| Code | Description | Claims | Beneficiaries | Total Paid |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
29,886 |
22,522 |
$3.55M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
18,926 |
14,147 |
$3.24M |
| Y7506 |
|
35,164 |
21,116 |
$3.10M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
35,394 |
26,804 |
$2.71M |
| X4011 |
State-specific procedure code |
12,412 |
10,030 |
$2.67M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
50,760 |
40,548 |
$1.86M |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
48,349 |
40,819 |
$1.78M |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
49,017 |
40,829 |
$1.40M |
| 80053 |
Comprehensive metabolic panel |
47,055 |
40,207 |
$1.36M |
| 92507 |
Treatment of speech, language, voice, communication, and/or auditory processing disorder |
13,257 |
4,613 |
$1.26M |
| X4003 |
|
16,920 |
15,024 |
$1.26M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
29,137 |
24,352 |
$924K |
| 71045 |
Radiologic examination, chest; single view |
24,952 |
20,375 |
$669K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
7,152 |
6,185 |
$644K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
14,236 |
10,545 |
$595K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
11,631 |
3,557 |
$575K |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
14,425 |
5,029 |
$415K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
12,333 |
10,282 |
$388K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
2,592 |
945 |
$334K |
| X4006 |
|
1,116 |
739 |
$310K |
| 81001 |
|
7,758 |
6,723 |
$297K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
3,062 |
2,223 |
$256K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
2,924 |
2,568 |
$241K |
| 90834 |
Psychotherapy, 45 minutes with patient |
7,141 |
4,019 |
$240K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
4,121 |
2,957 |
$234K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
2,341 |
1,994 |
$230K |
| 83690 |
|
6,582 |
5,692 |
$225K |
| 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 |
2,051 |
1,778 |
$222K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
3,398 |
2,896 |
$212K |
| 97597 |
|
6,901 |
1,622 |
$197K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
3,327 |
2,954 |
$185K |
| 99223 |
Prolong inpt eval add15 m |
2,124 |
1,818 |
$171K |
| 87633 |
Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets |
426 |
410 |
$164K |
| T1040 |
Medicaid certified community behavioral health clinic services, per diem |
631 |
121 |
$154K |
| 70450 |
Computed tomography, head or brain; without contrast material |
3,739 |
3,109 |
$146K |
| 64615 |
|
2,144 |
1,252 |
$138K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
576 |
279 |
$132K |
| 84484 |
|
5,879 |
4,358 |
$126K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
4,266 |
3,507 |
$126K |
| 73630 |
|
5,080 |
3,755 |
$112K |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
28,175 |
17,863 |
$105K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
1,446 |
1,297 |
$95K |
| 99239 |
Hospital discharge day management, more than 30 minutes |
2,593 |
2,144 |
$92K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
5,573 |
5,377 |
$86K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
2,188 |
1,860 |
$79K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
2,260 |
1,955 |
$78K |
