| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
Emergency department visit for the evaluation and management, high severity |
39,815 |
37,133 |
$11.36M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
13,896 |
12,228 |
$6.22M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
28,727 |
26,965 |
$4.95M |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
14,770 |
14,253 |
$2.09M |
| G0378 |
Hospital observation service, per hour |
9,795 |
5,311 |
$1.07M |
| 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 |
10,215 |
9,381 |
$883K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
12,562 |
10,892 |
$810K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
7,356 |
6,396 |
$714K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
49,849 |
43,262 |
$425K |
| A0427 |
Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) |
518 |
482 |
$424K |
| C9803 |
Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
8,596 |
7,881 |
$239K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
16,484 |
14,025 |
$228K |
| 36415 |
Collection of venous blood by venipuncture |
8,883 |
7,091 |
$193K |
| J8499 |
Prescription drug, oral, non chemotherapeutic, nos |
104,622 |
34,369 |
$181K |
| A0428 |
Ambulance service, basic life support, non-emergency transport, (bls) |
192 |
178 |
$165K |
| 70450 |
Computed tomography, head or brain; without contrast material |
1,153 |
944 |
$163K |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
3,457 |
860 |
$155K |
| 95810 |
Polysomnography; sleep staging with 4 or more additional parameters |
162 |
157 |
$144K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
637 |
499 |
$140K |
| 71046 |
Radiologic examination, chest; 2 views |
4,017 |
3,468 |
$138K |
| A0429 |
Ambulance service, basic life support, emergency transport (bls-emergency) |
207 |
191 |
$134K |
| 99233 |
Prolong inpt eval add15 m |
1,932 |
603 |
$131K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
699 |
137 |
$100K |
| 99223 |
Prolong inpt eval add15 m |
697 |
569 |
$92K |
| 95811 |
|
136 |
127 |
$83K |
| J0475 |
Injection, baclofen, 10 mg |
340 |
300 |
$80K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
597 |
579 |
$76K |
| J0585 |
Injection, onabotulinumtoxina, 1 unit |
66 |
53 |
$71K |
| 82962 |
|
3,233 |
950 |
$63K |
| 90837 |
Psychotherapy, 53 minutes with patient |
692 |
379 |
$63K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
1,369 |
773 |
$58K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
2,096 |
1,593 |
$53K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
321 |
283 |
$52K |
| 99222 |
Initial hospital care, per day, moderate complexity |
571 |
434 |
$50K |
| 99239 |
Hospital discharge day management, more than 30 minutes |
661 |
624 |
$47K |
| 62369 |
|
304 |
269 |
$40K |
| H0035 |
Mental health partial hospitalization, treatment, less than 24 hours |
66 |
12 |
$39K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
593 |
578 |
$38K |
| 80053 |
Comprehensive metabolic panel |
7,338 |
5,843 |
$37K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
1,020 |
961 |
$34K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
42,558 |
35,879 |
$31K |
| A0425 |
Ground mileage, per statute mile |
1,202 |
1,001 |
$30K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
649 |
377 |
$25K |
| 36591 |
|
308 |
234 |
$24K |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
6,081 |
4,044 |
$20K |
| 88307 |
|
196 |
149 |
$18K |
| 71045 |
Radiologic examination, chest; single view |
1,235 |
973 |
$15K |
| 82565 |
|
942 |
622 |
$15K |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
163 |
159 |
$14K |
| T1016 |
Case management, each 15 minutes |
329 |
210 |
$14K |
| C8929 |
Transthoracic echocardiography with contrast, or without contrast followed by with contrast, real-time with image documentation (2d), includes m-mode recording, when performed, complete, with spectral doppler echocardiography, and with color flow doppler echocardiography |
30 |
29 |
$13K |
| 99231 |
Subsequent hospital care, per day, straightforward or low complexity |
529 |
204 |
$12K |
| 96367 |
|
68 |
56 |
$11K |
| A0130 |
Non-emergency transportation: wheelchair van |
155 |
148 |
$11K |
| 90834 |
Psychotherapy, 45 minutes with patient |
56 |
40 |
$10K |
| 99220 |
|
74 |
73 |
$10K |
| 99217 |
|
191 |
181 |
