| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
161,314 |
128,111 |
$15.52M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
38,214 |
33,319 |
$4.64M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
26,964 |
24,778 |
$3.10M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
25,238 |
22,937 |
$2.86M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
18,126 |
14,166 |
$2.42M |
| 96361 |
Intravenous infusion, hydration; each additional hour |
6,300 |
3,303 |
$1.70M |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
24,616 |
6,899 |
$1.54M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
9,363 |
7,811 |
$1.13M |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
3,515 |
2,459 |
$884K |
| 90837 |
Psychotherapy, 53 minutes with patient |
8,822 |
4,814 |
$822K |
| 70450 |
Computed tomography, head or brain; without contrast material |
4,681 |
3,427 |
$787K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
5,586 |
3,236 |
$611K |
| G0378 |
Hospital observation service, per hour |
10,114 |
3,225 |
$520K |
| 80053 |
Comprehensive metabolic panel |
41,630 |
32,852 |
$477K |
| U0004 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc, making use of high throughput technologies as described by cms-2020-01-r |
2,881 |
2,586 |
$450K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
1,227 |
920 |
$398K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
2,760 |
1,259 |
$389K |
| 20610 |
|
2,739 |
1,687 |
$383K |
| 92551 |
|
4,335 |
3,790 |
$376K |
| 96127 |
|
2,634 |
1,917 |
$340K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
2,987 |
2,654 |
$326K |
| H0015 |
Alcohol and/or drug services; intensive outpatient (treatment program that operates at least 3 hours/day and at least 3 days/week and is based on an individualized treatment plan), including assessment, counseling; crisis intervention, and activity therapies or education |
3,278 |
243 |
$290K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
1,183 |
866 |
$268K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
1,748 |
1,053 |
$243K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
1,228 |
991 |
$241K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
1,144 |
791 |
$241K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
32,533 |
22,334 |
$240K |
| 96415 |
|
1,001 |
593 |
$238K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
2,283 |
1,169 |
$221K |
| 90834 |
Psychotherapy, 45 minutes with patient |
2,437 |
1,450 |
$206K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
67,194 |
50,979 |
$200K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
10,179 |
8,081 |
$191K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
588 |
428 |
$188K |
| 97010 |
|
6,660 |
2,272 |
$181K |
| J0485 |
Injection, belatacept, 1 mg |
631 |
223 |
$179K |
| 45385 |
Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) |
371 |
290 |
$176K |
| H0036 |
Community psychiatric supportive treatment, face-to-face, per 15 minutes |
3,689 |
1,517 |
$170K |
| 86359 |
|
5,490 |
4,624 |
$163K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
348 |
242 |
$157K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
889 |
751 |
$148K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
2,391 |
1,246 |
