| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
120,645 |
110,448 |
$10.40M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
59,967 |
51,829 |
$3.62M |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
17,083 |
16,188 |
$1.50M |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
7,011 |
6,298 |
$1.24M |
| 70450 |
Computed tomography, head or brain; without contrast material |
10,909 |
9,016 |
$813K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
22,794 |
19,052 |
$779K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
7,142 |
6,735 |
$767K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
5,820 |
5,137 |
$759K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
10,344 |
7,510 |
$576K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
27,308 |
22,418 |
$525K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
3,395 |
3,007 |
$438K |
| 80053 |
Comprehensive metabolic panel |
25,722 |
20,880 |
$386K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
5,116 |
4,094 |
$208K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
1,097 |
987 |
$188K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
637 |
555 |
$188K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
17,345 |
16,523 |
$172K |
| G0378 |
Hospital observation service, per hour |
7,585 |
3,935 |
$169K |
| G0382 |
Level 3 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room or emergency department; (2) it is held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment; or (3) during the calendar year immediately preceding the calendar year in which a determination under 42 cfr 489.24 is being made, based on a representative sample of patient visits that occurred during that calendar year, it provides at least one-third of all of its outpatient visits for the treatment of emergency medical conditions on an urgent basis without requiring a previously scheduled appointment) |
1,944 |
1,836 |
$165K |
| 81003 |
|
31,785 |
28,183 |
$151K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
3,035 |
2,726 |
$137K |
| 85027 |
|
59,416 |
45,946 |
$113K |
| 71045 |
Radiologic examination, chest; single view |
22,145 |
18,712 |
$97K |
| 73130 |
|
2,100 |
1,889 |
$86K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
917 |
876 |
$84K |
| 87070 |
|
9,614 |
9,216 |
$79K |
| 71046 |
Radiologic examination, chest; 2 views |
7,301 |
6,647 |
$66K |
| A9270 |
Non-covered item or service |
16,128 |
4,540 |
$65K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
14,982 |
14,399 |
$65K |
| 12001 |
|
957 |
887 |
$62K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
10,058 |
9,100 |
$60K |
| 10060 |
|
808 |
746 |
$54K |
| 72131 |
|
1,554 |
1,354 |
$54K |
| 93971 |
|
1,229 |
1,091 |
$53K |
| 74174 |
|
586 |
517 |
$52K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
1,782 |
1,587 |
$44K |
| 73610 |
|
2,064 |
1,900 |
$44K |
| 73630 |
|
2,662 |
2,439 |
$41K |
| 12011 |
|
527 |
498 |
$40K |
| 84702 |
|
4,801 |
4,097 |
$40K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
1,475 |
1,128 |
$39K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
3,089 |
2,804 |
$38K |
| 80047 |
|
1,267 |
1,120 |
$35K |
| 73562 |
|
2,693 |
2,324 |
$32K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
5,880 |
5,093 |
$31K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
1,257 |
1,155 |
$31K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
28,279 |
20,734 |
$31K |
| 86850 |
|
2,108 |
1,809 |
$30K |
| 70491 |
|
116 |
109 |
$30K |
| 85610 |
|
13,607 |
11,062 |
$30K |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
2,833 |
1,968 |
$30K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
1,130 |
1,029 |
$30K |
| 73110 |
|
1,667 |
1,507 |
$29K |
| 73030 |
|
2,141 |
1,829 |
$29K |
| 70496 |
|
287 |
248 |
$25K |
| 70486 |
|
768 |
657 |
$24K |
| J7050 |
Infusion, normal saline solution, 250 cc |
1,566 |
1,261 |
$22K |
| 86900 |
|
3,079 |
2,694 |
$20K |
| 84484 |
|
17,790 |
11,983 |
$19K |
| 85730 |
|
11,855 |
9,740 |
$19K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
2,796 |
2,651 |
$19K |
| 93970 |
|
383 |
336 |
$18K |
| 12002 |
|
359 |
328 |
$18K |
| 73590 |
|
601 |
507 |
$18K |
| 76830 |
Ultrasound, transvaginal |
568 |
548 |
$18K |
| 72129 |
|
298 |
280 |
$17K |
| 80076 |
|
11,053 |
10,067 |
$17K |
