| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
Emergency department visit for the evaluation and management, high severity |
40,273 |
35,753 |
$6.04M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
29,197 |
24,900 |
$4.98M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
31,265 |
27,945 |
$3.25M |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
6,985 |
6,412 |
$1.31M |
| G0378 |
Hospital observation service, per hour |
8,248 |
5,992 |
$1.04M |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
34,565 |
28,458 |
$979K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
20,006 |
16,955 |
$835K |
| 70450 |
Computed tomography, head or brain; without contrast material |
9,002 |
7,998 |
$636K |
| 71046 |
Radiologic examination, chest; 2 views |
16,789 |
15,010 |
$598K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
5,618 |
4,665 |
$486K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
6,840 |
6,266 |
$475K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
13,468 |
10,999 |
$440K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
13,426 |
3,814 |
$440K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
11,202 |
9,335 |
$438K |
| 76801 |
|
4,890 |
4,353 |
$421K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
80,473 |
61,642 |
$372K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
3,411 |
3,200 |
$353K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
2,707 |
2,526 |
$336K |
| 76830 |
Ultrasound, transvaginal |
3,015 |
2,854 |
$330K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
9,875 |
8,333 |
$323K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
2,750 |
2,379 |
$309K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
3,642 |
2,766 |
$280K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
60,369 |
44,980 |
$274K |
| 59025 |
Fetal non-stress test |
3,836 |
3,398 |
$272K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
3,161 |
2,527 |
$259K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
2,700 |
2,394 |
$250K |
| 71045 |
Radiologic examination, chest; single view |
12,897 |
10,271 |
$245K |
| 93971 |
|
2,302 |
2,128 |
$234K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
1,974 |
1,826 |
$228K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
2,087 |
1,930 |
$214K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
16,239 |
13,314 |
$207K |
| 87637 |
Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV |
2,520 |
2,254 |
$205K |
| 84484 |
|
29,413 |
19,863 |
$204K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
2,303 |
2,103 |
$199K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
1,509 |
1,438 |
$195K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
857 |
745 |
$188K |
| 93970 |
|
1,727 |
1,551 |
$184K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
6,915 |
2,254 |
$183K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
5,674 |
4,769 |
$180K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
2,335 |
2,169 |
$177K |
| 80053 |
Comprehensive metabolic panel |
29,280 |
22,544 |
$175K |
| 83880 |
|
7,999 |
6,746 |
$175K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
5,663 |
4,860 |
$145K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
2,212 |
1,126 |
$144K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
2,479 |
2,281 |
$127K |
| 73630 |
|
2,805 |
2,429 |
$114K |
| 93458 |
|
269 |
248 |
$110K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
6,364 |
3,784 |
$109K |
| 72100 |
|
2,152 |
1,997 |
$107K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
773 |
573 |
$106K |
| 36430 |
|
1,355 |
1,019 |
$104K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
1,083 |
