| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
74,044 |
68,273 |
$3.63M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
69,222 |
66,501 |
$1.20M |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
5,549 |
5,372 |
$860K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
4,716 |
4,597 |
$673K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
22,392 |
19,196 |
$650K |
| 90833 |
Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) |
10,505 |
9,303 |
$525K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
6,843 |
6,326 |
$454K |
| 90834 |
Psychotherapy, 45 minutes with patient |
3,789 |
2,318 |
$366K |
| J0585 |
Injection, onabotulinumtoxina, 1 unit |
343 |
279 |
$279K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
3,274 |
3,240 |
$270K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
1,704 |
1,452 |
$269K |
| 90837 |
Psychotherapy, 53 minutes with patient |
2,015 |
984 |
$252K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
4,840 |
4,710 |
$242K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
9,969 |
4,843 |
$236K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,843 |
2,554 |
$232K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
2,657 |
2,617 |
$228K |
| 71046 |
Radiologic examination, chest; 2 views |
7,502 |
7,127 |
$214K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
2,303 |
2,279 |
$192K |
| 76830 |
Ultrasound, transvaginal |
1,113 |
1,081 |
$185K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
1,262 |
1,223 |
$183K |
| 99215 |
Prolong outpt/office vis |
3,319 |
3,110 |
$183K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
1,193 |
925 |
$146K |
| 93000 |
|
12,118 |
11,949 |
$137K |
| 31231 |
|
601 |
596 |
$127K |
| 92015 |
Determination of refractive state |
11,039 |
9,948 |
$126K |
| 96127 |
|
6,822 |
6,817 |
$122K |
| 64483 |
|
486 |
478 |
$94K |
| 92567 |
|
2,879 |
2,870 |
$84K |
| 76801 |
|
500 |
458 |
$83K |
| 97803 |
|
1,468 |
1,348 |
$77K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
3,872 |
3,863 |
$72K |
| 92134 |
|
3,299 |
3,108 |
$69K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
504 |
451 |
$67K |
| 92557 |
|
1,030 |
1,027 |
$63K |
| 92341 |
|
1,690 |
1,676 |
$60K |
| 90739 |
|
198 |
198 |
$59K |
| 80061 |
Lipid panel |
8,411 |
8,341 |
$58K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
2,123 |
2,112 |
$54K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
10,704 |
10,594 |
$52K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
2,784 |
1,351 |
$51K |
| 73630 |
|
1,278 |
1,064 |
$47K |
| 20610 |
|
803 |
759 |
$46K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
409 |
408 |
$42K |
| 97802 |
|
380 |
380 |
$41K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
167 |
154 |
$40K |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
10,352 |
9,283 |
$39K |
| 99397 |
|
1,579 |
1,576 |
$39K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
55 |
55 |
$36K |
| 76642 |
|
329 |
282 |
$36K |
| 86003 |
|
171 |
170 |
$35K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
561 |
557 |
$35K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
249 |
243 |
$33K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
631 |
623 |
$32K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
15,557 |
15,475 |
$32K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