| 81025 |
|
4,767 |
4,408 |
$16K |
| 71250 |
|
553 |
468 |
$16K |
| 73080 |
|
932 |
837 |
$16K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
26,639 |
22,534 |
$14K |
| 72128 |
|
475 |
404 |
$14K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
3,235 |
2,823 |
$14K |
| 97597 |
|
392 |
161 |
$13K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
908 |
772 |
$13K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
2,052 |
1,679 |
$13K |
| 81001 |
|
2,497 |
2,152 |
$13K |
| 74018 |
|
736 |
681 |
$12K |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
1,787 |
1,533 |
$11K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
2,735 |
2,207 |
$11K |
| 72100 |
|
727 |
671 |
$11K |
| 93458 |
|
73 |
62 |
$11K |
| 73140 |
|
404 |
379 |
$10K |
| 83735 |
|
14,716 |
11,104 |
$10K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
13,181 |
10,667 |
$10K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
5,500 |
3,987 |
$9K |
| 72170 |
|
1,015 |
756 |
$9K |
| 73090 |
|
660 |
611 |
$9K |
| J1170 |
Injection, hydromorphone, up to 4 mg |
4,007 |
2,873 |
$8K |
| C1769 |
Guide wire |
797 |
658 |
$8K |
| 93017 |
|
629 |
549 |
$8K |
| 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 |
617 |
454 |
$7K |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
2,205 |
1,720 |
$7K |
| 74022 |
|
159 |
144 |
$6K |
| 97162 |
|
334 |
292 |
$6K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
11,606 |
9,940 |
$6K |
| 87210 |
|
689 |
634 |
$6K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
2,826 |
2,681 |
$6K |
| J2704 |
Injection, propofol, 10 mg |
1,172 |
922 |
$6K |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
2,950 |
2,439 |
$6K |
| 80069 |
|
362 |
230 |
$5K |
| 85379 |
|
3,933 |
3,468 |
$5K |
| 86901 |
|
2,980 |
2,600 |
$5K |
| 83880 |
|
3,595 |
2,971 |
$5K |
| J0690 |
Injection, cefazolin sodium, 500 mg |
1,095 |
699 |
$5K |
| 83605 |
|
6,729 |
5,370 |
$5K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
8,005 |
7,603 |
$5K |
| 87807 |
|
907 |
883 |
$5K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
9,759 |
8,110 |
$5K |
| G0381 |
Level 2 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room or emergency department; (2) it is held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment; or (3) during the calendar year immediately preceding the calendar year in which a determination under 42 cfr 489.24 is being made, based on a representative sample of patient visits that occurred during that calendar year, it provides at least one-third of all of its outpatient visits for the treatment of emergency medical conditions on an urgent basis without requiring a previously scheduled appointment) |
39 |
39 |
$4K |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
4,683 |
3,625 |
$4K |
| 84703 |
|
4,067 |
3,709 |
$4K |
| 73502 |
|
312 |
279 |
$3K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
7,830 |
6,313 |
$3K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,830 |
1,574 |
$3K |
| 72132 |
|
329 |
302 |
$3K |
| 88304 |
|
129 |
112 |
$3K |
| C1894 |
Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser |
392 |
332 |
$3K |
| J0360 |
Injection, hydralazine hcl, up to 20 mg |
627 |
423 |
$3K |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
3,599 |
3,264 |
$3K |
| 90715 |
|
1,684 |
1,477 |
$3K |
| J1815 |
Injection, insulin, per 5 units |
1,759 |
932 |
$3K |
| 83690 |
|
12,415 |
10,643 |
$3K |
| G0383 |
Level 4 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room or emergency department; (2) it is held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment; or (3) during the calendar year immediately preceding the calendar year in which a determination under 42 cfr 489.24 is being made, based on a representative sample of patient visits that occurred during that calendar year, it provides at least one-third of all of its outpatient visits for the treatment of emergency medical conditions on an urgent basis without requiring a previously scheduled appointment) |
63 |
59 |
$2K |
| 71101 |
|
65 |
60 |
$2K |
| 72050 |
|
43 |
40 |
$2K |
| J3370 |
Injection, vancomycin hcl, 500 mg |
817 |
578 |
$2K |
| 80061 |
Lipid panel |
956 |
818 |
$2K |
| 72040 |
|
98 |
85 |
$2K |
| 80306 |
|
375 |
332 |
$2K |
| 70498 |
|
162 |
136 |
$2K |
| 82803 |
|
58 |
42 |