| 99231 |
Subsequent hospital care, per day, straightforward or low complexity |
3,885 |
1,296 |
$76K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
1,896 |
1,670 |
$72K |
| 71046 |
Radiologic examination, chest; 2 views |
3,254 |
2,959 |
$71K |
| 87400 |
|
3,585 |
3,431 |
$69K |
| 95810 |
Polysomnography; sleep staging with 4 or more additional parameters |
586 |
546 |
$68K |
| 74018 |
|
1,636 |
1,298 |
$68K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
769 |
206 |
$66K |
| 83735 |
|
1,242 |
1,001 |
$60K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
480 |
326 |
$60K |
| 99222 |
Initial hospital care, per day, moderate complexity |
794 |
700 |
$59K |
| 84443 |
Thyroid stimulating hormone (TSH) |
4,536 |
4,266 |
$54K |
| 85610 |
|
1,365 |
1,109 |
$49K |
| 81000 |
|
7,865 |
5,816 |
$48K |
| 20610 |
|
875 |
465 |
$44K |
| 85027 |
|
1,636 |
1,505 |
$43K |
| 81003 |
|
4,126 |
3,662 |
$41K |
| 47562 |
|
22 |
13 |
$38K |
| 80061 |
Lipid panel |
3,547 |
3,402 |
$34K |
| J3490 |
Unclassified drugs |
7,771 |
5,048 |
$34K |
| 99215 |
Prolong outpt/office vis |
615 |
478 |
$31K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
427 |
310 |
$30K |
| 84512 |
|
512 |
458 |
$30K |
| G0378 |
Hospital observation service, per hour |
409 |
185 |
$30K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
549 |
494 |
$29K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
958 |
943 |
$28K |
| 17110 |
|
490 |
294 |
$27K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
318 |
263 |
$26K |
| 81025 |
|
658 |
621 |
$25K |
| J0585 |
Injection, onabotulinumtoxina, 1 unit |
282 |
170 |
$24K |
| 59025 |
Fetal non-stress test |
356 |
220 |
$24K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
1,169 |
1,020 |
$24K |
| 45385 |
Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) |
68 |
33 |
$24K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
234 |
173 |
$23K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
2,149 |
2,086 |
$23K |
| 72100 |
|
974 |
849 |
$23K |
| 64483 |
|
106 |
53 |
$22K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
896 |
881 |
$22K |
| 69436 |
Tympanostomy (requiring insertion of ventilating tube), general anesthesia |
43 |
24 |
$21K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
254 |
121 |
$21K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,033 |
832 |
$21K |
| 87081 |
|
233 |
221 |
$20K |
| 95816 |
|
280 |
154 |
$20K |
| 45378 |
Colonoscopy, flexible; diagnostic, including collection of specimen(s) |
52 |
27 |
$20K |
| 87420 |
|
455 |
432 |
$19K |
| 99233 |
Prolong inpt eval add15 m |
482 |
159 |
$19K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
154 |
46 |
$19K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
1,361 |
1,136 |
$19K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
926 |
898 |
$18K |
| 84703 |
|
829 |
776 |
$18K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
543 |
468 |
$18K |
| 99205 |
Prolong outpt/office vis |
275 |
247 |
$18K |
| 87040 |
|
727 |
580 |
$18K |
| 83605 |
|
1,261 |
996 |
$18K |
| 95886 |
|
298 |
163 |
$17K |
| 64493 |
|
76 |
39 |
$17K |
| 73560 |
|
873 |
652 |
$17K |
| 72110 |
|
456 |
418 |
$16K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
983 |
873 |
$16K |
| 17000 |
|
763 |
405 |
$15K |
| 36415 |
Collection of venous blood by venipuncture |
4,563 |