1,601 |
1,082 |
$31K |
| 87428 |
|
267 |
264 |
$31K |
| 90686 |
|
4,748 |
4,729 |
$28K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
445 |
442 |
$28K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
293 |
288 |
$27K |
| 73562 |
|
699 |
570 |
$26K |
| 64615 |
|
364 |
364 |
$26K |
| 76813 |
|
150 |
143 |
$26K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
542 |
515 |
$24K |
| 97161 |
|
382 |
380 |
$23K |
| 90791 |
Psychiatric diagnostic evaluation |
180 |
174 |
$23K |
| 76536 |
|
173 |
169 |
$22K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
5,622 |
5,206 |
$21K |
| 99188 |
|
389 |
389 |
$20K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
1,002 |
546 |
$20K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
51 |
51 |
$20K |
| 80053 |
Comprehensive metabolic panel |
3,801 |
3,600 |
$20K |
| 90656 |
|
1,259 |
1,259 |
$18K |
| 95004 |
Percutaneous tests with allergenic extracts, immediate type reaction |
114 |
114 |
$17K |
| 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 |
281 |
215 |
$17K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,062 |
988 |
$16K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,689 |
1,686 |
$15K |
| 90480 |
|
534 |
533 |
$15K |
| 87081 |
|
1,188 |
1,177 |
$13K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
31 |
27 |
$13K |
| 90960 |
End-stage renal disease related services monthly, for patients 20 years and older, with 4 or more face-to-face visits |
447 |
446 |
$12K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
369 |
364 |
$12K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
245 |
190 |
$12K |
| 90832 |
Psychotherapy, 30 minutes with patient |
206 |
157 |
$12K |
| 84443 |
Thyroid stimulating hormone (TSH) |
3,096 |
3,055 |
$11K |
| 90662 |
|
2,178 |
2,171 |
$11K |
| 97164 |
|
329 |
324 |
$11K |
| G0279 |
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) |
172 |
169 |
$10K |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
1,125 |
1,123 |
$10K |
| 97162 |
|
167 |
167 |
$10K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
519 |
506 |
$10K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
341 |
339 |
$9K |
| 71271 |
|
59 |
57 |
$9K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,433 |
1,431 |
$9K |
| 69210 |
|
343 |
293 |
$9K |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
1,025 |
991 |
$9K |
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
329 |
138 |
$9K |
| 90694 |
|
419 |
419 |
$9K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
2,270 |
2,259 |
$8K |
| A9575 |
Injection, gadoterate meglumine, 0.1 ml |
292 |
287 |
$8K |
| 91320 |
|
268 |
268 |
$8K |
| 84165 |
|
546 |
543 |
$8K |
| 73030 |
|
258 |
244 |
$8K |
| 11721 |
|
589 |
581 |
$8K |
| 86704 |
|
667 |
664 |
$7K |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
271 |
82 |
$7K |
| 0012A |
|
443 |
442 |
$7K |
| 87340 |
|
701 |
699 |
$7K |
| 85027 |
|
3,901 |
3,784 |
$7K |
| 90847 |
Family psychotherapy with the patient present, 50 minutes |
78 |
68 |
$6K |
| 90674 |
|
129 |
129 |
$6K |
| 86706 |
|
650 |
649 |
$6K |
| 83970 |
|
1,466 |
1,449 |
$6K |
| 73130 |
|
150 |
113 |
$6K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
886 |
885 |
$6K |
| G0008 |
Administration of influenza virus vaccine |
3,814 |
3,793 |
$5K |
| 81025 |
|
343 |
339 |
$5K |
| 82728 |
|
1,534 |
1,502 |