$143K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
841 |
660 |
$138K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
10,177 |
8,087 |
$135K |
| 87536 |
|
5,627 |
4,755 |
$133K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
1,225 |
1,034 |
$133K |
| 76000 |
|
1,531 |
1,031 |
$126K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
1,922 |
1,046 |
$123K |
| 36415 |
Collection of venous blood by venipuncture |
116,664 |
81,191 |
$122K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
5,188 |
1,874 |
$116K |
| Q3014 |
Telehealth originating site facility fee |
4,526 |
4,189 |
$116K |
| 84443 |
Thyroid stimulating hormone (TSH) |
11,384 |
9,224 |
$115K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
547 |
436 |
$109K |
| 80061 |
Lipid panel |
12,593 |
10,525 |
$106K |
| 97162 |
|
1,736 |
1,395 |
$95K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
619 |
534 |
$94K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
846 |
762 |
$93K |
| 83021 |
|
9,819 |
8,139 |
$92K |
| 64493 |
|
138 |
100 |
$89K |
| 86592 |
|
5,499 |
4,556 |
$86K |
| 95886 |
|
645 |
593 |
$83K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
1,017 |
781 |
$82K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
884 |
801 |
$81K |
| 97113 |
|
1,134 |
380 |
$78K |
| 97161 |
|
1,564 |
1,241 |
$72K |
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
1,411 |
198 |
$72K |
| 96367 |
|
1,289 |
688 |
$71K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
23,290 |
18,088 |
$69K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
3,747 |
2,912 |
$68K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
5,291 |
3,832 |
$67K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
4,302 |
3,597 |
$67K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
799 |
683 |
$65K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
2,423 |
681 |
$63K |
| 93798 |
|
1,092 |
201 |
$62K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
556 |
465 |
$62K |
| 86360 |
|
3,372 |
3,011 |
$60K |
| 97165 |
|
964 |
733 |
$59K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
619 |
534 |
$55K |
| 71046 |
Radiologic examination, chest; 2 views |
5,135 |
4,125 |
$54K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
248 |
199 |
$51K |
| 72141 |
|
338 |
268 |
$51K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
1,296 |
1,117 |
$49K |
| 71250 |
|
666 |
573 |
$48K |
| 94060 |
|
465 |
410 |
$47K |
| 97535 |
Self-care/home management training, each 15 minutes |
1,987 |
1,197 |
$47K |
| 93970 |
|
425 |
343 |
$46K |
| 82607 |
|
3,469 |
2,892 |
$46K |
| 93017 |
|
710 |
534 |
$45K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
18,602 |
12,090 |
$44K |
| 84484 |
|
14,810 |
9,846 |
$43K |
| 87660 |
|
5,981 |
4,960 |
$42K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
1,110 |
799 |
$42K |
| 87480 |
|
5,909 |
4,890 |
$42K |
| 84439 |
|
3,200 |
2,546 |
$42K |
| 71045 |
Radiologic examination, chest; single view |
9,254 |
7,132 |
$42K |
| 86850 |
|
2,146 |
1,591 |
$42K |
| 93975 |
|
668 |
508 |
$41K |
| 71271 |
|
313 |
273 |
$41K |
| 90791 |
Psychiatric diagnostic evaluation |
362 |
297 |
$41K |
| 85027 |
|
10,263 |
6,867 |
$41K |
| 83735 |
|
16,771 |
10,419 |
$40K |
| 73221 |
|
212 |
184 |
$39K |
| 87510 |
|
