| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
97,815 |
84,560 |
$10.25M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
56,130 |
50,838 |
$6.13M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
45,726 |
38,686 |
$5.16M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
27,003 |
21,761 |
$3.26M |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
19,279 |
18,297 |
$2.15M |
| 41899 |
Unlisted procedure, dentoalveolar structures |
1,594 |
1,120 |
$1.83M |
| 96361 |
Intravenous infusion, hydration; each additional hour |
5,934 |
3,308 |
$1.79M |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
5,469 |
3,993 |
$1.34M |
| 70450 |
Computed tomography, head or brain; without contrast material |
5,196 |
4,163 |
$1.16M |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
16,345 |
4,129 |
$996K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
3,196 |
1,510 |
$792K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
6,065 |
3,486 |
$706K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
3,250 |
2,781 |
$589K |
| G0378 |
Hospital observation service, per hour |
8,460 |
2,467 |
$523K |
| 64635 |
|
1,212 |
1,017 |
$511K |
| 92507 |
Treatment of speech, language, voice, communication, and/or auditory processing disorder |
7,175 |
2,269 |
$471K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
7,545 |
2,823 |
$442K |
| 95810 |
Polysomnography; sleep staging with 4 or more additional parameters |
815 |
745 |
$429K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
3,824 |
2,253 |
$424K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
1,542 |
1,156 |
$411K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
1,384 |
1,105 |
$400K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,973 |
3,676 |
$371K |
| 80053 |
Comprehensive metabolic panel |
52,048 |
43,245 |
$356K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
1,427 |
1,112 |
$350K |
| 64493 |
|
534 |
442 |
$266K |
| 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 |
1,488 |
1,446 |
$251K |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
13,484 |
10,691 |
$219K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
4,073 |
1,405 |
$186K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
2,089 |
2,006 |
$172K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
26,986 |
20,828 |
$152K |
| C1713 |
Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) |
1,097 |
635 |
$151K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
750 |
621 |
$150K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
1,184 |
1,145 |
$141K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
413 |
311 |
$132K |
| 71046 |
Radiologic examination, chest; 2 views |
15,530 |
13,499 |
$132K |
| 93303 |
Transthoracic echocardiography for congenital cardiac anomalies, follow-up or limited study |
447 |
384 |
$129K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
1,638 |
1,240 |
$127K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
9,940 |
8,408 |
$127K |
| 95811 |
|
227 |
201 |
$126K |
| 93017 |
|
1,831 |
1,515 |
$122K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
1,406 |
1,081 |
$116K |
| 70496 |
|
544 |
431 |
$111K |
| 76770 |
|
709 |
566 |
$109K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
1,278 |
621 |
$104K |
| 76642 |
|
855 |
706 |
$103K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
10,023 |
8,404 |
$101K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
