| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
26,935 |
23,782 |
$3.79M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
21,612 |
18,139 |
$2.99M |
| 96361 |
Intravenous infusion, hydration; each additional hour |
8,004 |
7,171 |
$2.64M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
16,857 |
15,260 |
$2.25M |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
10,440 |
9,617 |
$1.60M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
9,923 |
9,266 |
$1.48M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
8,806 |
8,123 |
$1.38M |
| 45385 |
Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) |
1,358 |
1,345 |
$1.29M |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
1,750 |
1,699 |
$999K |
| 59025 |
Fetal non-stress test |
3,302 |
1,351 |
$930K |
| 70450 |
Computed tomography, head or brain; without contrast material |
9,177 |
8,337 |
$846K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
10,709 |
10,623 |
$794K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
5,191 |
4,885 |
$680K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
11,596 |
3,861 |
$634K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
22,507 |
19,634 |
$618K |
| S9485 |
Crisis intervention mental health services, per diem |
1,502 |
1,047 |
$558K |
| G0378 |
Hospital observation service, per hour |
7,810 |
4,675 |
$527K |
| 76830 |
Ultrasound, transvaginal |
4,493 |
4,335 |
$511K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
668 |
658 |
$465K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
3,093 |
2,847 |
$410K |
| U0004 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc, making use of high throughput technologies as described by cms-2020-01-r |
6,731 |
6,280 |
$400K |
| S5102 |
Day care services, adult; per diem |
6,156 |
485 |
$390K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
5,919 |
2,438 |
$383K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
13,812 |
11,433 |
$376K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
3,443 |
3,176 |
$345K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
2,080 |
1,991 |
$314K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
12,875 |
4,111 |
$305K |
| 80053 |
Comprehensive metabolic panel |
64,241 |
56,393 |
$269K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
5,895 |
5,239 |
$266K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
2,376 |
2,186 |
$264K |
| 71046 |
Radiologic examination, chest; 2 views |
21,589 |
19,852 |
$251K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
9,173 |
8,861 |
$239K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
9,183 |
8,870 |
$238K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
2,150 |
2,072 |
$230K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
58,414 |
48,492 |
$222K |
| 76642 |
|
1,698 |
1,657 |
$216K |
| 84443 |
Thyroid stimulating hormone (TSH) |
23,287 |
22,528 |
$207K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
9,043 |
3,792 |
$191K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
10,872 |
10,791 |
$187K |
| 97161 |
|
3,402 |
3,155 |
$179K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
1,041 |
1,035 |
$177K |
| T2003 |
Non-emergency transportation; encounter/trip |
11,430 |
436 |
$176K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
1,307 |
1,200 |
$175K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
10,624 |
10,374 |
$159K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
1,146 |
1,111 |
$153K |
| 93971 |
|
1,318 |
1,224 |
$150K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
795 |
789 |
$146K |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
