| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
4,835 |
2,353 |
$470K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
849 |
752 |
$151K |
| 64494 |
|
375 |
235 |
$139K |
| 64495 |
|
293 |
167 |
$138K |
| 11043 |
|
937 |
478 |
$135K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
1,577 |
1,392 |
$130K |
| 69436 |
Tympanostomy (requiring insertion of ventilating tube), general anesthesia |
210 |
174 |
$121K |
| 64493 |
|
339 |
255 |
$121K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
9,651 |
8,627 |
$110K |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
940 |
835 |
$92K |
| 84703 |
|
244 |
213 |
$88K |
| 36415 |
Collection of venous blood by venipuncture |
3,293 |
2,842 |
$86K |
| 85027 |
|
327 |
261 |
$85K |
| 88304 |
|
199 |
171 |
$85K |
| J2704 |
Injection, propofol, 10 mg |
1,492 |
1,356 |
$76K |
| 82948 |
|
209 |
144 |
$76K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
264 |
217 |
$70K |
| 85610 |
|
387 |
333 |
$68K |
| 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 |
1,282 |
1,204 |
$66K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
1,046 |
896 |
$66K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,560 |
2,398 |
$62K |
| 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) |
628 |
565 |
$52K |
| 42820 |
Tonsillectomy and adenoidectomy; younger than age 12 |
50 |
45 |
$51K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,686 |
1,597 |
$50K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
1,555 |
1,454 |
$46K |
| 45385 |
Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) |
150 |
132 |
$45K |
| 52281 |
|
14 |
12 |
$43K |
| 93458 |
|
43 |
34 |
$38K |
| 71046 |
Radiologic examination, chest; 2 views |
316 |
273 |
$36K |
| 66984 |
Extracapsular cataract removal with insertion of intraocular lens prosthesis |
103 |
75 |
$33K |
| 88342 |
|
594 |
516 |
$32K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
112 |
99 |
$30K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
837 |
213 |
$27K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
1,032 |
993 |
$26K |
| 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) |
281 |
254 |
$23K |
| 11045 |
|
224 |
52 |
$22K |
| J1644 |
Injection, heparin sodium, per 1000 units |
15 |
14 |
$22K |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
958 |
871 |
$22K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
1,596 |
1,404 |
$22K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
710 |
624 |
$22K |
| J1212 |
Injection, dmso, dimethyl sulfoxide, 50%, 50 ml |
38 |
29 |
$21K |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
2,736 |
2,279 |
$20K |
| 80047 |
|
104 |
86 |
$20K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
366 |
321 |
$18K |
| 85730 |
|
164 |
145 |
$18K |
| C1894 |
Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser |
46 |
37 |
$17K |
| C1725 |
Catheter, transluminal angioplasty, non-laser (may include guidance, infusion/perfusion capability) |
45 |
36 |
$17K |
| C1769 |
Guide wire |
41 |
33 |
$17K |
| 87077 |
|
488 |
427 |
$17K |
| 97597 |
|
538 |
334 |
$17K |
| 20610 |
|
41 |
26 |
$16K |
| 11044 |
|
91 |
39 |
$15K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
470 |
421 |
$14K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
122 |
115 |
$13K |
| 00145 |
|
36 |
27 |
$11K |
| 80053 |
Comprehensive metabolic panel |
1,462 |
1,274 |
$11K |
| 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 |
81 |
69 |
$11K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
1,664 |
1,436 |
$11K |
| 00731 |
|
187 |
169 |
$10K |
| 82962 |
|
573 |
383 |
$10K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
1,601 |
1,344 |
$9K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
359 |
332 |
$9K |
| 00910 |
|
25 |
19 |
$8K |
| 00812 |
|
20 |
16 |
$7K |
| 00813 |
|
96 |
82 |
$5K |
| 80355 |
|
92 |
83 |
$5K |
| A6453 |
Self-adherent bandage, elastic, non-knitted/non-woven, width less than three inches, per yard |
123 |
46 |
$4K |
| G0260 |
Injection procedure for sacroiliac joint; provision of anesthetic, steroid and/or other therapeutic agent, with or without arthrography |
138 |
118 |
$4K |
| G0384 |
Level 5 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) |
58 |
54 |
$4K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
39 |
39 |
$3K |
| 87205 |
|
332 |
271 |
$3K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
168 |
130 |
$3K |
| 87075 |
|
255 |
208 |
$3K |
| 87186 |
|
233 |
180 |
$3K |
| 00170 |
Anesthesia for intraoral procedures, including biopsy |
31 |
27 |
$3K |
| Q3014 |
Telehealth originating site facility fee |
70 |
58 |
$3K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
120 |
119 |
$3K |
| 71045 |
Radiologic examination, chest; single view |
438 |
391 |
$3K |
| 99205 |
Prolong outpt/office vis |
44 |
38 |
$2K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
28 |
26 |
$2K |
| V2632 |
Posterior chamber intraocular lens |
72 |
42 |
$2K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
114 |
92 |
$2K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
87 |
73 |
$2K |
| 00142 |
|
20 |
15 |
$1K |
| 80061 |
Lipid panel |
233 |
204 |
$1K |
| A4649 |
Surgical supply; miscellaneous |
46 |
27 |
$1K |
| 87102 |
|
117 |
94 |
$986.92 |
| J8501 |
Aprepitant, oral, 5 mg |
55 |
40 |
$975.61 |
| Q4100 |
Skin substitute, not otherwise specified |
56 |
40 |
$920.09 |
| 00811 |
|
53 |
51 |
$841.15 |
| 84484 |
|
231 |
148 |
$805.68 |
| 88313 |
|
13 |
13 |
$693.78 |
| 87210 |
|
117 |
94 |
$588.06 |
| 64635 |
|
32 |
28 |
$578.20 |
| 70450 |
Computed tomography, head or brain; without contrast material |
25 |
24 |
$550.58 |
| J7030 |
Infusion, normal saline solution , 1000 cc |
297 |
240 |
$484.23 |
| 92504 |
|
84 |
78 |
$450.54 |
| 84443 |
Thyroid stimulating hormone (TSH) |
13 |
13 |
$443.62 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
95 |
88 |
$350.50 |
| 81001 |
|
277 |
241 |
$325.77 |
| 83605 |
|
48 |
41 |
$206.81 |
| 90686 |
|
31 |
27 |
$196.00 |
| 83880 |
|
32 |
27 |
$155.67 |
| 96375 |
Therapeutic injection; each additional sequential IV push |
17 |
15 |
$144.48 |
| 81003 |
|
15 |
15 |
$118.20 |
| G0008 |
Administration of influenza virus vaccine |
100 |
92 |
$85.92 |
| 73562 |
|
23 |
18 |
$62.72 |
| 73630 |
|
13 |
12 |
$46.65 |
| 64636 |
|
19 |
16 |
$42.35 |
| 87040 |
|
22 |
12 |
$37.28 |
| 83690 |
|
18 |
17 |
$21.82 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
40 |
30 |
$13.37 |
| 90674 |
|
30 |
30 |
$8.92 |
| J0330 |
Injection, succinylcholine chloride, up to 20 mg |
17 |
16 |
$0.00 |
| C1780 |
Lens, intraocular (new technology) |
17 |
12 |
$0.00 |
| C1713 |
Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) |
15 |
13 |
$0.00 |