89,823 |
71,755 |
$92K |
| 94726 |
|
850 |
747 |
$91K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
948 |
908 |
$87K |
| 84443 |
Thyroid stimulating hormone (TSH) |
8,732 |
7,328 |
$86K |
| 70491 |
|
343 |
266 |
$85K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
15,200 |
14,200 |
$78K |
| 97535 |
Self-care/home management training, each 15 minutes |
2,502 |
1,219 |
$73K |
| 84484 |
|
25,975 |
18,765 |
$70K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
39,280 |
31,279 |
$69K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
481 |
409 |
$68K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
1,779 |
1,601 |
$65K |
| 36415 |
Collection of venous blood by venipuncture |
98,655 |
76,097 |
$61K |
| 93971 |
|
873 |
717 |
$61K |
| 76536 |
|
614 |
534 |
$61K |
| 71250 |
|
686 |
617 |
$59K |
| 93325 |
|
597 |
516 |
$57K |
| 97113 |
|
800 |
251 |
$56K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
426 |
371 |
$56K |
| 93975 |
|
424 |
269 |
$56K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
1,440 |
657 |
$55K |
| 97162 |
|
1,357 |
1,118 |
$55K |
| 12001 |
|
350 |
293 |
$53K |
| 62323 |
|
152 |
99 |
$53K |
| 71271 |
|
397 |
364 |
$52K |
| 94060 |
|
849 |
745 |
$50K |
| 97161 |
|
821 |
693 |
$48K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
778 |
644 |
$48K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
575 |
411 |
$46K |
| 70486 |
|
709 |
584 |
$45K |
| 96367 |
|
1,240 |
655 |
$45K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
34,439 |
16,705 |
$44K |
| 94729 |
|
874 |
766 |
$43K |
| 97166 |
|
687 |
559 |
$41K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
1,661 |
1,471 |
$40K |
| 74018 |
|
1,635 |
1,324 |
$39K |
| 86900 |
|
2,053 |
1,455 |
$37K |
| J1756 |
Injection, iron sucrose, 1 mg |
1,020 |
351 |
$37K |
| 92557 |
|
541 |
465 |
$36K |
| 97035 |
|
1,003 |
296 |
$36K |
| 80061 |
Lipid panel |
2,961 |
2,574 |
$35K |
| 72100 |
|
1,375 |
1,122 |
$34K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
356 |
344 |
$33K |
| 86140 |
|
3,615 |
2,866 |
$33K |
| 78815 |
Positron emission tomography (PET) for limited area imaging |
104 |
89 |
$33K |
| 76830 |
Ultrasound, transvaginal |
706 |
483 |
$32K |
| 93226 |
|
383 |
291 |
$31K |
| 72131 |
|
370 |
291 |
$30K |
| 97165 |
|
494 |
404 |
$29K |
| J3490 |
Unclassified drugs |
351 |
131 |
$28K |
| 80047 |
|
5,681 |
3,496 |
$27K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
2,218 |
1,898 |
$27K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
1,730 |
1,560 |
$27K |
| 0202U |
Oncology (prostate), multianalyte, gene expression profiling |
228 |
183 |
$27K |
| 71045 |
Radiologic examination, chest; single view |
10,787 |
9,032 |
$27K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
8,184 |
6,610 |
$26K |
| 93970 |
|
207 |
175 |
$26K |
| 87070 |
|
14,095 |
12,437 |
$25K |
| 70498 |
|
589 |
463 |
$25K |
| 64490 |
|
42 |
32 |
$24K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
1,542 |
1,247 |
$24K |
| 87507 |
|
233 |
179 |
$24K |
| 80320 |
|
1,801 |
1,575 |
$24K |
| 86850 |
|
1,949 |
1,368 |
$22K |
| 85027 |
|
5,027 |
3,312 |
$20K |
| 73030 |
|
1,328 |
1,064 |
$20K |
| 73630 |
|
1,799 |
1,533 |
$20K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
17,743 |
12,167 |
$19K |
| 80076 |
|
7,222 |
5,167 |
$19K |
| 97116 |
|
997 |
455 |
$18K |
| 84439 |
|
2,210 |
1,809 |
$18K |
| 72040 |
|
538 |
464 |
$17K |