5,893 |
4,878 |
$39K |
| 86140 |
|
3,921 |
3,096 |
$39K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
685 |
483 |
$38K |
| 76770 |
|
316 |
282 |
$38K |
| 87640 |
|
2,107 |
1,691 |
$38K |
| 73610 |
|
2,574 |
1,964 |
$37K |
| C8929 |
Transthoracic echocardiography with contrast, or without contrast followed by with contrast, real-time with image documentation (2d), includes m-mode recording, when performed, complete, with spectral doppler echocardiography, and with color flow doppler echocardiography |
235 |
188 |
$37K |
| 76536 |
|
399 |
345 |
$36K |
| 73562 |
|
2,353 |
1,625 |
$35K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
7,156 |
3,429 |
$33K |
| 17110 |
|
213 |
165 |
$33K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
316 |
257 |
$33K |
| 72100 |
|
1,586 |
1,279 |
$32K |
| J3490 |
Unclassified drugs |
2,307 |
1,261 |
$32K |
| 86900 |
|
2,291 |
1,716 |
$30K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
272 |
199 |
$30K |
| 70496 |
|
187 |
136 |
$30K |
| 82728 |
|
2,735 |
2,226 |
$28K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
5,069 |
3,843 |
$28K |
| 80305 |
|
2,250 |
473 |
$28K |
| 72131 |
|
505 |
379 |
$28K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
1,442 |
511 |
$28K |
| 64483 |
|
46 |
38 |
$27K |
| 97166 |
|
726 |
525 |
$27K |
| 90677 |
|
300 |
241 |
$27K |
| 90686 |
|
2,354 |
1,989 |
$27K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
2,133 |
1,514 |
$27K |
| 99215 |
Prolong outpt/office vis |
240 |
215 |
$27K |
| 90832 |
Psychotherapy, 30 minutes with patient |
421 |
299 |
$26K |
| 78815 |
Positron emission tomography (PET) for limited area imaging |
54 |
49 |
$26K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
4,814 |
3,740 |
$26K |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
1,451 |
1,212 |
$26K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
3,285 |
2,604 |
$26K |
| 74183 |
|
118 |
99 |
$26K |
| 20550 |
|
179 |
120 |
$25K |
| 73630 |
|
2,252 |
1,628 |
$25K |
| 80320 |
|
3,161 |
2,221 |
$24K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
12,975 |
9,932 |
$24K |
| 93971 |
|
339 |
273 |
$24K |
| 97163 |
|
371 |
326 |
$23K |
| 73030 |
|
1,857 |
1,333 |
$23K |
| 87641 |
|
2,126 |
1,709 |
$22K |
| 85610 |
|
17,139 |
10,178 |
$22K |
| 94729 |
|
448 |
394 |
$22K |
| 62370 |
|
322 |
262 |
$21K |
| 97116 |
|
936 |
342 |
$21K |
| 80076 |
|
4,654 |
3,382 |
$21K |
| 86803 |
|
2,113 |
1,707 |
$21K |
| 76830 |
Ultrasound, transvaginal |
676 |
531 |
$21K |
| 95810 |
Polysomnography; sleep staging with 4 or more additional parameters |
43 |
41 |
$20K |
| 76937 |
|
1,665 |
1,059 |
$19K |
| 83540 |
|
3,312 |
2,558 |
$19K |
| 94726 |
|
364 |
314 |
$19K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
270 |
239 |
$19K |
| 36000 |
|
1,033 |
685 |
$19K |
| 73502 |
|
1,312 |
1,022 |
$19K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
2,202 |
1,777 |
$19K |
| 87340 |
|
2,062 |
1,650 |
$18K |
| 36592 |
|
999 |
537 |
$18K |
| 73130 |
|
1,702 |
1,220 |
$18K |
| 80197 |
|
2,619 |
1,587 |
$18K |
| 86480 |
|
705 |
566 |
$18K |
| G0123 |
Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, screening by cytotechnologist under physician supervision |
1,882 |
1,534 |
$17K |
| H2020 |
Therapeutic behavioral services, per diem |
