| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
40,820 |
37,285 |
$13.75M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
43,746 |
39,595 |
$11.13M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
40,114 |
37,740 |
$7.16M |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
46,908 |
41,957 |
$3.89M |
| 71045 |
Radiologic examination, chest; single view |
20,491 |
18,591 |
$893K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
7,633 |
6,989 |
$844K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
6,011 |
5,725 |
$593K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
10,843 |
4,253 |
$388K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
914 |
838 |
$302K |
| 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 |
5,366 |
5,054 |
$286K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
504 |
466 |
$238K |
| 70450 |
Computed tomography, head or brain; without contrast material |
2,597 |
2,278 |
$204K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
5,657 |
5,291 |
$175K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
4,606 |
2,059 |
$168K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
1,394 |
553 |
$161K |
| 29581 |
|
1,614 |
603 |
$128K |
| 20610 |
|
418 |
367 |
$118K |
| 71046 |
Radiologic examination, chest; 2 views |
3,105 |
2,840 |
$118K |
| 80053 |
Comprehensive metabolic panel |
91,243 |
83,466 |
$102K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
2,603 |
2,382 |
$92K |
| 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 |
3,495 |
3,302 |
$82K |
| 97597 |
|
1,089 |
573 |
$76K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
804 |
657 |
$69K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
275 |
253 |
$63K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
90,831 |
82,731 |
$50K |
| 80061 |
Lipid panel |
8,010 |
7,638 |
$46K |
| 45385 |
Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) |
101 |
90 |
$44K |
| J1745 |
Injection, infliximab, excludes biosimilar, 10 mg |
34 |
26 |
$41K |
| 36415 |
Collection of venous blood by venipuncture |
85,398 |
77,310 |
$40K |
| 84443 |
Thyroid stimulating hormone (TSH) |
4,929 |
4,693 |
$37K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
1,270 |
1,129 |
$32K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
131 |
125 |
$28K |
| Q5103 |
Injection, infliximab-dyyb, biosimilar, (inflectra), 10 mg |
63 |
55 |
$28K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
401 |
396 |
$27K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
1,332 |
571 |
$22K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
3,809 |
3,628 |
$22K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
1,740 |
1,657 |
$21K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
119 |
117 |
$20K |
| 73110 |
|
419 |
350 |
$18K |
| 95811 |
|
39 |
37 |
$18K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
6,495 |
6,240 |
$16K |
| 96415 |
|
273 |
251 |
$14K |
| 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 |
5,097 |
3,667 |
$14K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
5,080 |
4,437 |
$12K |
| 73564 |
|
187 |
174 |
$10K |
| G0399 |
Home sleep test (hst) with type iii portable monitor, unattended; minimum of 4 channels: 2 respiratory movement/airflow, 1 ecg/heart rate and 1 oxygen saturation |
96 |
94 |
$10K |
| C9803 |
Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
675 |
625 |
$10K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
167 |
103 |
$10K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
43,757 |
37,773 |
$9K |
| 93296 |
|
654 |
621 |
$9K |
| 73030 |
|
139 |
119 |
$6K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
3,260 |
3,083 |
$6K |
| G0008 |
Administration of influenza virus vaccine |
303 |
299 |
$6K |
| 84484 |
|
27,754 |