1,234 |
1,200 |
$141K |
| G2023 |
Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
4,648 |
4,271 |
$138K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
1,022 |
961 |
$135K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
4,640 |
4,434 |
$120K |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
4,073 |
4,027 |
$112K |
| 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 |
6,455 |
5,356 |
$109K |
| 84484 |
|
15,948 |
12,637 |
$105K |
| 76536 |
|
768 |
758 |
$102K |
| 92507 |
Treatment of speech, language, voice, communication, and/or auditory processing disorder |
672 |
257 |
$101K |
| G0108 |
Diabetes outpatient self-management training services, individual, per 30 minutes |
1,598 |
1,409 |
$101K |
| 84702 |
|
8,696 |
7,289 |
$100K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
21,704 |
21,081 |
$98K |
| 80074 |
|
2,519 |
2,435 |
$96K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
2,180 |
2,023 |
$96K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
763 |
661 |
$95K |
| 45378 |
Colonoscopy, flexible; diagnostic, including collection of specimen(s) |
64 |
63 |
$91K |
| 80061 |
Lipid panel |
27,780 |
27,265 |
$91K |
| 85027 |
|
28,183 |
25,924 |
$91K |
| 97803 |
|
1,233 |
1,084 |
$90K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
665 |
621 |
$90K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
19,208 |
17,008 |
$88K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
4,192 |
4,122 |
$81K |
| ATP14 |
|
12,174 |
9,815 |
$77K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
1,293 |
1,166 |
$76K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
7,449 |
5,366 |
$72K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
740 |
740 |
$70K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
812 |
592 |
$69K |
| 83735 |
|
21,458 |
18,391 |
$69K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
23,140 |
19,715 |
$69K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
1,450 |
1,211 |
$62K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
1,142 |
1,044 |
$62K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
12,458 |
11,194 |
$62K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
810 |
394 |
$60K |
| 73630 |
|
3,411 |
3,221 |
$59K |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
2,739 |
2,699 |
$56K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
3,368 |
3,194 |
$56K |
| 82607 |
|
7,238 |
7,056 |
$56K |
| 93975 |
|
370 |
358 |
$55K |
| 77080 |
|
1,184 |
1,165 |
$55K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
7,495 |
6,867 |
$53K |
| 99215 |
Prolong outpt/office vis |
304 |
287 |
$48K |
| 73562 |
|
2,398 |
2,171 |
$47K |
| 87480 |
|
2,858 |
2,744 |
$47K |
| 87510 |
|
2,851 |
2,741 |
$46K |
| 88342 |
|
2,651 |
2,506 |
$46K |
| 87660 |
|
2,879 |
2,768 |
$46K |
| 80050 |
General health panel |
2,963 |
2,932 |
$44K |
| 71250 |
|
749 |
725 |
$43K |
| 73130 |
|
1,761 |
1,664 |
$41K |
| 82728 |
|
5,306 |
5,131 |
$41K |
| 72100 |
|
1,580 |
1,519 |
$41K |
| 77065 |
Tomosynthesis, mammo |
675 |
649 |
$37K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
239 |
230 |
$37K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
21,571 |
18,294 |
$36K |
| 83690 |
|
8,972 |
8,137 |
$36K |
| 87070 |
|
6,997 |
6,535 |
$36K |
| 0002A |
|
1,199 |
1,181 |
$35K |
| 77061 |
|
314 |
314 |
$35K |
| 84153 |
|
2,102 |
2,085 |
$33K |
| 83880 |
|
3,186 |
2,873 |
$33K |
| 81001 |
|
19,161 |
17,289 |
$32K |
| 90791 |
Psychiatric diagnostic evaluation |
860 |
470 |
$32K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
100 |
99 |
$31K |
| 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 |
488 |