936 |
$102K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
1,740 |
1,616 |
$99K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
7,369 |
2,672 |
$96K |
| 80076 |
|
26,241 |
21,526 |
$91K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
3,947 |
2,948 |
$91K |
| 78815 |
Positron emission tomography (PET) for limited area imaging |
461 |
423 |
$90K |
| 84702 |
|
17,744 |
15,199 |
$87K |
| 76642 |
|
1,623 |
1,491 |
$86K |
| 73564 |
|
1,778 |
1,508 |
$85K |
| 81001 |
|
43,080 |
37,233 |
$81K |
| 83690 |
|
18,063 |
15,929 |
$81K |
| APT15 |
|
6,700 |
5,740 |
$79K |
| 97162 |
|
3,344 |
2,645 |
$79K |
| 70486 |
|
633 |
585 |
$75K |
| 83735 |
|
22,268 |
14,402 |
$74K |
| 73130 |
|
1,584 |
1,375 |
$73K |
| 73030 |
|
2,030 |
1,774 |
$73K |
| 86901 |
|
11,414 |
9,225 |
$72K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
1,029 |
887 |
$70K |
| 29581 |
|
910 |
336 |
$67K |
| 73610 |
|
1,623 |
1,430 |
$67K |
| P9016 |
Red blood cells, leukocytes reduced, each unit |
1,163 |
912 |
$65K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
2,786 |
2,432 |
$64K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
479 |
327 |
$62K |
| 84112 |
|
1,250 |
1,147 |
$61K |
| 93356 |
|
647 |
622 |
$59K |
| 82731 |
|
1,118 |
1,056 |
$55K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
497 |
465 |
$51K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
10,354 |
9,251 |
$51K |
| 96376 |
|
3,222 |
2,464 |
$49K |
| 93017 |
|
925 |
699 |
$49K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
2,147 |
747 |
$48K |
| 88307 |
|
760 |
645 |
$47K |
| 86850 |
|
6,547 |
5,535 |
$47K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
1,450 |
1,054 |
$46K |
| 77066 |
Tomosynthesis, mammo |
688 |
651 |
$45K |
| 77412 |
|
669 |
53 |
$44K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
860 |
716 |
$44K |
| 97161 |
|
1,422 |
1,150 |
$36K |
| A9552 |
Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries |
530 |
487 |
$35K |
| 94760 |
|
6,337 |
3,026 |
$34K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
5,413 |
2,484 |
$34K |
| J2785 |
Injection, regadenoson, 0.1 mg |
600 |
435 |
$33K |
| 71250 |
|
533 |
503 |
$32K |
| 82805 |
|
2,053 |
1,046 |
$32K |
| 85027 |
|
13,915 |
8,533 |
$32K |
| 76536 |
|
330 |
320 |
$31K |
| 96367 |
|
1,108 |
541 |
$30K |
| 36415 |
Collection of venous blood by venipuncture |
58,496 |
41,031 |
$30K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
135 |
124 |
$30K |
| 73562 |
|
906 |
738 |
$29K |
| 84443 |
Thyroid stimulating hormone (TSH) |
3,692 |
3,040 |
$28K |
| 76775 |
|
350 |
333 |
$28K |
| 87631 |
|
947 |
856 |
$28K |
| 86900 |
|
11,407 |
9,224 |
$28K |
| 77065 |
Tomosynthesis, mammo |
695 |
623 |
$27K |
| 94762 |
|
1,406 |
865 |
$27K |
| 86920 |
|
2,134 |
1,609 |
$27K |
| 81025 |
|
5,566 |
4,955 |
$26K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
252 |
227 |
$25K |
| 88304 |
|
1,118 |
998 |
$25K |
| 73110 |
|
565 |
525 |
$25K |
| 82948 |
|
16,268 |
7,153 |
$24K |
| 97535 |
Self-care/home management training, each 15 minutes |
2,491 |
1,238 |
$23K |
| 73502 |
|
1,271 |
1,155 |
$23K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
1,833 |
1,715 |
$23K |
| 85730 |
|
8,130 |
6,139 |
$22K |
| 82962 |
|
7,852 |
2,708 |
$21K |
| 83605 |
|
3,928 |
2,672 |
$20K |
| 87040 |
|
5,142 |
2,443 |
$20K |
| 70498 |
|
199 |
175 |
$19K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
1,849 |
1,730 |
$19K |
| 90715 |
|
1,155 |
1,031 |
$18K |
| 85610 |
|
9,213 |
7,440 |
$18K |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
2,375 |
1,990 |
$18K |
| 85379 |
|
3,219 |
2,598 |
$17K |
| G0279 |
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) |
