Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers

NORTON HOSPITALS, INC

NPI: 1891799227 · LOUISVILLE, KY 40202 · General Acute Care Hospital · NPI assigned 06/13/2005

Billing Flags · Automated signals — not evidence of fraud
Entity Proliferation

Authorized official GAST, SHELLEY controls 20+ related entities in our dataset. Read more

$299.00M
Total Medicaid Paid
3,175,044
Total Claims
2,209,384
Beneficiaries
826
Codes Billed
2018-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialGAST, SHELLEY (VP MANAGED CARE)
Parent OrganizationNORTON HOSPITALS INC
NPI Enumeration Date06/13/2005

Related Entities

Other providers sharing the same authorized official: GAST, SHELLEY

ProviderCityStateTotal Paid
NORTON HOSPITALS INC LOUISVILLE KY $419.58M
COMMUNITY MEDICAL ASSOCIATES, INC. LOUISVILLE KY $135.33M
NORTON CHILDRENS MEDICAL GROUP, LLC LOUISVILLE KY $107.36M
COMMUNITY MEDICAL ASSOCIATES, INC. LOUISVILLE KY $48.97M
NORTON CLARK HOSPITAL, LLC JEFFERSONVILLE IN $19.62M
NORTON - KINGS DAUGHTERS HEALTH INC MADISON IN $11.81M
NORTON SCOTT HOSPITAL, LLC SCOTTSBURG IN $9.17M
NORTON CLARK PHYSICIAN PRACTICES, LLC CLARKSVILLE IN $7.07M
NORTON HOSPITALS INC LOUISVILLE KY $3.38M
COMMUNITY MEDICAL ASSOCIATES, INC. LOUISVILLE KY $1.21M
NORTON CHILDREN'S MEDICAL GROUP, LLC LOUISVILLE KY $1.15M
COMMUNITY MEDICAL ASSOCIATES, INC. LOUISVILLE KY $957K
COMMUNITY MEDICAL ASSOCIATES, INC. LOUISVILLE KY $808K
NORTON SCOTT HOSPITAL, LLC SCOTTSBURG IN $560K
NORTON HOSPITALS, INC LOUISVILLE KY $438K
COMMUNITY MEDICAL ASSOCIATES, INC. LOUISVILLE KY $357K
NORTON CLARK PHYSICIAN PRACTICES, LLC SELLERSBURG IN $273K
NORTON CHILDREN'S MEDICAL GROUP, LLC LOUISVILLE KY $260K
NORTON CHILDREN'S MEDICAL GROUP, LLC LOUISVILLE KY $238K
NORTON CHILDREN'S MEDICAL GROUP, LLC LOUISVILLE KY $189K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 4,219 $17K
2019 11,226 $36K
2020 6,192 $75K
2021 38,845 $1.32M
2022 379,721 $25.73M
2023 1,529,843 $144.10M
2024 1,204,998 $127.72M