460 |
$31K |
| 81025 |
|
6,129 |
5,605 |
$30K |
| 77062 |
|
284 |
284 |
$30K |
| 93017 |
|
267 |
262 |
$30K |
| 90834 |
Psychotherapy, 45 minutes with patient |
1,837 |
1,095 |
$29K |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
1,947 |
1,860 |
$29K |
| 82948 |
|
12,609 |
8,267 |
$28K |
| 84439 |
|
5,458 |
5,272 |
$28K |
| 0001A |
|
1,237 |
1,203 |
$28K |
| 86803 |
|
2,629 |
2,605 |
$27K |
| 86850 |
|
4,767 |
4,355 |
$27K |
| 83550 |
|
5,003 |
4,838 |
$25K |
| 87186 |
|
5,697 |
5,207 |
$24K |
| 90686 |
|
1,012 |
1,000 |
$23K |
| 86480 |
|
430 |
428 |
$23K |
| 85379 |
|
3,977 |
3,747 |
$23K |
| 73610 |
|
1,913 |
1,782 |
$22K |
| S5100 |
Day care services, adult; per 15 minutes |
467 |
217 |
$22K |
| 82746 |
|
2,757 |
2,682 |
$21K |
| 82043 |
|
8,411 |
8,231 |
$21K |
| 83540 |
|
5,408 |
5,213 |
$20K |
| 94060 |
|
119 |
118 |
$20K |
| 84146 |
|
1,529 |
1,468 |
$20K |
| 73030 |
|
1,516 |
1,378 |
$19K |
| 82570 |
|
8,362 |
8,104 |
$19K |
| 97802 |
|
204 |
204 |
$18K |
| 87077 |
|
4,191 |
3,810 |
$18K |
| 80076 |
|
7,011 |
6,639 |
$17K |
| 82553 |
|
3,226 |
2,598 |
$17K |
| ATP15 |
|
2,867 |
2,345 |
$17K |
| 90715 |
|
820 |
803 |
$16K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
3,533 |
3,213 |
$16K |
| 82150 |
|
4,116 |
3,778 |
$16K |
| 83001 |
|
950 |
942 |
$16K |
| 70496 |
|
58 |
58 |
$15K |
| 85610 |
|
10,732 |
6,763 |
$15K |
| 87205 |
|
4,629 |
4,172 |
$14K |
| 82550 |
|
10,975 |
9,009 |
$14K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
237 |
230 |
$13K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
125 |
123 |
$12K |
| 86900 |
|
4,883 |
4,448 |
$12K |
| 81003 |
|
9,551 |
8,904 |
$12K |
| 86140 |
|
4,091 |
3,743 |
$12K |
| 97162 |
|
157 |
153 |
$12K |
| 84403 |
|
519 |
509 |
$12K |
| 83970 |
|
1,495 |
1,458 |
$11K |
| C9803 |
Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
3,311 |
3,007 |
$11K |
| 87650 |
|
1,106 |
1,051 |
$11K |
| 84144 |
|
620 |
486 |
$11K |
| 76770 |
|
85 |
83 |
$11K |
| 12001 |
|
57 |
54 |
$11K |
| 86592 |
|
2,879 |
2,818 |
$11K |
| 86780 |
|
1,026 |
1,011 |
$11K |
| 86787 |
|
859 |
848 |
$10K |
| 86901 |
|
4,067 |
3,695 |
$10K |
| 87522 |
Neg quan hep c or qual rna |
258 |
257 |
$10K |
| 84480 |
|
1,008 |
978 |
$10K |
| 77066 |
Tomosynthesis, mammo |
239 |
239 |
$10K |
| 86038 |
|
1,013 |
1,002 |
$10K |
| ATP08 |
|
5,450 |
4,331 |
$10K |
| 85730 |
|
3,139 |
2,878 |
$9K |
| 73110 |
|
588 |
521 |
$9K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
36 |
36 |
$9K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
7,190 |
6,059 |
$9K |
| 87147 |
|
1,835 |
1,637 |
$9K |
| 94729 |
|
98 |
98 |
$9K |
| 71271 |
|
161 |
159 |
$9K |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
2,157 |
1,807 |
$9K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
6,738 |
5,636 |
$8K |
| 80055 |
|
232 |
223 |
$8K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
6,596 |
5,259 |
$8K |
| J2704 |
Injection, propofol, 10 mg |
8,848 |
7,976 |
$8K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
670 |
651 |
$8K |
| 85652 |
|
5,130 |
4,850 |
$7K |
| 86706 |
|
791 |
783 |
$7K |
| 36415 |
Collection of venous blood by venipuncture |
58,175 |
46,423 |
$7K |
| Q3014 |
Telehealth originating site facility fee |
3,540 |
2,417 |
$7K |
| 82784 |
|
681 |
650 |
$7K |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
4,152 |
3,692 |
$7K |
| 84703 |
|
1,229 |
1,149 |
$6K |
| ATP17 |
|
4,576 |
4,069 |
$6K |
| 82670 |
|
253 |
249 |
$6K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
69 |
62 |
$6K |
| 83655 |
|
545 |
544 |
$6K |
| 82274 |
|
399 |
398 |
$6K |
| 82565 |
|
3,908 |
3,651 |