3,643 |
$15K |
| 87581 |
|
487 |
467 |
$15K |
| 87486 |
|
486 |
466 |
$15K |
| 97598 |
|
827 |
179 |
$14K |
| 99443 |
|
963 |
550 |
$13K |
| 76830 |
Ultrasound, transvaginal |
427 |
404 |
$13K |
| 73610 |
|
1,017 |
816 |
$13K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
1,840 |
1,771 |
$12K |
| 92526 |
|
154 |
61 |
$12K |
| 99309 |
Subsequent nursing facility care, per day, low to moderate complexity |
789 |
634 |
$11K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
341 |
329 |
$11K |
| 94726 |
|
248 |
161 |
$11K |
| 11102 |
|
279 |
151 |
$11K |
| 90832 |
Psychotherapy, 30 minutes with patient |
664 |
414 |
$10K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
131 |
120 |
$10K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
849 |
722 |
$9K |
| 87070 |
|
1,069 |
1,038 |
$9K |
| 83880 |
|
638 |
500 |
$9K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
133 |
111 |
$9K |
| 95251 |
|
582 |
505 |
$8K |
| 11721 |
|
3,083 |
1,375 |
$8K |
| 73565 |
|
520 |
458 |
$7K |
| 94060 |
|
166 |
110 |
$7K |
| T1015 |
Clinic visit/encounter, all-inclusive |
675 |
583 |
$7K |
| 86850 |
|
222 |
200 |
$6K |
| 87071 |
|
847 |
827 |
$6K |
| 82962 |
|
226 |
144 |
$5K |
| 90791 |
Psychiatric diagnostic evaluation |
62 |
57 |
$5K |
| 99406 |
|
2,648 |
1,617 |
$5K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
37 |
36 |
$5K |
| 93458 |
|
16 |
12 |
$5K |
| 11045 |
|
255 |
77 |
$5K |
| 84439 |
|
905 |
847 |
$5K |
| 86140 |
|
1,897 |
1,679 |
$5K |
| 76642 |
|
236 |
173 |
$4K |
| 82550 |
|
168 |
152 |
$4K |
| 86900 |
|
88 |
81 |
$4K |
| 73110 |
|
454 |
405 |
$4K |
| 86141 |
|
15 |
13 |
$4K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
86 |
78 |
$4K |
| 95909 |
|
47 |
28 |
$4K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
87 |
79 |
$4K |
| 64484 |
|
101 |
52 |
$4K |
| 85730 |
|
121 |
92 |
$4K |
| 64635 |
|
29 |
16 |
$4K |
| 73130 |
|
518 |
405 |
$4K |
| 72050 |
|
81 |
74 |
$4K |
| 80076 |
|
902 |
830 |
$3K |
| 99490 |
Ccm add 20min |
422 |
369 |
$3K |
| 99308 |
Subsequent nursing facility care, per day, straightforward |
373 |
175 |
$3K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
137 |
133 |
$3K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
72 |
65 |
$3K |
| 88342 |
|
43 |
39 |
$3K |
| 95811 |
|
40 |
38 |
$3K |
| 93016 |
|
287 |
253 |
$2K |
| 36600 |
|
63 |
60 |
$2K |
| 82805 |
|
59 |
56 |
$2K |
| 71250 |
|
96 |
74 |
$2K |
| 82565 |
|
875 |
806 |
$2K |
| 20553 |
|
26 |
15 |
$2K |
| 72141 |
|
28 |
25 |
$2K |
| 93018 |
|
269 |
238 |
$2K |
| 76770 |
|
103 |
95 |
$2K |
| 95910 |
|
21 |
14 |
$2K |
| 99221 |
|
66 |
52 |
$2K |
| 64494 |
|
53 |
27 |
$2K |
| 99442 |
|
93 |
78 |
$2K |
| 51798 |
|
296 |
211 |
$2K |
| 73030 |
|
216 |
186 |
$2K |
| 76801 |
|
49 |
44 |
$2K |
| 94729 |
|
297 |
198 |
$2K |
| 93017 |
|
29 |
24 |
$2K |
| 94799 |
|
13 |
12 |
$2K |
| 83540 |
|
218 |
175 |
$1K |
| 17003 |
|
317 |
226 |
$1K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
27 |
27 |
$1K |
| Y7510 |
|
21 |
16 |
$1K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
178 |
150 |
$1K |
| 85651 |
|
491 |
441 |
$1K |
| 36591 |
|
55 |
36 |
$1K |
| 82607 |
|
132 |
127 |
$1K |
| 72040 |
|
134 |
118 |
$1K |
| 92504 |
|
123 |
107 |
$1K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
33 |
29 |
$1K |
| 88304 |
|
83 |
75 |
$1K |
| 76536 |
|
55 |
51 |
$1K |
