J0330 |
Injection, succinylcholine chloride, up to 20 mg |
36 |
34 |
$0.00 |
| J2470 |
Injection, pantoprazole sodium, 40 mg |
25 |
12 |
$0.00 |
| J0461 |
Injection, atropine sulfate, 0.01 mg |
60 |
42 |
$0.00 |
| J1250 |
Injection, dobutamine hydrochloride, per 250 mg |
14 |
13 |
$0.00 |
| C9399 |
Unclassified drugs or biologicals |
137 |
39 |
$0.00 |
| A6213 |
Foam dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing |
17 |
12 |
$0.00 |
| Q9968 |
Injection, non-radioactive, non-contrast, visualization adjunct (e.g., methylene blue, isosulfan blue), 1 mg |
31 |
25 |
$0.00 |
| 91305 |
|
13 |
12 |
$0.00 |
| 95911 |
|
13 |
12 |
$0.00 |
| J2795 |
Injection, ropivacaine hydrochloride, 1 mg |
17 |
15 |
$0.00 |
| 0352U |
|
18 |
18 |
$0.00 |
| J2003 |
Injection, lidocaine hydrochloride, 1 mg |
21 |
19 |
$0.00 |
| 96368 |
|
12 |
12 |
$0.00 |