$6K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
6,429 |
5,656 |
$6K |
| 87088 |
|
1,300 |
1,179 |
$6K |
| 83605 |
|
1,228 |
1,068 |
$6K |
| 94726 |
|
62 |
62 |
$5K |
| 83516 |
|
504 |
487 |
$5K |
| 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 |
1,228 |
1,118 |
$5K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
5,546 |
4,844 |
$5K |
| 97116 |
|
197 |
120 |
$5K |
| J1170 |
Injection, hydromorphone, up to 4 mg |
1,349 |
853 |
$4K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
2,800 |
2,476 |
$4K |
| 86762 |
|
359 |
350 |
$4K |
| 83002 |
|
269 |
266 |
$4K |
| 73140 |
|
173 |
159 |
$4K |
| J0690 |
Injection, cefazolin sodium, 500 mg |
2,240 |
1,694 |
$4K |
| 87340 |
|
483 |
472 |
$4K |
| 87081 |
|
818 |
797 |
$4K |
| 87400 |
|
394 |
294 |
$4K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
49 |
46 |
$4K |
| 73502 |
|
341 |
319 |
$4K |
| J1644 |
Injection, heparin sodium, per 1000 units |
1,993 |
871 |
$4K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
213 |
189 |
$4K |
| 93970 |
|
25 |
25 |
$4K |
| 84550 |
|
2,682 |
2,539 |
$4K |
| 87040 |
|
629 |
527 |
$4K |
| 74018 |
|
100 |
95 |
$3K |
| 86618 |
|
188 |
182 |
$3K |
| 0004A |
|
106 |
105 |
$3K |
| 82951 |
|
281 |
239 |
$3K |
| 74183 |
|
12 |
12 |
$3K |
| A4649 |
Surgical supply; miscellaneous |
757 |
717 |
$3K |
| 87653 |
|
98 |
95 |
$3K |
| 84520 |
|
2,630 |
2,445 |
$3K |
| 71045 |
Radiologic examination, chest; single view |
1,157 |
1,043 |
$3K |
| 86431 |
|
581 |
567 |
$3K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
42 |
29 |
$3K |
| 88142 |
|
139 |
139 |
$2K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
6,224 |
5,654 |
$2K |
| 82248 |
|
2,242 |
2,070 |
$2K |
| 82947 |
|
1,129 |
1,086 |
$2K |
| 87625 |
|
147 |
145 |
$2K |
| 87634 |
|
40 |
39 |
$2K |
| ATP18 |
|
1,486 |
1,316 |
$2K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
20 |
13 |
$2K |
| J3490 |
Unclassified drugs |
1,080 |
859 |
$2K |
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
349 |
65 |
$2K |
| 84402 |
|
89 |
87 |
$2K |
| 70486 |
|
185 |
173 |
$2K |
| 82950 |
|
368 |
366 |
$2K |
| 82465 |
|
896 |
858 |
$2K |
| 84460 |
|
890 |
854 |
$1K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
1,493 |
1,072 |
$1K |
| 87075 |
|
270 |
247 |
$1K |
| 80051 |
|
453 |
420 |
$1K |
| 86039 |
|
107 |
107 |
$1K |
| 85014 |
|
419 |
397 |
$1K |
| 0031A |
|
40 |
38 |
$1K |
| 83020 |
|
98 |
98 |
$1K |
| 0012A |
|
96 |
90 |
$1K |
| ATP03 |
|
2,446 |
2,206 |
$1K |
| 90688 |
|
72 |
72 |
$1K |
| ATP11 |
|
861 |
781 |
$1K |
| 83021 |
|
69 |
69 |
$1K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
674 |
572 |
$1K |
| 0064A |
|
38 |
37 |
$1K |
| 84100 |
|
1,948 |
1,661 |
$1K |
| 90656 |
|
43 |
43 |
$1K |
| 81002 |
|
523 |
458 |
$1K |
| 73080 |
|
52 |
50 |
$1K |
| A9585 |
Injection, gadobutrol, 0.1 ml |
1,416 |
1,260 |
$1K |
| G0008 |
Administration of influenza virus vaccine |
748 |
732 |
$1K |
| 76775 |
|
13 |
12 |
$1K |
| 86765 |
|
80 |
79 |
$959.30 |
| 86200 |
|
83 |
83 |
$953.59 |
| 86235 |
|
20 |
16 |
$938.93 |
| 83721 |
|
540 |
534 |
$937.02 |
| 95250 |
|
44 |
37 |
$925.51 |
| 80164 |
|
455 |
418 |
$890.32 |
| 0011A |
|
91 |
87 |
$861.42 |
| 72040 |
|
13 |
13 |
$837.38 |
| 86735 |
|
66 |
66 |
$810.11 |
| 83718 |
|
112 |
112 |
$801.44 |
| 97597 |
|
45 |
26 |
$795.06 |
| ATP16 |
|
149 |
107 |
$794.97 |
| 88304 |
|
39 |
39 |
$725.07 |
| 84450 |
|
349 |
326 |
$720.25 |
| G0279 |
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) |
40 |
40 |
$711.00 |
| 94762 |
|
252 |
241 |
$661.64 |
| 0054A |
|
46 |
29 |
$659.90 |
| 99219 |
|
74 |
69 |
$577.62 |
| 86430 |
|
131 |
131 |
$577.36 |
| 85018 |
|
