| Code | Description | Claims | Beneficiaries | Total Paid |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
25,903 |
24,774 |
$5.82M |
| G0378 |
Hospital observation service, per hour |
4,693 |
2,628 |
$3.56M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
9,617 |
9,293 |
$2.64M |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
7,228 |
6,682 |
$476K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
3,014 |
2,908 |
$469K |
| T1015 |
Clinic visit/encounter, all-inclusive |
7,196 |
5,313 |
$430K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
2,845 |
2,674 |
$420K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
2,593 |
2,573 |
$235K |
| 76818 |
|
2,807 |
1,585 |
$207K |
| 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 |
2,333 |
2,196 |
$159K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
2,727 |
2,557 |
$140K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
720 |
677 |
$121K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,439 |
2,222 |
$105K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
1,491 |
1,441 |
$97K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
700 |
677 |
$82K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,191 |
1,147 |
$77K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
1,823 |
1,288 |
$68K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
542 |
363 |
$65K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
2,614 |
2,568 |
$57K |
| 80053 |
Comprehensive metabolic panel |
9,740 |
7,960 |
$53K |
| 76801 |
|
1,074 |
975 |
$48K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
1,992 |
1,808 |
$48K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
1,089 |
983 |
$44K |
| 76830 |
Ultrasound, transvaginal |
857 |
833 |
$40K |
| 59025 |
Fetal non-stress test |
1,011 |
839 |
$39K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,170 |
963 |
$38K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
1,044 |
1,008 |
$38K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
555 |
537 |
$37K |
| T1001 |
Nursing assessment / evaluation |
230 |
225 |
$33K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
8,220 |
7,488 |
$32K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
22,109 |
18,252 |
$31K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
335 |
329 |
$31K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
608 |
529 |
$29K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
5,989 |
5,203 |
$28K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
420 |
330 |
$27K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
145 |
143 |
$27K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
553 |
537 |
$24K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
1,302 |
1,087 |
$23K |
| 76813 |
|
325 |
316 |
$23K |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
1,304 |
1,283 |
$22K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
404 |
340 |
$22K |
| 71046 |
Radiologic examination, chest; 2 views |
1,956 |
1,909 |
$22K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
2,481 |
1,927 |
$21K |
| 93976 |
|
172 |
158 |
$21K |
| 76642 |
|
433 |
389 |
$20K |
| 84443 |
Thyroid stimulating hormone (TSH) |
1,708 |
1,616 |
$20K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
782 |
341 |
$20K |
| 77066 |
Tomosynthesis, mammo |
174 |
171 |
$17K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
698 |
631 |
$17K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
262 |
255 |
$16K |
| 70450 |
Computed tomography, head or brain; without contrast material |
999 |
949 |
$13K |
| 97162 |
|
262 |
241 |
$12K |
| 76536 |
|
201 |
196 |
$12K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
705 |
671 |
$10K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
77 |
75 |
$10K |
| 93971 |
|
276 |
270 |
$10K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
401 |
388 |
$10K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
73 |
72 |
$10K |
| 99215 |
Prolong outpt/office vis |
98 |
97 |
$9K |
| 77065 |
Tomosynthesis, mammo |
120 |
103 |
$9K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,158 |
1,117 |
$9K |
| 92507 |
Treatment of speech, language, voice, communication, and/or auditory processing disorder |
584 |
130 |
$9K |
| 80061 |
Lipid panel |
786 |
760 |
$9K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
333 |
328 |
$9K |
| 99429 |
|
88 |
85 |
$9K |
| 71250 |
|
143 |
137 |
$8K |
| 96417 |
|
126 |
94 |
$8K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
770 |
730 |
$7K |
| 84702 |
|
1,720 |
1,591 |
$7K |
| 93975 |
|
81 |
78 |
$7K |
| 93325 |
|
72 |
71 |
