| Code | Description | Claims | Beneficiaries | Total Paid |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
940,012 |
874,914 |
$24.29M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
268,088 |
253,680 |
$10.95M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
241,617 |
232,216 |
$8.17M |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
177,060 |
170,868 |
$6.08M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
96,855 |
92,749 |
$5.57M |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
158,622 |
150,725 |
$4.68M |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
76,347 |
73,639 |
$2.63M |
| 99215 |
Prolong outpt/office vis |
32,681 |
31,242 |
$1.91M |
| 99244 |
Office or other outpatient consultation, moderate to high complexity |
28,630 |
27,171 |
$1.60M |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
28,833 |
27,268 |
$1.60M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
17,286 |
16,695 |
$1.50M |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
32,513 |
30,916 |
$1.06M |
| 99243 |
|
32,441 |
31,766 |
$1.02M |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
85,789 |
37,273 |
$996K |
| 99479 |
Subsequent intensive care, per day, very low birth weight infant |
9,034 |
3,526 |
$808K |
| 99460 |
|
11,007 |
10,517 |
$796K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
19,580 |
18,993 |
$785K |
| 95720 |
|
4,836 |
3,285 |
$758K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
9,559 |
7,260 |
$724K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
19,909 |
16,905 |
$639K |
| 69436 |
Tympanostomy (requiring insertion of ventilating tube), general anesthesia |
4,474 |
4,042 |
$587K |
| 92015 |
Determination of refractive state |
32,931 |
30,775 |
$542K |
| 95004 |
Percutaneous tests with allergenic extracts, immediate type reaction |
9,149 |
8,390 |
$510K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
20,326 |
12,806 |
$486K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
7,415 |
6,946 |
$437K |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
57,636 |
53,662 |
$436K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
13,945 |
13,294 |
$432K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
8,262 |
7,872 |
$391K |
| 99480 |
Subsequent intensive care, per day, low birth weight infant |
4,433 |
1,775 |
$382K |
| 42820 |
Tonsillectomy and adenoidectomy; younger than age 12 |
1,836 |
1,769 |
$332K |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
11,790 |
6,109 |
$329K |
| 95951 |
|
2,417 |
1,468 |
$328K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
22,985 |
21,658 |
$302K |
| 93303 |
Transthoracic echocardiography for congenital cardiac anomalies, follow-up or limited study |
6,073 |
5,591 |
$291K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
11,382 |
10,236 |
$278K |
| 99469 |
Subsequent inpatient neonatal critical care, per day, 28 days or younger |
1,016 |
405 |
$277K |
| 99233 |
Prolong inpt eval add15 m |
6,394 |
3,836 |
$246K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
5,457 |
5,167 |
$195K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
10,151 |
9,901 |
$190K |
| 76770 |
|
6,892 |
6,591 |
$158K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
1,262 |
1,214 |
$137K |
| 99219 |
|
2,300 |
2,261 |
$125K |
| 93320 |
|
7,474 |
6,641 |
$112K |
| 99205 |
Prolong outpt/office vis |
