| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
Emergency department visit for the evaluation and management, high severity |
11,534 |
10,145 |
$1.74M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
6,613 |
5,904 |
$1.49M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
9,821 |
9,113 |
$1.04M |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
13,943 |
10,682 |
$714K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
8,244 |
6,070 |
$460K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
5,464 |
2,966 |
$414K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
5,938 |
5,152 |
$394K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
2,802 |
2,562 |
$334K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
12,582 |
3,500 |
$283K |
| 87637 |
Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV |
3,037 |
2,831 |
$239K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
2,778 |
1,950 |
$177K |
| 70450 |
Computed tomography, head or brain; without contrast material |
1,981 |
1,797 |
$145K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
715 |
686 |
$138K |
| 59025 |
Fetal non-stress test |
1,575 |
692 |
$133K |
| 71046 |
Radiologic examination, chest; 2 views |
4,364 |
4,023 |
$126K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
6,015 |
4,581 |
$121K |
| 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 |
2,564 |
2,357 |
$112K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
4,561 |
1,960 |
$100K |
| 80053 |
Comprehensive metabolic panel |
26,131 |
21,663 |
$90K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
295 |
275 |
$90K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
5,782 |
1,859 |
$87K |
| 80061 |
Lipid panel |
5,508 |
5,376 |
$78K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
1,124 |
1,093 |
$71K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
27,735 |
22,786 |
$67K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
3,530 |
1,211 |
$66K |
| 84443 |
Thyroid stimulating hormone (TSH) |
8,322 |
7,882 |
$61K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
2,807 |
2,719 |
$58K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
2,806 |
2,719 |
$58K |
| 71045 |
Radiologic examination, chest; single view |
2,105 |
1,810 |
$49K |
| 20610 |
|
388 |
354 |
$45K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
1,093 |
1,074 |
$44K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
1,572 |
1,492 |
$44K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
810 |
464 |
$43K |
| 97161 |
|
1,036 |
906 |
$42K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
450 |
404 |
$41K |
| 76830 |
Ultrasound, transvaginal |
695 |
664 |
$36K |
| 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 |
2,835 |
2,298 |
$36K |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
2,048 |
1,995 |
$33K |
| 36415 |
Collection of venous blood by venipuncture |
32,225 |
25,574 |
$29K |
| 95810 |
Polysomnography; sleep staging with 4 or more additional parameters |
67 |
66 |
$29K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
563 |
539 |
$27K |
| 86850 |
|
1,801 |
1,682 |
$24K |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
1,125 |
1,100 |
$24K |
| C9803 |
Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
1,760 |
1,588 |
$22K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
1,507 |
1,472 |
$22K |
| 87088 |
|
6,497 |
5,876 |
$21K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
3,941 |
3,816 |
$21K |
| 94060 |
|
210 |
195 |
$21K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
226 |
212 |
$21K |
| 80306 |
|
3,915 |
3,460 |
$21K |
| 88142 |
|
1,451 |
1,426 |
$20K |
| 80055 |
|
797 |
782 |
$19K |
| 92507 |
Treatment of speech, language, voice, communication, and/or auditory processing disorder |
557 |
174 |
$19K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
446 |
427 |
$18K |
| 96367 |
|
330 |
206 |
$18K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
780 |
713 |
$17K |
| 73630 |
|
1,345 |
1,182 |
$16K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
160 |
152 |
$16K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
79 |
75 |
$16K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
1,749 |
1,285 |
$16K |
| 97597 |
|
329 |
145 |
$15K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
6,962 |