396 |
69 |
$17K |
| 93299 |
|
529 |
513 |
$17K |
| 74018 |
|
1,017 |
793 |
$17K |
| 87077 |
|
3,610 |
2,282 |
$17K |
| 77300 |
|
50 |
37 |
$17K |
| 72110 |
|
1,192 |
1,064 |
$16K |
| 90833 |
Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) |
188 |
132 |
$16K |
| 90715 |
|
1,153 |
907 |
$16K |
| 64635 |
|
21 |
12 |
$16K |
| 45378 |
Colonoscopy, flexible; diagnostic, including collection of specimen(s) |
33 |
27 |
$15K |
| 82570 |
|
3,192 |
2,382 |
$15K |
| 82805 |
|
622 |
409 |
$15K |
| 99385 |
|
158 |
132 |
$15K |
| 77336 |
|
216 |
106 |
$15K |
| 95117 |
|
718 |
249 |
$15K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
1,293 |
1,123 |
$14K |
| 83550 |
|
2,778 |
2,258 |
$14K |
| 72050 |
|
773 |
632 |
$14K |
| 73110 |
|
1,145 |
835 |
$14K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
70 |
53 |
$13K |
| 82947 |
|
17,729 |
8,606 |
$13K |
| 97035 |
|
272 |
78 |
$13K |
| 85651 |
|
4,134 |
3,404 |
$12K |
| P9016 |
Red blood cells, leukocytes reduced, each unit |
72 |
37 |
$12K |
| 86038 |
|
991 |
822 |
$12K |
| 93454 |
|
13 |
12 |
$12K |
| 0002A |
|
409 |
350 |
$12K |
| 84100 |
|
6,560 |
4,219 |
$12K |
| 0001A |
|
407 |
335 |
$11K |
| 81001 |
|
10,663 |
8,242 |
$11K |
| 76642 |
|
117 |
93 |
$11K |
| 84403 |
|
1,066 |
869 |
$11K |
| 84153 |
|
1,019 |
873 |
$11K |
| 70498 |
|
215 |
156 |
$10K |
| J0585 |
Injection, onabotulinumtoxina, 1 unit |
18 |
12 |
$10K |
| 81003 |
|
10,884 |
9,218 |
$10K |
| 43235 |
|
30 |
27 |
$10K |
| 83880 |
|
2,526 |
1,741 |
$10K |
| 72040 |
|
631 |
467 |
$10K |
| 82248 |
|
2,740 |
1,950 |
$10K |
| 84481 |
|
1,134 |
869 |
$9K |
| 73564 |
|
339 |
213 |
$9K |
| 82746 |
|
1,387 |
1,126 |
$9K |
| 83970 |
|
694 |
570 |
$9K |
| 84702 |
|
740 |
529 |
$9K |
| J0897 |
Injection, denosumab, 1 mg |
13 |
12 |
$9K |
| 93296 |
|
354 |
270 |
$9K |
| 93922 |
|
160 |
143 |
$9K |
| 64721 |
|
22 |
13 |
$8K |
| 87799 |
|
1,034 |
771 |
$8K |
| 83605 |
|
5,060 |
3,212 |
$8K |
| 99152 |
|
1,417 |
986 |
$8K |
| 86706 |
|
648 |
535 |
$8K |
| 94799 |
|
900 |
299 |
$8K |
| 64415 |
|
37 |
27 |
$8K |
| 83516 |
|
754 |
549 |
$8K |
| 87070 |
|
1,780 |
1,245 |
$8K |
| 77334 |
|
14 |
12 |
$8K |
| 85730 |
|
7,040 |
5,041 |
$8K |
| 87522 |
Neg quan hep c or qual rna |
355 |
288 |
$7K |
| 80164 |
|
576 |
446 |
$7K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
79 |
68 |
$7K |
| 83690 |
|
6,844 |
4,997 |
$7K |
| 86901 |
|
2,288 |
1,712 |
$7K |
| 70486 |
|
487 |
330 |
$7K |
| 87497 |
|
442 |
290 |
$7K |
| 83883 |
|
511 |
383 |
$7K |
| 84550 |
|
3,613 |
2,564 |
$7K |
| 96523 |
|
199 |
93 |
$7K |
| 87186 |
|
2,417 |
1,584 |
$7K |
| 86704 |
|
738 |
604 |
$7K |
| 86481 |
|
473 |
415 |
$7K |
| 73590 |
|
654 |
489 |
$6K |
| 81025 |
|
8,896 |
7,519 |
$6K |
| 73560 |
|
865 |
609 |
$6K |
| 82043 |
|
1,533 |
1,313 |
$6K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
970 |
860 |
$6K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
3,237 |
2,102 |
$6K |
| 20611 |
|
19 |
12 |
$6K |
| 96116 |
|
34 |
26 |
$6K |
| 99386 |
|
63 |
57 |
$5K |
| J1756 |
Injection, iron sucrose, 1 mg |
524 |
125 |
$5K |
| 70491 |
|
24 |
14 |
$5K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
2,490 |
2,228 |
$5K |
| 84270 |
|
704 |
580 |
$5K |
| 74022 |
|
291 |
203 |
$5K |
| 82784 |
