| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
125,144 |
102,874 |
$6.54M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
115,583 |
95,103 |
$4.62M |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
6,611 |
5,854 |
$375K |
| 80050 |
General health panel |
9,256 |
8,538 |
$286K |
| 59426 |
|
3,456 |
1,763 |
$242K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
3,462 |
3,104 |
$234K |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
7,827 |
2,454 |
$163K |
| 59425 |
|
2,317 |
1,791 |
$149K |
| J0178 |
Injection, aflibercept, 1 mg |
225 |
161 |
$148K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
4,354 |
3,605 |
$123K |
| 80061 |
Lipid panel |
17,145 |
15,840 |
$121K |
| 73630 |
|
6,411 |
4,556 |
$121K |
| 99308 |
Subsequent nursing facility care, per day, straightforward |
18,356 |
11,391 |
$110K |
| 36415 |
Collection of venous blood by venipuncture |
42,225 |
36,425 |
$108K |
| 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 |
1,321 |
1,234 |
$94K |
| 99215 |
Prolong outpt/office vis |
1,429 |
1,083 |
$88K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
14,729 |
13,623 |
$76K |
| 80053 |
Comprehensive metabolic panel |
15,418 |
13,703 |
$75K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
1,849 |
983 |
$75K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
2,209 |
1,800 |
$74K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
5,680 |
5,236 |
$70K |
| 66984 |
Extracapsular cataract removal with insertion of intraocular lens prosthesis |
470 |
248 |
$70K |
| 67028 |
Intravitreal injection of a pharmacologic agent |
2,095 |
1,508 |
$66K |
| 90960 |
End-stage renal disease related services monthly, for patients 20 years and older, with 4 or more face-to-face visits |
1,441 |
1,150 |
$63K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
18,885 |
14,528 |
$60K |
| 99309 |
Subsequent nursing facility care, per day, low to moderate complexity |
5,830 |
3,988 |
$58K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
1,917 |
1,685 |
$58K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
1,374 |
591 |
$55K |
| 59430 |
|
559 |
477 |
$52K |
| 84443 |
Thyroid stimulating hormone (TSH) |
6,747 |
6,258 |
$50K |
| 92134 |
|
3,762 |
2,941 |
$47K |
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
71 |
65 |
$44K |
| 99223 |
Prolong inpt eval add15 m |
630 |
541 |
$39K |
| 82607 |
|
4,262 |
3,942 |
$34K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
1,165 |
1,053 |
$25K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
295 |
260 |
$25K |
| 84439 |
|
5,108 |
4,715 |
$25K |
| J9035 |
Injection, bevacizumab, 10 mg |
738 |
597 |
$24K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
4,029 |
3,504 |
$23K |
| 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 |
414 |
284 |
$23K |
| 11721 |
|
1,866 |
1,547 |
$22K |
| 92136 |
|
1,069 |
937 |
$21K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
1,195 |
1,135 |
$21K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
1,194 |
1,133 |
$21K |
| 87428 |
|
704 |
632 |
$20K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
784 |
609 |
$19K |
| 81002 |
|
6,722 |
4,178 |
$17K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
2,033 |
858 |
$16K |
| 84153 |
|
1,467 |
1,350 |
$16K |
| 82728 |
|
1,942 |
1,781 |
$15K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
977 |
833 |
$13K |
| 82746 |
|
1,545 |
1,429 |
$12K |
| 92083 |
|
495 |
439 |
$12K |
| 92250 |
|
1,547 |
1,365 |
