| Code | Description | Claims | Beneficiaries | Total Paid |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
29,007 |
27,650 |
$3.82M |
| G0378 |
Hospital observation service, per hour |
4,523 |
4,244 |
$3.65M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
25,646 |
24,712 |
$2.94M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
24,803 |
24,177 |
$2.17M |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
5,055 |
4,942 |
$488K |
| 87637 |
Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV |
3,962 |
3,926 |
$439K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
3,072 |
2,972 |
$434K |
| G0379 |
Direct admission of patient for hospital observation care |
418 |
362 |
$278K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
43,499 |
37,740 |
$276K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
9,066 |
8,436 |
$207K |
| 71046 |
Radiologic examination, chest; 2 views |
14,248 |
13,878 |
$202K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
47,588 |
40,892 |
$189K |
| T1015 |
Clinic visit/encounter, all-inclusive |
4,050 |
3,334 |
$177K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
18,613 |
17,223 |
$150K |
| 70450 |
Computed tomography, head or brain; without contrast material |
3,109 |
2,979 |
$142K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
1,344 |
839 |
$124K |
| 80076 |
|
19,574 |
18,379 |
$123K |
| 84484 |
|
15,061 |
13,327 |
$123K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
1,194 |
1,168 |
$80K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
800 |
772 |
$78K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
384 |
379 |
$77K |
| 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 |
1,173 |
1,141 |
$69K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
5,829 |
5,005 |
$68K |
| 83735 |
|
14,485 |
12,844 |
$65K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
1,576 |
1,494 |
$58K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
241 |
235 |
$57K |
| 0002A |
|
1,259 |
1,253 |
$55K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
5,579 |
4,908 |
$54K |
| 84703 |
|
6,422 |
6,235 |
$53K |
| 0001A |
|
1,323 |
1,310 |
$52K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
1,286 |
1,257 |
$50K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
922 |
875 |
$47K |
| 83690 |
|
12,654 |
12,044 |
$45K |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
479 |
478 |
$42K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
342 |
338 |
$40K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
426 |
424 |
$37K |
| 81001 |
|
17,390 |
16,558 |
$37K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
275 |
270 |
$37K |
| 69436 |
Tympanostomy (requiring insertion of ventilating tube), general anesthesia |
77 |
77 |
$36K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
2,246 |
1,830 |
$33K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
402 |
395 |
$28K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
504 |
495 |
$28K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
563 |
551 |
$27K |
| 80053 |
Comprehensive metabolic panel |
3,722 |
3,077 |
$27K |
| 72141 |
|
141 |
140 |
$26K |
| 36415 |
Collection of venous blood by venipuncture |
24,931 |
21,351 |
$25K |
| C1713 |
Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) |
65 |
62 |
$25K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
248 |
243 |
$25K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
3,054 |
2,623 |
$24K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
367 |
363 |
$23K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
661 |
589 |
