| Code | Description | Claims | Beneficiaries | Total Paid |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
85,398 |
83,694 |
$10.33M |
| 99472 |
Subsequent inpatient pediatric critical care, per day, 2-5 years |
16,084 |
2,346 |
$10.26M |
| 99469 |
Subsequent inpatient neonatal critical care, per day, 28 days or younger |
10,952 |
2,349 |
$6.66M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
26,887 |
26,394 |
$4.63M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
51,703 |
50,784 |
$3.95M |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
18,730 |
18,702 |
$3.78M |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
33,703 |
15,900 |
$3.73M |
| 99233 |
Prolong inpt eval add15 m |
21,145 |
8,677 |
$2.84M |
| 99479 |
Subsequent intensive care, per day, very low birth weight infant |
13,488 |
2,809 |
$2.60M |
| 99480 |
Subsequent intensive care, per day, low birth weight infant |
11,705 |
2,687 |
$2.13M |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
15,787 |
15,780 |
$1.99M |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
6,616 |
2,436 |
$1.94M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
19,998 |
19,791 |
$1.90M |
| 99215 |
Prolong outpt/office vis |
10,659 |
10,151 |
$1.83M |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
29,417 |
29,120 |
$1.82M |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
6,840 |
6,840 |
$1.76M |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
10,508 |
9,656 |
$1.71M |
| 99238 |
Hospital discharge day management, 30 minutes or less |
14,995 |
14,820 |
$1.68M |
| 01967 |
Neuraxial labor analgesia/anesthesia for planned vaginal delivery |
3,229 |
3,229 |
$1.46M |
| 93303 |
Transthoracic echocardiography for congenital cardiac anomalies, follow-up or limited study |
9,599 |
8,483 |
$1.32M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
4,817 |
4,743 |
$1.27M |
| 99468 |
|
857 |
832 |
$1.22M |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
10,247 |
10,133 |
$1.16M |
| 99471 |
|
929 |
889 |
$1.16M |
| 76819 |
Fetal biophysical profile; without non-stress testing |
8,844 |
7,072 |
$1.15M |
| 71045 |
Radiologic examination, chest; single view |
82,363 |
46,772 |
$1.00M |
| 99222 |
Initial hospital care, per day, moderate complexity |
4,434 |
4,305 |
$887K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
4,267 |
4,267 |
$875K |
| 76801 |
|
4,608 |
4,608 |
$838K |
| 99460 |
|
5,406 |
5,399 |
$813K |
| 99205 |
Prolong outpt/office vis |
2,935 |
2,931 |
$771K |
| 01922 |
|
2,580 |
2,489 |
$747K |
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
475 |
475 |
$606K |
| 99223 |
Prolong inpt eval add15 m |
2,653 |
2,567 |
$595K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
5,543 |
5,486 |
$584K |
| 70450 |
Computed tomography, head or brain; without contrast material |
9,795 |
9,262 |
$507K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
3,227 |
3,187 |
$481K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
6,848 |
6,784 |
$464K |
| 76770 |
|
8,154 |