$5K |
| 77080 |
|
253 |
243 |
$5K |
| 84466 |
|
1,756 |
1,724 |
$5K |
| 97535 |
Self-care/home management training, each 15 minutes |
167 |
107 |
$5K |
| 20553 |
|
86 |
66 |
$5K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
2,176 |
1,991 |
$5K |
| 0011A |
|
453 |
452 |
$5K |
| 94729 |
|
83 |
83 |
$5K |
| 36415 |
Collection of venous blood by venipuncture |
14,259 |
11,774 |
$4K |
| 94726 |
|
83 |
83 |
$4K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
515 |
454 |
$4K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
12 |
12 |
$4K |
| 94060 |
|
84 |
83 |
$4K |
| 90677 |
|
155 |
155 |
$4K |
| 82565 |
|
4,626 |
4,465 |
$4K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
3,604 |
3,342 |
$4K |
| 88141 |
|
77 |
77 |
$4K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
41 |
38 |
$4K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
39 |
39 |
$4K |
| J1030 |
Injection, methylprednisolone acetate, 40 mg |
252 |
247 |
$3K |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
69 |
69 |
$3K |
| 86140 |
|
676 |
665 |
$3K |
| 73502 |
|
91 |
88 |
$3K |
| 82607 |
|
1,874 |
1,863 |
$3K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
52 |
52 |
$3K |
| 73610 |
|
69 |
65 |
$3K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
70 |
70 |
$3K |
| 90653 |
|
256 |
256 |
$3K |
| 95886 |
|
14 |
14 |
$3K |
| 82785 |
|
105 |
103 |
$3K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
315 |
305 |
$3K |
| 85651 |
|
759 |
745 |
$3K |
| 83540 |
|
1,765 |
1,732 |
$2K |
| 92060 |
|
30 |
28 |
$2K |
| 97035 |
|
148 |
88 |
$2K |
| 92555 |
|
76 |
76 |
$2K |
| 0001A |
|
125 |
124 |
$2K |
| 92579 |
|
36 |
36 |
$2K |
| 88342 |
|
28 |
27 |
$2K |
| 0002A |
|
104 |
103 |
$2K |
| 83655 |
|
95 |
95 |
$2K |
| 83735 |
|
1,434 |
1,383 |
$2K |
| 80305 |
|
294 |
268 |
$2K |
| 92133 |
|
91 |
86 |
$2K |
| 59025 |
Fetal non-stress test |
19 |
14 |
$2K |
| 86780 |
|
78 |
78 |
$2K |
| 80051 |
|
1,719 |
1,630 |
$2K |
| Q9966 |
Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml |
1,063 |
959 |
$2K |
| ATP08 |
|
1,548 |
1,462 |
$2K |
| 82570 |
|
3,155 |
3,082 |
$2K |
| 72100 |
|
45 |
40 |
$2K |
| 76770 |
|
12 |
12 |
$2K |
| 99309 |
Subsequent nursing facility care, per day, low to moderate complexity |
78 |
56 |
$2K |
| ATP14 |
|
1,202 |
1,140 |
$2K |
| 99308 |
Subsequent nursing facility care, per day, straightforward |
133 |
101 |
$2K |
| 82043 |
|
2,905 |
2,872 |
$1K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
2,914 |
2,911 |
$1K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
70 |
70 |
$1K |
| 86803 |
|
57 |
57 |
$1K |
| 97165 |
|
12 |
12 |
$1K |
| 0071A |
|
25 |
25 |
$1K |
| 67028 |
Intravitreal injection of a pharmacologic agent |
26 |
25 |
$1K |
| 90961 |
|
76 |
76 |
$1K |
| ATP03 |
|
758 |
755 |
$1K |
| 0072A |
|
22 |
22 |
$1K |
| 73140 |
|
27 |
24 |
$990.05 |
| 80503 |
|
30 |
30 |
$960.36 |
| 99223 |
Prolong inpt eval add15 m |
14 |
14 |
$863.01 |
| 93296 |
|
51 |
51 |
$843.76 |
| J1010 |
Injection, methylprednisolone acetate, 1 mg |
91 |
90 |
$791.17 |
| 90836 |
|
14 |
13 |
$786.64 |
| G0009 |
Administration of pneumococcal vaccine |
106 |
106 |
$724.67 |
| 73110 |
|
14 |
13 |
$714.84 |
| 88341 |
|
12 |
12 |
$699.23 |
| 92285 |
|
28 |
28 |
$692.64 |
| 0124A |
|
56 |
56 |
$688.05 |
| 80076 |
|
276 |
264 |
$676.73 |
| 77089 |
|
134 |
129 |
$672.01 |
