| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
Emergency department visit for the evaluation and management, high severity |
19,786 |
16,527 |
$4.01M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
14,477 |
12,295 |
$2.24M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
5,511 |
4,740 |
$2.18M |
| G0381 |
Level 2 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room or emergency department; (2) it is held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment; or (3) during the calendar year immediately preceding the calendar year in which a determination under 42 cfr 489.24 is being made, based on a representative sample of patient visits that occurred during that calendar year, it provides at least one-third of all of its outpatient visits for the treatment of emergency medical conditions on an urgent basis without requiring a previously scheduled appointment) |
13,073 |
11,373 |
$1.19M |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
6,008 |
5,247 |
$841K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
2,811 |
2,504 |
$539K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
13,004 |
11,564 |
$495K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
1,841 |
990 |
$298K |
| 71046 |
Radiologic examination, chest; 2 views |
4,012 |
3,632 |
$238K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
4,622 |
3,876 |
$237K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
519 |
491 |
$210K |
| 45385 |
Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) |
302 |
275 |
$196K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
4,296 |
3,539 |
$192K |
| 11043 |
|
629 |
351 |
$174K |
| 27447 |
|
25 |
24 |
$172K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
1,179 |
1,040 |
$152K |
| 15275 |
|
106 |
46 |
$149K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
1,956 |
1,264 |
$142K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
1,164 |
1,037 |
$115K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
1,039 |
899 |
$111K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
3,002 |
2,664 |
$110K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
837 |
737 |
$109K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
1,190 |
1,040 |
$105K |
| 71045 |
Radiologic examination, chest; single view |
2,249 |
2,030 |
$102K |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
880 |
817 |
$96K |
| 70450 |
Computed tomography, head or brain; without contrast material |
2,371 |
2,092 |
$82K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
530 |
483 |
$81K |
| 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 |
1,973 |
1,724 |
$76K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
524 |
428 |
$67K |
| 76830 |
Ultrasound, transvaginal |
669 |
623 |
$66K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
91 |
82 |
$55K |
| 11044 |
|
55 |
29 |
$51K |
| G0382 |
Level 3 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room or emergency department; (2) it is held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment; or (3) during the calendar year immediately preceding the calendar year in which a determination under 42 cfr 489.24 is being made, based on a representative sample of patient visits that occurred during that calendar year, it provides at least one-third of all of its outpatient visits for the treatment of emergency medical conditions on an urgent basis without requiring a previously scheduled appointment) |
292 |
263 |
$47K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
478 |
430 |
$42K |
| 87637 |
Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV |
389 |
362 |
$40K |
| 93971 |
|
607 |
526 |
$39K |
| 93976 |
|
393 |
356 |
$37K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
860 |
778 |
$32K |
| 82947 |
|
10,079 |
8,161 |
$31K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
1,071 |
432 |
$26K |
| 71250 |
|
536 |
510 |
$25K |
| 70498 |
|
105 |
102 |
$25K |
| 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 |
1,904 |
1,677 |
$24K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
116 |
111 |
$24K |
| 29581 |
|
254 |
111 |
$23K |
| 97161 |
|
678 |
612 |
$20K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
164 |
142 |
$19K |
| 74183 |
|
139 |
123 |
$19K |
| 97165 |
|
426 |
395 |
$16K |
| G0383 |