$12K |
| 90674 |
|
652 |
560 |
$11K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
753 |
688 |
$11K |
| 99205 |
Prolong outpt/office vis |
265 |
241 |
$11K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
2,745 |
2,511 |
$11K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
378 |
311 |
$11K |
| 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 |
154 |
133 |
$11K |
| 82043 |
|
3,530 |
3,263 |
$10K |
| 99222 |
Initial hospital care, per day, moderate complexity |
293 |
224 |
$10K |
| 99460 |
|
152 |
141 |
$10K |
| 82570 |
|
3,805 |
3,517 |
$9K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
371 |
242 |
$9K |
| 90686 |
|
2,063 |
1,821 |
$9K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
518 |
494 |
$9K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
682 |
631 |
$9K |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
921 |
864 |
$8K |
| 83550 |
|
1,764 |
1,625 |
$8K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
990 |
820 |
$8K |
| 84481 |
|
701 |
659 |
$8K |
| 82550 |
|
2,717 |
2,476 |
$8K |
| 99335 |
|
517 |
292 |
$8K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
459 |
202 |
$8K |
| 20610 |
|
517 |
366 |
$8K |
| 83540 |
|
2,165 |
1,993 |
$7K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
426 |
362 |
$7K |
| 83970 |
|
385 |
355 |
$7K |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
533 |
498 |
$6K |
| 20552 |
|
349 |
279 |
$6K |
| 95886 |
|
223 |
189 |
$5K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
1,907 |
1,345 |
$5K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
467 |
101 |
$5K |
| 90682 |
|
357 |
331 |
$4K |
| 62370 |
|
220 |
147 |
$4K |
| 99462 |
|
149 |
101 |
$4K |
| 85027 |
|
876 |
832 |
$4K |
| 80305 |
|
473 |
296 |
$4K |
| 99307 |
|
1,103 |
906 |
$4K |
| 83735 |
|
1,040 |
934 |
$3K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
847 |
633 |
$3K |
| 99305 |
|
299 |
174 |
$3K |
| 84403 |
|
218 |
202 |
$3K |
| 17110 |
|
40 |
38 |
$3K |
| 84550 |
|
1,403 |
1,292 |
$3K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
52 |
36 |
$3K |
| 96127 |
|
1,227 |
1,113 |
$3K |
| 92133 |
|
186 |
135 |
$3K |
| 96367 |
|
167 |
71 |
$3K |
| 85652 |
|
1,786 |
1,621 |
$3K |
| 99442 |
|
203 |
153 |
$2K |
| 97161 |
|
42 |
38 |
$2K |
| 81001 |
|
1,636 |
1,489 |
$2K |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
735 |
627 |
$2K |
| 83690 |
|
518 |
464 |
$2K |
| G0482 |
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; 15-21 drug class(es), including metabolite(s) if performed |
106 |
89 |
$2K |
| 96417 |
|
69 |
39 |
$2K |
| 86803 |
|
207 |
186 |
$2K |
| 3044F |
|
4,672 |
4,181 |
$2K |
| 82565 |
|
911 |
414 |
$2K |
| 99219 |
|
31 |
26 |
$1K |
| 64493 |
|
30 |
25 |
$1K |
| 86140 |
|
380 |
356 |
$1K |
| 86592 |
|
567 |
538 |
$1K |
| 94664 |
|
190 |
179 |
$1K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
211 |
171 |
$1K |
| 80076 |
|
596 |
331 |
$1K |
| 83001 |
|
65 |
64 |
$1K |
| 54150 |
|
13 |
13 |
$1K |
| 90715 |
|
368 |
265 |
$1K |
| 94375 |
|
59 |
57 |
$1K |
| 99201 |
|
30 |
27 |
$1K |
| 99000 |
|
1,143 |
955 |
$1K |
| 73564 |
|
60 |
48 |
$970.39 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
16 |
12 |
$963.96 |
| 86225 |
|
133 |
122 |
$954.13 |
| 86038 |
|
199 |
180 |
$866.33 |
| 86430 |
|
261 |
245 |
$840.80 |
| 3046F |
|
351 |
312 |
$680.00 |
| 76882 |
|
22 |
12 |
$678.39 |
| 99443 |
|
33 |
14 |
$662.25 |
| 83721 |
|
301 |
263 |
$584.38 |
| J1040 |
Injection, methylprednisolone acetate, 80 mg |
