| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| G0378 |
Hospital observation service, per hour |
2,505 |
2,169 |
$1.16M |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
2,523 |
1,596 |
$690K |
| 11043 |
|
3,047 |
1,909 |
$665K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
15,180 |
12,143 |
$517K |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
4,427 |
4,136 |
$496K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
2,406 |
2,205 |
$289K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
3,109 |
2,837 |
$245K |
| 90834 |
Psychotherapy, 45 minutes with patient |
1,591 |
996 |
$115K |
| G0382 |
Level 3 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room or emergency department; (2) it is held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment; or (3) during the calendar year immediately preceding the calendar year in which a determination under 42 cfr 489.24 is being made, based on a representative sample of patient visits that occurred during that calendar year, it provides at least one-third of all of its outpatient visits for the treatment of emergency medical conditions on an urgent basis without requiring a previously scheduled appointment) |
1,021 |
968 |
$77K |
| 90832 |
Psychotherapy, 30 minutes with patient |
1,208 |
897 |
$64K |
| 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 |
525 |
354 |
$48K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
2,354 |
695 |
$31K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
912 |
344 |
$30K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
996 |
954 |
$17K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
1,253 |
1,106 |
$13K |
| 71046 |
Radiologic examination, chest; 2 views |
2,629 |
2,470 |
$10K |
| G0383 |
Level 4 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room or emergency department; (2) it is held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment; or (3) during the calendar year immediately preceding the calendar year in which a determination under 42 cfr 489.24 is being made, based on a representative sample of patient visits that occurred during that calendar year, it provides at least one-third of all of its outpatient visits for the treatment of emergency medical conditions on an urgent basis without requiring a previously scheduled appointment) |
128 |
123 |
$8K |
| 97162 |
|
66 |
66 |
$6K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
6,770 |
5,826 |
$6K |
| 97163 |
|
26 |
26 |
$5K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
26 |
26 |
$4K |
| 73562 |
|
338 |
270 |
$4K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
8,704 |
5,862 |
$4K |
| 82962 |
|
4,717 |
3,067 |
$2K |
| 90694 |
|
175 |
161 |
$2K |
| 84484 |
|
4,953 |
3,885 |
$2K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
11,854 |
8,373 |
$2K |
| 80053 |
Comprehensive metabolic panel |
5,884 |
5,218 |
$2K |
| 70450 |
Computed tomography, head or brain; without contrast material |
1,611 |
1,540 |
$1K |
| 81001 |
|
3,760 |
3,439 |
$1K |
| 81025 |
|
460 |
430 |
$791.24 |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
259 |
236 |
$668.97 |
| 85610 |
|
4,731 |
3,539 |
$655.50 |
| 90833 |
Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) |
436 |
423 |
$654.01 |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
15 |
12 |
$632.31 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
321 |
316 |
$593.74 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
468 |
379 |
$590.84 |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
1,126 |
1,022 |
$587.47 |
| 83605 |
|
1,387 |
1,232 |
$583.58 |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
112 |
37 |
$571.42 |
| 73630 |
|
46 |
40 |
$534.64 |
| 36415 |
Collection of venous blood by venipuncture |
5,334 |
3,313 |
$468.34 |
| 87633 |
Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets |
13 |
13 |
$467.87 |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
54 |
52 |
$465.18 |
| 83735 |
|
5,212 |
3,738 |
$410.64 |
| 71045 |
Radiologic examination, chest; single view |
2,063 |
1,889 |
$404.66 |
| 97150 |
Therapeutic procedure(s), group (2 or more individuals) |
24 |
12 |
$377.43 |
| 83690 |
|
2,106 |
1,932 |
$351.89 |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
87 |
55 |
$337.42 |
| 83880 |
|
1,783 |