| 92523 |
|
264 |
238 |
$17K |
| 72141 |
|
140 |
124 |
$17K |
| 93458 |
|
13 |
13 |
$17K |
| 82728 |
|
1,916 |
1,674 |
$16K |
| 73130 |
|
1,472 |
1,230 |
$16K |
| 93225 |
|
390 |
296 |
$16K |
| 77065 |
Tomosynthesis, mammo |
600 |
486 |
$16K |
| 76870 |
|
165 |
126 |
$16K |
| 73502 |
|
890 |
715 |
$15K |
| 82607 |
|
1,513 |
1,320 |
$15K |
| 86803 |
|
621 |
519 |
$15K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
27,272 |
21,531 |
$15K |
| 81001 |
|
25,508 |
21,367 |
$14K |
| 90715 |
|
947 |
675 |
$14K |
| 83880 |
|
7,081 |
5,804 |
$14K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
2,249 |
1,674 |
$14K |
| 73564 |
|
1,392 |
1,141 |
$14K |
| 84702 |
|
1,495 |
954 |
$13K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
62 |
52 |
$12K |
| 83735 |
|
14,141 |
10,720 |
$12K |
| 93270 |
|
245 |
206 |
$12K |
| 83970 |
|
392 |
329 |
$12K |
| 77336 |
|
70 |
27 |
$12K |
| 99152 |
|
1,626 |
1,276 |
$12K |
| 73610 |
|
1,568 |
1,302 |
$11K |
| 81003 |
|
10,197 |
8,455 |
$11K |
| 73110 |
|
910 |
771 |
$11K |
| 92567 |
|
950 |
823 |
$11K |
| 73562 |
|
246 |
213 |
$11K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
9,598 |
8,691 |
$11K |
| 52000 |
|
31 |
27 |
$11K |
| 96415 |
|
67 |
30 |
$10K |
| 88307 |
|
101 |
54 |
$10K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
110 |
99 |
$10K |
| 72072 |
|
324 |
265 |
$10K |
| 82248 |
|
15,360 |
12,897 |
$10K |
| 87641 |
|
499 |
412 |
$9K |
| 83540 |
|
1,906 |
1,673 |
$9K |
| 83550 |
|
1,798 |
1,581 |
$9K |
| 95819 |
|
76 |
66 |
$8K |
| J2790 |
Injection, rho d immune globulin, human, full dose, 300 micrograms (1500 i.u.) |
122 |
64 |
$8K |
| 83690 |
|
21,168 |
17,370 |
$8K |
| 82746 |
|
1,349 |
1,178 |
$8K |
| 92558 |
|
125 |
106 |
$8K |
| 93660 |
|
90 |
72 |
$8K |
| 85651 |
|
2,677 |
2,136 |
$8K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
548 |
441 |
$8K |
| 82948 |
|
7,898 |
3,829 |
$8K |
| 86592 |
|
542 |
404 |
$8K |
| 82077 |
|
4,893 |
3,662 |
$7K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
2,249 |
1,674 |
$7K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
15,543 |
10,964 |
$7K |
| 77066 |
Tomosynthesis, mammo |
268 |
214 |
$7K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
538 |
381 |
$7K |
| 12011 |
|
52 |
48 |
$7K |
| 83605 |
|
3,949 |
2,549 |
$7K |
| 84703 |
|
11,284 |
8,815 |
$7K |
| 82565 |
|
1,518 |
1,229 |
$6K |
| 87340 |
|
425 |
333 |
$6K |
| 96376 |
|
2,816 |
1,346 |
$6K |
| G0279 |
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) |
935 |
767 |
$5K |
| 85610 |
|
5,786 |
3,840 |
$5K |
| 84156 |
|
612 |
496 |
$5K |
| 92579 |
|
62 |
55 |
$5K |
| 84153 |
|
329 |
290 |
$5K |
| 87807 |
|
2,586 |
2,183 |
$5K |
| 20610 |
|
57 |
25 |
$5K |
| 86901 |
|
2,049 |
1,455 |
$5K |
| 87077 |
|
2,887 |
2,084 |
$5K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
17 |
12 |
$4K |
| 73080 |
|
472 |
393 |
$4K |
| 87205 |
|
2,793 |
2,016 |
$4K |
| 86038 |
|
270 |
226 |
$4K |
| 97597 |
|
169 |
117 |
$4K |
| 87522 |
Neg quan hep c or qual rna |
102 |
82 |
$4K |
| 87420 |
|
151 |
145 |
$4K |
| 87186 |
|
2,327 |
1,746 |
$4K |
| J0702 |
Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg |
413 |
384 |
$4K |
| C1769 |
Guide wire |
876 |
657 |
$4K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
190 |
172 |
$3K |
| V5266 |
Battery for use in hearing device |
491 |
430 |
$3K |
| 71101 |
|
515 |
427 |
$3K |
| 85730 |
|
2,499 |
1,943 |
$3K |
| 74174 |
|