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99284 Emergency department visit for the evaluation and management, high severity 82,795 66,586 $25.52M
99283 Emergency department visit for the evaluation and management, moderate severity 90,211 78,673 $24.81M
74177 Computed tomography, abdomen and pelvis; with contrast material 17,425 14,832 $11.48M
99285 Emergency department visit for the evaluation and management, high severity with immediate threat to life 33,977 20,500 $9.78M
J9271 Injection, pembrolizumab, 1 mg 1,056 760 $9.54M
99282 Emergency department visit for the evaluation and management, low to moderate severity 36,822 32,646 $8.77M
C1776 Joint device (implantable) 880 640 $8.24M
70450 Computed tomography, head or brain; without contrast material 19,606 15,226 $6.40M
93306 Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete 11,025 9,653 $6.20M
C1713 Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) 3,888 2,627 $5.94M
87637 Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV 49,359 44,591 $5.81M
J3490 Unclassified drugs 99,742 25,842 $5.44M
70551 Magnetic resonance imaging, brain; without contrast material 6,386 5,539 $4.06M
70553 Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences 6,136 4,572 $3.88M
72148 Magnetic resonance imaging, lumbar spine; without contrast material 4,988 4,530 $3.41M
J0585 Injection, onabotulinumtoxina, 1 unit 5,575 3,835 $3.37M
96375 Therapeutic injection; each additional sequential IV push 28,995 19,402 $3.21M
74176 Computed tomography, abdomen and pelvis; without contrast material 6,802 5,515 $3.12M
71275 Computed tomographic angiography, chest, with contrast material 6,203 5,223 $3.12M
96374 Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance 54,864 26,139 $2.48M
96365 Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour 29,410 12,042 $2.40M
93005 Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report 46,072 35,822 $2.34M
87633 Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets 7,051 6,608 $2.17M
43239 Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple 5,208 3,357 $2.10M
77386 4,590 416 $2.05M
72141 2,815 2,491 $1.98M
78452 Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress 4,929 2,135 $1.95M
72125 Computed tomography, cervical spine; without contrast material 4,770 4,107 $1.95M
96361 Intravenous infusion, hydration; each additional hour 31,007 18,855 $1.85M
99281 Emergency department visit for the evaluation and management, self-limited or minor 8,231 7,309 $1.76M
71260 Computed tomography, thorax, diagnostic; with contrast material 4,972 3,342 $1.73M
80053 Comprehensive metabolic panel 139,764 93,208 $1.72M
76770 7,651 7,176 $1.71M
71045 Radiologic examination, chest; single view 31,660 23,028 $1.61M
Q9967 Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml 34,342 28,952 $1.60M
G0378 Hospital observation service, per hour 16,992 8,440 $1.53M
78815 Positron emission tomography (PET) for limited area imaging 1,193 1,021 $1.53M
71046 Radiologic examination, chest; 2 views 17,876 15,730 $1.49M
96413 Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance 10,214 5,331 $1.49M
58571 757 297 $1.46M
76705 Ultrasound, abdominal, real time with image documentation; limited 7,734 7,087 $1.31M
74019 9,383 8,770 $1.28M
93458 701 321 $1.27M
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular 25,811 11,255 $1.23M
72131 2,817 2,275 $1.17M
71250 4,766 3,654 $1.16M
73721 Magnetic resonance imaging, any joint of lower extremity; without contrast material 2,201 1,958 $1.15M
42820 Tonsillectomy and adenoidectomy; younger than age 12 1,299 1,178 $1.15M
93017 3,307 2,995 $1.13M
36415 Collection of venous blood by venipuncture 198,260 72,004 $1.11M
47562 853 527 $1.10M
70496 1,962 1,626 $1.10M
93320 3,372 3,153 $1.09M
99291 Critical care, evaluation and management of the critically ill patient, first 30-74 minutes 2,286 1,312 $1.06M
58661 700 526 $1.04M
G0330 Facility services for dental rehabilitation procedure(s) performed on a patient who requires monitored anesthesia (e.g., general, intravenous sedation (monitored anesthesia care) and use of an operating room 1,049 970 $1.03M
45380 Colonoscopy, flexible; with biopsy, single or multiple 2,422 1,627 $985K
96360 Intravenous infusion, hydration; initial, 31 minutes to 1 hour 11,663 8,022 $975K
Q5121 Injection, infliximab-axxq, biosimilar, (avsola), 10 mg 516 343 $967K
85025 Blood count; complete (CBC), automated, and automated differential WBC count 143,952 101,520 $960K
88305 Level IV - Surgical pathology, gross and microscopic examination 7,439 6,351 $954K
G0463 Hospital outpatient clinic visit for assessment and management of a patient 28,959 17,665 $944K
