| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
Emergency department visit for the evaluation and management, high severity |
31,220 |
21,827 |
$4.83M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
29,784 |
19,370 |
$3.37M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
9,207 |
6,434 |
$1.97M |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
42,522 |
40,310 |
$469K |
| 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 |
3,059 |
2,965 |
$248K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
1,599 |
1,490 |
$214K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
11,264 |
10,989 |
$145K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
1,235 |
1,101 |
$101K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
972 |
927 |
$99K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
2,552 |
2,428 |
$85K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
1,399 |
1,314 |
$82K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
2,551 |
2,427 |
$82K |
| 36415 |
Collection of venous blood by venipuncture |
25,814 |
22,454 |
$64K |
| 0202U |
Oncology (prostate), multianalyte, gene expression profiling |
188 |
179 |
$61K |
| 90834 |
Psychotherapy, 45 minutes with patient |
524 |
232 |
$53K |
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
833 |
202 |
$52K |
| 59025 |
Fetal non-stress test |
402 |
254 |
$50K |
| 87428 |
|
1,889 |
1,829 |
$50K |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
6,817 |
6,063 |
$49K |
| D2930 |
Prefabricated stainless steel crown - primary tooth |
90 |
90 |
$47K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
1,024 |
958 |
$44K |
| 71046 |
Radiologic examination, chest; 2 views |
515 |
494 |
$31K |
| 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 |
1,732 |
1,681 |
$29K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
288 |
266 |
$28K |
| 87081 |
|
4,561 |
4,399 |
$28K |
| 80053 |
Comprehensive metabolic panel |
12,142 |
11,418 |
$23K |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
169 |
166 |
$22K |
| 69436 |
Tympanostomy (requiring insertion of ventilating tube), general anesthesia |
27 |
25 |
$22K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
2,535 |
2,472 |
$18K |
| 84443 |
Thyroid stimulating hormone (TSH) |
1,570 |
1,498 |
$17K |
| 80061 |
Lipid panel |
1,491 |
1,452 |
$16K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
2,440 |
1,725 |
$16K |
| 90791 |
Psychiatric diagnostic evaluation |
131 |
121 |
$16K |
| 71045 |
Radiologic examination, chest; single view |
280 |
266 |
$16K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
108 |
80 |
$15K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
378 |
370 |
$13K |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
576 |
548 |
$13K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
701 |
680 |
$13K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
659 |
641 |
$12K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
15,445 |
14,375 |
$12K |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
305 |
283 |
$9K |
| 86900 |
|
144 |
133 |
$9K |
| 45385 |
Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) |
23 |
12 |
$6K |
| 87480 |
|
296 |
279 |
$6K |
| 87510 |
|
296 |
279 |
$6K |
| 87660 |
|
296 |
279 |
$6K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
172 |
169 |
$6K |
| 83655 |
|
550 |
529 |
$6K |
| D0190 |
|
334 |
332 |
$5K |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
234 |
102 |
$5K |
| D1351 |
Sealant - per tooth |
250 |
65 |
$5K |
| D1206 |
Topical application of fluoride varnish |
346 |
343 |
$5K |
| 88142 |
|
231 |
208 |
$4K |
| 87807 |
|
410 |
377 |
$4K |
| 87210 |
|
573 |
532 |
$4K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
164 |
157 |
$4K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
705 |
664 |
$4K |
| 87449 |
|
840 |
375 |
$4K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
280 |
258 |
$3K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
29 |
26 |
$3K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
14 |
13 |
$3K |
| 81002 |
|
1,054 |
1,015 |
$3K |
| 87088 |
|
552 |
473 |