382 |
241 |
$556.63 |
| 80074 |
|
12 |
12 |
$532.35 |
| 83525 |
|
135 |
124 |
$518.60 |
| 86376 |
|
53 |
47 |
$496.62 |
| 99318 |
|
46 |
42 |
$485.73 |
| 95806 |
|
15 |
12 |
$484.01 |
| J1030 |
Injection, methylprednisolone acetate, 40 mg |
209 |
165 |
$420.19 |
| 99441 |
|
121 |
93 |
$404.31 |
| 80051 |
|
231 |
116 |
$393.99 |
| 62369 |
|
16 |
12 |
$385.60 |
| 99233 |
Prolong inpt eval add15 m |
17 |
12 |
$381.07 |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
99 |
56 |
$372.40 |
| 95990 |
|
13 |
12 |
$305.22 |
| 82310 |
|
230 |
118 |
$304.47 |
| 62368 |
|
25 |
15 |
$299.06 |
| 64494 |
|
14 |
12 |
$267.79 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
627 |
265 |
$263.70 |
| 73610 |
|
13 |
12 |
$246.66 |
| 82150 |
|
53 |
50 |
$244.97 |
| 83002 |
|
14 |
13 |
$236.56 |
| G2211 |
Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established) |
2,272 |
1,753 |
$215.59 |
| 99231 |
Subsequent hospital care, per day, straightforward or low complexity |
112 |
28 |
$190.73 |
| 81003 |
|
769 |
640 |
$190.04 |
| 92025 |
|
13 |
12 |
$189.68 |
| 82248 |
|
75 |
69 |
$176.61 |
| 84100 |
|
101 |
95 |
$174.25 |
| G0103 |
Prostate cancer screening; prostate specific antigen test (psa) |
16 |
14 |
$154.48 |
| 93000 |
|
319 |
297 |
$136.18 |
| 94760 |
|
112 |
103 |
$104.80 |
| 99152 |
|
15 |
13 |
$96.36 |
| 84460 |
|
25 |
25 |
$87.21 |
| 88141 |
|
70 |
66 |
$76.00 |
| 83615 |
|
16 |
13 |
$70.51 |
| 82044 |
|
56 |
53 |
$49.56 |
| 84156 |
|
36 |
33 |
$49.18 |
| 84450 |
|
15 |
15 |
$47.33 |
| 82947 |
|
14 |
13 |
$43.18 |
| 85610 |
|
47 |
24 |
$43.05 |
| 71046 |
Radiologic examination, chest; 2 views |
101 |
91 |
$36.00 |
| 81025 |
|
358 |
303 |
$28.37 |
| 86580 |
|
25 |
24 |
$21.48 |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
228 |
194 |
$8.68 |
| 99490 |
Ccm add 20min |
779 |
494 |
$0.00 |
| 3078F |
|
8,502 |
7,535 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
405 |
339 |
$0.00 |
| 3077F |
|
1,096 |
1,007 |
$0.00 |
| G0179 |
Physician or allowed practitioner re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and allowed practitioners to affirm the initial implementation of the plan of care |
582 |
536 |
$0.00 |
| 3051F |
|
441 |
403 |
$0.00 |
| 72100 |
|
25 |
24 |
$0.00 |
| 82274 |
|
42 |
41 |
$0.00 |
| 2024F |
|
124 |
104 |
$0.00 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
12 |
12 |
$0.00 |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
28 |
28 |
$0.00 |
| 3062F |
|
37 |
30 |
$0.00 |
| 90662 |
|
15 |
15 |
$0.00 |
| 94060 |
|
14 |
14 |
$0.00 |
| 3008F |
|
26,295 |
22,908 |
$0.00 |
| 3061F |
|
1,164 |
1,048 |
$0.00 |
| 3074F |
|
12,912 |
11,353 |
$0.00 |
| 3079F |
|
4,898 |
4,470 |
$0.00 |
| 3080F |
|
818 |
749 |
$0.00 |
| 3075F |
|
2,342 |
2,148 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
463 |
439 |
$0.00 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
149 |
120 |
$0.00 |
| 3072F |
|
664 |
636 |
$0.00 |
| J3590 |
Unclassified biologics |
217 |
114 |
$0.00 |
| 3060F |
|
308 |
270 |
$0.00 |
| 76830 |
Ultrasound, transvaginal |
46 |
44 |
$0.00 |
| 3052F |
|
108 |
97 |
$0.00 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
307 |
196 |
$0.00 |
| 99385 |
|
109 |
97 |
$0.00 |
| J3420 |
Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg |
67 |
55 |
$0.00 |
| 99386 |
|
49 |
41 |
$0.00 |
| 87340 |
|
14 |
13 |
$0.00 |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
48 |
16 |
$0.00 |
| 99024 |
|
17 |
12 |
$0.00 |