70498 1,918 1,632 $916K
76830 Ultrasound, transvaginal 4,894 4,348 $897K
44970 526 456 $897K
J2350 Injection, ocrelizumab, 1 mg 53 37 $895K
74018 7,599 6,872 $876K
J0741 Injection, cabotegravir and rilpivirine, 2mg/3mg 147 126 $874K
62323 3,169 1,676 $864K
93303 Transthoracic echocardiography for congenital cardiac anomalies, follow-up or limited study 3,496 3,078 $858K
C1762 Connective tissue, human (includes fascia lata) 287 222 $834K
95713 2,702 1,559 $834K
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 10,533 8,916 $811K
72146 1,153 1,024 $770K
93975 3,429 3,112 $755K
70486 1,844 1,672 $753K
95810 Polysomnography; sleep staging with 4 or more additional parameters 1,450 1,304 $733K
45378 Colonoscopy, flexible; diagnostic, including collection of specimen(s) 1,356 1,140 $723K
64615 5,208 3,629 $723K
70491 1,912 1,426 $694K
J3380 Injection, vedolizumab, intravenous, 1 mg 106 99 $684K
45385 Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) 1,723 1,138 $678K
69436 Tympanostomy (requiring insertion of ventilating tube), general anesthesia 1,893 1,804 $659K
83880 19,748 17,158 $650K
64643 747 656 $638K
77067 Screening mammography, bilateral, including computer-aided detection 8,928 8,674 $635K
C1769 Guide wire 4,013 3,361 $634K
74178 1,153 761 $624K
P9016 Red blood cells, leukocytes reduced, each unit 2,365 1,458 $615K
76856 Ultrasound, pelvic (nonobstetric), real time with image documentation; complete 4,097 3,863 $599K
93971 3,534 3,261 $590K
76536 3,788 3,478 $587K
77063 Screening digital breast tomosynthesis, bilateral 10,270 9,295 $584K
C1889 Implantable/insertable device, not otherwise classified 301 251 $574K
87651 Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe 20,494 19,485 $568K
27447 699 139 $563K
73221 1,122 1,035 $562K
J1745 Injection, infliximab, excludes biosimilar, 10 mg 152 131 $561K
97110 Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion 12,059 3,809 $554K
J0185 Injection, aprepitant, 1 mg 1,811 1,068 $553K
72156 803 637 $543K
74183 1,005 723 $543K
72197 877 660 $540K
80307 Drug test(s), presumptive, any number of drug classes; immunoassay 11,739 10,096 $538K
C1874 Stent, coated/covered, with delivery system 198 178 $535K
76817 Ultrasound, pregnant uterus, real time with image documentation, transvaginal 3,271 2,812 $535K
97530 Therapeutic activities, direct patient contact, each 15 minutes 11,580 4,651 $534K
36512 1,081 508 $534K
76801 3,936 3,304 $523K
73630 5,677 4,706 $514K
84484 31,915 22,963 $492K
95812 1,619 1,534 $489K
41899 Unlisted procedure, dentoalveolar structures 672 544 $487K
J9173 Injection, durvalumab, 10 mg 137 50 $476K
C1725 Catheter, transluminal angioplasty, non-laser (may include guidance, infusion/perfusion capability) 958 773 $468K
99211 Office or other outpatient visit for the evaluation and management of an established patient, minimal severity 23,751 20,751 $465K
96415 2,607 1,875 $462K
J1756 Injection, iron sucrose, 1 mg 6,004 2,752 $453K
72158 752 589 $450K
93970 1,965 1,813 $431K
77334 866 504 $428K
54161 1,028 985 $423K
76642 4,445 4,217 $422K
76700 Ultrasound, abdominal, real time with image documentation; complete 1,773 1,600 $418K
93325 4,434 4,109 $413K
C1781 Mesh (implantable) 538 413 $398K
11042 Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm 2,171 970 $384K
A9575 Injection, gadoterate meglumine, 0.1 ml 12,674 7,317 $380K
95716 856 669 $370K
76870 1,943 1,783 $369K
72157 551 472 $369K
64642 698 523 $358K
73130 5,094 3,790 $355K
73610 4,677 3,917 $351K
59025 Fetal non-stress test 5,263 4,289 $347K
73562 4,696 3,358 $347K
43235 686 462 $345K
54300 561 546 $342K
94640 Pressurized or nonpressurized inhalation treatment for acute airway obstruction 12,501 10,188 $337K
96367 3,216 1,586 $337K
77066 Tomosynthesis, mammo 2,606 2,388 $330K
96366 Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour 4,117 2,584 $328K
62321 908 573 $325K
73030 4,240 2,931 $323K
64721 732 455 $322K
36561 776 251 $322K
J0897 Injection, denosumab, 1 mg 240 158 $321K
36430 1,765 1,133 $317K
Q5103 Injection, infliximab-dyyb, biosimilar, (inflectra), 10 mg 126 96 $316K
80048 Basic metabolic panel (calcium, ionized) 23,118 14,646 $316K
72128 962 797 $315K
74455 1,445 1,357 $314K
A9552 Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries 2,265 1,420 $301K
95700 2,377 2,123 $299K
77412 1,393 177 $299K
77295 418 244 $294K
70544 862 679 $293K
J0561 Injection, penicillin g benzathine, 100,000 units 1,071 843 $293K
C8908 Magnetic resonance imaging without contrast followed by with contrast, breast; bilateral 520 391 $293K
87798 Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism 10,020 9,094 $292K