|
646 |
500 |
$5K |
| 72170 |
|
887 |
651 |
$5K |
| 73080 |
|
405 |
311 |
$5K |
| 82140 |
|
694 |
499 |
$4K |
| 86431 |
|
584 |
505 |
$4K |
| 86160 |
|
735 |
494 |
$4K |
| 82550 |
|
1,217 |
820 |
$4K |
| 73552 |
|
459 |
374 |
$4K |
| 77080 |
|
81 |
78 |
$4K |
| 88142 |
|
290 |
240 |
$4K |
| 82565 |
|
941 |
638 |
$4K |
| 95908 |
|
29 |
24 |
$4K |
| 78264 |
|
20 |
14 |
$4K |
| 00731 |
|
1,047 |
728 |
$4K |
| 84156 |
|
1,499 |
1,087 |
$4K |
| 86695 |
|
116 |
113 |
$4K |
| 86200 |
|
440 |
376 |
$4K |
| 95806 |
|
56 |
51 |
$3K |
| 76981 |
|
43 |
43 |
$3K |
| 96368 |
|
335 |
204 |
$3K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
13,465 |
9,486 |
$3K |
| 80329 |
|
897 |
654 |
$3K |
| 84146 |
|
534 |
401 |
$3K |
| 88172 |
|
47 |
24 |
$3K |
| 86225 |
|
448 |
363 |
$3K |
| 90836 |
|
28 |
25 |
$3K |
| 72072 |
|
179 |
141 |
$3K |
| 86235 |
|
360 |
280 |
$3K |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
13,033 |
9,602 |
$3K |
| J2704 |
Injection, propofol, 10 mg |
11,479 |
6,674 |
$3K |
| 77065 |
Tomosynthesis, mammo |
101 |
78 |
$3K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
7,502 |
4,585 |
$3K |
| 99153 |
Mod sedat endo service >5yrs |
571 |
400 |
$3K |
| 95004 |
Percutaneous tests with allergenic extracts, immediate type reaction |
34 |
25 |
$3K |
| 96376 |
|
2,549 |
1,125 |
$2K |
| 86762 |
|
203 |
163 |
$2K |
| 85378 |
|
1,855 |
1,316 |
$2K |
| 73090 |
|
248 |
172 |
$2K |
| 94618 |
|
43 |
38 |
$2K |
| 57454 |
|
12 |
12 |
$2K |
| 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 |
12 |
12 |
$2K |
| 93270 |
|
41 |
39 |
$2K |
| 74174 |
|
27 |
26 |
$2K |
| 86832 |
|
412 |
307 |
$2K |
| 86833 |
|
412 |
307 |
$2K |
| 82977 |
|
518 |
385 |
$2K |
| 87040 |
|
1,288 |
508 |
$2K |
| 73120 |
|
153 |
90 |
$2K |
| 86787 |
|
144 |
118 |
$2K |
| J1642 |
Injection, heparin sodium, (heparin lock flush), per 10 units |
3,158 |
1,304 |
$2K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
10,854 |
6,117 |
$2K |
| 82670 |
|
106 |
91 |
$2K |
| 99406 |
|
91 |
78 |
$2K |
| 96138 |
|
36 |
26 |
$2K |
| 87506 |
|
14 |
12 |
$2K |
| 93880 |
|
29 |
26 |
$2K |
| 77002 |
|
108 |
79 |
$2K |
| 96133 |
|
43 |
26 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,680 |
1,454 |
$2K |
| 81002 |
|
4,349 |
3,237 |
$2K |
| 83001 |
|
189 |
148 |
$2K |
| 86696 |
|
128 |
125 |
$2K |
| 00811 |
|
303 |
261 |
$1K |
| 73700 |
|
14 |
12 |
$1K |
| 86593 |
|
160 |
120 |
$1K |
| 88304 |
|
220 |
143 |
$1K |
| H2012 |
Behavioral health day treatment, per hour |
25 |
12 |
$1K |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
7,212 |
4,406 |
$1K |
| 82330 |
|
818 |
519 |
$1K |
| 87205 |
|
931 |
553 |
$1K |
| 90674 |
|
69 |
55 |
$1K |
| 84703 |
|
480 |
352 |
$1K |
| 86780 |
|
172 |
158 |
$1K |
| 93799 |
|
81 |
13 |
$1K |
| 92523 |
|
21 |
12 |
$1K |
| 84520 |
|
506 |
341 |
$1K |
| 90630 |
|
49 |
38 |
$1K |
| 36416 |
|
8,120 |
4,263 |
$1K |
| C1889 |
Implantable/insertable device, not otherwise classified |
1,573 |
1,086 |
$1K |
| 84165 |
|
210 |
169 |
$1K |
| G2066 |
Interrogation device evaluation(s), (remote) up to 30 days; implantable cardiovascular physiologic monitor system, implantable loop recorder system, or subcutaneous cardiac rhythm monitor system, remote data acquisition(s), receipt of transmissions and technician review, technical support and distribution of results |