5,924 |
$15K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
139 |
88 |
$15K |
| 81001 |
|
15,270 |
13,269 |
$14K |
| 72100 |
|
487 |
479 |
$14K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
2,419 |
2,239 |
$14K |
| 84439 |
|
2,889 |
2,781 |
$13K |
| 73610 |
|
891 |
791 |
$12K |
| 86703 |
|
1,515 |
1,479 |
$12K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
1,012 |
998 |
$11K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
135 |
125 |
$10K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
3,308 |
2,826 |
$10K |
| 82728 |
|
1,635 |
1,534 |
$10K |
| 84484 |
|
4,544 |
3,456 |
$10K |
| 87186 |
|
2,640 |
2,375 |
$9K |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
162 |
151 |
$9K |
| 87081 |
|
2,464 |
2,380 |
$9K |
| 82607 |
|
1,228 |
1,184 |
$8K |
| 83880 |
|
974 |
818 |
$8K |
| 86618 |
|
1,096 |
537 |
$8K |
| 83735 |
|
5,347 |
4,255 |
$8K |
| 87077 |
|
2,252 |
2,035 |
$8K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
5,047 |
4,210 |
$8K |
| 83605 |
|
3,197 |
2,605 |
$7K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
76 |
39 |
$7K |
| 83690 |
|
4,270 |
3,754 |
$7K |
| 93976 |
|
137 |
123 |
$7K |
| 82803 |
|
1,513 |
1,211 |
$7K |
| 73562 |
|
517 |
441 |
$6K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
543 |
453 |
$6K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
554 |
538 |
$6K |
| 73110 |
|
438 |
378 |
$6K |
| 73130 |
|
544 |
479 |
$6K |
| 81025 |
|
3,109 |
2,893 |
$6K |
| 73030 |
|
536 |
463 |
$6K |
| 84703 |
|
2,046 |
1,928 |
$5K |
| 86140 |
|
3,588 |
3,086 |
$5K |
| 87400 |
|
582 |
556 |
$5K |
| 84702 |
|
811 |
550 |
$5K |
| 85027 |
|
2,279 |
1,931 |
$5K |
| 87653 |
|
326 |
318 |
$5K |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
141 |
119 |
$5K |
| 74019 |
|
574 |
550 |
$5K |
| M0243 |
Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring |
15 |
15 |
$4K |
| M0245 |
Intravenous infusion, bamlanivimab and etesevimab, includes infusion and post administration monitoring |
18 |
16 |
$4K |
| 71271 |
|
80 |
78 |
$4K |
| 87070 |
|
1,207 |
1,083 |
$4K |
| 85610 |
|
3,005 |
2,433 |
$4K |
| 82570 |
|
1,333 |
1,227 |
$4K |
| 87040 |
|
1,678 |
1,012 |
$4K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
30 |
28 |
$4K |
| 87205 |
|
1,911 |
1,739 |
$4K |
| 87147 |
|
1,550 |
1,435 |
$3K |
| 84481 |
|
332 |
324 |
$3K |
| 88342 |
|
329 |
312 |
$3K |
| 93971 |
|
60 |
55 |
$3K |
| 85730 |
|
1,838 |
1,643 |
$2K |
| 85651 |
|
1,524 |
1,395 |
$2K |
| 76775 |
|
75 |
63 |
$2K |
| 86803 |
|
267 |
261 |
$2K |
| 83540 |
|
723 |
680 |
$2K |
| 97113 |
|
35 |
12 |
$2K |
| 82950 |
|
731 |
714 |
$2K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
152 |
114 |
$2K |
| 81220 |
CFTR (cystic fibrosis transmembrane conductance regulator) gene analysis; common variants |
12 |
12 |
$2K |
| 97162 |
|
49 |
43 |
$2K |
| 85007 |
|
1,847 |
1,528 |
$2K |
| 83550 |
|
452 |
420 |
$2K |
| 85379 |
|
857 |
788 |
$2K |
| 87420 |
|
293 |
283 |
$2K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
141 |
129 |
$2K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
26 |
26 |
$2K |
| 95886 |
|
167 |
159 |
$1K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
249 |
240 |
$1K |
| 74018 |
|
113 |
100 |
$1K |
| 84156 |
|
673 |
571 |
$1K |
| 94664 |
|
247 |
128 |
$1K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
78 |
64 |
$1K |
| 86900 |
|
111 |
102 |
$999.78 |
| 87210 |
|
369 |
348 |
$973.16 |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
109 |
90 |
$911.59 |
| Q9969 |
Tc-99m from non-highly enriched uranium source, full cost recovery add-on, per study dose |
158 |
145 |
$824.83 |
| 82746 |
|
130 |
124 |
$796.66 |
| 85652 |
|
805 |
709 |
$787.55 |
| G0297 |
Low dose ct scan (ldct) for lung cancer screening |
20 |
20 |
$766.34 |
| 86677 |
|
247 |
237 |
$704.21 |
| 73502 |
|
89 |
80 |
$698.16 |
| 87468 |
|
44 |
43 |
$621.91 |
| 87469 |
|
44 |
43 |
$617.58 |
| 87484 |
|
44 |
43 |
$615.41 |
| G0378 |
Hospital observation service, per hour |
238 |
186 |
$588.62 |
| 93017 |
|
18 |
13 |
$534.60 |
| 82043 |
|
140 |
138 |
$532.72 |
| 84550 |
|
309 |
247 |
$504.63 |
| 87501 |
|
27 |
26 |
$454.18 |
| 87340 |
|
78 |
76 |
$394.97 |
| 82150 |
|
172 |
161 |
$366.10 |
| 11721 |
|
28 |
26 |
$334.18 |
| 87478 |
|
28 |
27 |
$324.99 |
| 82550 |
|
128 |
103 |
