| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
Emergency department visit for the evaluation and management, high severity |
19,430 |
15,474 |
$3.38M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
11,967 |
8,564 |
$3.06M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
18,638 |
16,343 |
$2.60M |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
4,798 |
3,909 |
$2.39M |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
3,243 |
2,627 |
$1.39M |
| 70450 |
Computed tomography, head or brain; without contrast material |
4,468 |
3,528 |
$1.08M |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
10,312 |
4,805 |
$767K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
12,220 |
9,530 |
$679K |
| 71045 |
Radiologic examination, chest; single view |
9,359 |
6,997 |
$576K |
| 41899 |
Unlisted procedure, dentoalveolar structures |
277 |
235 |
$510K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
18,973 |
10,300 |
$481K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
14,215 |
9,581 |
$429K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
11,163 |
2,518 |
$400K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
11,319 |
9,705 |
$359K |
| 71046 |
Radiologic examination, chest; 2 views |
4,323 |
3,730 |
$348K |
| G0378 |
Hospital observation service, per hour |
1,583 |
1,090 |
$294K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
8,269 |
6,582 |
$294K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
1,146 |
954 |
$284K |
| 80053 |
Comprehensive metabolic panel |
29,713 |
22,157 |
$281K |
| 36415 |
Collection of venous blood by venipuncture |
63,797 |
32,165 |
$277K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
2,968 |
1,306 |
$262K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
14,282 |
7,247 |
$246K |
| 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 |
3,194 |
2,406 |
$237K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
34,281 |
25,195 |
$226K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
6,816 |
5,121 |
$223K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
914 |
695 |
$220K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
996 |
424 |
$218K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
5,184 |
1,060 |
$206K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
2,464 |
1,661 |
$190K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
1,052 |
966 |
$167K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
2,367 |
2,147 |
$163K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
874 |
687 |
$159K |
| 71250 |
|
707 |
541 |
$159K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
222 |
103 |
$146K |
| 0240U |
|
1,975 |
1,215 |
$139K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
3,466 |
1,121 |
$123K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
10,538 |
4,825 |
$109K |
| 73030 |
|
932 |
747 |
$96K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
262 |
234 |
$95K |
| 84484 |
|
8,946 |
6,410 |
$93K |
| 83880 |
|
3,352 |
2,580 |
$90K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
285 |
243 |
$89K |
| 73630 |
|
1,050 |
891 |
$89K |
| 73564 |
|
577 |
448 |
$88K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
200 |
185 |
$86K |
| 73130 |
|
996 |
848 |
$83K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
1,973 |
1,882 |
$83K |
| D7140 |
Extraction, erupted tooth or exposed root |
113 |
53 |
$79K |
| Q0138 |
Injection, ferumoxytol, for treatment of iron deficiency anemia, 1 mg (non-esrd use) |
374 |
219 |
$73K |
| 73610 |
|
837 |
733 |
$72K |
| 80305 |
|
6,182 |
5,081 |
$62K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
7,948 |
6,181 |
$62K |
| 72131 |
|
258 |
195 |
$58K |
| 96376 |
|
3,589 |
2,315 |
$56K |
| 84443 |
Thyroid stimulating hormone (TSH) |
3,438 |
2,888 |
$50K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
290 |
258 |
$49K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
72 |
50 |
$48K |
| 83605 |
|
5,159 |
3,839 |
$47K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
2,573 |
1,828 |
$47K |
| 84145 |
|
2,504 |
1,952 |
$45K |
| 83690 |
|
7,554 |
6,133 |
$42K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
2,207 |
1,903 |
$42K |
| 59025 |
Fetal non-stress test |
664 |
443 |
$41K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
1,523 |
975 |
$40K |
| 74018 |
|
455 |
389 |
$38K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
11,287 |
7,699 |
$37K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
134 |
102 |
$37K |
| 84703 |
|
4,742 |
4,173 |