8,077 |
$445K |
| 93304 |
|
5,438 |
3,928 |
$419K |
| 93320 |
|
10,850 |
8,786 |
$389K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
9,173 |
8,978 |
$384K |
| 93000 |
|
15,178 |
14,607 |
$377K |
| 95819 |
|
764 |
763 |
$345K |
| 42820 |
Tonsillectomy and adenoidectomy; younger than age 12 |
757 |
756 |
$336K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
5,965 |
5,914 |
$333K |
| 99462 |
|
4,768 |
3,659 |
$317K |
| 71046 |
Radiologic examination, chest; 2 views |
19,546 |
18,971 |
$296K |
| 90791 |
Psychiatric diagnostic evaluation |
2,360 |
2,360 |
$292K |
| 74018 |
|
21,966 |
15,834 |
$291K |
| 99476 |
|
487 |
106 |
$266K |
| 99221 |
|
1,934 |
1,863 |
$259K |
| 69436 |
Tympanostomy (requiring insertion of ventilating tube), general anesthesia |
990 |
989 |
$251K |
| 90833 |
Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) |
2,181 |
2,148 |
$226K |
| 88307 |
|
2,596 |
2,586 |
$210K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
2,146 |
2,145 |
$202K |
| 76506 |
|
3,890 |
3,125 |
$192K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
1,852 |
1,840 |
$187K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
950 |
950 |
$182K |
| 92579 |
|
4,466 |
4,451 |
$178K |
| 99477 |
|
317 |
312 |
$176K |
| 93325 |
|
18,547 |
13,460 |
$171K |
| 00170 |
Anesthesia for intraoral procedures, including biopsy |
521 |
520 |
$157K |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
11,194 |
8,352 |
$152K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
2,401 |
2,389 |
$150K |
| 01961 |
|
406 |
405 |
$141K |
| 95810 |
Polysomnography; sleep staging with 4 or more additional parameters |
764 |
763 |
$141K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
779 |
778 |
$125K |
| 96040 |
|
3,146 |
3,134 |
$124K |
| H0004 |
Behavioral health counseling and therapy, per 15 minutes |
1,997 |
1,130 |
$123K |
| 92567 |
|
9,475 |
9,447 |
$120K |
| 99217 |
|
1,090 |
1,082 |
$119K |
| 95782 |
|
587 |
587 |
$118K |
| 90960 |
End-stage renal disease related services monthly, for patients 20 years and older, with 4 or more face-to-face visits |
1,433 |
1,433 |
$118K |
| 44970 |
|
125 |
125 |
$118K |
| 92557 |
|
3,687 |
3,677 |
$114K |
| 99475 |
|
129 |
127 |
$113K |
| 94010 |
|
3,055 |
3,017 |
$111K |
| 93321 |
|
7,062 |
5,272 |
$105K |
| 95951 |
|
252 |
108 |
$104K |
| 74019 |
|
5,752 |
5,529 |
$103K |
| 99239 |
Hospital discharge day management, more than 30 minutes |
578 |
569 |
$91K |
| 77066 |
Tomosynthesis, mammo |
523 |
523 |
$90K |
| 93317 |
|
575 |
302 |
$87K |
| 42830 |
|
286 |
286 |
$87K |
| 97803 |
|
2,306 |
2,249 |
$86K |
| 93970 |
|
2,224 |
2,018 |
$82K |
| 76642 |
|
765 |
763 |
$81K |
| 72170 |
|
6,105 |
6,042 |
$81K |
| 99231 |
Subsequent hospital care, per day, straightforward or low complexity |
1,361 |
839 |
$79K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
4,542 |
4,520 |
$77K |
| 54150 |
|
526 |
525 |
$76K |
| 54161 |
|
274 |
274 |
$75K |
| 77427 |
|
298 |
152 |
$73K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