22,559 |
$6K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
277 |
263 |
$6K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
29 |
26 |
$5K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
237 |
227 |
$5K |
| 86900 |
|
48 |
48 |
$5K |
| 83605 |
|
19,952 |
16,571 |
$4K |
| 73130 |
|
110 |
100 |
$4K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
80 |
52 |
$4K |
| L3908 |
Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf |
84 |
74 |
$4K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
13 |
13 |
$4K |
| 86803 |
|
744 |
708 |
$4K |
| 84439 |
|
690 |
657 |
$3K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
71 |
71 |
$3K |
| 73610 |
|
82 |
74 |
$3K |
| 85027 |
|
1,590 |
1,531 |
$3K |
| 81025 |
|
10,022 |
9,203 |
$3K |
| 81001 |
|
36,010 |
32,724 |
$3K |
| 87340 |
|
779 |
740 |
$3K |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
117 |
112 |
$3K |
| 84481 |
|
266 |
251 |
$2K |
| 86704 |
|
511 |
487 |
$2K |
| 83880 |
|
4,743 |
4,276 |
$2K |
| 86235 |
|
98 |
77 |
$2K |
| 87070 |
|
392 |
367 |
$2K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
4,867 |
4,278 |
$2K |
| 86140 |
|
1,344 |
1,261 |
$2K |
| 86706 |
|
522 |
498 |
$2K |
| 72020 |
|
84 |
78 |
$2K |
| 86200 |
|
441 |
422 |
$2K |
| 86160 |
|
224 |
199 |
$2K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
1,483 |
1,346 |
$2K |
| 86780 |
|
183 |
180 |
$2K |
| 83690 |
|
14,028 |
12,898 |
$2K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
2,432 |
2,218 |
$2K |
| 82728 |
|
298 |
284 |
$2K |
| 82043 |
|
684 |
638 |
$1K |
| 84466 |
|
294 |
281 |
$1K |
| 97162 |
|
26 |
24 |
$1K |
| 90686 |
|
87 |
87 |
$1K |
| 87634 |
|
1,282 |
1,258 |
$1K |
| 97165 |
|
16 |
15 |
$1K |
| 83735 |
|
11,162 |
9,820 |
$1K |
| 85652 |
|
1,373 |
1,283 |
$1K |
| 87631 |
|
772 |
719 |
$1K |
| 93798 |
|
35 |
24 |
$1K |
| 88142 |
|
74 |
73 |
$926.97 |
| 82550 |
|
1,093 |
791 |
$908.25 |
| 90662 |
|
99 |
96 |
$803.11 |
| 84305 |
|
127 |
118 |
$762.34 |
| 83540 |
|
294 |
281 |
$730.33 |
| 82607 |
|
103 |
99 |
$714.40 |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
73 |
72 |
$633.98 |
| G0123 |
Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, screening by cytotechnologist under physician supervision |
41 |
39 |
$631.36 |
| J3490 |
Unclassified drugs |
844 |
376 |
$618.68 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
17 |
16 |
$578.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
12 |
12 |
$489.00 |
| 94761 |
|
28,872 |
27,674 |
$487.31 |
| 95249 |
|
103 |
97 |
$447.17 |
| 73630 |
|
13 |
12 |
$444.84 |
| 87081 |
|
102 |
95 |
$421.11 |
| 86431 |
|
230 |
217 |
$414.73 |
| 82746 |
|
54 |
53 |
$384.65 |
| 90656 |
|
16 |
16 |
$383.36 |
| 95250 |
|
12 |
12 |
$380.59 |
| 87150 |
|
14 |
14 |
$346.67 |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
14 |
14 |
$335.27 |
| 87186 |
|
109 |
99 |
$324.99 |
| 87077 |
|
96 |
88 |
$310.00 |
| J7030 |
Infusion, normal saline solution , 1000 cc |
6,258 |
5,198 |
$203.72 |
| 94760 |
|
10,144 |
9,848 |
$196.21 |
| 86850 |
|
51 |
50 |
$181.05 |
| 87808 |
|
13 |
13 |
$152.27 |
| 88312 |
|
97 |
86 |
$140.98 |
| 82570 |
|
248 |
239 |
$134.04 |
| G0103 |
Prostate cancer screening; prostate specific antigen test (psa) |
13 |
13 |
$123.60 |
| 87210 |
|
25 |
25 |
$113.93 |
| 84480 |
|
12 |
12 |
$113.40 |
| 87040 |
|
739 |
291 |
$102.12 |
| 88313 |
|
72 |
60 |
$101.88 |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
125 |
124 |
$86.28 |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
83 |
82 |
$86.28 |
| 85610 |
|
683 |
610 |
$82.00 |
| 88342 |
|
507 |
455 |
$75.02 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
826 |
704 |
$62.86 |
| 86039 |
|
16 |
14 |
$62.51 |
| 82805 |
|
15 |
13 |
$55.00 |
| 80069 |
|
14 |
12 |
$44.40 |