$23K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
118 |
116 |
$22K |
| 71045 |
Radiologic examination, chest; single view |
4,353 |
4,076 |
$22K |
| 93971 |
|
430 |
414 |
$20K |
| 45378 |
Colonoscopy, flexible; diagnostic, including collection of specimen(s) |
68 |
68 |
$20K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
3,926 |
3,682 |
$18K |
| 76642 |
|
480 |
426 |
$18K |
| 70498 |
|
235 |
229 |
$18K |
| J3490 |
Unclassified drugs |
3,978 |
2,968 |
$17K |
| 71250 |
|
331 |
319 |
$16K |
| 70496 |
|
222 |
215 |
$16K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
593 |
573 |
$14K |
| 93970 |
|
232 |
227 |
$13K |
| 87040 |
|
1,441 |
1,334 |
$13K |
| 70486 |
|
238 |
233 |
$13K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
1,446 |
1,354 |
$13K |
| 93296 |
|
1,219 |
1,212 |
$13K |
| 77065 |
Tomosynthesis, mammo |
234 |
225 |
$13K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
413 |
398 |
$13K |
| 96376 |
|
1,297 |
952 |
$12K |
| 93976 |
|
210 |
203 |
$12K |
| 88342 |
|
496 |
479 |
$12K |
| 97597 |
|
456 |
231 |
$11K |
| 93975 |
|
143 |
140 |
$11K |
| 77066 |
Tomosynthesis, mammo |
155 |
154 |
$11K |
| 87631 |
|
83 |
80 |
$10K |
| 45385 |
Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) |
39 |
38 |
$10K |
| 73610 |
|
608 |
580 |
$10K |
| 87081 |
|
2,118 |
2,078 |
$9K |
| J2785 |
Injection, regadenoson, 0.1 mg |
350 |
325 |
$9K |
| 76801 |
|
321 |
307 |
$9K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,563 |
1,531 |
$9K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
1,088 |
756 |
$9K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
343 |
336 |
$9K |
| 72100 |
|
464 |
461 |
$9K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
565 |
548 |
$9K |
| 93017 |
|
484 |
475 |
$9K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
562 |
545 |
$9K |
| 76830 |
Ultrasound, transvaginal |
286 |
279 |
$9K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
366 |
365 |
$9K |
| 74174 |
|
73 |
67 |
$9K |
| 81025 |
|
2,897 |
2,786 |
$8K |
| 83605 |
|
2,400 |
1,903 |
$8K |
| 73630 |
|
843 |
780 |
$8K |
| 80050 |
General health panel |
182 |
180 |
$8K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
736 |
323 |
$8K |
| 80299 |
|
390 |
353 |
$7K |
| 84443 |
Thyroid stimulating hormone (TSH) |
973 |
935 |
$7K |
| 85379 |
|
1,165 |
1,113 |
$7K |
| 73030 |
|
567 |
544 |
$7K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
533 |
506 |
$7K |
| 90715 |
|
990 |
950 |
$7K |
| 83880 |
|
801 |
719 |
$6K |
| 73562 |
|
475 |
460 |
$6K |
| 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 |
348 |
345 |
$6K |
| 80061 |
Lipid panel |
1,208 |
1,138 |
$6K |
| 84702 |
|
505 |
470 |
$6K |
| 76536 |
|
128 |
127 |
$6K |
| 87088 |
|
1,222 |
1,161 |
$6K |
| 73130 |
|
548 |
502 |
$6K |
| 70491 |
|
86 |
86 |
$5K |
| 72131 |
|
103 |
100 |
$5K |
| 81003 |
|
1,943 |
1,914 |
$5K |
| 43235 |
|
50 |
50 |
$5K |
| 73502 |
|
368 |
357 |
$5K |
| 93922 |
|
241 |
231 |
$4K |
| 86850 |
|
1,088 |
1,020 |
$4K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
58 |
57 |
$4K |
| 88341 |
|
79 |
74 |
$4K |
| 84999 |
|
1,090 |
982 |
$4K |
| 10060 |
|
58 |
57 |
$4K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
92 |
90 |
$3K |
| 73110 |
|
352 |
335 |
$3K |
| 93880 |
|
41 |
41 |
$3K |
| 73700 |
|
53 |
51 |
$3K |
| 72040 |
|
233 |
232 |
$3K |
| 74019 |
|
271 |
239 |
$3K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
16,253 |
12,375 |
$3K |
| 86900 |
|
1,300 |
1,222 |
$3K |
| 0003A |
|
111 |
111 |
$3K |
| 86901 |
|
1,298 |
1,221 |
$3K |
| 73560 |
|
251 |
235 |
$3K |
| 96367 |
|
368 |
298 |
$3K |
| J2710 |