2,021 |
2,016 |
$72K |
| 90961 |
|
668 |
668 |
$71K |
| J9355 |
Injection, trastuzumab, excludes biosimilar, 10 mg |
21 |
12 |
$68K |
| 93308 |
|
1,224 |
1,014 |
$67K |
| 93315 |
|
327 |
201 |
$66K |
| 88342 |
|
1,835 |
1,810 |
$64K |
| 96112 |
|
533 |
533 |
$64K |
| 99219 |
|
321 |
320 |
$62K |
| 97802 |
|
1,139 |
1,131 |
$61K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
490 |
426 |
$60K |
| 59426 |
|
50 |
50 |
$59K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
499 |
499 |
$59K |
| 72082 |
|
2,313 |
2,300 |
$57K |
| 94060 |
|
1,069 |
1,026 |
$56K |
| 73590 |
|
3,948 |
3,618 |
$56K |
| 93227 |
|
1,261 |
1,257 |
$51K |
| 96127 |
|
7,562 |
7,507 |
$51K |
| 78815 |
Positron emission tomography (PET) for limited area imaging |
379 |
377 |
$49K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
418 |
414 |
$49K |
| 95816 |
|
201 |
201 |
$49K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
687 |
685 |
$45K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
576 |
574 |
$43K |
| 00731 |
|
342 |
312 |
$43K |
| 74230 |
|
1,033 |
1,023 |
$41K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
282 |
272 |
$41K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
4,502 |
4,460 |
$41K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
628 |
622 |
$38K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
356 |
356 |
$35K |
| 96111 |
|
294 |
294 |
$33K |
| Q4040 |
Cast supplies, short leg cast, pediatric (0-10 years), fiberglass |
555 |
343 |
$30K |
| 29450 |
|
187 |
87 |
$29K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
1,467 |
1,285 |
$29K |
| 73070 |
|
2,221 |
1,974 |
$29K |
| 59400 |
Routine obstetric care including antepartum care, vaginal delivery, and postpartum care |
12 |
12 |
$28K |
| 93225 |
|
815 |
802 |
$28K |
| 25600 |
|
102 |
101 |
$28K |
| 95251 |
|
704 |
696 |
$27K |
| 73090 |
|
1,998 |
1,779 |
$27K |
| 51798 |
|
2,378 |
2,348 |
$27K |
| 96118 |
|
95 |
70 |
$26K |
| 73630 |
|
1,849 |
1,734 |
$25K |
| 51741 |
|
1,956 |
1,938 |
$25K |
| 90962 |
|
296 |
296 |
$25K |
| 51600 |
|
356 |
356 |
$24K |
| 76885 |
|
402 |
400 |
$24K |
| 93971 |
|
936 |
923 |
$24K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
730 |
723 |
$24K |
| 73551 |
|
1,662 |
1,539 |
$21K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
80 |
79 |
$21K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
282 |
236 |
$21K |
| 71250 |
|
455 |
449 |
$19K |
| 59514 |
|
12 |
12 |
$19K |
| 73610 |
|
1,385 |
1,314 |
$19K |
| 72132 |
|
187 |
186 |
$18K |
| 96409 |
|
142 |
110 |
$17K |
| 99218 |
|
120 |
118 |
$17K |
| 73552 |
|
1,163 |
1,085 |
$16K |
| 93567 |
|
193 |
188 |
$16K |
| 99155 |
|
107 |
105 |
$16K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
162 |
161 |
$16K |
| 76536 |
|
384 |
379 |
$15K |
| 95720 |
|
55 |
27 |
$15K |
| 76825 |
|
47 |
43 |
$15K |
| 85060 |
|
836 |
815 |
$15K |
| 73560 |
|
1,016 |
940 |
$15K |
| 76800 |
|
153 |
150 |
$15K |
| 99156 |
|
114 |
114 |
$14K |
| 73100 |
|
1,017 |
942 |
$14K |
| 90847 |