1,496 |
1,449 |
$105K |
| 94010 |
|
17,773 |
16,862 |
$103K |
| 99462 |
|
3,204 |
2,484 |
$102K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
4,802 |
4,647 |
$95K |
| 95810 |
Polysomnography; sleep staging with 4 or more additional parameters |
1,432 |
1,390 |
$94K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,673 |
2,604 |
$91K |
| 67311 |
|
192 |
180 |
$88K |
| 99472 |
Subsequent inpatient pediatric critical care, per day, 2-5 years |
291 |
109 |
$88K |
| 88307 |
|
1,456 |
1,400 |
$80K |
| 92060 |
|
5,814 |
5,463 |
$79K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
32,908 |
32,279 |
$73K |
| 99223 |
Prolong inpt eval add15 m |
910 |
815 |
$69K |
| 01922 |
|
410 |
389 |
$67K |
| 93325 |
|
19,117 |
17,135 |
$67K |
| 99254 |
|
929 |
856 |
$61K |
| 99245 |
|
928 |
901 |
$61K |
| 76801 |
|
2,250 |
2,049 |
$60K |
| 76820 |
|
3,089 |
1,814 |
$59K |
| 99217 |
|
1,693 |
1,668 |
$56K |
| 99253 |
|
1,249 |
1,190 |
$49K |
| 95812 |
|
1,702 |
1,611 |
$49K |
| 95819 |
|
1,901 |
1,858 |
$47K |
| 96127 |
|
25,864 |
23,032 |
$47K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
3,258 |
3,054 |
$45K |
| 99231 |
Subsequent hospital care, per day, straightforward or low complexity |
2,830 |
1,484 |
$45K |
| 00170 |
Anesthesia for intraoral procedures, including biopsy |
639 |
627 |
$42K |
| 42830 |
|
405 |
384 |
$40K |
| 99239 |
Hospital discharge day management, more than 30 minutes |
926 |
866 |
$38K |
| 17110 |
|
1,299 |
1,256 |
$37K |
| 99242 |
|
1,580 |
1,566 |
$34K |
| 76825 |
|
389 |
363 |
$34K |
| 93304 |
|
1,161 |
1,085 |
$32K |
| 76813 |
|
789 |
714 |
$32K |
| 99222 |
Initial hospital care, per day, moderate complexity |
569 |
515 |
$32K |
| 96161 |
|
20,295 |
19,892 |
$31K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
867 |
821 |
$29K |
| 64643 |
|
424 |
388 |
$29K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
409 |
209 |
$29K |
| 90677 |
|
5,607 |
5,428 |
$27K |
| 99471 |
|
39 |
39 |
$26K |
| 64642 |
|
359 |
340 |
$25K |
| 92201 |
|
1,548 |
985 |
$25K |
| 49452 |
|
288 |
214 |
$24K |
| 71046 |
Radiologic examination, chest; 2 views |
2,703 |
2,610 |
$24K |
| 95251 |
|
1,456 |
1,350 |
$22K |
| 92250 |
|
3,115 |
2,679 |
$21K |
| 88300 |
|
5,646 |
5,239 |
$20K |
| 99442 |
|
957 |
928 |
$19K |
| 88304 |
|
2,168 |
2,030 |
$18K |
| 99381 |
|
597 |
545 |
$18K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
236 |
216 |
$17K |
| 95782 |
|
265 |
249 |
$16K |
| 54150 |
|
325 |
293 |
$16K |
| 71045 |
Radiologic examination, chest; single view |
2,114 |
1,568 |
$14K |
| 93321 |
|
2,089 |
1,973 |
$13K |
| 99417 |
Prolong home eval add 15m |
398 |
281 |
$13K |
| 72082 |
|
968 |
929 |
$12K |
| 95718 |
|
115 |
111 |
$12K |
| 74019 |
|
1,356 |
1,276 |
$11K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,092 |
888 |
$11K |
| 95165 |
Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy, multiple dose vials |
278 |
270 |
$11K |
| 96112 |
|
422 |
383 |
$11K |
| 99383 |
|
219 |
209 |
$10K |
| 76827 |
|
399 |
374 |
$10K |
| 76857 |
|
602 |
558 |
$9K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
808 |
584 |
$9K |
| 88342 |
|
344 |
318 |
$8K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
450 |
426 |
$8K |
| 74018 |
|
1,145 |
1,014 |
$7K |
| 99252 |
|
229 |
220 |
$7K |
| 92551 |
|
1,180 |
1,101 |
$7K |
| 90619 |
|
654 |
634 |
$7K |
| 93227 |
|
305 |