Injection, neostigmine methylsulfate, up to 0.5 mg |
605 |
513 |
$2K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
89 |
89 |
$2K |
| C1769 |
Guide wire |
122 |
116 |
$2K |
| 82728 |
|
289 |
274 |
$2K |
| 96417 |
|
42 |
27 |
$2K |
| 85730 |
|
1,068 |
958 |
$2K |
| 85610 |
|
1,617 |
1,390 |
$2K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
1,058 |
1,030 |
$2K |
| 82550 |
|
606 |
557 |
$2K |
| 85027 |
|
807 |
707 |
$2K |
| 0223U |
|
13 |
12 |
$2K |
| C1781 |
Mesh (implantable) |
12 |
12 |
$2K |
| 80320 |
|
253 |
238 |
$2K |
| 87210 |
|
475 |
452 |
$2K |
| 87077 |
|
409 |
398 |
$2K |
| J2704 |
Injection, propofol, 10 mg |
6,019 |
5,081 |
$2K |
| 82962 |
|
2,723 |
1,661 |
$2K |
| 74018 |
|
157 |
153 |
$2K |
| 77062 |
|
68 |
67 |
$1K |
| J1170 |
Injection, hydromorphone, up to 4 mg |
3,316 |
2,443 |
$1K |
| 99153 |
Mod sedat endo service >5yrs |
512 |
482 |
$1K |
| 84439 |
|
279 |
267 |
$1K |
| 73590 |
|
111 |
107 |
$1K |
| 76775 |
|
41 |
41 |
$1K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
282 |
267 |
$1K |
| 84100 |
|
642 |
488 |
$1K |
| 83540 |
|
258 |
250 |
$1K |
| J1756 |
Injection, iron sucrose, 1 mg |
278 |
96 |
$1K |
| 77061 |
|
67 |
67 |
$1K |
| 87070 |
|
369 |
344 |
$1K |
| 12001 |
|
77 |
75 |
$1K |
| 73090 |
|
120 |
115 |
$1K |
| 97161 |
|
285 |
272 |
$1K |
| 87186 |
|
288 |
278 |
$1K |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
6,135 |
4,951 |
$1K |
| 82607 |
|
164 |
162 |
$1K |
| 73080 |
|
110 |
107 |
$1K |
| 88304 |
|
310 |
301 |
$977.90 |
| 87075 |
|
213 |
197 |
$927.00 |
| 77336 |
|
27 |
13 |
$913.95 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
13,948 |
11,242 |
$899.64 |
| 73140 |
|
119 |
119 |
$880.12 |
| 94729 |
|
27 |
24 |
$824.38 |
| 76870 |
|
29 |
25 |
$819.92 |
| 88313 |
|
12 |
12 |
$815.76 |
| 93225 |
|
41 |
40 |
$800.53 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
2,547 |
1,625 |
$783.43 |
| 83550 |
|
226 |
219 |
$757.76 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
7,226 |
5,648 |
$734.24 |
| A9500 |
Technetium tc-99m sestamibi, diagnostic, per study dose |
384 |
375 |
$725.76 |
| 87205 |
|
320 |
299 |
$703.62 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
2,680 |
2,009 |
$703.24 |
| 12002 |
|
26 |
26 |
$695.81 |
| 99152 |
|
276 |
267 |
$668.71 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
7,546 |
6,143 |
$663.09 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
3,181 |
2,523 |
$601.91 |
| 85652 |
|
500 |
469 |
$575.69 |
| 72128 |
|
12 |
12 |
$560.33 |
| 97165 |
|
287 |
277 |
$543.20 |
| J1644 |
Injection, heparin sodium, per 1000 units |
3,023 |
1,448 |
$539.74 |
| 86140 |
|
494 |
458 |
$536.47 |
| J3370 |
Injection, vancomycin hcl, 500 mg |
322 |
165 |
$534.93 |
| 72070 |
|
30 |
30 |
$529.25 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
578 |
517 |
$468.86 |
| 80329 |
|
102 |
96 |
$467.86 |
| 86920 |
|
27 |
24 |
$402.36 |
| 86308 |
|
77 |
75 |
$376.73 |
| 59025 |
Fetal non-stress test |
145 |
130 |
$365.63 |
| 82010 |
|
123 |
115 |
$317.90 |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
1,129 |
518 |
$314.03 |
| 12011 |
|
12 |
12 |
$311.85 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
10,898 |
9,039 |
$306.01 |
| 71101 |
|
26 |
25 |
$282.39 |
| 82553 |
|
80 |
77 |
$277.33 |
| C1894 |
Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser |
119 |
115 |
$269.37 |
| C9113 |
Injection, pantoprazole sodium, per vial |
562 |
271 |
$255.54 |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
1,354 |
1,104 |
$241.49 |
| 36430 |
|
27 |
24 |
$236.47 |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
12 |
12 |