173 |
141 |
$997.96 |
| 29581 |
|
16 |
12 |
$993.66 |
| 73060 |
|
90 |
68 |
$987.08 |
| 90682 |
|
51 |
43 |
$973.31 |
| 82533 |
|
92 |
75 |
$959.31 |
| 82040 |
|
250 |
197 |
$956.53 |
| 82785 |
|
136 |
113 |
$946.74 |
| 88342 |
|
1,288 |
941 |
$937.24 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
2,251 |
1,200 |
$935.71 |
| 86376 |
|
125 |
109 |
$907.69 |
| 86003 |
|
64 |
53 |
$906.80 |
| 97012 |
|
28 |
12 |
$888.56 |
| 90651 |
|
131 |
96 |
$888.08 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
5,085 |
3,203 |
$860.26 |
| 96132 |
|
34 |
26 |
$853.33 |
| 83520 |
|
79 |
64 |
$853.19 |
| 84132 |
|
420 |
285 |
$829.42 |
| 86920 |
|
89 |
37 |
$829.05 |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
2,064 |
640 |
$825.33 |
| 87081 |
|
70 |
54 |
$824.03 |
| 90688 |
|
47 |
36 |
$793.02 |
| J1644 |
Injection, heparin sodium, per 1000 units |
5,581 |
1,464 |
$782.54 |
| 83615 |
|
186 |
137 |
$775.01 |
| 85018 |
|
505 |
235 |
$762.16 |
| 82105 |
|
136 |
120 |
$740.38 |
| 01810 |
|
266 |
201 |
$735.70 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
3,075 |
1,314 |
$727.78 |
| 94762 |
|
179 |
125 |
$725.62 |
| 80299 |
|
246 |
145 |
$704.31 |
| J1815 |
Injection, insulin, per 5 units |
1,215 |
349 |
$683.70 |
| 90662 |
|
88 |
79 |
$680.13 |
| 83993 |
|
32 |
30 |
$662.75 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
9,376 |
7,179 |
$660.18 |
| 83002 |
|
60 |
54 |
$636.79 |
| 84145 |
|
215 |
125 |
$635.71 |
| 84425 |
|
111 |
100 |
$563.57 |
| 29125 |
|
229 |
185 |
$533.95 |
| 82150 |
|
48 |
42 |
$528.30 |
| 90461 |
|
252 |
189 |
$518.05 |
| 90670 |
|
68 |
67 |
$497.50 |
| 00813 |
|
270 |
212 |
$492.08 |
| 82525 |
|
69 |
56 |
$479.91 |
| J7050 |
Infusion, normal saline solution, 250 cc |
13,329 |
4,207 |
$478.92 |
| 83874 |
|
164 |
91 |
$462.52 |
| 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 |
198 |
155 |
$459.18 |
| 84460 |
|
184 |
160 |
$449.15 |
| 83525 |
|
50 |
37 |
$448.56 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
7,779 |
5,411 |
$425.59 |
| 87109 |
|
17 |
16 |
$396.02 |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
2,574 |
1,273 |
$370.59 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
54 |
38 |
$361.90 |
| 72080 |
|
15 |
12 |
$345.20 |
| 82272 |
|
119 |
91 |
$328.86 |
| 96139 |
|
14 |
12 |
$326.34 |
| 90633 |
|
38 |
38 |
$323.25 |
| 84450 |
|
113 |
95 |
$316.56 |
| J3420 |
Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg |
653 |
446 |
$315.00 |
| 72128 |
|
32 |
26 |
$295.14 |
| G0472 |
Hepatitis c antibody screening, for individual at high risk and other covered indication(s) |
31 |
25 |
$288.50 |
| 84207 |
|
52 |
43 |
$286.43 |
| J3370 |
Injection, vancomycin hcl, 500 mg |
941 |
415 |
$277.00 |
| 80047 |
|
15 |
13 |
$270.36 |
| J0330 |
Injection, succinylcholine chloride, up to 20 mg |
3,451 |
1,927 |
$261.20 |
| 90723 |
|
60 |
48 |
$250.55 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
2,154 |
1,219 |
$238.85 |
| J2360 |
Injection, orphenadrine citrate, up to 60 mg |
659 |
439 |
$230.98 |
| 73140 |
|
36 |
24 |
$206.44 |
| H0048 |
Alcohol and/or other drug testing: collection and handling only, specimens other than blood |