290 |
$7K |
| 99218 |
|
195 |
189 |
$7K |
| 96160 |
|
4,205 |
4,167 |
$7K |
| 99188 |
|
405 |
376 |
$6K |
| 90686 |
|
1,239 |
1,183 |
$6K |
| 90656 |
|
5,500 |
5,301 |
$6K |
| 59025 |
Fetal non-stress test |
310 |
184 |
$6K |
| 70450 |
Computed tomography, head or brain; without contrast material |
146 |
140 |
$5K |
| 72081 |
|
519 |
497 |
$4K |
| 99220 |
|
56 |
56 |
$4K |
| 99382 |
|
87 |
86 |
$4K |
| 99443 |
|
154 |
150 |
$3K |
| 92226 |
|
345 |
222 |
$3K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
14 |
14 |
$3K |
| 99384 |
|
52 |
50 |
$3K |
| 99173 |
|
1,188 |
1,116 |
$3K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
112 |
100 |
$3K |
| 99225 |
|
103 |
89 |
$2K |
| 90651 |
|
766 |
752 |
$2K |
| 96111 |
|
124 |
123 |
$2K |
| 90461 |
|
2,699 |
616 |
$2K |
| 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) |
18,561 |
17,619 |
$2K |
| 99441 |
|
156 |
149 |
$2K |
| 76942 |
|
106 |
96 |
$1K |
| 90715 |
|
383 |
367 |
$1K |
| 00126 |
|
34 |
33 |
$1K |
| 99226 |
|
42 |
38 |
$1K |
| 92541 |
|
194 |
171 |
$1K |
| 99255 |
|
14 |
14 |
$1K |
| 99309 |
Subsequent nursing facility care, per day, low to moderate complexity |
48 |
42 |
$1K |
| 93272 |
|
59 |
58 |
$1K |
| 99236 |
Prolong inpt eval add15 m |
12 |
12 |
$1K |
| 73140 |
|
205 |
189 |
$1K |
| 99350 |
Prolong home eval add 15m |
12 |
12 |
$1K |
| 95873 |
|
75 |
67 |
$1K |
| 76818 |
|
36 |
27 |
$1K |
| 95813 |
|
27 |
26 |
$1K |
| 00140 |
|
15 |
15 |
$1K |
| 92133 |
|
119 |
104 |
$987.33 |
| 90633 |
|
841 |
809 |
$977.50 |
| 00731 |
|
15 |
15 |
$936.87 |
| 11900 |
|
72 |
70 |
$924.92 |
| 95874 |
|
42 |
39 |
$841.63 |
| 92542 |
|
205 |
183 |
$825.18 |
| 96132 |
|
17 |
13 |
$819.54 |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
12 |
12 |
$705.88 |
| 73610 |
|
101 |
97 |
$697.72 |
| 85060 |
|
43 |
39 |
$642.56 |
| 95816 |
|
26 |
26 |
$625.17 |
| 41010 |
|
12 |
12 |
$614.39 |
| 11102 |
|
25 |
25 |
$578.88 |
| 92134 |
|
87 |
69 |
$568.01 |
| 73630 |
|
71 |
69 |
$526.85 |
| 73564 |
|
60 |
60 |
$506.91 |
| 74230 |
|
27 |
27 |
$466.27 |
| 92545 |
|
193 |
171 |
$462.20 |
| 99308 |
Subsequent nursing facility care, per day, straightforward |
31 |
27 |
$386.88 |
| 77074 |
|
24 |
24 |
$362.01 |
| 72170 |
|
49 |
45 |
$346.89 |
| 99221 |
|
13 |
12 |
$346.77 |
| 69210 |
|
32 |
26 |
$337.54 |
| 90734 |
|
160 |
149 |
$335.88 |
| 99241 |
|
27 |
26 |
$325.52 |
| 99201 |
|
28 |
27 |
$309.59 |
| 99251 |
|
13 |
12 |
$225.14 |
| 73130 |
|
28 |
28 |
$208.43 |
| 92202 |
|
16 |
13 |
$194.07 |
| 73110 |
|
24 |
24 |
$174.75 |
| 90620 |
|
41 |
40 |
$158.75 |
| 92225 |
|
16 |
15 |
$157.58 |
| 40806 |
|
14 |
12 |
$144.78 |
| 94060 |
|
12 |
12 |
$127.93 |
| 73080 |
|
24 |
24 |
$126.17 |
| 73090 |
|
16 |
15 |
$114.53 |
| 90710 |
|
166 |
166 |
$103.75 |
| 77072 |
|
15 |
15 |
$93.93 |
| 87081 |
|
26 |
17 |
$91.36 |
| 73590 |
|
12 |
12 |
$86.20 |
| V5266 |
Battery for use in hearing device |
13 |
13 |
$40.74 |
| 95012 |
|
12 |
12 |
$25.56 |
| 90700 |
|
50 |
48 |
$20.00 |
| 90697 |
|
2,959 |
2,870 |
$17.85 |
| 90680 |
|
2,101 |
2,027 |
$11.90 |
| 90713 |
|
68 |
64 |
$10.00 |
| 90744 |
|
42 |
39 |
$10.00 |
| 90716 |
|
140 |
127 |
$10.00 |
| 90707 |
|
105 |
95 |
$0.00 |
| 90648 |
|
12 |
12 |
$0.00 |
| 1036F |
|
1,523 |
1,307 |
$0.00 |
| 90696 |
|
61 |
61 |
$0.00 |
| 93790 |
|
25 |
25 |
$0.00 |
| 96120 |
|
18 |
12 |
$0.00 |
| 90660 |
|
40 |
40 |
$0.00 |