Family psychotherapy with the patient present, 50 minutes |
185 |
153 |
$14K |
| 90837 |
Psychotherapy, 53 minutes with patient |
307 |
167 |
$14K |
| 96156 |
|
205 |
205 |
$14K |
| 73562 |
|
1,174 |
1,047 |
$13K |
| Q4008 |
Cast supplies, long arm cast, pediatric (0-10 years), fiberglass |
296 |
291 |
$13K |
| 72129 |
|
139 |
139 |
$13K |
| 99235 |
|
51 |
51 |
$13K |
| 93228 |
|
303 |
301 |
$12K |
| 88304 |
|
1,158 |
1,157 |
$12K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,135 |
1,088 |
$12K |
| 74455 |
|
342 |
342 |
$12K |
| 77072 |
|
811 |
811 |
$12K |
| 90935 |
Hemodialysis procedure with single evaluation by a physician |
511 |
204 |
$12K |
| 96154 |
|
504 |
422 |
$11K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
226 |
224 |
$11K |
| 54640 |
|
12 |
12 |
$11K |
| 74240 |
|
157 |
157 |
$10K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
96 |
96 |
$10K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
258 |
202 |
$10K |
| 90832 |
Psychotherapy, 30 minutes with patient |
191 |
170 |
$9K |
| 73130 |
|
694 |
658 |
$9K |
| 36415 |
Collection of venous blood by venipuncture |
3,773 |
3,650 |
$9K |
| 96133 |
|
29 |
29 |
$9K |
| 92551 |
|
771 |
770 |
$9K |
| 99478 |
|
43 |
12 |
$8K |
| 77065 |
Tomosynthesis, mammo |
75 |
74 |
$8K |
| 99157 |
|
48 |
48 |
$8K |
| 01920 |
|
12 |
12 |
$8K |
| 76830 |
Ultrasound, transvaginal |
160 |
159 |
$8K |
| 69620 |
|
12 |
12 |
$8K |
| 51728 |
|
26 |
26 |
$8K |
| 99442 |
|
215 |
209 |
$7K |
| 96132 |
|
61 |
54 |
$7K |
| 90674 |
|
304 |
303 |
$7K |
| 93533 |
|
13 |
13 |
$7K |
| 88341 |
|
81 |
80 |
$6K |
| 36620 |
|
90 |
90 |
$6K |
| 99051 |
|
869 |
857 |
$6K |
| 42821 |
|
12 |
12 |
$6K |
| 91200 |
|
170 |
170 |
$5K |
| 00790 |
|
15 |
14 |
$5K |
| 77334 |
|
39 |
26 |
$5K |
| H0002 |
Behavioral health screening to determine eligibility for admission to treatment program |
208 |
208 |
$5K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
247 |
228 |
$5K |
| 73030 |
|
523 |
478 |
$5K |
| 90715 |
|
165 |
165 |
$5K |
| 99443 |
|
70 |
67 |
$5K |
| 92587 |
|
259 |
259 |
$5K |
| 76870 |
|
103 |
102 |
$5K |
| 93018 |
|
216 |
216 |
$5K |
| 96101 |
|
32 |
30 |
$5K |
| 92593 |
|
116 |
113 |
$5K |
| 88112 |
|
257 |
249 |
$5K |
| 36226 |
|
12 |
12 |
$4K |
| 72158 |
|
28 |
28 |
$4K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
145 |
144 |
$4K |
| 96158 |
|
136 |
133 |
$4K |
| 74241 |
|
76 |
76 |
$4K |
| 96151 |
|
154 |
142 |
$4K |
| 72100 |
|
282 |
280 |
$4K |
| 00300 |
|
13 |
13 |
$3K |
| 72081 |
|
173 |
168 |
$3K |
| 99220 |
|
13 |
13 |
$3K |
| 73140 |
|
312 |
294 |
$3K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
233 |
229 |
$3K |
| 95813 |
|
30 |
29 |
$3K |
| 96450 |
|
26 |
25 |
$3K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
24 |
24 |
$3K |
| 51797 |
|
24 |
24 |
$3K |
| H0031 |
Mental health assessment, by non-physician |
29 |
29 |
$3K |
| 70486 |
|
50 |
50 |
$3K |
| 74178 |
|
34 |
34 |
$3K |
| 95886 |
|
36 |
36 |
$3K |
| 95117 |
|
260 |
147 |
$3K |
| 92523 |
|
16 |
16 |
$3K |
| 73080 |
|
189 |
176 |
$3K |