$2K |
| 73060 |
|
41 |
38 |
$2K |
| 76870 |
|
26 |
26 |
$2K |
| 76801 |
|
593 |
529 |
$2K |
| J7999 |
Compounded drug, not otherwise classified |
76 |
57 |
$2K |
| 82248 |
|
4,234 |
3,018 |
$1K |
| 72192 |
|
38 |
25 |
$1K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
354 |
320 |
$1K |
| 80143 |
|
665 |
589 |
$1K |
| J3490 |
Unclassified drugs |
894 |
795 |
$1K |
| 82550 |
|
985 |
787 |
$1K |
| 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 |
49 |
42 |
$1K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
312 |
140 |
$1K |
| 87040 |
|
3,428 |
2,539 |
$1K |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
2,216 |
1,927 |
$1K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
185 |
174 |
$970.54 |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
1,101 |
598 |
$848.96 |
| 82077 |
|
1,126 |
945 |
$836.74 |
| 86140 |
|
894 |
799 |
$722.73 |
| 84443 |
Thyroid stimulating hormone (TSH) |
2,101 |
1,811 |
$718.07 |
| J2060 |
Injection, lorazepam, 2 mg |
1,985 |
1,522 |
$684.35 |
| 84100 |
|
1,201 |
911 |
$670.42 |
| 72110 |
|
16 |
14 |
$649.63 |
| A9502 |
Technetium tc-99m tetrofosmin, diagnostic, per study dose |
453 |
386 |
$581.67 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
821 |
711 |
$564.21 |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
1,066 |
845 |
$490.24 |
| G1003 |
Clinical decision support mechanism medicalis, as defined by the medicare appropriate use criteria program |
657 |
470 |
$475.48 |
| 73552 |
|
40 |
29 |
$427.74 |
| 73560 |
|
16 |
13 |
$403.08 |
| 73650 |
|
15 |
13 |
$316.90 |
| 74019 |
|
29 |
28 |
$315.10 |
| 70360 |
|
14 |
13 |
$312.54 |
| 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 |
2,357 |
2,186 |
$275.62 |
| 72070 |
|
13 |
13 |
$252.66 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
2,109 |
1,879 |
$246.90 |
| 29125 |
|
159 |
148 |
$222.09 |
| 97163 |
|
16 |
15 |
$214.22 |
| J0330 |
Injection, succinylcholine chloride, up to 20 mg |
42 |
37 |
$151.73 |
| 87400 |
|
1,739 |
1,652 |
$146.70 |
| J2360 |
Injection, orphenadrine citrate, up to 60 mg |
967 |
875 |
$140.16 |
| 82800 |
|
246 |
193 |
$128.23 |
| J2785 |
Injection, regadenoson, 0.1 mg |
224 |
187 |
$120.00 |
| 80179 |
|
656 |
579 |
$109.47 |
| 96376 |
|
1,191 |
977 |
$102.92 |
| J8540 |
Dexamethasone, oral, 0.25 mg |
507 |
466 |
$75.42 |
| 87430 |
|
1,116 |
1,077 |
$72.38 |
| 76881 |
|
12 |
12 |
$71.05 |
| J0561 |
Injection, penicillin g benzathine, 100,000 units |
66 |
65 |
$67.30 |
| J2550 |
Injection, promethazine hcl, up to 50 mg |
711 |
530 |
$48.24 |
| 82553 |
|
48 |
27 |
$30.33 |
| 86141 |
|
142 |
117 |
$18.21 |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
92 |
54 |
$12.40 |
| 85651 |
|
140 |
126 |
$6.15 |
| S0119 |
Ondansetron, oral, 4 mg (for circumstances falling under the medicare statute, use hcpcs q code) |
930 |
904 |
$0.00 |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
225 |
196 |
$0.00 |
| S0028 |
Injection, famotidine, 20 mg |
1,157 |
1,038 |
$0.00 |
| C9113 |
Injection, pantoprazole sodium, per vial |
193 |
135 |
$0.00 |
| J1644 |
Injection, heparin sodium, per 1000 units |
160 |
82 |
$0.00 |
| J2710 |
Injection, neostigmine methylsulfate, up to 0.5 mg |
42 |
38 |
$0.00 |
| 82009 |
|
86 |
78 |
$0.00 |
| C1713 |
Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) |
29 |
25 |
$0.00 |
| J2800 |
Injection, methocarbamol, up to 10 ml |
32 |
27 |
$0.00 |
| Q0244 |
Injection, casirivimab and imdevimab, 1200 mg |
73 |
68 |
$0.00 |
| S0030 |
Injection, metronidazole, 500 mg |
14 |
13 |
$0.00 |
| 36600 |
|
12 |
12 |
$0.00 |
| 99152 |
|
13 |
12 |
$0.00 |
| 84439 |
|
15 |
12 |
$0.00 |
| J1630 |
Injection, haloperidol, up to 5 mg |
264 |
215 |
$0.00 |
| M0243 |
Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring |
74 |
66 |
$0.00 |
| J0456 |
Injection, azithromycin, 500 mg |
336 |
282 |
$0.00 |
| J2543 |
Injection, piperacillin sodium/tazobactam sodium, 1 gram/0.125 grams (1.125 grams) |
130 |
92 |
$0.00 |
| 82150 |
|
13 |
12 |
$0.00 |
| 82607 |
|
12 |
12 |
$0.00 |
| 97166 |
|
43 |
39 |
$0.00 |
| J2370 |
Injection, phenylephrine hcl, up to 1 ml |
28 |
24 |
$0.00 |
| C1725 |
Catheter, transluminal angioplasty, non-laser (may include guidance, infusion/perfusion capability) |
16 |
12 |
$0.00 |
| 00790 |
|
15 |
12 |
$0.00 |