$296.15 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
5,152 |
4,625 |
$280.83 |
| 82784 |
|
26 |
25 |
$275.61 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
46 |
36 |
$274.38 |
| 76377 |
|
4,292 |
3,709 |
$226.69 |
| 84153 |
|
13 |
12 |
$212.96 |
| G0103 |
Prostate cancer screening; prostate specific antigen test (psa) |
12 |
12 |
$146.12 |
| 86706 |
|
25 |
25 |
$138.60 |
| 86901 |
|
227 |
200 |
$132.86 |
| 80076 |
|
27 |
26 |
$124.61 |
| 86038 |
|
13 |
12 |
$114.22 |
| 84145 |
|
29 |
28 |
$112.52 |
| J0136 |
Injection, acetaminophen (b braun), not therapeutically equivalent to j0131, 10 mg |
145 |
128 |
$103.55 |
| 86704 |
|
13 |
13 |
$79.65 |
| J2704 |
Injection, propofol, 10 mg |
2,411 |
2,133 |
$74.33 |
| 84100 |
|
41 |
37 |
$70.66 |
| 86708 |
|
12 |
12 |
$69.10 |
| 84436 |
|
25 |
25 |
$65.58 |
| 36591 |
|
28 |
16 |
$64.79 |
| 84450 |
|
15 |
13 |
$60.14 |
| 74022 |
|
53 |
51 |
$58.26 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
807 |
671 |
$58.10 |
| 86592 |
|
19 |
19 |
$46.53 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
5,811 |
4,836 |
$46.11 |
| 94726 |
|
26 |
25 |
$40.96 |
| 81003 |
|
500 |
451 |
$39.80 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
2,840 |
2,539 |
$28.30 |
| 88304 |
|
41 |
41 |
$27.98 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
1,658 |
1,313 |
$27.20 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
1,047 |
577 |
$26.48 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
3,259 |
2,702 |
$22.50 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
1,926 |
1,721 |
$21.40 |
| 94729 |
|
26 |
25 |
$20.48 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
2,786 |
2,525 |
$18.58 |
| 94727 |
|
25 |
24 |
$15.36 |
| 96376 |
|
974 |
648 |
$10.50 |
| 82962 |
|
15 |
13 |
$10.05 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
6,170 |
5,292 |
$7.80 |
| 99153 |
Mod sedat endo service >5yrs |
204 |
190 |
$3.71 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
1,624 |
1,371 |
$3.31 |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
614 |
524 |
$0.00 |
| 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 |
1,777 |
1,573 |
$0.00 |
| J8540 |
Dexamethasone, oral, 0.25 mg |
232 |
189 |
$0.00 |
| J3490 |
Unclassified drugs |
1,179 |
719 |
$0.00 |
| J7050 |
Infusion, normal saline solution, 250 cc |
1,390 |
801 |
$0.00 |
| J2360 |
Injection, orphenadrine citrate, up to 60 mg |
125 |
114 |
$0.00 |
| J2175 |
Injection, meperidine hydrochloride, per 100 mg |
41 |
41 |
$0.00 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
230 |
208 |
$0.00 |
| J1642 |
Injection, heparin sodium, (heparin lock flush), per 10 units |
249 |
65 |
$0.00 |
| J2060 |
Injection, lorazepam, 2 mg |
521 |
447 |
$0.00 |
| J1790 |
Injection, droperidol, up to 5 mg |
51 |
44 |
$0.00 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
75 |
68 |
$0.00 |
| 99156 |
|
13 |
12 |
$0.00 |
| 94760 |
|
24 |
12 |
$0.00 |
| J0330 |
Injection, succinylcholine chloride, up to 20 mg |
12 |
12 |
$0.00 |
| J2274 |
Injection, morphine sulfate, preservative-free for epidural or intrathecal use, 10 mg |
286 |
219 |
$0.00 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
909 |
720 |
$0.00 |
| G2023 |
Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
1,184 |
1,162 |
$0.00 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
483 |
445 |
$0.00 |
| A9577 |
Injection, gadobenate dimeglumine (multihance), per ml |
394 |
369 |
$0.00 |
| J2550 |
Injection, promethazine hcl, up to 50 mg |
44 |
39 |
$0.00 |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
325 |
299 |
$0.00 |
| J0171 |
Injection, adrenalin, epinephrine, 0.1 mg |
21 |
17 |
$0.00 |
| A9575 |
Injection, gadoterate meglumine, 0.1 ml |
102 |
91 |
$0.00 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
180 |
150 |
$0.00 |
| 99152 |
|
94 |
81 |
$0.00 |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
70 |
58 |
$0.00 |
| A4216 |
Sterile water, saline and/or dextrose, diluent/flush, 10 ml |
30 |
24 |
$0.00 |
| J2710 |
Injection, neostigmine methylsulfate, up to 0.5 mg |
16 |
16 |
$0.00 |
| C9113 |
Injection, pantoprazole sodium, per vial |
28 |
26 |
$0.00 |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
12 |
12 |
$0.00 |
| J1171 |
Injection, hydromorphone, 0.1 mg |
17 |
15 |
$0.00 |