$10K |
| 90839 |
|
96 |
90 |
$9K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
178 |
173 |
$9K |
| 99221 |
|
126 |
117 |
$8K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
106 |
88 |
$8K |
| 90791 |
Psychiatric diagnostic evaluation |
44 |
40 |
$8K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
143 |
117 |
$7K |
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
335 |
94 |
$5K |
| 99219 |
|
54 |
54 |
$5K |
| 99225 |
|
87 |
30 |
$4K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
36 |
24 |
$4K |
| 71250 |
|
13 |
13 |
$4K |
| 94726 |
|
27 |
27 |
$4K |
| 90935 |
Hemodialysis procedure with single evaluation by a physician |
80 |
26 |
$3K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
22 |
19 |
$3K |
| 84484 |
|
5,629 |
3,789 |
$3K |
| 81003 |
|
4,264 |
3,827 |
$3K |
| 85027 |
|
4,236 |
3,515 |
$2K |
| S0209 |
Wheelchair van, mileage, per mile |
152 |
145 |
$2K |
| 80076 |
|
4,532 |
3,764 |
$2K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
1,156 |
907 |
$2K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
139 |
133 |
$2K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
139 |
133 |
$2K |
| 90832 |
Psychotherapy, 30 minutes with patient |
41 |
31 |
$2K |
| 59025 |
Fetal non-stress test |
95 |
78 |
$2K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
456 |
296 |
$2K |
| 85610 |
|
1,372 |
798 |
$2K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
272 |
184 |
$1K |
| 87631 |
|
13 |
13 |
$1K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
1,147 |
693 |
$1K |
| 82947 |
|
272 |
161 |
$1K |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
632 |
424 |
$945.15 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
1,455 |
1,038 |
$930.87 |
| 97162 |
|
35 |
25 |
$918.22 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
257 |
227 |
$906.89 |
| 94010 |
|
13 |
12 |
$692.21 |
| 85060 |
|
40 |
35 |
$633.72 |
| 83735 |
|
2,584 |
1,617 |
$614.27 |
| J1642 |
Injection, heparin sodium, (heparin lock flush), per 10 units |
458 |
324 |
$602.53 |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
31 |
28 |
$593.08 |
| 88342 |
|
14 |
13 |
$518.05 |
| 83690 |
|
2,571 |
2,059 |
$506.53 |
| J3490 |
Unclassified drugs |
165 |
106 |
$449.64 |
| 81025 |
|
2,790 |
2,574 |
$401.88 |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
1,346 |
1,072 |
$332.48 |
| H2012 |
Behavioral health day treatment, per hour |
116 |
12 |
$310.52 |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
57 |
40 |
$261.34 |
| 99152 |
|
28 |
26 |
$248.33 |
| 95874 |
|
74 |
55 |
$239.87 |
| 81001 |
|
322 |
255 |
$228.43 |
| 96376 |
|
115 |
67 |
$221.80 |
| 88304 |
|
16 |
15 |
$206.30 |
| 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) |
49 |
49 |
$129.51 |
| 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 |
341 |
281 |
$110.92 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
116 |
93 |
$101.78 |
| 82803 |
|
90 |
63 |
$75.04 |
| 83880 |
|
33 |
28 |
$48.69 |
| J7050 |
Infusion, normal saline solution, 250 cc |
684 |
537 |
$44.39 |
| 83615 |
|
80 |
63 |
$41.66 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
862 |
549 |
$39.80 |
| 83605 |
|
211 |
118 |
$38.46 |
| 84132 |
|
167 |
107 |
$34.02 |
| 97166 |
|
14 |
12 |
$28.23 |
| 82077 |
|
14 |
12 |
$26.68 |
| 80320 |
|
137 |
105 |
$17.82 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
42 |
28 |
$12.63 |
| 85379 |
|
49 |
25 |
$11.40 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
137 |
114 |
$11.05 |
| 85018 |
|
22 |
12 |
$0.98 |
| 84520 |
|
58 |
39 |
$0.41 |
| 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 |
12 |
12 |
$0.08 |
| 86140 |
|
31 |
28 |
$0.04 |
| 85652 |
|
33 |
30 |
$0.02 |
| 87210 |
|
77 |
74 |
$0.00 |
| A4216 |
Sterile water, saline and/or dextrose, diluent/flush, 10 ml |
149 |
45 |
$0.00 |
| 94729 |
|
27 |
27 |
$0.00 |
| 97810 |
|
29 |
12 |
$0.00 |
| A9270 |
Non-covered item or service |
1,085 |
259 |
$0.00 |
| 87430 |
|
153 |
145 |
$0.00 |
| J7999 |
Compounded drug, not otherwise classified |
24 |
13 |
$0.00 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
42 |
27 |
$0.00 |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
31 |
15 |
$0.00 |
| 87503 |
|
26 |
13 |
$0.00 |
| J8597 |
Antiemetic drug, oral, not otherwise specified |
15 |
14 |
$0.00 |
| J2704 |
Injection, propofol, 10 mg |
21 |
15 |
$0.00 |