$35K |
| 83735 |
|
6,701 |
4,518 |
$35K |
| 92507 |
Treatment of speech, language, voice, communication, and/or auditory processing disorder |
1,459 |
388 |
$35K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
2,454 |
2,218 |
$34K |
| 72100 |
|
308 |
271 |
$33K |
| 87899 |
|
2,343 |
2,160 |
$32K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
10,705 |
8,602 |
$32K |
| 87040 |
|
3,051 |
2,147 |
$32K |
| 93971 |
|
384 |
322 |
$31K |
| 96367 |
|
1,384 |
570 |
$31K |
| 82728 |
|
2,708 |
2,330 |
$29K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
687 |
613 |
$29K |
| 81001 |
|
11,555 |
9,444 |
$29K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
952 |
824 |
$28K |
| 82607 |
|
2,269 |
1,983 |
$28K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
879 |
761 |
$26K |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
7,614 |
5,406 |
$25K |
| J2704 |
Injection, propofol, 10 mg |
5,307 |
4,473 |
$24K |
| 85027 |
|
4,128 |
3,326 |
$23K |
| 85379 |
|
2,985 |
2,473 |
$23K |
| 82746 |
|
1,855 |
1,620 |
$22K |
| 80320 |
|
316 |
282 |
$22K |
| 85730 |
|
4,614 |
3,748 |
$21K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
7,248 |
5,457 |
$21K |
| 87088 |
|
2,838 |
2,371 |
$20K |
| 74022 |
|
154 |
136 |
$20K |
| 85610 |
|
5,514 |
4,411 |
$19K |
| 62323 |
|
71 |
65 |
$19K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
256 |
215 |
$18K |
| 83550 |
|
2,493 |
2,166 |
$18K |
| 84439 |
|
2,244 |
1,842 |
$18K |
| 81003 |
|
9,182 |
7,215 |
$18K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
13,380 |
9,518 |
$17K |
| 96523 |
|
995 |
549 |
$16K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
320 |
296 |
$16K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
605 |
549 |
$16K |
| J3490 |
Unclassified drugs |
3,444 |
939 |
$15K |
| 87450 |
|
1,503 |
1,409 |
$15K |
| G0481 |
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; 8-14 drug class(es), including metabolite(s) if performed |
113 |
104 |
$15K |
| 82803 |
|
853 |
623 |
$15K |
| 81025 |
|
2,093 |
1,809 |
$15K |
| 76642 |
|
143 |
111 |
$15K |
| 80061 |
Lipid panel |
1,205 |
1,015 |
$14K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
510 |
463 |
$14K |
| 83540 |
|
2,594 |
2,222 |
$14K |
| 80050 |
General health panel |
413 |
317 |
$13K |
| 73110 |
|
161 |
136 |
$13K |
| 84702 |
|
1,020 |
748 |
$13K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
990 |
861 |
$13K |
| J1170 |
Injection, hydromorphone, up to 4 mg |
6,361 |
3,661 |
$12K |
| 90715 |
|
580 |
522 |
$12K |
| 86140 |
|
3,101 |
2,464 |
$12K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
485 |
178 |
$12K |
| J7050 |
Infusion, normal saline solution, 250 cc |
3,794 |
1,773 |
$11K |
| 36600 |
|
864 |
631 |
$11K |
| 12001 |
|
59 |
58 |
$11K |
| 82150 |
|
1,872 |
1,588 |
$11K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
1,649 |
1,208 |
$11K |
| 97161 |
|
177 |
159 |
$10K |
| 87186 |
|
1,144 |
958 |
$10K |
| C1713 |
Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) |
19 |
13 |
$9K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
172 |
144 |
$9K |
| 83615 |
|
1,811 |
1,448 |
$8K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
219 |
198 |
$8K |
| 82553 |
|
764 |
629 |
$8K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
4,016 |
3,006 |
$8K |
| 82550 |
|
1,341 |
1,035 |
$7K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
841 |
771 |
$7K |
| 97535 |
Self-care/home management training, each 15 minutes |
367 |
164 |
$7K |
| J1756 |
Injection, iron sucrose, 1 mg |
200 |
69 |
$7K |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
3,497 |
1,602 |
$7K |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
1,329 |
959 |
$6K |
| M0243 |
Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring |
71 |
41 |
$6K |
| 86756 |
|
392 |
385 |
$6K |
| 84238 |
|
158 |
145 |
$6K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
951 |
789 |
$6K |
| 87077 |
|
635 |
521 |
$5K |
| 73502 |
|
108 |
78 |
$5K |
| 73221 |
|
16 |
14 |
$5K |
| 97162 |
|
122 |
97 |
$5K |
| 77080 |
|
107 |
70 |
$5K |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
3,616 |
2,465 |
$5K |
| 93017 |
|
29 |
27 |
$5K |
| 73560 |
|
75 |
52 |
$5K |
| 94760 |
|
467 |
311 |
$5K |
| J1642 |
Injection, heparin sodium, (heparin lock flush), per 10 units |
2,925 |
1,393 |
$4K |
| J1040 |
Injection, methylprednisolone acetate, 80 mg |
465 |
414 |
$4K |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
856 |
571 |
$4K |
| 84481 |
|
271 |
231 |
$4K |
| 86850 |
|
599 |