Level 4 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room or emergency department; (2) it is held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment; or (3) during the calendar year immediately preceding the calendar year in which a determination under 42 cfr 489.24 is being made, based on a representative sample of patient visits that occurred during that calendar year, it provides at least one-third of all of its outpatient visits for the treatment of emergency medical conditions on an urgent basis without requiring a previously scheduled appointment) |
82 |
78 |
$16K |
| 72141 |
|
67 |
63 |
$16K |
| 73700 |
|
262 |
245 |
$15K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
72 |
68 |
$13K |
| 87631 |
|
4,788 |
4,297 |
$13K |
| 86900 |
|
785 |
703 |
$12K |
| 76536 |
|
153 |
146 |
$11K |
| 76770 |
|
165 |
154 |
$10K |
| 97116 |
|
348 |
214 |
$10K |
| 72197 |
|
29 |
26 |
$8K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
90 |
82 |
$8K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
13 |
13 |
$7K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
6,930 |
5,942 |
$6K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
13,333 |
10,375 |
$5K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
190 |
147 |
$5K |
| 72100 |
|
701 |
637 |
$5K |
| 73630 |
|
1,104 |
997 |
$4K |
| 84443 |
Thyroid stimulating hormone (TSH) |
951 |
856 |
$4K |
| 10060 |
|
30 |
25 |
$4K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
467 |
354 |
$3K |
| 70486 |
|
130 |
118 |
$3K |
| 73560 |
|
1,253 |
1,107 |
$3K |
| 82247 |
|
7,770 |
6,617 |
$3K |
| 73030 |
|
837 |
735 |
$3K |
| 82040 |
|
7,793 |
6,633 |
$2K |
| 36415 |
Collection of venous blood by venipuncture |
8,145 |
5,997 |
$2K |
| G0380 |
Level 1 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room or emergency department; (2) it is held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment; or (3) during the calendar year immediately preceding the calendar year in which a determination under 42 cfr 489.24 is being made, based on a representative sample of patient visits that occurred during that calendar year, it provides at least one-third of all of its outpatient visits for the treatment of emergency medical conditions on an urgent basis without requiring a previously scheduled appointment) |
40 |
35 |
$2K |
| 73610 |
|
890 |
795 |
$2K |
| 70491 |
|
16 |
13 |
$2K |
| 82310 |
|
10,088 |
8,167 |
$2K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
97 |
93 |
$2K |
| 73130 |
|
635 |
573 |
$2K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
536 |
498 |
$2K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
1,326 |
1,194 |
$2K |
| 80053 |
Comprehensive metabolic panel |
3,880 |
3,073 |
$1K |
| 93970 |
|
16 |
12 |
$1K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
3,689 |
3,079 |
$1K |
| 83735 |
|
6,144 |
4,881 |
$1K |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
1,026 |
899 |
$1K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
1,108 |
1,014 |
$1K |
| 73502 |
|
243 |
220 |
$1K |
| C9803 |
Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
649 |
573 |
$997.04 |
| 82374 |
|
10,079 |
8,159 |
$906.77 |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
639 |
571 |
$888.48 |
| 83718 |
|
142 |
127 |
$750.72 |
| 86140 |
|
446 |
362 |
$696.54 |
| 85027 |
|
2,351 |
2,046 |
$659.60 |
| G0378 |
Hospital observation service, per hour |
6,523 |
5,626 |
$655.21 |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
845 |
734 |
$605.79 |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
3,339 |
2,918 |
$601.30 |
| 73110 |
|
492 |
438 |
$574.40 |
| 73140 |
|
167 |
155 |
$571.82 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
2,168 |
1,956 |
$571.80 |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
833 |
736 |
$489.82 |
| 83880 |
|
637 |
548 |
$458.20 |
| 82607 |
|
65 |
61 |
$446.09 |
| 85652 |
|
396 |
302 |
$410.22 |
| 76870 |
|
16 |
12 |
$355.38 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
71 |
63 |
$345.30 |
| 81001 |
|
4,308 |
3,734 |
$338.64 |
| 80048 |
Basic metabolic panel (calcium, ionized) |
1,853 |
1,270 |
$329.34 |
| 85610 |
|
1,437 |
1,254 |
$298.19 |
| 84146 |
|
17 |
17 |
$296.16 |
| 82746 |
|
23 |
23 |
$294.84 |
| 85007 |
|
1,999 |
1,739 |
$290.70 |
| 81025 |
|
4,242 |
3,682 |
$287.35 |
| 87077 |
|
1,231 |
1,117 |
$270.27 |
| 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 |
610 |
540 |
$262.95 |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
255 |
245 |
$253.00 |
| J2272 |
Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg |
203 |
165 |
$244.02 |
| 87186 |
|
1,129 |
1,020 |
$239.67 |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
1,048 |
974 |
$224.76 |
| 84480 |
|
16 |
16 |
$216.64 |
| 11056 |
|
15 |
12 |
$211.61 |
| 82248 |
|
523 |
406 |
$210.39 |
| 70496 |
|
106 |
103 |
$194.21 |
| 84439 |
|
25 |