$3K |
| 76830 |
Ultrasound, transvaginal |
25 |
24 |
$3K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
433 |
407 |
$3K |
| 84439 |
|
389 |
374 |
$3K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
2,172 |
1,924 |
$2K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
122 |
115 |
$2K |
| 85027 |
|
508 |
484 |
$2K |
| 99233 |
Prolong inpt eval add15 m |
59 |
26 |
$2K |
| 87340 |
|
192 |
177 |
$1K |
| 90832 |
Psychotherapy, 30 minutes with patient |
57 |
36 |
$1K |
| 82607 |
|
126 |
125 |
$1K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
15 |
12 |
$1K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
12 |
12 |
$1K |
| 83735 |
|
1,060 |
994 |
$1K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
1,100 |
981 |
$986.99 |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
12 |
12 |
$975.92 |
| 74018 |
|
13 |
13 |
$937.37 |
| 85018 |
|
390 |
376 |
$890.00 |
| 86762 |
|
92 |
84 |
$791.81 |
| 87653 |
|
32 |
26 |
$782.04 |
| 99222 |
Initial hospital care, per day, moderate complexity |
12 |
12 |
$762.31 |
| 86593 |
|
159 |
151 |
$648.24 |
| J2704 |
Injection, propofol, 10 mg |
600 |
570 |
$644.18 |
| 82728 |
|
62 |
61 |
$629.11 |
| 86803 |
|
50 |
49 |
$603.63 |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
949 |
819 |
$585.29 |
| 0240U |
|
15 |
15 |
$570.52 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
650 |
609 |
$565.64 |
| 80306 |
|
527 |
364 |
$535.21 |
| D1330 |
|
31 |
31 |
$509.02 |
| 84702 |
|
49 |
43 |
$485.46 |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
279 |
262 |
$433.42 |
| 82746 |
|
42 |
41 |
$403.11 |
| 99239 |
Hospital discharge day management, more than 30 minutes |
12 |
12 |
$403.02 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
557 |
526 |
$399.27 |
| 86780 |
|
43 |
36 |
$376.26 |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
314 |
182 |
$362.07 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
172 |
155 |
$354.83 |
| 86703 |
|
42 |
36 |
$351.99 |
| 87102 |
|
26 |
25 |
$341.10 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
251 |
231 |
$292.14 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
140 |
135 |
$280.90 |
| D0602 |
|
206 |
205 |
$197.15 |
| 82950 |
|
44 |
41 |
$185.33 |
| 83550 |
|
26 |
26 |
$132.80 |
| 81001 |
|
1,710 |
1,614 |
$109.44 |
| 87147 |
|
24 |
24 |
$108.24 |
| 83540 |
|
26 |
26 |
$98.40 |
| 81025 |
|
14 |
14 |
$81.80 |
| 82565 |
|
16 |
14 |
$66.11 |
| D0603 |
|
45 |
45 |
$42.00 |
| 84703 |
|
864 |
809 |
$21.38 |
| 83690 |
|
1,464 |
1,377 |
$14.51 |
| 85730 |
|
79 |
71 |
$13.34 |
| 81003 |
|
874 |
813 |
$12.71 |
| 99153 |
Mod sedat endo service >5yrs |
121 |
108 |
$8.02 |
| 85610 |
|
137 |
122 |
$4.37 |
| 84484 |
|
824 |
585 |
$4.28 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
14 |
13 |
$1.98 |
| 82077 |
|
117 |
106 |
$0.00 |
| 86901 |
|
144 |
133 |
$0.00 |
| 83605 |
|
498 |
428 |
$0.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
889 |
835 |
$0.00 |
| J1790 |
Injection, droperidol, up to 5 mg |
40 |
36 |
$0.00 |
| 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 |
28 |
26 |
$0.00 |
| 86850 |
|
144 |
133 |
$0.00 |
| 83880 |
|
16 |
14 |
$0.00 |
| A9270 |
Non-covered item or service |
94 |
90 |
$0.00 |
| Q9965 |
Low osmolar contrast material, 100-199 mg/ml iodine concentration, per ml |
16 |
14 |
$0.00 |
| 86140 |
|
51 |
48 |
$0.00 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
22 |
18 |
$0.00 |
| 36416 |
|
24 |
24 |
$0.00 |
| G0500 |
Moderate sedation services provided by the same physician or other qualified health care professional performing a gastrointestinal endoscopic service that sedation supports, requiring the presence of an independent trained observer to assist in the monitoring of the patient's level of consciousness and physiological status; initial 15 minutes of intra-service time; patient age 5 years or older (additional time may be reported with 99153, as appropriate) |
109 |
97 |
$0.00 |
| 80179 |
|
16 |
14 |
$0.00 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
158 |
147 |
$0.00 |
| 80143 |
|
17 |
14 |
$0.00 |
| 80076 |
|
28 |
27 |
$0.00 |