458 |
$4K |
| 72110 |
|
32 |
24 |
$4K |
| 94664 |
|
691 |
558 |
$4K |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
4,073 |
3,483 |
$3K |
| 82962 |
|
987 |
656 |
$3K |
| 85045 |
|
1,132 |
911 |
$3K |
| 87210 |
|
480 |
291 |
$3K |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
1,953 |
1,215 |
$3K |
| 71271 |
|
16 |
12 |
$3K |
| J2543 |
Injection, piperacillin sodium/tazobactam sodium, 1 gram/0.125 grams (1.125 grams) |
273 |
161 |
$3K |
| 80179 |
|
314 |
266 |
$3K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
15 |
13 |
$3K |
| C9113 |
Injection, pantoprazole sodium, per vial |
367 |
259 |
$2K |
| 85044 |
|
690 |
616 |
$2K |
| 87070 |
|
306 |
261 |
$2K |
| 72072 |
|
27 |
25 |
$2K |
| 82948 |
|
383 |
226 |
$2K |
| 83874 |
|
211 |
178 |
$2K |
| 82668 |
|
177 |
155 |
$2K |
| 94010 |
|
99 |
71 |
$2K |
| 87081 |
|
451 |
388 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
698 |
597 |
$2K |
| 82947 |
|
717 |
371 |
$2K |
| 82805 |
|
36 |
28 |
$2K |
| 86901 |
|
972 |
761 |
$2K |
| 87076 |
|
286 |
252 |
$2K |
| 86900 |
|
966 |
758 |
$2K |
| J0690 |
Injection, cefazolin sodium, 500 mg |
381 |
309 |
$2K |
| A9500 |
Technetium tc-99m sestamibi, diagnostic, per study dose |
16 |
14 |
$2K |
| 76536 |
|
14 |
12 |
$2K |
| J1596 |
Injection, glycopyrrolate, 0.1 mg |
331 |
297 |
$1K |
| 72040 |
|
16 |
15 |
$1K |
| 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 |
44 |
22 |
$1K |
| 12011 |
|
12 |
12 |
$1K |
| 80143 |
|
85 |
76 |
$1K |
| 36416 |
|
157 |
112 |
$1K |
| G0279 |
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) |
86 |
64 |
$1K |
| 73080 |
|
12 |
12 |
$1K |
| 87205 |
|
264 |
239 |
$1K |
| J2550 |
Injection, promethazine hcl, up to 50 mg |
913 |
584 |
$1K |
| J2920 |
Injection, methylprednisolone sodium succinate, up to 40 mg |
331 |
189 |
$1K |
| 84100 |
|
304 |
229 |
$1K |
| J2710 |
Injection, neostigmine methylsulfate, up to 0.5 mg |
397 |
332 |
$1K |
| 73590 |
|
14 |
12 |
$948.71 |
| 84425 |
|
40 |
39 |
$875.88 |
| J3420 |
Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg |
229 |
176 |
$871.94 |
| J2060 |
Injection, lorazepam, 2 mg |
1,172 |
815 |
$870.64 |
| 97116 |
|
67 |
25 |
$852.70 |
| 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 |
74 |
67 |
$824.12 |
| J0330 |
Injection, succinylcholine chloride, up to 20 mg |
237 |
205 |
$813.59 |
| 80329 |
|
30 |
29 |
$805.09 |
| A9579 |
Injection, gadolinium-based magnetic resonance contrast agent, not otherwise specified (nos), per ml |
26 |
24 |
$763.90 |
| 73090 |
|
14 |
13 |
$724.77 |
| 80074 |
|
18 |
15 |
$674.43 |
| J0153 |
Injection, adenosine, 1 mg (not to be used to report any adenosine phosphate compounds) |
14 |
12 |
$645.49 |
| 77065 |
Tomosynthesis, mammo |
21 |
12 |
$616.37 |
| 83010 |
|
60 |
57 |
$607.86 |
| J1644 |
Injection, heparin sodium, per 1000 units |
197 |
119 |
$573.25 |
| 51701 |
|
48 |
36 |
$559.05 |
| 85651 |
|
130 |
110 |
$526.94 |
| 99152 |
|
13 |
13 |
$483.36 |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
119 |
98 |
$469.94 |
| 94762 |
|
72 |
40 |
$442.53 |
| 77066 |
Tomosynthesis, mammo |
15 |
12 |
$435.72 |
| 88304 |
|
15 |
14 |
$415.13 |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
34 |
24 |
$412.60 |
| 85652 |
|
243 |
170 |
$402.82 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
233 |
182 |
$402.24 |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
358 |
309 |
$296.04 |
| J0737 |
Injection, clindamycin phosphate (baxter), not therapeutically equivalent to j0736, 300 mg |
76 |
69 |
$285.75 |
| 97166 |
|
23 |
13 |
$262.63 |
| 81015 |
|
350 |
257 |
$249.90 |
| J1030 |
Injection, methylprednisolone acetate, 40 mg |
31 |
27 |
$242.30 |
| 96368 |
|
13 |
12 |
$240.96 |
| 80076 |
|
40 |
35 |
$240.32 |
| J2795 |
Injection, ropivacaine hydrochloride, 1 mg |
25 |
15 |
$192.91 |
| 87420 |
|
14 |
13 |
$181.81 |
| J2272 |
Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg |
102 |
86 |
$174.60 |
| J2003 |
Injection, lidocaine hydrochloride, 1 mg |
136 |
118 |
$167.02 |
| 86308 |
|
31 |
25 |
$141.29 |
| 86038 |
|
12 |
12 |
$135.27 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
32 |
29 |
$86.82 |
| J0689 |
Injection, cefazolin sodium (baxter), not therapeutically equivalent to j0690, 500 mg |
18 |
12 |
$82.06 |
| 86880 |
|
13 |
13 |
$59.56 |
| 84550 |
|
13 |
12 |
$58.08 |
| J1171 |
Injection, hydromorphone, 0.1 mg |
26 |
24 |
$47.16 |
| J1940 |
Injection, furosemide, up to 20 mg |
15 |
12 |
$14.42 |
| A9270 |
Non-covered item or service |
546 |
112 |
$0.00 |