574 |
553 |
$17K |
| 97597 |
|
227 |
144 |
$17K |
| J2505 |
Injection, pegfilgrastim, 6 mg |
27 |
12 |
$16K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
581 |
546 |
$16K |
| 87186 |
|
3,761 |
2,647 |
$16K |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
9,313 |
6,200 |
$15K |
| 97116 |
|
2,229 |
1,050 |
$14K |
| 97166 |
|
1,519 |
1,172 |
$14K |
| 87088 |
|
3,148 |
2,746 |
$14K |
| 87077 |
|
3,157 |
2,453 |
$13K |
| 99152 |
|
671 |
606 |
$13K |
| 93976 |
|
83 |
79 |
$13K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
89 |
83 |
$13K |
| 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 |
179 |
166 |
$12K |
| C9803 |
Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
1,617 |
1,425 |
$12K |
| J1453 |
Injection, fosaprepitant, 1 mg |
75 |
39 |
$11K |
| 72050 |
|
183 |
168 |
$11K |
| 99153 |
Mod sedat endo service >5yrs |
384 |
349 |
$11K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
383 |
354 |
$11K |
| 88311 |
|
1,077 |
970 |
$11K |
| 12001 |
|
41 |
38 |
$11K |
| 70496 |
|
105 |
88 |
$11K |
| A9577 |
Injection, gadobenate dimeglumine (multihance), per ml |
946 |
865 |
$11K |
| 80320 |
|
806 |
703 |
$10K |
| 74174 |
|
38 |
36 |
$9K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
2,134 |
1,768 |
$9K |
| 77336 |
|
201 |
73 |
$9K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,442 |
1,349 |
$9K |
| 17250 |
|
85 |
70 |
$9K |
| 87070 |
|
1,965 |
1,681 |
$8K |
| 36600 |
|
623 |
484 |
$8K |
| 88342 |
|
315 |
282 |
$8K |
| 10060 |
|
26 |
25 |
$8K |
| A9502 |
Technetium tc-99m tetrofosmin, diagnostic, per study dose |
705 |
502 |
$8K |
| 84145 |
|
2,944 |
2,216 |
$8K |
| 99215 |
Prolong outpt/office vis |
105 |
100 |
$7K |
| 74240 |
|
66 |
65 |
$7K |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
2,152 |
1,635 |
$7K |
| 94664 |
|
559 |
440 |
$7K |
| 80069 |
|
2,522 |
1,086 |
$7K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
286 |
225 |
$6K |
| J7050 |
Infusion, normal saline solution, 250 cc |
1,330 |
849 |
$6K |
| 82565 |
|
1,658 |
1,519 |
$6K |
| 93880 |
|
170 |
128 |
$6K |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
6,062 |
2,148 |
$6K |
| 80061 |
Lipid panel |
1,212 |
936 |
$6K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
8,755 |
7,285 |
$6K |
| 36592 |
|
423 |
277 |
$6K |
| 82728 |
|
936 |
788 |
$6K |
| 82607 |
|
725 |
638 |
$5K |
| G0481 |
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; 8-14 drug class(es), including metabolite(s) if performed |
53 |
43 |
$5K |
| 80143 |
|
507 |
443 |
$5K |
| 70491 |
|
42 |
37 |
$5K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
10,315 |
8,972 |
$5K |
| 80179 |
|
502 |
437 |
$5K |
| A9579 |
Injection, gadolinium-based magnetic resonance contrast agent, not otherwise specified (nos), per ml |
477 |
439 |
$5K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
114 |
106 |
$5K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,649 |
1,299 |
$4K |
| 87210 |
|
1,702 |
1,601 |
$4K |
| 86140 |
|
1,719 |
1,301 |
$4K |
| 76937 |
|
175 |
152 |
$4K |
| 84132 |
|
3,118 |
2,044 |
$4K |
| 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 |
83 |
72 |
$4K |
| 76376 |
|
37 |
35 |
$4K |
| 78306 |
|
26 |
24 |
$4K |
| J1756 |
Injection, iron sucrose, 1 mg |
79 |
39 |
$4K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
15,912 |
12,401 |
$4K |
| 78580 |
|
36 |
33 |
$4K |
| J0690 |
Injection, cefazolin sodium, 500 mg |
4,240 |
3,022 |
$4K |
| 82550 |
|
1,721 |
1,253 |
$3K |
| 84100 |
|
3,406 |
1,881 |
$3K |
| C1713 |
Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) |
64 |
47 |
$3K |
| 72141 |
|
27 |
24 |
$3K |
| 97163 |
|
122 |
111 |
$3K |
| J1170 |