338 |
322 |
$535.43 |
| 82040 |
|
872 |
820 |
$523.23 |
| ATP10 |
|
336 |
271 |
$519.94 |
| 86364 |
|
56 |
55 |
$486.87 |
| 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 |
219 |
192 |
$474.42 |
| 86141 |
|
42 |
42 |
$466.05 |
| 82652 |
|
14 |
14 |
$456.56 |
| 86225 |
|
41 |
41 |
$455.62 |
| 90653 |
|
111 |
109 |
$450.17 |
| 93976 |
|
27 |
25 |
$449.05 |
| ATP02 |
|
379 |
329 |
$447.56 |
| 90662 |
|
180 |
177 |
$431.68 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
674 |
555 |
$358.53 |
| 86694 |
|
14 |
14 |
$355.32 |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
38 |
32 |
$340.30 |
| 84156 |
|
125 |
102 |
$339.89 |
| 84436 |
|
96 |
95 |
$312.01 |
| ATP07 |
|
129 |
110 |
$286.62 |
| J2060 |
Injection, lorazepam, 2 mg |
972 |
759 |
$283.40 |
| 90691 |
|
12 |
12 |
$274.62 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
823 |
588 |
$257.97 |
| 87427 |
|
25 |
25 |
$243.67 |
| J1630 |
Injection, haloperidol, up to 5 mg |
150 |
126 |
$224.64 |
| 83993 |
|
12 |
12 |
$218.16 |
| 86160 |
|
12 |
12 |
$211.32 |
| J1815 |
Injection, insulin, per 5 units |
136 |
41 |
$210.73 |
| G0103 |
Prostate cancer screening; prostate specific antigen test (psa) |
985 |
971 |
$208.31 |
| 72170 |
|
157 |
147 |
$193.96 |
| 87045 |
|
25 |
25 |
$192.08 |
| 91300 |
|
983 |
864 |
$183.25 |
| ATP09 |
|
98 |
77 |
$179.20 |
| 86800 |
|
13 |
12 |
$171.54 |
| 71100 |
|
27 |
26 |
$153.74 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
19 |
15 |
$143.08 |
| 80178 |
|
160 |
141 |
$134.82 |
| 82310 |
|
78 |
75 |
$124.18 |
| 85384 |
|
16 |
12 |
$120.41 |
| Q9966 |
Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml |
269 |
254 |
$118.27 |
| 81015 |
|
84 |
83 |
$116.58 |
| 86308 |
|
26 |
26 |
$107.18 |
| 86769 |
|
17 |
15 |
$84.26 |
| 88341 |
|
39 |
39 |
$82.04 |
| 96376 |
|
1,040 |
697 |
$55.89 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
406 |
364 |
$51.98 |
| 84075 |
|
12 |
12 |
$44.00 |
| 94761 |
|
1,150 |
1,029 |
$25.28 |
| 90694 |
|
14 |
14 |
$25.08 |
| 85041 |
|
12 |
12 |
$19.32 |
| 84132 |
|
96 |
81 |
$18.92 |
| 80320 |
|
3,114 |
2,695 |
$18.24 |
| 85007 |
|
29 |
26 |
$14.16 |
| 80185 |
|
15 |
13 |
$13.67 |
| 80177 |
|
14 |
13 |
$13.67 |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
201 |
179 |
$8.64 |
| G8978 |
Mobility: walking & moving around functional limitation, current status, at therapy episode outset and at reporting intervals |
492 |
468 |
$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 |
557 |
515 |
$0.00 |
| 29125 |
|
12 |
12 |
$0.00 |
| 01999 |
|
27 |
25 |
$0.00 |
| G0476 |
Infectious agent detection by nucleic acid (dna or rna); human papillomavirus (hpv), high-risk types (e.g., 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68) for cervical cancer screening, must be performed in addition to pap test |
76 |
75 |
$0.00 |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
66 |
26 |
$0.00 |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
25 |
25 |
$0.00 |
| 99001 |
|
54 |
54 |
$0.00 |
| 94760 |
|
1,035 |
967 |
$0.00 |
| G0328 |
Colorectal cancer screening; fecal occult blood test, immunoassay, 1-3 simultaneous |
70 |
70 |
$0.00 |
| 91301 |
|
29 |
26 |
$0.00 |
| 36000 |
|
629 |
599 |
$0.00 |
| 80069 |
|
111 |
108 |
$0.00 |
| G8980 |
Mobility: walking & moving around functional limitation, discharge status, at discharge from therapy or to end reporting |
14 |
13 |
$0.00 |
| J2370 |
Injection, phenylephrine hcl, up to 1 ml |
13 |
13 |
$0.00 |
| 70498 |
|
56 |
56 |
$0.00 |
| 91303 |
|
16 |
16 |
$0.00 |
| 91306 |
|
17 |
17 |
$0.00 |
| 91305 |
|
14 |
13 |
$0.00 |
| C1769 |
Guide wire |
16 |
12 |
$0.00 |