13 |
12 |
$3K |
| 77080 |
|
50 |
36 |
$3K |
| 94010 |
|
97 |
79 |
$3K |
| G0260 |
Injection procedure for sacroiliac joint; provision of anesthetic, steroid and/or other therapeutic agent, with or without arthrography |
39 |
31 |
$3K |
| 84425 |
|
233 |
201 |
$3K |
| 73140 |
|
349 |
291 |
$3K |
| 12002 |
|
15 |
12 |
$3K |
| 82043 |
|
457 |
422 |
$3K |
| 74183 |
|
15 |
13 |
$3K |
| C1894 |
Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser |
707 |
558 |
$3K |
| 64495 |
|
150 |
145 |
$3K |
| 93880 |
|
46 |
36 |
$3K |
| 36591 |
|
1,493 |
742 |
$3K |
| 97163 |
|
56 |
45 |
$3K |
| 92610 |
|
61 |
44 |
$3K |
| 73590 |
|
345 |
290 |
$3K |
| 82570 |
|
673 |
537 |
$3K |
| 85014 |
|
710 |
417 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,025 |
712 |
$2K |
| 87040 |
|
2,812 |
1,325 |
$2K |
| 86762 |
|
95 |
68 |
$2K |
| A9609 |
Fludeoxyglucose f18 up to 15 millicuries |
13 |
12 |
$2K |
| 10060 |
|
13 |
13 |
$2K |
| 95816 |
|
17 |
14 |
$2K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
15 |
12 |
$2K |
| 85018 |
|
822 |
514 |
$2K |
| J0571 |
Buprenorphine, oral, 1 mg |
517 |
149 |
$2K |
| 86430 |
|
140 |
119 |
$2K |
| 80143 |
|
1,781 |
1,396 |
$2K |
| 84146 |
|
278 |
223 |
$2K |
| 83516 |
|
67 |
36 |
$2K |
| 81025 |
|
3,139 |
2,231 |
$2K |
| 84403 |
|
101 |
92 |
$2K |
| 87640 |
|
80 |
61 |
$2K |
| 64636 |
|
1,184 |
963 |
$2K |
| 84134 |
|
124 |
104 |
$2K |
| 82947 |
|
419 |
346 |
$2K |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
3,899 |
2,083 |
$2K |
| 84550 |
|
364 |
302 |
$2K |
| 84100 |
|
994 |
564 |
$2K |
| 93242 |
|
45 |
41 |
$2K |
| 84520 |
|
825 |
559 |
$2K |
| 73090 |
|
474 |
379 |
$2K |
| 80329 |
|
239 |
115 |
$1K |
| 82330 |
|
566 |
320 |
$1K |
| J1170 |
Injection, hydromorphone, up to 4 mg |
2,736 |
1,270 |
$1K |
| 73560 |
|
44 |
29 |
$1K |
| 86308 |
|
286 |
209 |
$1K |
| 72170 |
|
264 |
233 |
$1K |
| 85379 |
|
1,622 |
1,240 |
$1K |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
2,593 |
907 |
$1K |
| 82784 |
|
154 |
86 |
$1K |
| 86706 |
|
53 |
40 |
$1K |
| J2543 |
Injection, piperacillin sodium/tazobactam sodium, 1 gram/0.125 grams (1.125 grams) |
415 |
130 |
$1K |
| 82140 |
|
393 |
291 |
$1K |
| 87808 |
|
738 |
601 |
$1K |
| 82803 |
|
874 |
621 |
$1K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
19,069 |
14,097 |
$1K |
| 80179 |
|
1,770 |
1,403 |
$1K |
| 84145 |
|
1,520 |
1,147 |
$974.95 |
| 82550 |
|
878 |
642 |
$965.69 |
| J0500 |
Injection, dicyclomine hcl, up to 20 mg |
48 |
28 |
$916.44 |
| 84132 |
|
577 |
422 |
$890.81 |
| 76775 |
|
13 |
12 |
$862.07 |
| J2469 |
Injection, palonosetron hcl, 25 mcg |
181 |
67 |
$857.65 |
| 93246 |
|
12 |
12 |
$852.55 |
| 80051 |
|
182 |
143 |
$824.43 |
| 00170 |
Anesthesia for intraoral procedures, including biopsy |
1,907 |
1,327 |
$812.27 |
| C1725 |
Catheter, transluminal angioplasty, non-laser (may include guidance, infusion/perfusion capability) |
16 |
12 |
$791.73 |
| 99153 |
Mod sedat endo service >5yrs |
219 |
180 |
$773.71 |
| 87210 |
|
767 |
512 |
$772.24 |
| 87147 |
|
679 |
509 |
$743.28 |
| J1953 |
Injection, levetiracetam, 10 mg |
119 |
64 |
$686.28 |
| 82374 |
|
472 |
278 |
$681.57 |
| 83615 |
|
336 |
272 |
$627.52 |
| J2360 |
Injection, orphenadrine citrate, up to 60 mg |
1,259 |
896 |
$593.65 |
| 87220 |
|
608 |
400 |
$537.96 |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
2,468 |
1,251 |
$511.07 |
| 82272 |
|
317 |
233 |
$505.63 |
| J1642 |