Injection, hydromorphone, up to 4 mg |
2,937 |
1,658 |
$3K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
91 |
71 |
$3K |
| 74022 |
|
57 |
52 |
$3K |
| 97165 |
|
343 |
278 |
$3K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
2,870 |
2,248 |
$3K |
| 96415 |
|
57 |
38 |
$3K |
| 74018 |
|
111 |
86 |
$3K |
| 90870 |
|
25 |
12 |
$3K |
| 82010 |
|
471 |
402 |
$3K |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
3,761 |
3,192 |
$3K |
| 84550 |
|
861 |
738 |
$2K |
| J0897 |
Injection, denosumab, 1 mg |
30 |
27 |
$2K |
| 95816 |
|
13 |
12 |
$2K |
| C1769 |
Guide wire |
1,429 |
1,292 |
$2K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
5,172 |
4,038 |
$2K |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
2,218 |
1,776 |
$2K |
| 76770 |
|
26 |
26 |
$2K |
| 87147 |
|
687 |
572 |
$2K |
| 77334 |
|
21 |
14 |
$2K |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
1,315 |
976 |
$2K |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
5,028 |
3,680 |
$2K |
| J1644 |
Injection, heparin sodium, per 1000 units |
5,077 |
2,638 |
$2K |
| 82746 |
|
309 |
282 |
$2K |
| 82248 |
|
888 |
767 |
$2K |
| J3480 |
Injection, potassium chloride, per 2 meq |
1,473 |
967 |
$2K |
| 36591 |
|
114 |
79 |
$2K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
2,461 |
1,855 |
$2K |
| 96368 |
|
92 |
86 |
$2K |
| APT16 |
|
126 |
96 |
$2K |
| J2175 |
Injection, meperidine hydrochloride, per 100 mg |
882 |
773 |
$2K |
| J3370 |
Injection, vancomycin hcl, 500 mg |
752 |
576 |
$2K |
| 83550 |
|
403 |
368 |
$2K |
| 73080 |
|
59 |
53 |
$2K |
| 84156 |
|
711 |
588 |
$2K |
| J0360 |
Injection, hydralazine hcl, up to 20 mg |
1,581 |
1,124 |
$1K |
| 92507 |
Treatment of speech, language, voice, communication, and/or auditory processing disorder |
117 |
31 |
$1K |
| J0330 |
Injection, succinylcholine chloride, up to 20 mg |
1,196 |
1,059 |
$1K |
| 88341 |
|
19 |
16 |
$1K |
| 83615 |
|
802 |
597 |
$1K |
| Q9957 |
Injection, perflutren lipid microspheres, per ml |
81 |
70 |
$1K |
| J0561 |
Injection, penicillin g benzathine, 100,000 units |
16 |
14 |
$1K |
| 59020 |
|
13 |
13 |
$1K |
| 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 |
704 |
588 |
$1K |
| 87340 |
|
282 |
231 |
$1K |
| 85007 |
|
526 |
464 |
$977.93 |
| 87205 |
|
869 |
691 |
$969.38 |
| J2790 |
Injection, rho d immune globulin, human, full dose, 300 micrograms (1500 i.u.) |
13 |
12 |
$966.72 |
| 82570 |
|
325 |
280 |
$954.44 |
| J0702 |
Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg |
44 |
24 |
$953.78 |
| 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 |
19 |
17 |
$934.12 |
| 73590 |
|
36 |
28 |
$931.23 |
| 85045 |
|
439 |
325 |
$921.16 |
| 81003 |
|
691 |
612 |
$900.47 |
| 90686 |
|
185 |
130 |
$850.27 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
7,516 |
6,687 |
$797.46 |
| 72040 |
|
17 |
14 |
$794.42 |
| C9290 |
Injection, bupivacaine liposome, 1 mg |
30 |
28 |
$786.19 |
| 29125 |
|
28 |
25 |
$746.15 |
| 84439 |
|
144 |
121 |
$699.97 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
38 |
27 |
$698.48 |
| 92610 |
|
110 |
77 |
$628.61 |
| J0171 |
Injection, adrenalin, epinephrine, 0.1 mg |
321 |
288 |
$589.41 |
| 97167 |
|
31 |
26 |
$582.68 |
| J2060 |
Injection, lorazepam, 2 mg |
1,281 |
950 |
$545.53 |
| J2550 |
Injection, promethazine hcl, up to 50 mg |
532 |
303 |
$529.47 |
| 96417 |
|
52 |
28 |
$523.94 |
| 73560 |
|
19 |
15 |
$495.91 |
| 78582 |
|
13 |
13 |
$491.92 |
| 86592 |
|
182 |
161 |
$468.88 |
| J2370 |
Injection, phenylephrine hcl, up to 1 ml |
964 |
887 |
$371.26 |
| J1940 |
Injection, furosemide, up to 20 mg |
720 |
346 |
$366.67 |
| C1887 |
Catheter, guiding (may include infusion/perfusion capability) |
