| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
59,980 |
52,772 |
$2.46M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
12,778 |
11,082 |
$2.25M |
| X4011 |
State-specific procedure code |
10,227 |
8,244 |
$2.21M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
10,818 |
8,761 |
$2.00M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
10,052 |
9,451 |
$1.44M |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
36,026 |
29,474 |
$1.42M |
| 80053 |
Comprehensive metabolic panel |
30,375 |
24,654 |
$1.10M |
| 87070 |
|
14,959 |
12,712 |
$834K |
| Y7506 |
|
5,307 |
3,350 |
$731K |
| Y7507 |
|
3,491 |
2,463 |
$681K |
| 81015 |
|
15,583 |
12,850 |
$596K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
10,127 |
9,563 |
$566K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
11,623 |
8,965 |
$539K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
20,568 |
18,729 |
$453K |
| X4003 |
|
9,245 |
6,899 |
$450K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
6,244 |
4,824 |
$400K |
| 71045 |
Radiologic examination, chest; single view |
7,335 |
5,929 |
$378K |
| 81003 |
|
2,088 |
1,902 |
$368K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
3,261 |
2,827 |
$288K |
| 94760 |
|
3,109 |
2,863 |
$252K |
| 20553 |
|
3,037 |
2,806 |
$187K |
| 71046 |
Radiologic examination, chest; 2 views |
1,768 |
1,559 |
$163K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
1,719 |
1,462 |
$158K |
| 20610 |
|
1,167 |
1,092 |
$119K |
| 84484 |
|
7,623 |
5,612 |
$118K |
| 70450 |
Computed tomography, head or brain; without contrast material |
2,292 |
1,760 |
$105K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
4,551 |
4,424 |
$102K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
1,246 |
936 |
$102K |
| 82550 |
|
6,559 |
4,741 |
$98K |
| 66984 |
Extracapsular cataract removal with insertion of intraocular lens prosthesis |
234 |
174 |
$96K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
1,281 |
968 |
$93K |
| 59025 |
Fetal non-stress test |
623 |
458 |
$87K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
2,215 |
1,869 |
$76K |
| 84702 |
|
1,532 |
1,325 |
$74K |
| 81002 |
|
17,569 |
12,407 |
$54K |
| 36415 |
Collection of venous blood by venipuncture |
2,140 |
1,920 |
$52K |
| 83690 |
|
2,477 |
1,888 |
$52K |
| 86592 |
|
1,164 |
1,117 |
$45K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
181 |
127 |
$45K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
1,820 |
1,463 |
$44K |
| 87340 |
|
794 |
759 |
$43K |
| 82553 |
|
3,207 |
2,388 |
$42K |
| 86701 |
|
419 |
388 |
$41K |
| 84443 |
Thyroid stimulating hormone (TSH) |
3,728 |
3,367 |
$41K |
| 86762 |
|
754 |
717 |
$39K |
| 73630 |
|
1,044 |
840 |
$39K |
| 86803 |
|
755 |
724 |
$39K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
451 |
303 |
$38K |
| 87634 |
|
1,262 |
1,113 |
$37K |
| 82947 |
|
549 |
516 |
$34K |
| 94060 |
|
356 |
330 |
$31K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
717 |
661 |
$31K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
481 |
363 |
$31K |
| 94761 |
|
645 |
579 |
$30K |
| 71250 |
|
1,042 |
758 |
$29K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
280 |
256 |
$27K |
| 86141 |
|
1,662 |
1,245 |
$27K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
242 |
175 |
$27K |
| 80061 |
Lipid panel |
2,252 |
2,119 |
$27K |
| 86900 |
|
443 |
434 |
$26K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
281 |
274 |
$26K |
| 86885 |
|
458 |
448 |
$25K |
| 83880 |
|
2,296 |
1,589 |
$24K |
| 87633 |
Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets |
180 |
149 |
$23K |
| 36600 |
|
642 |
355 |
$22K |
| 86756 |
|
83 |
68 |
$22K |
| 95117 |
|
991 |
352 |
$21K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
426 |
354 |
$21K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
529 |
471 |
$20K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
639 |
623 |
$20K |
| 87186 |
|
1,039 |
780 |
$20K |
| 87077 |
|
1,040 |
782 |
$20K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
168 |
96 |
$20K |
| 82805 |
|
801 |
459 |
$19K |
| 87653 |
|
357 |
340 |
$19K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
230 |
205 |
$17K |
| 76801 |
|
270 |
259 |
$15K |
| 94726 |
|
225 |
216 |
$15K |
| 83605 |
|
2,192 |
1,533 |
$14K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
2,115 |
2,017 |
$14K |
| 84439 |
|
1,620 |
1,481 |