1,049 |
236 |
$202.72 |
| 82950 |
|
17 |
12 |
$200.85 |
| G0008 |
Administration of influenza virus vaccine |
248 |
226 |
$198.73 |
| 82627 |
|
13 |
12 |
$196.34 |
| 85014 |
|
181 |
80 |
$195.60 |
| A6021 |
Collagen dressing, sterile, size 16 sq. in. or less, each |
66 |
56 |
$188.16 |
| 36591 |
|
25 |
12 |
$187.07 |
| C1713 |
Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) |
1,223 |
788 |
$182.71 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
1,046 |
593 |
$161.28 |
| J1030 |
Injection, methylprednisolone acetate, 40 mg |
983 |
735 |
$154.24 |
| 90647 |
|
42 |
29 |
$144.30 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
3,053 |
2,078 |
$143.16 |
| 84630 |
|
35 |
32 |
$138.00 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
9,254 |
5,927 |
$131.11 |
| 86334 |
|
31 |
27 |
$130.45 |
| Q9965 |
Low osmolar contrast material, 100-199 mg/ml iodine concentration, per ml |
476 |
403 |
$126.48 |
| 73620 |
|
16 |
12 |
$116.58 |
| 73100 |
|
17 |
14 |
$115.03 |
| 86308 |
|
16 |
12 |
$114.66 |
| C1894 |
Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser |
855 |
607 |
$111.74 |
| 84134 |
|
16 |
14 |
$108.58 |
| 82747 |
|
29 |
26 |
$99.62 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
6,660 |
2,691 |
$98.19 |
| A9575 |
Injection, gadoterate meglumine, 0.1 ml |
1,360 |
1,075 |
$95.75 |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
1,045 |
666 |
$95.51 |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
1,921 |
1,123 |
$94.07 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
1,795 |
1,033 |
$92.72 |
| 85046 |
|
96 |
80 |
$92.33 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
53 |
38 |
$89.76 |
| 85007 |
|
20 |
12 |
$89.52 |
| J0360 |
Injection, hydralazine hcl, up to 20 mg |
267 |
158 |
$89.41 |
| J2919 |
Injection, methylprednisolone sodium succinate, 5 mg |
333 |
238 |
$89.00 |
| J2060 |
Injection, lorazepam, 2 mg |
626 |
317 |
$88.94 |
| 93280 |
|
13 |
12 |
$84.98 |
| 86255 |
|
16 |
14 |
$84.13 |
| 84591 |
|
17 |
15 |
$81.11 |
| 82962 |
|
244 |
209 |
$78.97 |
| A6196 |
Alginate or other fiber gelling dressing, wound cover, sterile, pad size 16 sq. in. or less, each dressing |
31 |
28 |
$76.28 |
| 84590 |
|
17 |
15 |
$69.98 |
| 90734 |
|
44 |
30 |
$67.75 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
4,699 |
2,843 |
$65.58 |
| 86800 |
|
12 |
12 |
$64.30 |
| 36600 |
|
18 |
13 |
$60.06 |
| 84252 |
|
14 |
13 |
$58.85 |
| 87075 |
|
124 |
65 |
$56.79 |
| C1769 |
Guide wire |
933 |
656 |
$56.59 |
| 74021 |
|
19 |
13 |
$50.16 |
| 82010 |
|
26 |
12 |
$48.45 |
| 82172 |
|
12 |
12 |
$47.04 |
| J0171 |
Injection, adrenalin, epinephrine, 0.1 mg |
211 |
136 |
$45.23 |
| A6222 |
Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
131 |
110 |
$44.76 |
| 84466 |
|
22 |
18 |
$31.58 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
288 |
158 |
$28.02 |
| A6212 |
Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing |
39 |
36 |
$24.85 |
| A6445 |
Conforming bandage, non-elastic, knitted/woven, sterile, width less than three inches, per yard |
55 |
43 |
$24.43 |
| J1940 |
Injection, furosemide, up to 20 mg |
266 |
128 |
$20.69 |
| J3480 |
Injection, potassium chloride, per 2 meq |
430 |
200 |
$20.03 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