503 |
473 |
$308.32 |
| 77080 |
|
15 |
13 |
$280.42 |
| 83540 |
|
99 |
89 |
$265.92 |
| A9540 |
Technetium tc-99m macroaggregated albumin, diagnostic, per study dose, up to 10 millicuries |
58 |
55 |
$257.78 |
| J2543 |
Injection, piperacillin sodium/tazobactam sodium, 1 gram/0.125 grams (1.125 grams) |
29 |
12 |
$251.98 |
| J2272 |
Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg |
97 |
87 |
$249.82 |
| 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 |
19 |
17 |
$201.60 |
| J1953 |
Injection, levetiracetam, 10 mg |
151 |
105 |
$201.32 |
| 72072 |
|
13 |
12 |
$201.16 |
| 90935 |
Hemodialysis procedure with single evaluation by a physician |
220 |
108 |
$186.14 |
| 86706 |
|
48 |
38 |
$184.50 |
| 81015 |
|
139 |
126 |
$160.66 |
| A9503 |
Technetium tc-99m medronate, diagnostic, per study dose, up to 30 millicuries |
27 |
25 |
$117.56 |
| Q9963 |
High osmolar contrast material, 350-399 mg/ml iodine concentration, per ml |
16 |
13 |
$108.48 |
| J3105 |
Injection, terbutaline sulfate, up to 1 mg |
60 |
59 |
$97.80 |
| C1894 |
Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser |
214 |
194 |
$88.52 |
| A9558 |
Xenon xe-133 gas, diagnostic, per 10 millicuries |
13 |
13 |
$66.70 |
| J1741 |
Injection, ibuprofen, 100 mg |
30 |
26 |
$46.18 |
| 82310 |
|
13 |
12 |
$35.76 |
| J7642 |
Glycopyrrolate, inhalation solution, compounded product, administered through dme, concentrated form, per milligram |
43 |
41 |
$29.07 |
| 87075 |
|
13 |
12 |
$28.41 |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
58 |
54 |
$24.90 |
| J1630 |
Injection, haloperidol, up to 5 mg |
29 |
26 |
$21.25 |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
90 |
72 |
$20.15 |
| J3490 |
Unclassified drugs |
31 |
27 |
$17.74 |
| J1643 |
Injection, heparin sodium (pfizer), not therapeutically equivalent to j1644, per 1000 units |
111 |
91 |
$11.53 |
| J2371 |
Injection, phenylephrine hydrochloride, 20 micrograms |
402 |
370 |
$10.53 |
| S0028 |
Injection, famotidine, 20 mg |
13 |
13 |
$6.50 |
| A9270 |
Non-covered item or service |
2,148 |
1,274 |
$4.19 |
| J7644 |
Ipratropium bromide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per milligram |
14 |
12 |
$3.52 |
| G8997 |
Swallowing functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting |
39 |
30 |
$0.01 |
| G8996 |
Swallowing functional limitation, current status at therapy episode outset and at reporting intervals |
40 |
31 |
$0.01 |
| G8978 |
Mobility: walking & moving around functional limitation, current status, at therapy episode outset and at reporting intervals |
637 |
483 |
$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 |
648 |
492 |
$0.00 |
| C1776 |
Joint device (implantable) |
13 |
13 |
$0.00 |
| 90653 |
|
17 |
14 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
27 |
27 |
$0.00 |
| C1725 |
Catheter, transluminal angioplasty, non-laser (may include guidance, infusion/perfusion capability) |
72 |
65 |
$0.00 |
| G8987 |
Self care functional limitation, current status, at therapy episode outset and at reporting intervals |
103 |
74 |
$0.00 |
| G0257 |
Unscheduled or emergency dialysis treatment for an esrd patient in a hospital outpatient department that is not certified as an esrd facility |
80 |
50 |
$0.00 |
| G8980 |
Mobility: walking & moving around functional limitation, discharge status, at discharge from therapy or to end reporting |
68 |
52 |
$0.00 |
| G8988 |
Self care functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting |
84 |
60 |
$0.00 |
| C1893 |
Introducer/sheath, guiding, intracardiac electrophysiological, fixed-curve, other than peel-away |
39 |
35 |
$0.00 |