$7K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
144 |
144 |
$7K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
758 |
718 |
$7K |
| 73564 |
|
393 |
356 |
$6K |
| G0279 |
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) |
224 |
207 |
$6K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
42 |
41 |
$6K |
| 76770 |
|
115 |
113 |
$6K |
| 72100 |
|
291 |
283 |
$5K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
6,722 |
6,276 |
$5K |
| 71045 |
Radiologic examination, chest; single view |
1,995 |
1,883 |
$5K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
258 |
234 |
$5K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
178 |
169 |
$5K |
| 84484 |
|
2,987 |
2,379 |
$5K |
| 72141 |
|
28 |
26 |
$5K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
107 |
106 |
$4K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
1,453 |
1,358 |
$4K |
| 73030 |
|
288 |
258 |
$4K |
| 86803 |
|
236 |
229 |
$4K |
| 76825 |
|
57 |
56 |
$4K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
343 |
324 |
$4K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
508 |
491 |
$4K |
| 83880 |
|
478 |
452 |
$4K |
| 85027 |
|
1,363 |
1,122 |
$4K |
| 86703 |
|
218 |
213 |
$4K |
| A9500 |
Technetium tc-99m sestamibi, diagnostic, per study dose |
119 |
118 |
$3K |
| 96411 |
|
68 |
45 |
$3K |
| J1756 |
Injection, iron sucrose, 1 mg |
51 |
25 |
$3K |
| 73630 |
|
349 |
311 |
$3K |
| G2012 |
Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related e/m service provided within the previous 7 days nor leading to an e/m service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion |
347 |
336 |
$3K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
26 |
26 |
$3K |
| 96415 |
|
99 |
75 |
$3K |
| 73610 |
|
250 |
231 |
$3K |
| 86780 |
|
308 |
297 |
$3K |
| 36415 |
Collection of venous blood by venipuncture |
5,586 |
4,698 |
$3K |
| 93970 |
|
80 |
76 |
$3K |
| 85610 |
|
2,630 |
2,193 |
$3K |
| 29125 |
|
25 |
25 |
$3K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
13 |
13 |
$3K |
| 90715 |
|
231 |
225 |
$3K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
641 |
611 |
$3K |
| 76827 |
|
57 |
56 |
$3K |
| 81001 |
|
3,486 |
3,264 |
$3K |
| 86850 |
|
1,100 |
1,013 |
$3K |
| A9585 |
Injection, gadobutrol, 0.1 ml |
478 |
463 |
$3K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
389 |
382 |
$3K |
| 80076 |
|
1,130 |
1,049 |
$3K |
| 76641 |
|
45 |
41 |
$3K |
| 93017 |
|
69 |
67 |
$2K |
| 59430 |
|
36 |
35 |
$2K |
| 86900 |
|
1,539 |
1,410 |
$2K |
| 83735 |
|
1,238 |
865 |
$2K |
| 0011A |
|
49 |
49 |
$2K |
| 73130 |
|
172 |
147 |
$2K |
| 85730 |
|
1,497 |
1,371 |
$2K |
| 29515 |
|
14 |
13 |
$2K |
| 83690 |
|
1,884 |
1,754 |
$2K |
| 73502 |
|
136 |
127 |
$2K |
| 82570 |
|
325 |
308 |
$2K |
| D1110 |
Prophylaxis - adult |
58 |
58 |
$2K |
| 80320 |
|
351 |
322 |
$2K |
| 86901 |
|
1,463 |
1,336 |
$2K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
391 |
372 |
$2K |
| 87631 |
|
61 |
61 |
$2K |
| 96367 |
|
73 |
55 |
$2K |
| 82728 |
|
291 |
266 |
$2K |
| 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 |
138 |
132 |
$1K |
| 76820 |
|
36 |
13 |
$1K |
| 82607 |
|
234 |
219 |
$1K |
| 80329 |
|
333 |
309 |
$1K |
| 85379 |
|
727 |
677 |
$1K |
| 81003 |
|
1,781 |
1,705 |
$1K |
| 90686 |
|
193 |
187 |
$1K |
| 77080 |
|
27 |
25 |
$1K |
| 72050 |
|
51 |
42 |
$1K |
| 87040 |
|
489 |
339 |
$1K |
| 83540 |
|
256 |
238 |
$1K |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
28 |
27 |
$1K |
| 70486 |
|
25 |
24 |
$1K |
| 82247 |
|
341 |
289 |
$1K |
| D0120 |
Periodic oral evaluation - established patient |
57 |
57 |
$991.10 |
| 84439 |
|
243 |
231 |
$953.25 |
| 72110 |
|
39 |
39 |
$937.56 |
| 82043 |
|
114 |
110 |
$845.40 |
| 76775 |
|
13 |
12 |
$802.92 |
| 77062 |
|
38 |
38 |
$765.45 |
| 82746 |
|
130 |
125 |
$723.63 |
| 96376 |
|
787 |
524 |
$691.87 |
| 87186 |
|
235 |
226 |
$658.43 |
| 82550 |
|
529 |
460 |
$640.41 |
| A9579 |
Injection, gadolinium-based magnetic resonance contrast agent, not otherwise specified (nos), per ml |
126 |
121 |
$640.38 |
| 87340 |
|
70 |
68 |
$631.05 |
| 90658 |
|
78 |
77 |
$622.00 |
| J3490 |
Unclassified drugs |
3,303 |
2,050 |
$608.40 |
| 90746 |
|
12 |
12 |
$587.20 |
| 90474 |
|
353 |
348 |
$582.81 |
| 83605 |
|
452 |
410 |
$581.44 |
| 88720 |
|
99 |
95 |
$555.22 |
| 83550 |
|
222 |
207 |
$519.17 |
| 87077 |
|
188 |
179 |
$491.96 |
| 86762 |
|
40 |
38 |
$485.33 |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
12 |
12 |
$479.00 |
| G0433 |
Infectious agent antibody detection by enzyme-linked immunosorbent assay (elisa) technique, hiv-1 and/or hiv-2, screening |