| 97161 |
|
27 |
24 |
$1K |
| 11056 |
|
92 |
42 |
$985.31 |
| 94618 |
|
26 |
25 |
$921.30 |
| Y7507 |
|
16 |
15 |
$844.83 |
| 82728 |
|
141 |
117 |
$826.12 |
| 73562 |
|
136 |
104 |
$809.68 |
| 64495 |
|
26 |
12 |
$767.65 |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
28 |
24 |
$717.27 |
| 97760 |
|
106 |
98 |
$672.24 |
| 84145 |
|
56 |
45 |
$652.68 |
| Q3014 |
Telehealth originating site facility fee |
36 |
31 |
$617.41 |
| 87801 |
Infectious agent detection by nucleic acid; amplified probe, multiple organisms |
13 |
13 |
$598.97 |
| 72114 |
|
20 |
20 |
$560.54 |
| J7050 |
Infusion, normal saline solution, 250 cc |
139 |
92 |
$508.34 |
| 86803 |
|
56 |
54 |
$471.60 |
| 87806 |
|
19 |
18 |
$461.23 |
| 86003 |
|
18 |
15 |
$445.28 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
16 |
16 |
$408.98 |
| 82044 |
|
124 |
121 |
$389.43 |
| 71271 |
|
12 |
12 |
$375.08 |
| 99201 |
|
13 |
13 |
$362.05 |
| 82803 |
|
24 |
21 |
$354.45 |
| 93294 |
|
22 |
12 |
$347.77 |
| 64636 |
|
29 |
15 |
$339.63 |
| 99217 |
|
15 |
12 |
$331.38 |
| 83550 |
|
179 |
143 |
$329.31 |
| 82330 |
|
46 |
44 |
$323.71 |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
15 |
13 |
$298.79 |
| 93970 |
|
16 |
16 |
$293.81 |
| 82785 |
|
30 |
27 |
$274.06 |
| 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 |
266 |
218 |
$260.46 |
| 84481 |
|
19 |
18 |
$252.25 |
| 86762 |
|
31 |
29 |
$248.09 |
| 90833 |
Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) |
44 |
40 |
$247.50 |
| 93296 |
|
23 |
13 |
$228.83 |
| 93880 |
|
15 |
13 |
$225.34 |
| 76882 |
|
14 |
12 |
$221.29 |
| 83921 |
|
12 |
12 |
$179.82 |
| 83615 |
|
80 |
63 |
$176.58 |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
13 |
12 |
$169.90 |
| 87340 |
|
31 |
29 |
$168.81 |
| 84702 |
|
13 |
13 |
$155.83 |
| 82950 |
|
53 |
48 |
$149.31 |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
25 |
25 |
$148.96 |
| 82746 |
|
14 |
14 |
$137.85 |
| 83655 |
|
13 |
13 |
$127.99 |
| 86592 |
|
43 |
41 |
$105.52 |
| 80051 |
|
31 |
30 |
$96.16 |
| 73590 |
|
14 |
12 |
$95.20 |
| 84480 |
|
16 |
13 |
$93.75 |
| 87077 |
|
14 |
12 |
$85.90 |
| 73502 |
|
15 |
12 |
$71.95 |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
12 |
12 |
$31.58 |
| 85378 |
|
16 |
12 |
$31.08 |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
12 |
12 |
$28.07 |
| 85018 |
|
12 |
12 |
$25.02 |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
20 |
18 |
$20.82 |
| 1125F |
|
147 |
117 |
$18.69 |
| 1126F |
|
700 |
598 |
$15.85 |
| 99441 |
|
16 |
12 |
$6.74 |
| 81015 |
|
25 |
22 |
$5.50 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
28 |
16 |
$2.66 |
| 1008F |
|
802 |
760 |
$0.10 |
| 3078F |
|
151 |
142 |
$0.03 |
| 3725F |
|
1,310 |
792 |
$0.03 |
| 1160F |
|
602 |
574 |
$0.03 |
| 3074F |
|
118 |
116 |
$0.02 |
| 3077F |
|
48 |
43 |
$0.01 |
| A9270 |
Non-covered item or service |
12 |
12 |
$0.00 |
| J2704 |
Injection, propofol, 10 mg |
28 |
27 |
$0.00 |
| J1642 |
Injection, heparin sodium, (heparin lock flush), per 10 units |
19 |
12 |
$0.00 |
| 3079F |
|
14 |
13 |
$0.00 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
13 |
12 |
$0.00 |
| J7030 |
Infusion, normal saline solution , 1000 cc |
39 |
26 |
$0.00 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
55 |
44 |
$0.00 |
| C9113 |
Injection, pantoprazole sodium, per vial |
13 |
13 |
$0.00 |