| 99443 |
|
92 |
83 |
$666.79 |
| 86580 |
|
46 |
46 |
$661.51 |
| 88304 |
|
12 |
12 |
$626.81 |
| 20552 |
|
13 |
13 |
$601.24 |
| 82310 |
|
1,234 |
1,212 |
$599.31 |
| 85610 |
|
3,164 |
1,813 |
$582.25 |
| 90620 |
|
15 |
15 |
$579.30 |
| ATP02 |
|
459 |
454 |
$568.54 |
| ATP07 |
|
359 |
351 |
$563.06 |
| 99231 |
Subsequent hospital care, per day, straightforward or low complexity |
49 |
25 |
$563.04 |
| 0064A |
|
37 |
37 |
$547.08 |
| 84460 |
|
756 |
744 |
$537.15 |
| 84520 |
|
848 |
822 |
$496.99 |
| 99442 |
|
159 |
148 |
$490.00 |
| 84100 |
|
1,155 |
1,142 |
$486.20 |
| ATP04 |
|
392 |
389 |
$442.57 |
| 86850 |
|
26 |
26 |
$425.23 |
| 84132 |
|
808 |
792 |
$416.50 |
| ATP11 |
|
369 |
369 |
$400.84 |
| 83880 |
|
125 |
116 |
$396.87 |
| 93295 |
|
13 |
13 |
$378.25 |
| ATP05 |
|
363 |
357 |
$376.65 |
| A4627 |
Spacer, bag or reservoir, with or without mask, for use with metered dose inhaler |
27 |
27 |
$345.28 |
| 82040 |
|
796 |
786 |
$335.38 |
| 92083 |
|
12 |
12 |
$334.92 |
| 0004A |
|
28 |
28 |
$321.09 |
| 81003 |
|
1,998 |
1,856 |
$315.34 |
| 87807 |
|
13 |
13 |
$300.30 |
| ATP09 |
|
334 |
333 |
$293.60 |
| ATP15 |
|
292 |
287 |
$272.25 |
| 82120 |
|
27 |
27 |
$265.86 |
| ATP17 |
|
386 |
386 |
$252.31 |
| 95117 |
|
17 |
12 |
$242.06 |
| 90661 |
|
548 |
548 |
$240.00 |
| 84436 |
|
25 |
25 |
$220.86 |
| 87210 |
|
27 |
27 |
$217.27 |
| 90785 |
|
14 |
13 |
$212.94 |
| 84479 |
|
25 |
25 |
$208.10 |
| 83718 |
|
14 |
14 |
$194.94 |
| 87220 |
|
27 |
27 |
$189.82 |
| ATP06 |
|
186 |
183 |
$177.76 |
| 84439 |
|
65 |
63 |
$175.36 |
| 87186 |
|
263 |
249 |
$166.69 |
| 83986 |
|
27 |
27 |
$159.10 |
| 87077 |
|
342 |
321 |
$145.28 |
| 84156 |
|
77 |
76 |
$144.96 |
| 86901 |
|
26 |
26 |
$130.23 |
| 86900 |
|
26 |
26 |
$130.23 |
| 81002 |
|
806 |
789 |
$120.98 |
| 82465 |
|
14 |
14 |
$103.68 |
| ATP10 |
|
147 |
147 |
$98.56 |
| 99441 |
|
27 |
24 |
$80.03 |
| 99307 |
|
14 |
13 |
$69.36 |
| ATP12 |
|
146 |
146 |
$65.10 |
| 82947 |
|
26 |
26 |
$58.20 |
| 98967 |
|
25 |
25 |
$50.02 |
| 0031A |
|
18 |
18 |
$45.87 |
| J1756 |
Injection, iron sucrose, 1 mg |
28 |
12 |
$42.00 |
| Q2038 |
Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (fluzone) |
116 |
104 |
$42.00 |
| 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) |
14 |
14 |
$38.72 |
| 98966 |
|
12 |
12 |
$38.00 |
| 81001 |
|
47 |
43 |
$37.86 |
| 96160 |
|
16 |
15 |
$36.54 |
| 84550 |
|
49 |
49 |
$31.65 |
| 80069 |
|
15 |
13 |
$28.50 |
| ATP18 |
|
79 |
79 |
$21.94 |
| J3420 |
Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg |
38 |
36 |
$21.21 |
| 84295 |
|
67 |
64 |
$19.72 |
| G0127 |
Trimming of dystrophic nails, any number |
13 |
13 |
$19.24 |
| 90688 |
|
26 |
23 |
$19.17 |
| ATP13 |
|
12 |
12 |
$10.89 |
| 82948 |
|
28 |
26 |
$5.04 |
| 90680 |
|
77 |
77 |
$0.00 |
| 90698 |
|
52 |
52 |
$0.00 |
| 90474 |
|
40 |
40 |
$0.00 |
| 91301 |
|
234 |
232 |
$0.00 |
| 91305 |
|
15 |
15 |
$0.00 |
| 91307 |
|
49 |
47 |
$0.00 |
| 90651 |
|
12 |
12 |
$0.00 |
| 0054A |
|
13 |
13 |
$0.00 |
| 91322 |
|
12 |
12 |
$0.00 |
| 90670 |
|
175 |
175 |
$0.00 |
| G1004 |
Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program |
215 |
190 |
$0.00 |
| 91321 |
|
156 |
155 |
$0.00 |
| 91300 |
|
103 |
93 |
$0.00 |
| 91312 |
|
53 |
53 |
$0.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
12 |
12 |
$0.00 |
| 90633 |
|
14 |
14 |
$0.00 |