25 |
$180.81 |
| 82728 |
|
39 |
37 |
$169.13 |
| 86850 |
|
754 |
676 |
$162.77 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
1,176 |
906 |
$137.49 |
| J3490 |
Unclassified drugs |
27,269 |
10,843 |
$129.39 |
| 81003 |
|
2,682 |
2,414 |
$121.77 |
| 84478 |
|
160 |
144 |
$118.26 |
| 83540 |
|
42 |
40 |
$117.42 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
1,261 |
1,094 |
$113.14 |
| 83690 |
|
3,711 |
3,213 |
$111.18 |
| 90715 |
|
363 |
330 |
$110.32 |
| 73080 |
|
89 |
82 |
$96.05 |
| 83550 |
|
25 |
24 |
$91.85 |
| 87070 |
|
1,910 |
1,708 |
$81.50 |
| 87040 |
|
835 |
385 |
$80.01 |
| 86901 |
|
785 |
703 |
$72.32 |
| 84484 |
|
5,468 |
2,873 |
$60.12 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
4,274 |
3,749 |
$58.27 |
| 82962 |
|
3,988 |
2,151 |
$57.30 |
| J3360 |
Injection, diazepam, up to 5 mg |
50 |
38 |
$41.46 |
| 84702 |
|
315 |
262 |
$33.42 |
| 85730 |
|
29 |
26 |
$28.65 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
6,023 |
5,035 |
$24.54 |
| 87088 |
|
167 |
152 |
$23.57 |
| 83605 |
|
1,065 |
768 |
$20.40 |
| 81002 |
|
1,122 |
1,007 |
$20.23 |
| 96376 |
|
1,261 |
845 |
$18.59 |
| 87075 |
|
26 |
25 |
$18.08 |
| 87205 |
|
555 |
475 |
$16.28 |
| 84520 |
|
10,290 |
8,337 |
$15.08 |
| 84460 |
|
7,770 |
6,622 |
$10.10 |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
2,843 |
2,241 |
$10.00 |
| 85379 |
|
842 |
749 |
$9.72 |
| 84100 |
|
280 |
183 |
$9.04 |
| 82565 |
|
10,294 |
8,341 |
$6.49 |
| 87081 |
|
56 |
55 |
$6.34 |
| 82550 |
|
35 |
28 |
$6.22 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
1,724 |
1,380 |
$6.04 |
| 84450 |
|
7,761 |
6,613 |
$4.94 |
| 84132 |
|
10,079 |
8,152 |
$4.39 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
3,838 |
3,152 |
$4.35 |
| 84155 |
|
7,761 |
6,613 |
$3.50 |
| 82435 |
|
10,084 |
8,162 |
$3.41 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
914 |
793 |
$2.88 |
| J8597 |
Antiemetic drug, oral, not otherwise specified |
343 |
306 |
$1.00 |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
627 |
252 |
$0.84 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
861 |
641 |
$0.00 |
| J7999 |
Compounded drug, not otherwise classified |
337 |
253 |
$0.00 |
| J1030 |
Injection, methylprednisolone acetate, 40 mg |
80 |
74 |
$0.00 |
| 84075 |
|
7,762 |
6,614 |
$0.00 |
| 72170 |
|
95 |
79 |
$0.00 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
940 |
794 |
$0.00 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
1,442 |
1,069 |
$0.00 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
1,110 |
999 |
$0.00 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
1,787 |
805 |
$0.00 |
| J2060 |
Injection, lorazepam, 2 mg |
221 |
183 |
$0.00 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
990 |
921 |
$0.00 |
| C9290 |
Injection, bupivacaine liposome, 1 mg |
56 |
53 |
$0.00 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
76 |
63 |
$0.00 |
| C1889 |
Implantable/insertable device, not otherwise classified |
197 |
191 |
$0.00 |
| Q4196 |
Puraply am, per square centimeter (add-on, list separately in addition to primary procedure) |
146 |
63 |
$0.00 |
| J1010 |
Injection, methylprednisolone acetate, 1 mg |
110 |
100 |
$0.00 |
| 12001 |
|
100 |
83 |
$0.00 |
| J2003 |
Injection, lidocaine hydrochloride, 1 mg |
147 |
132 |
$0.00 |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
59 |
52 |
$0.00 |
| 74019 |
|
46 |
41 |
$0.00 |
| J8540 |
Dexamethasone, oral, 0.25 mg |
76 |
25 |
$0.00 |
| 71101 |
|
45 |
41 |
$0.00 |
| J1790 |
Injection, droperidol, up to 5 mg |
12 |
12 |
$0.00 |
| 82803 |
|
14 |
12 |
$0.00 |
| C1776 |
Joint device (implantable) |
351 |
333 |
$0.00 |
| A9575 |
Injection, gadoterate meglumine, 0.1 ml |
1,026 |
872 |
$0.00 |
| 84295 |
|
10,085 |
8,162 |
$0.00 |
| G1004 |
Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program |
1,079 |
816 |
$0.00 |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
474 |
409 |
$0.00 |
| J2919 |
Injection, methylprednisolone sodium succinate, 5 mg |
77 |
65 |
$0.00 |
| 84145 |
|
65 |
58 |
$0.00 |
| C1713 |
Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) |
250 |
231 |
$0.00 |
| J3370 |
Injection, vancomycin hcl, 500 mg |
316 |
250 |
$0.00 |
| 64999 |
|
41 |
38 |
$0.00 |
| 82465 |
|
145 |
129 |
$0.00 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
82 |
69 |
$0.00 |
| 81513 |
|
27 |
26 |
$0.00 |
| 86618 |
|
42 |
41 |
$0.00 |
| 64447 |
|
58 |
53 |
$0.00 |
| J1644 |
Injection, heparin sodium, per 1000 units |
59 |
27 |
$0.00 |
| 73590 |
|
29 |
28 |
$0.00 |
| J1171 |
Injection, hydromorphone, 0.1 mg |
15 |
14 |
$0.00 |