$220.53 |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
324 |
246 |
$219.03 |
| J2795 |
Injection, ropivacaine hydrochloride, 1 mg |
159 |
114 |
$212.67 |
| 95816 |
|
37 |
34 |
$209.08 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
58 |
41 |
$208.54 |
| 83615 |
|
37 |
31 |
$197.42 |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
206 |
184 |
$196.23 |
| J1040 |
Injection, methylprednisolone acetate, 80 mg |
66 |
59 |
$182.73 |
| 97162 |
|
103 |
100 |
$179.25 |
| J0171 |
Injection, adrenalin, epinephrine, 0.1 mg |
119 |
88 |
$176.20 |
| 94761 |
|
463 |
348 |
$169.56 |
| 94060 |
|
14 |
13 |
$169.25 |
| J7050 |
Infusion, normal saline solution, 250 cc |
2,819 |
1,626 |
$158.31 |
| 82746 |
|
25 |
25 |
$143.52 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
5,666 |
5,041 |
$142.42 |
| J3480 |
Injection, potassium chloride, per 2 meq |
465 |
242 |
$138.73 |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
1,707 |
1,253 |
$136.57 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
3,055 |
2,578 |
$133.06 |
| J7060 |
5% dextrose/water (500 ml = 1 unit) |
661 |
439 |
$127.89 |
| 82140 |
|
62 |
59 |
$111.13 |
| J1815 |
Injection, insulin, per 5 units |
1,549 |
600 |
$109.98 |
| 88307 |
|
30 |
27 |
$101.20 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
1,466 |
1,263 |
$98.10 |
| J0295 |
Injection, ampicillin sodium/sulbactam sodium, per 1.5 gm |
233 |
135 |
$92.35 |
| 84550 |
|
16 |
12 |
$84.94 |
| S0030 |
Injection, metronidazole, 500 mg |
104 |
64 |
$84.48 |
| 88173 |
|
12 |
12 |
$75.13 |
| J2060 |
Injection, lorazepam, 2 mg |
479 |
357 |
$73.75 |
| A9270 |
Non-covered item or service |
32,650 |
12,201 |
$70.45 |
| 85045 |
|
15 |
12 |
$66.96 |
| 84145 |
|
56 |
53 |
$48.86 |
| J0692 |
Injection, cefepime hydrochloride, 500 mg |
25 |
13 |
$26.46 |
| 88108 |
|
14 |
13 |
$23.12 |
| J7999 |
Compounded drug, not otherwise classified |
170 |
148 |
$20.96 |
| 94760 |
|
81 |
61 |
$17.99 |
| J2543 |
Injection, piperacillin sodium/tazobactam sodium, 1 gram/0.125 grams (1.125 grams) |
25 |
12 |
$17.04 |
| 88311 |
|
14 |
13 |
$13.62 |
| 85018 |
|
21 |
15 |
$13.42 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
2,805 |
2,544 |
$12.83 |
| J2370 |
Injection, phenylephrine hcl, up to 1 ml |
90 |
68 |
$10.80 |
| 84132 |
|
12 |
12 |
$6.97 |
| J8540 |
Dexamethasone, oral, 0.25 mg |
868 |
818 |
$1.60 |
| J1630 |
Injection, haloperidol, up to 5 mg |
29 |
24 |
$0.89 |
| J1940 |
Injection, furosemide, up to 20 mg |
33 |
26 |
$0.55 |
| G1004 |
Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program |
5,380 |
4,444 |
$0.26 |
| Q9969 |
Tc-99m from non-highly enriched uranium source, full cost recovery add-on, per study dose |
94 |
94 |
$0.00 |
| J2469 |
Injection, palonosetron hcl, 25 mcg |
115 |
66 |
$0.00 |
| J1836 |
Injection, metronidazole, 10 mg |
185 |
130 |
$0.00 |
| 82077 |
|
28 |
27 |
$0.00 |
| J3420 |
Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg |
16 |
12 |
$0.00 |
| J2471 |
Injection, pantoprazole (hikma), not therapeutically equivalent to j2470, 40 mg |
57 |
27 |
$0.00 |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
552 |
536 |
$0.00 |
| J0689 |
Injection, cefazolin sodium (baxter), not therapeutically equivalent to j0690, 500 mg |
177 |
156 |
$0.00 |
| J1596 |
Injection, glycopyrrolate, 0.1 mg |
13 |
12 |
$0.00 |
| 0004A |
|
36 |
36 |
$0.00 |
| J2919 |
Injection, methylprednisolone sodium succinate, 5 mg |
78 |
54 |
$0.00 |
| J1171 |
Injection, hydromorphone, 0.1 mg |
76 |
50 |
$0.00 |
| J9271 |
Injection, pembrolizumab, 1 mg |
18 |
12 |
$0.00 |
| 0054A |
|
17 |
17 |
$0.00 |