Injection, heparin sodium, (heparin lock flush), per 10 units |
2,773 |
1,280 |
$467.77 |
| 69209 |
|
15 |
13 |
$461.94 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
2,361 |
1,184 |
$459.61 |
| 84460 |
|
66 |
49 |
$451.84 |
| 00731 |
|
504 |
373 |
$401.92 |
| 01936 |
|
1,675 |
1,525 |
$399.24 |
| 76376 |
|
473 |
257 |
$392.48 |
| J2704 |
Injection, propofol, 10 mg |
12,104 |
7,325 |
$371.90 |
| 84450 |
|
51 |
25 |
$344.04 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
10,831 |
7,645 |
$335.85 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
14,566 |
9,039 |
$323.81 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
965 |
623 |
$322.92 |
| 80305 |
|
208 |
128 |
$315.97 |
| J7050 |
Infusion, normal saline solution, 250 cc |
602 |
320 |
$313.12 |
| 85046 |
|
272 |
208 |
$274.72 |
| J1040 |
Injection, methylprednisolone acetate, 80 mg |
2,217 |
1,794 |
$265.78 |
| 82533 |
|
58 |
42 |
$265.71 |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
1,211 |
780 |
$263.60 |
| 01992 |
|
1,373 |
1,190 |
$258.93 |
| 73552 |
|
39 |
28 |
$252.62 |
| 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 |
187 |
176 |
$238.69 |
| 83525 |
|
12 |
12 |
$238.25 |
| 51798 |
|
51 |
40 |
$230.68 |
| 73060 |
|
73 |
58 |
$227.30 |
| 80164 |
|
33 |
26 |
$226.37 |
| 70360 |
|
27 |
17 |
$223.75 |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
788 |
477 |
$218.53 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
8,187 |
5,227 |
$218.36 |
| 87075 |
|
497 |
298 |
$217.50 |
| 88304 |
|
554 |
344 |
$216.19 |
| 36600 |
|
36 |
25 |
$216.12 |
| 82150 |
|
25 |
15 |
$208.06 |
| 51701 |
|
15 |
13 |
$195.99 |
| 82010 |
|
580 |
399 |
$176.45 |
| J1644 |
Injection, heparin sodium, per 1000 units |
1,075 |
496 |
$174.78 |
| J2371 |
Injection, phenylephrine hydrochloride, 20 micrograms |
587 |
400 |
$173.55 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
12,915 |
10,085 |
$169.88 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
2,819 |
1,550 |
$169.71 |
| J1790 |
Injection, droperidol, up to 5 mg |
1,560 |
1,017 |
$169.36 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
3,085 |
1,810 |
$151.26 |
| J2919 |
Injection, methylprednisolone sodium succinate, 5 mg |
425 |
319 |
$146.26 |
| A9500 |
Technetium tc-99m sestamibi, diagnostic, per study dose |
1,423 |
1,138 |
$143.36 |
| 36416 |
|
1,507 |
753 |
$135.05 |
| J1010 |
Injection, methylprednisolone acetate, 1 mg |
291 |
233 |
$132.18 |
| 29125 |
|
111 |
102 |
$124.39 |
| J0688 |
Injection, cefazolin sodium (hikma), not therapeutically equivalent to j0690, 500 mg |
544 |
406 |
$116.33 |
| J2920 |
Injection, methylprednisolone sodium succinate, up to 40 mg |
92 |
57 |
$106.21 |
| J2795 |
Injection, ropivacaine hydrochloride, 1 mg |
1,265 |
1,123 |
$104.49 |
| J2550 |
Injection, promethazine hcl, up to 50 mg |
216 |
109 |
$99.44 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
1,152 |
676 |
$97.30 |
| 83883 |
|
19 |
12 |
$93.22 |
| 82950 |
|
13 |
13 |
$89.16 |
| J3370 |
Injection, vancomycin hcl, 500 mg |
409 |
190 |
$76.41 |
| J7030 |
Infusion, normal saline solution , 1000 cc |
838 |
647 |
$76.39 |
| J2060 |
Injection, lorazepam, 2 mg |
1,193 |
746 |
$74.55 |
| A9579 |
Injection, gadolinium-based magnetic resonance contrast agent, not otherwise specified (nos), per ml |
1,456 |
1,181 |
$66.80 |
| 84295 |
|
25 |
17 |
$66.63 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