$12K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
503 |
472 |
$12K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
142 |
126 |
$12K |
| 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 |
168 |
140 |
$12K |
| 80050 |
General health panel |
152 |
131 |
$12K |
| 74022 |
|
42 |
39 |
$11K |
| 17110 |
|
150 |
137 |
$11K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
170 |
132 |
$11K |
| 11043 |
|
33 |
13 |
$11K |
| 69436 |
Tympanostomy (requiring insertion of ventilating tube), general anesthesia |
25 |
12 |
$10K |
| 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 |
743 |
721 |
$10K |
| 93041 |
|
49 |
48 |
$10K |
| 83735 |
|
2,374 |
1,781 |
$10K |
| 95165 |
Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy, multiple dose vials |
26 |
25 |
$8K |
| 92557 |
|
185 |
183 |
$8K |
| 85610 |
|
1,510 |
1,139 |
$8K |
| 86901 |
|
443 |
434 |
$8K |
| 82962 |
|
1,095 |
729 |
$8K |
| 84145 |
|
717 |
499 |
$7K |
| 87040 |
|
898 |
628 |
$7K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
727 |
152 |
$7K |
| 85651 |
|
527 |
431 |
$7K |
| X4006 |
|
19 |
12 |
$7K |
| 97597 |
|
149 |
107 |
$7K |
| 84703 |
|
1,863 |
1,563 |
$7K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
496 |
483 |
$6K |
| 73562 |
|
190 |
169 |
$6K |
| J3490 |
Unclassified drugs |
1,594 |
899 |
$6K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
192 |
178 |
$6K |
| 82950 |
|
457 |
411 |
$6K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
164 |
129 |
$6K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
95 |
72 |
$5K |
| 52000 |
|
47 |
46 |
$5K |
| 87801 |
Infectious agent detection by nucleic acid; amplified probe, multiple organisms |
135 |
131 |
$5K |
| 82607 |
|
195 |
180 |
$4K |
| 62323 |
|
14 |
13 |
$4K |
| 85730 |
|
1,194 |
901 |
$3K |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
771 |
564 |
$3K |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
245 |
188 |
$3K |
| 73130 |
|
82 |
76 |
$2K |
| 85027 |
|
14 |
14 |
$2K |
| 85007 |
|
14 |
14 |
$2K |
| 64405 |
|
108 |
104 |
$2K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
67 |
64 |
$2K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
64 |
63 |
$2K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
37 |
28 |
$2K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
277 |
260 |
$2K |
| 87220 |
|
274 |
265 |
$2K |
| 94729 |
|
200 |
192 |
$1K |
| 86235 |
|
25 |
25 |
$1K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
13 |
13 |
$974.76 |
| 86580 |
|
78 |
75 |
$962.01 |
| 87807 |
|
35 |
32 |
$866.94 |
| 11056 |
|
19 |
15 |
$865.38 |
| 74018 |
|
32 |
29 |
$860.99 |
| 82150 |
|
333 |
252 |
$853.18 |
| 82105 |
|
14 |
12 |
$785.85 |
| 86003 |
|
24 |
12 |
$752.01 |
| 71271 |
|
12 |
12 |
$746.07 |
| GO463 |
|
74 |
59 |
$712.39 |
| 69210 |
|
41 |
37 |
$668.17 |
| 82043 |
|
156 |
149 |
$667.28 |
| 85379 |
|
124 |
94 |
$580.40 |
| 92588 |
|
13 |
13 |
$571.87 |
| 87210 |
|
144 |
141 |
$557.57 |
| 80069 |
|
166 |
157 |
$469.24 |
| 84207 |
|
14 |
12 |
$397.28 |
| 20552 |
|
13 |
12 |
$352.80 |
| 84153 |
|
24 |
24 |
$327.41 |
| 27096 |
|
26 |
25 |
$286.35 |
| 92567 |
|
12 |
12 |
$228.27 |
| 88738 |
|
13 |
12 |
$216.66 |
| 86038 |
|
28 |
28 |
$201.11 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
607 |
587 |
$193.32 |
| 86200 |
|
25 |
25 |
$180.29 |
| 82785 |
|
14 |
13 |
$109.59 |
| 86431 |
|
26 |
26 |
$89.37 |
| J2704 |
Injection, propofol, 10 mg |
149 |
132 |
$83.66 |
| 83721 |
|
12 |
12 |
$78.43 |
| 82728 |
|
14 |
14 |
$74.23 |
| 82784 |
|
14 |
13 |
$61.95 |
| 82570 |
|
29 |
25 |
$53.15 |
| 83540 |
|
14 |
14 |
$35.21 |
| 84156 |
|
13 |
13 |
$18.10 |
| 85018 |
|
20 |
16 |
$14.70 |
| 85014 |
|
20 |
16 |
$14.70 |
| 84479 |
|
113 |
88 |
$6.38 |
| 84436 |
|
44 |
42 |
$0.00 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
65 |
59 |
$0.00 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
16 |
13 |
$0.00 |
| A9270 |
Non-covered item or service |
35 |
26 |
$0.00 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
16 |
13 |
$0.00 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
356 |
341 |
$0.00 |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
15 |
12 |
$0.00 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
77 |
77 |
$0.00 |
| J1580 |
Injection, garamycin, gentamicin, up to 80 mg |
16 |
13 |
$0.00 |
| J0171 |
Injection, adrenalin, epinephrine, 0.1 mg |
16 |
13 |
$0.00 |