681 |
304 |
$18.46 |
| G0103 |
Prostate cancer screening; prostate specific antigen test (psa) |
118 |
98 |
$16.03 |
| A6454 |
Self-adherent bandage, elastic, non-knitted/non-woven, width greater than or equal to three inches and less than five inches, per yard |
485 |
349 |
$14.69 |
| J2370 |
Injection, phenylephrine hcl, up to 1 ml |
705 |
317 |
$13.70 |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
1,312 |
1,015 |
$13.51 |
| J2371 |
Injection, phenylephrine hydrochloride, 20 micrograms |
758 |
548 |
$13.01 |
| 96373 |
|
51 |
45 |
$12.47 |
| J1010 |
Injection, methylprednisolone acetate, 1 mg |
247 |
202 |
$12.47 |
| J3411 |
Injection, thiamine hcl, 100 mg |
41 |
14 |
$9.02 |
| J0688 |
Injection, cefazolin sodium (hikma), not therapeutically equivalent to j0690, 500 mg |
32 |
26 |
$8.48 |
| 88112 |
|
17 |
12 |
$6.81 |
| 91300 |
|
827 |
560 |
$6.12 |
| 90700 |
|
20 |
12 |
$5.00 |
| J1630 |
Injection, haloperidol, up to 5 mg |
68 |
38 |
$2.70 |
| J1580 |
Injection, garamycin, gentamicin, up to 80 mg |
65 |
41 |
$2.54 |
| 99024 |
|
17 |
13 |
$2.41 |
| J2550 |
Injection, promethazine hcl, up to 50 mg |
13 |
12 |
$2.11 |
| 89051 |
|
29 |
13 |
$1.73 |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
348 |
207 |
$1.63 |
| 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 |
40 |
25 |
$1.54 |
| J1920 |
Injection, labetalol hydrochloride, 5 mg |
44 |
30 |
$1.25 |
| J8540 |
Dexamethasone, oral, 0.25 mg |
20 |
15 |
$1.17 |
| J7620 |
Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme |
127 |
75 |
$0.52 |
| S0164 |
Injection, pantoprazole sodium, 40 mg |
83 |
36 |
$0.50 |
| C1725 |
Catheter, transluminal angioplasty, non-laser (may include guidance, infusion/perfusion capability) |
1,531 |
1,151 |
$0.00 |
| A9500 |
Technetium tc-99m sestamibi, diagnostic, per study dose |
600 |
445 |
$0.00 |
| J1040 |
Injection, methylprednisolone acetate, 80 mg |
22 |
13 |
$0.00 |
| 64494 |
|
136 |
98 |
$0.00 |
| 94761 |
|
302 |
156 |
$0.00 |
| J2785 |
Injection, regadenoson, 0.1 mg |
395 |
294 |
$0.00 |
| C9399 |
Unclassified drugs or biologicals |
17 |
12 |
$0.00 |
| 99156 |
|
36 |
29 |
$0.00 |
| J2469 |
Injection, palonosetron hcl, 25 mcg |
75 |
38 |
$0.00 |
| 94760 |
|
107 |
85 |
$0.00 |
| 36430 |
|
76 |
40 |
$0.00 |
| 01400 |
|
19 |
13 |
$0.00 |
| 82553 |
|
38 |
32 |
$0.00 |
| 71101 |
|
16 |
13 |
$0.00 |
| J7060 |
5% dextrose/water (500 ml = 1 unit) |
29 |
12 |
$0.00 |
| J1596 |
Injection, glycopyrrolate, 0.1 mg |
31 |
29 |
$0.00 |
| 99173 |
|
211 |
152 |
$0.00 |
| 96417 |
|
76 |
37 |
$0.00 |
| A9541 |
Technetium tc-99m sulfur colloid, diagnostic, per study dose, up to 20 millicuries |
20 |
14 |
$0.00 |
| Q9950 |
Injection, sulfur hexafluoride lipid microspheres, per ml |
320 |
250 |
$0.00 |
| 00812 |
|
38 |
29 |
$0.00 |
| 88173 |
|
46 |
25 |
$0.00 |
| 99177 |
|
22 |
14 |
$0.00 |
| 99188 |
|
45 |
28 |
$0.00 |
| 01830 |
|
41 |
29 |
$0.00 |
| A9552 |
Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries |
29 |
27 |
$0.00 |
| Q0163 |
Diphenhydramine hydrochloride, 50 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at time of chemotherapy treatment not to exceed a 48 hour dosage regimen |
29 |
17 |
$0.00 |
| 64636 |
|
21 |
12 |
$0.00 |
| 01630 |
|
18 |
12 |
$0.00 |