5,106 |
3,451 |
$66.06 |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
1,581 |
1,130 |
$65.07 |
| J0171 |
Injection, adrenalin, epinephrine, 0.1 mg |
188 |
99 |
$46.13 |
| 72158 |
|
16 |
12 |
$45.75 |
| J2470 |
Injection, pantoprazole sodium, 40 mg |
98 |
72 |
$44.16 |
| J2175 |
Injection, meperidine hydrochloride, per 100 mg |
29 |
13 |
$43.52 |
| 80074 |
|
16 |
12 |
$42.53 |
| 88342 |
|
137 |
88 |
$40.23 |
| 85520 |
|
82 |
25 |
$39.05 |
| 80177 |
|
28 |
15 |
$35.78 |
| J0687 |
Injection, cefazolin sodium (wg critical care), not therapeutically equivalent to j0690, 500 mg |
123 |
71 |
$34.82 |
| 80365 |
|
25 |
16 |
$19.30 |
| 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 |
439 |
405 |
$19.10 |
| J2003 |
Injection, lidocaine hydrochloride, 1 mg |
141 |
137 |
$12.20 |
| J0295 |
Injection, ampicillin sodium/sulbactam sodium, per 1.5 gm |
73 |
12 |
$11.67 |
| J0360 |
Injection, hydralazine hcl, up to 20 mg |
79 |
42 |
$11.53 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
1,899 |
1,246 |
$11.04 |
| J3480 |
Injection, potassium chloride, per 2 meq |
235 |
124 |
$10.41 |
| J1171 |
Injection, hydromorphone, 0.1 mg |
168 |
79 |
$9.98 |
| J0330 |
Injection, succinylcholine chloride, up to 20 mg |
28 |
12 |
$9.63 |
| 82435 |
|
21 |
14 |
$9.47 |
| 84155 |
|
16 |
15 |
$9.19 |
| J2370 |
Injection, phenylephrine hcl, up to 1 ml |
221 |
148 |
$3.34 |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
20 |
12 |
$2.57 |
| J1596 |
Injection, glycopyrrolate, 0.1 mg |
54 |
46 |
$1.30 |
| 64494 |
|
464 |
391 |
$1.15 |
| J1940 |
Injection, furosemide, up to 20 mg |
34 |
14 |
$0.69 |
| 84165 |
|
14 |
13 |
$0.00 |
| 01940 |
|
127 |
106 |
$0.00 |
| A9552 |
Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries |
74 |
61 |
$0.00 |
| Q9966 |
Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml |
228 |
183 |
$0.00 |
| J0744 |
Injection, ciprofloxacin for intravenous infusion, 200 mg |
59 |
41 |
$0.00 |
| A4641 |
Radiopharmaceutical, diagnostic, not otherwise classified |
25 |
12 |
$0.00 |
| J2710 |
Injection, neostigmine methylsulfate, up to 0.5 mg |
15 |
13 |
$0.00 |
| C1887 |
Catheter, guiding (may include infusion/perfusion capability) |
14 |
13 |
$0.00 |
| C1758 |
Catheter, ureteral |
14 |
12 |
$0.00 |
| 00840 |
|
206 |
89 |
$0.00 |
| C9113 |
Injection, pantoprazole sodium, per vial |
18 |
12 |
$0.00 |
| 76942 |
|
13 |
12 |
$0.00 |
| 64491 |
|
40 |
30 |
$0.00 |
| 94669 |
|
26 |
13 |
$0.00 |
| C2617 |
Stent, non-coronary, temporary, without delivery system |
53 |
39 |
$0.00 |
| 94761 |
|
1,438 |
953 |
$0.00 |
| J2785 |
Injection, regadenoson, 0.1 mg |
1,084 |
856 |
$0.00 |
| 93320 |
|
522 |
450 |
$0.00 |
| Q9965 |
Low osmolar contrast material, 100-199 mg/ml iodine concentration, per ml |
20 |
14 |
$0.00 |
| G0379 |
Direct admission of patient for hospital observation care |
26 |
21 |
$0.00 |
| 94760 |
|
177 |
103 |
$0.00 |
| 96368 |
|
370 |
202 |
$0.00 |
| C9399 |
Unclassified drugs or biologicals |
107 |
87 |
$0.00 |
| J8540 |
Dexamethasone, oral, 0.25 mg |
40 |
24 |
$0.00 |
| C1781 |
Mesh (implantable) |
21 |
13 |
$0.00 |
| A4648 |
Tissue marker, implantable, any type, each |
28 |
26 |
$0.00 |
| J2305 |
Injection, nitroglycerin, 5 mg |
40 |
30 |
$0.00 |
| 64492 |
|
14 |
14 |
$0.00 |
| 84300 |
|
16 |
12 |
$0.00 |
| 00813 |
|
18 |
16 |
$0.00 |
| C1889 |
Implantable/insertable device, not otherwise classified |
13 |
12 |
$0.00 |