| 96139 |
|
13 |
13 |
$3K |
| 93975 |
|
26 |
25 |
$3K |
| 99152 |
|
190 |
177 |
$2K |
| J2469 |
Injection, palonosetron hcl, 25 mcg |
15 |
13 |
$2K |
| 96113 |
|
29 |
29 |
$2K |
| 95811 |
|
12 |
12 |
$2K |
| 76882 |
|
64 |
61 |
$2K |
| 73600 |
|
156 |
150 |
$2K |
| 93566 |
|
27 |
26 |
$2K |
| 41010 |
|
14 |
14 |
$2K |
| 90686 |
|
407 |
407 |
$2K |
| 88302 |
|
191 |
191 |
$2K |
| 73110 |
|
158 |
147 |
$2K |
| 93244 |
|
49 |
49 |
$2K |
| 93565 |
|
27 |
26 |
$2K |
| 72157 |
|
13 |
13 |
$2K |
| 11100 |
|
15 |
15 |
$2K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
15 |
15 |
$2K |
| 82948 |
|
390 |
386 |
$2K |
| 85610 |
|
457 |
298 |
$2K |
| 77014 |
|
33 |
12 |
$2K |
| 31622 |
|
12 |
12 |
$2K |
| 51784 |
|
54 |
54 |
$2K |
| 93568 |
|
25 |
25 |
$2K |
| 88312 |
|
28 |
25 |
$2K |
| 77076 |
|
27 |
25 |
$1K |
| 72040 |
|
110 |
107 |
$1K |
| 69200 |
|
22 |
22 |
$1K |
| Q4012 |
Cast supplies, short arm cast, pediatric (0-10 years), fiberglass |
33 |
31 |
$1K |
| 36011 |
|
12 |
12 |
$1K |
| 73060 |
|
112 |
103 |
$1K |
| 99441 |
|
39 |
39 |
$1K |
| 99100 |
|
69 |
69 |
$1K |
| 82962 |
|
471 |
464 |
$1K |
| 74022 |
|
55 |
38 |
$1K |
| 99173 |
|
466 |
466 |
$1K |
| 70496 |
|
12 |
12 |
$1K |
| 93294 |
|
29 |
27 |
$1K |
| 70250 |
|
68 |
65 |
$1K |
| 73620 |
|
88 |
82 |
$1K |
| 77001 |
|
44 |
44 |
$1K |
| 76820 |
|
14 |
12 |
$1K |
| 72141 |
|
12 |
12 |
$1K |
| 11721 |
|
84 |
84 |
$1K |
| 92588 |
|
37 |
37 |
$953.48 |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
12 |
12 |
$947.45 |
| 70491 |
|
12 |
12 |
$877.06 |
| 77080 |
|
15 |
15 |
$876.13 |
| 96152 |
|
19 |
12 |
$851.88 |
| 12011 |
|
12 |
12 |
$843.09 |
| 95012 |
|
54 |
54 |
$830.00 |
| 73502 |
|
85 |
82 |
$824.08 |
| 73700 |
|
15 |
12 |
$814.05 |
| 85097 |
|
16 |
13 |
$786.42 |
| J9370 |
Vincristine sulfate, 1 mg |
104 |
90 |
$743.94 |
| 93298 |
|
15 |
13 |
$683.60 |
| 93316 |
|
14 |
13 |
$682.08 |
| 51705 |
|
14 |
13 |
$656.33 |
| 75820 |
|
13 |
13 |
$625.04 |
| 77280 |
|
12 |
12 |
$605.96 |
| 99495 |
|
38 |
38 |
$537.33 |
| 76775 |
|
12 |
12 |
$502.87 |
| 88313 |
|
16 |
15 |
$482.08 |
| 93923 |
|
25 |
25 |
$477.42 |
| 88173 |
|
13 |
13 |
$460.86 |
| 90474 |
|
26 |
26 |
$447.08 |
| 36416 |
|
175 |
165 |
$424.56 |
| 92556 |
|
14 |
14 |
$420.14 |
| 86077 |
|
14 |
13 |
$403.86 |
| 96367 |
|
14 |
13 |
$382.50 |
| 96138 |
|
13 |
13 |
$373.08 |
| 96361 |
Intravenous infusion, hydration; each additional hour |
12 |
12 |
$333.20 |
| J1626 |
Injection, granisetron hydrochloride, 100 mcg |
101 |
70 |
$326.65 |
| 90688 |
|
17 |
17 |
$303.28 |
| 73000 |
|
18 |
17 |
$262.26 |
| 93926 |
|
13 |
13 |
$260.67 |
| 74420 |
|
12 |
12 |
$246.22 |
| 87220 |
|
57 |
56 |
$216.24 |
| 76010 |
|
15 |
14 |
$190.50 |
| 82010 |
|
12 |
12 |
$87.24 |
| G0279 |
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) |
15 |
15 |
$74.36 |
| 20610 |
|
12 |
12 |
$70.89 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
39 |
38 |
$45.38 |
| J7611 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, concentrated form, 1 mg |
34 |
33 |
$4.76 |