| 97116 |
|
16 |
15 |
$42.75 |
| J7620 |
Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme |
13 |
13 |
$32.22 |
| 86038 |
|
13 |
12 |
$30.84 |
| J2704 |
Injection, propofol, 10 mg |
2,084 |
1,600 |
$25.23 |
| 72125 |
Computed tomography, cervical spine; without contrast material |
227 |
155 |
$25.06 |
| 90715 |
|
42 |
39 |
$21.96 |
| 82040 |
|
20 |
15 |
$21.10 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
2,862 |
2,561 |
$18.60 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
400 |
368 |
$18.18 |
| 84156 |
|
89 |
88 |
$17.64 |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
1,826 |
1,636 |
$17.04 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
4,244 |
3,500 |
$14.71 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
847 |
775 |
$13.30 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
1,639 |
1,261 |
$12.29 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
118 |
105 |
$12.00 |
| 82553 |
|
72 |
12 |
$10.00 |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
243 |
163 |
$9.32 |
| 87807 |
|
12 |
12 |
$9.00 |
| 84703 |
|
270 |
257 |
$6.39 |
| 80179 |
|
121 |
114 |
$4.29 |
| 80143 |
|
149 |
138 |
$4.29 |
| J0689 |
Injection, cefazolin sodium (baxter), not therapeutically equivalent to j0690, 500 mg |
88 |
76 |
$4.03 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
958 |
867 |
$3.71 |
| G1004 |
Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program |
3,687 |
2,771 |
$2.13 |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
43 |
40 |
$1.76 |
| 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) |
84 |
79 |
$0.00 |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
1,442 |
1,324 |
$0.00 |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
37 |
36 |
$0.00 |
| J3486 |
Injection, ziprasidone mesylate, 10 mg |
133 |
55 |
$0.00 |
| C1713 |
Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) |
101 |
65 |
$0.00 |
| J3260 |
Injection, tobramycin sulfate, up to 80 mg |
12 |
12 |
$0.00 |
| C1776 |
Joint device (implantable) |
12 |
12 |
$0.00 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
47 |
42 |
$0.00 |
| 87481 |
|
12 |
12 |
$0.00 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
15 |
15 |
$0.00 |
| 81513 |
|
12 |
12 |
$0.00 |
| 82948 |
|
15 |
12 |
$0.00 |
| J3370 |
Injection, vancomycin hcl, 500 mg |
12 |
12 |
$0.00 |
| 36416 |
|
565 |
543 |
$0.00 |
| 99153 |
Mod sedat endo service >5yrs |
59 |
54 |
$0.00 |
| J2795 |
Injection, ropivacaine hydrochloride, 1 mg |
615 |
473 |
$0.00 |
| J7050 |
Infusion, normal saline solution, 250 cc |
32 |
26 |
$0.00 |
| 82077 |
|
705 |
681 |
$0.00 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
27 |
26 |
$0.00 |
| 97535 |
Self-care/home management training, each 15 minutes |
16 |
12 |
$0.00 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
53 |
38 |
$0.00 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
574 |
473 |
$0.00 |
| 86901 |
|
48 |
48 |
$0.00 |
| J1030 |
Injection, methylprednisolone acetate, 40 mg |
283 |
247 |
$0.00 |
| J1010 |
Injection, methylprednisolone acetate, 1 mg |
159 |
138 |
$0.00 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
45 |
42 |
$0.00 |
| 85730 |
|
18 |
13 |
$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 |
92 |
89 |
$0.00 |
| 88311 |
|
12 |
12 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
42 |
39 |
$0.00 |
| A9579 |
Injection, gadolinium-based magnetic resonance contrast agent, not otherwise specified (nos), per ml |
16 |
16 |
$0.00 |
| J2060 |
Injection, lorazepam, 2 mg |
17 |
14 |
$0.00 |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
12 |
12 |
$0.00 |
| J2003 |
Injection, lidocaine hydrochloride, 1 mg |
24 |
15 |
$0.00 |
| J8597 |
Antiemetic drug, oral, not otherwise specified |
25 |
25 |
$0.00 |