33 |
32 |
$477.46 |
| J2704 |
Injection, propofol, 10 mg |
1,832 |
1,759 |
$471.22 |
| 90461 |
|
123 |
121 |
$468.15 |
| 86706 |
|
64 |
60 |
$447.69 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
3,977 |
2,424 |
$415.02 |
| 82248 |
|
95 |
79 |
$389.21 |
| 81025 |
|
134 |
125 |
$387.44 |
| 82378 |
|
29 |
24 |
$384.15 |
| Q0114 |
Fern test |
57 |
50 |
$371.90 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
63 |
46 |
$360.34 |
| 77061 |
|
16 |
15 |
$353.94 |
| A9270 |
Non-covered item or service |
19,095 |
5,192 |
$338.32 |
| 84156 |
|
116 |
104 |
$324.34 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
2,318 |
2,046 |
$295.61 |
| 86140 |
|
223 |
206 |
$247.57 |
| 81002 |
|
98 |
92 |
$247.53 |
| 90670 |
|
628 |
625 |
$247.46 |
| 74018 |
|
24 |
24 |
$235.69 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
120 |
118 |
$234.15 |
| 85652 |
|
182 |
173 |
$228.63 |
| 84100 |
|
350 |
236 |
$227.99 |
| 90682 |
|
18 |
18 |
$198.24 |
| 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 |
111 |
99 |
$191.85 |
| 74022 |
|
14 |
12 |
$174.20 |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
2,642 |
1,322 |
$164.26 |
| 83986 |
|
72 |
62 |
$161.74 |
| 80050 |
General health panel |
43 |
32 |
$149.95 |
| 87081 |
|
104 |
103 |
$143.38 |
| 88342 |
|
14 |
13 |
$138.48 |
| 94664 |
|
70 |
58 |
$125.47 |
| 73110 |
|
18 |
15 |
$123.81 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
1,815 |
1,440 |
$114.79 |
| 90648 |
|
500 |
497 |
$112.09 |
| 73080 |
|
12 |
12 |
$111.53 |
| 87070 |
|
84 |
82 |
$98.91 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
4,674 |
3,780 |
$96.74 |
| 84075 |
|
120 |
114 |
$75.48 |
| 84155 |
|
161 |
151 |
$73.05 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
1,744 |
1,657 |
$62.95 |
| 82040 |
|
159 |
149 |
$61.69 |
| J1644 |
Injection, heparin sodium, per 1000 units |
1,563 |
733 |
$58.98 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
343 |
269 |
$51.18 |
| 83615 |
|
33 |
27 |
$50.94 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
4,279 |
3,538 |
$45.01 |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
28 |
26 |
$42.40 |
| J1815 |
Injection, insulin, per 5 units |
1,500 |
464 |
$41.61 |
| 84460 |
|
67 |
63 |
$37.20 |
| 82553 |
|
19 |
13 |
$30.24 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
973 |
700 |
$28.04 |
| J2060 |
Injection, lorazepam, 2 mg |
523 |
363 |
$18.58 |
| 88304 |
|
12 |
12 |
$17.62 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
1,279 |
1,059 |
$16.54 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
453 |
341 |
$15.30 |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
16 |
13 |
$14.07 |
| 90723 |
|
440 |
437 |
$13.75 |
| P9604 |
Travel allowance one way in connection with medically necessary laboratory specimen collection drawn from home bound or nursing home bound patient; prorated trip charge |
108 |
75 |
$13.01 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
1,361 |
1,291 |
$11.86 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
1,833 |
1,510 |
$8.06 |
| 94760 |
|
18 |
14 |
$3.96 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
756 |
551 |
$3.50 |
| S0028 |
Injection, famotidine, 20 mg |
36 |
32 |
$2.98 |
| 90680 |
|
429 |
426 |
$2.18 |
| 36416 |
|
21 |
13 |
$1.50 |
| 90681 |
|
19 |
19 |
$0.16 |
| 91301 |
|
13 |
13 |
$0.04 |
| G1004 |
Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program |
338 |
239 |
$0.01 |
| J2919 |
Injection, methylprednisolone sodium succinate, 5 mg |
46 |
38 |
$0.00 |
| Q9966 |
Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml |
156 |
143 |
$0.00 |
| J3370 |
Injection, vancomycin hcl, 500 mg |
193 |
105 |
$0.00 |
| C9113 |
Injection, pantoprazole sodium, per vial |
231 |
110 |
$0.00 |
| J1596 |
Injection, glycopyrrolate, 0.1 mg |
92 |
91 |
$0.00 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
36 |
33 |
$0.00 |
| J2272 |
Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg |
181 |
155 |
$0.00 |
| J3371 |
Injection, vancomycin hcl (mylan), not therapeutically equivalent to j3370, 500 mg |
23 |
12 |
$0.00 |
| J1171 |
Injection, hydromorphone, 0.1 mg |
151 |
104 |
$0.00 |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
187 |
140 |
$0.00 |
| 90473 |
|
19 |
19 |
$0.00 |
| J7999 |
Compounded drug, not otherwise classified |
105 |
73 |
$0.00 |
| J2470 |
Injection, pantoprazole sodium, 40 mg |
37 |
24 |
$0.00 |
| J1790 |
Injection, droperidol, up to 5 mg |
12 |
12 |
$0.00 |
| J2003 |
Injection, lidocaine hydrochloride, 1 mg |
109 |
88 |
$0.00 |
| J0360 |
Injection, hydralazine hcl, up to 20 mg |
14 |
12 |
$0.00 |