1,643 |
$333.99 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
1,765 |
1,615 |
$245.67 |
| 73030 |
|
25 |
25 |
$219.09 |
| 90653 |
|
72 |
72 |
$211.63 |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
24 |
24 |
$210.90 |
| 85379 |
|
616 |
579 |
$190.58 |
| 73502 |
|
42 |
38 |
$172.49 |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
717 |
696 |
$160.21 |
| 90662 |
|
19 |
19 |
$130.40 |
| J3490 |
Unclassified drugs |
356 |
270 |
$128.02 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
784 |
594 |
$90.08 |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
323 |
300 |
$80.11 |
| 84443 |
Thyroid stimulating hormone (TSH) |
660 |
620 |
$74.78 |
| G0380 |
Level 1 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room or emergency department; (2) it is held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment; or (3) during the calendar year immediately preceding the calendar year in which a determination under 42 cfr 489.24 is being made, based on a representative sample of patient visits that occurred during that calendar year, it provides at least one-third of all of its outpatient visits for the treatment of emergency medical conditions on an urgent basis without requiring a previously scheduled appointment) |
381 |
365 |
$63.24 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
113 |
111 |
$60.12 |
| 94760 |
|
365 |
269 |
$36.66 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
1,889 |
1,737 |
$32.64 |
| 81003 |
|
115 |
107 |
$29.62 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
1,116 |
954 |
$26.20 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
250 |
163 |
$26.05 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
378 |
368 |
$26.01 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
24 |
17 |
$22.11 |
| 84100 |
|
1,082 |
722 |
$21.14 |
| 85730 |
|
16 |
13 |
$19.11 |
| J7050 |
Infusion, normal saline solution, 250 cc |
642 |
374 |
$13.05 |
| 86850 |
|
72 |
65 |
$8.45 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
1,093 |
1,036 |
$4.13 |
| J7030 |
Infusion, normal saline solution , 1000 cc |
147 |
136 |
$2.61 |
| J1644 |
Injection, heparin sodium, per 1000 units |
1,195 |
629 |
$1.45 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
57 |
53 |
$1.22 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
16 |
12 |
$1.00 |
| G8978 |
Mobility: walking & moving around functional limitation, current status, at therapy episode outset and at reporting intervals |
148 |
138 |
$0.03 |
| 87040 |
|
14 |
13 |
$0.00 |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
67 |
63 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
428 |
407 |
$0.00 |
| 86901 |
|
44 |
39 |
$0.00 |
| 87581 |
|
12 |
12 |
$0.00 |
| 87077 |
|
39 |
39 |
$0.00 |
| J2704 |
Injection, propofol, 10 mg |
136 |
120 |
$0.00 |
| 82550 |
|
50 |
42 |
$0.00 |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
32 |
12 |
$0.00 |
| 85027 |
|
16 |
13 |
$0.00 |
| 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 |
41 |
36 |
$0.00 |
| 84132 |
|
90 |
89 |
$0.00 |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
55 |
55 |
$0.00 |
| J1940 |
Injection, furosemide, up to 20 mg |
68 |
53 |
$0.00 |
| 90686 |
|
28 |
28 |
$0.00 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
208 |
191 |
$0.00 |
| 82803 |
|
26 |
25 |
$0.00 |
| 87428 |
|
19 |
19 |
$0.00 |
| 90688 |
|
12 |
12 |
$0.00 |
| 87486 |
|
12 |
12 |
$0.00 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
16 |
14 |
$0.00 |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
323 |
169 |
$0.00 |
| 80076 |
|
28 |
25 |
$0.00 |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
130 |
121 |
$0.00 |
| 87186 |
|
53 |
52 |
$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 |
169 |
156 |
$0.00 |
| 86900 |
|
44 |
39 |
$0.00 |
| 94799 |
|
34 |
26 |
$0.00 |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
12 |
12 |
$0.00 |
| G0279 |
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) |
12 |
12 |
$0.00 |
| 85014 |
|
18 |
14 |
$0.00 |
| 80061 |
Lipid panel |
26 |
26 |
$0.00 |
| 72125 |
Computed tomography, cervical spine; without contrast material |
27 |
26 |
$0.00 |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
29 |
25 |
$0.00 |
| 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 |
14 |
14 |
$0.00 |