58558 451 285 $291K
96376 3,439 2,500 $288K
C1887 Catheter, guiding (may include infusion/perfusion capability) 1,229 1,063 $284K
88342 4,395 3,788 $284K
J2997 Injection, alteplase recombinant, 1 mg 2,576 859 $272K
96417 1,880 1,124 $270K
97112 Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination 4,817 1,774 $269K
88341 1,699 1,337 $268K
78431 215 153 $259K
20680 293 231 $257K
93225 1,560 1,274 $255K
83735 30,991 22,071 $255K
74174 448 339 $253K
51600 1,402 1,341 $251K
95782 393 327 $250K
Q5118 Injection, bevacizumab-bvzr, biosimilar, (zirabev), 10 mg 187 51 $249K
52332 604 276 $247K
77300 837 517 $246K
73590 3,333 2,769 $246K
C1894 Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser 1,922 1,667 $245K
78264 856 587 $244K
49083 768 266 $239K
73090 3,342 2,812 $238K
50590 139 78 $236K
87486 8,580 7,833 $232K
75574 506 401 $230K
92507 Treatment of speech, language, voice, communication, and/or auditory processing disorder 4,096 1,636 $229K
97161 5,232 2,885 $223K
87581 8,448 7,829 $220K
77336 2,510 814 $217K
19083 522 306 $215K
49650 63 52 $213K
64644 460 305 $212K
87491 Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe 7,822 7,141 $211K
95811 454 406 $211K
51728 873 834 $210K
87591 Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe 7,718 7,131 $207K
93351 495 380 $204K
73110 2,871 2,367 $203K
95886 1,080 1,032 $203K
72100 2,202 1,859 $198K
J2785 Injection, regadenoson, 0.1 mg 1,524 1,426 $194K
78227 575 396 $193K
95813 589 557 $188K
C1768 Graft, vascular 79 56 $186K
84443 Thyroid stimulating hormone (TSH) 10,248 9,217 $182K
83690 27,331 23,675 $181K
74230 1,131 904 $181K
73700 617 507 $179K
77062 2,769 2,240 $179K
72040 1,902 1,628 $177K
27130 154 38 $175K
88307 1,409 1,172 $175K
93798 5,117 786 $171K
73560 2,125 1,728 $169K
51784 902 872 $166K
J2704 Injection, propofol, 10 mg 57,622 30,302 $164K
72110 1,548 1,296 $163K
36593 964 638 $161K
10060 871 783 $161K
76882 1,291 1,193 $161K
12011 1,427 1,351 $159K
84703 26,156 22,608 $157K
86850 15,328 12,035 $156K
76819 Fetal biophysical profile; without non-stress testing 1,115 942 $156K
77065 Tomosynthesis, mammo 2,191 1,816 $155K
70487 353 308 $154K
73070 2,361 1,932 $154K
C1726 Catheter, balloon dilatation, non-vascular 502 441 $153K
80061 Lipid panel 9,874 4,497 $153K
J9299 Injection, nivolumab, 1 mg 28 13 $153K
G0260 Injection procedure for sacroiliac joint; provision of anesthetic, steroid and/or other therapeutic agent, with or without arthrography 353 260 $153K
74240 993 892 $153K
A9500 Technetium tc-99m sestamibi, diagnostic, per study dose 1,759 1,641 $150K
96411 1,128 673 $147K
54640 196 184 $144K
49591 123 108 $143K
94660 968 544 $143K
81025 20,151 17,833 $142K
77290 940 408 $140K
88185 514 371 $139K
97535 Self-care/home management training, each 15 minutes 5,690 3,249 $138K
87661 Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe 5,675 5,259 $136K
12001 1,200 1,114 $135K
77080 2,136 1,631 $134K
55175 463 446 $133K
73521 1,218 1,139 $132K
73502 1,854 1,413 $132K
76885 967 921 $131K
93308 830 513 $130K
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 5,378 4,364 $127K
82728 10,579 9,061 $127K
97162 3,045 1,489 $125K
93880 876 701 $123K
72132 428 239 $122K
C2617 Stent, non-coronary, temporary, without delivery system 741 644 $122K
92526 1,801 983 $122K
93922 964 753 $122K
54360 375 366 $121K
73552 1,501 1,224 $121K
86920 1,498 1,107 $120K
94060 1,009 732 $120K
88360 682 522 $120K
J9171 Injection, docetaxel, 1 mg 92 64 $116K
72082 832 730 $115K
71271 2,705 2,376 $114K
88304 2,468 2,173 $114K
78306 748 302 $113K
97116 3,722 1,858 $111K
85730 17,537 14,862 $110K
99157 1,469 1,332 $109K
92611 869 809 $108K
95910 611 484 $107K
J1569 Injection, immune globulin, (gammagard liquid), non-lyophilized, (e.g., liquid), 500 mg 24 12 $104K
85027 19,598 15,786 $103K
86900 17,360 13,081 $101K
77072 1,034 979 $101K
Q9950 Injection, sulfur hexafluoride lipid microspheres, per ml 2,378 1,312 $101K
51797 678 658 $101K
76825 460 424 $101K
A9555 Rubidium rb-82, diagnostic, per study dose, up to 60 millicuries 617 290 $100K
87086 Culture, bacterial; quantitative colony count, urine 14,634 13,437 $99K
83605 6,292 4,992 $99K
76815 Ultrasound, pregnant uterus, real time with image documentation, limited 616 554 $99K
77061 1,931 1,538 $98K
73060 1,517 1,273 $96K
77387 761 96 $96K
77002 521 436 $96K
97140 Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) 2,195 1,001 $94K
94726 913 822 $93K
14040 302 279 $93K
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) 474 468 $93K
36902 179 39 $92K
87389 Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies 5,120 4,588 $92K
96416 424 247 $92K
85610 21,010 17,274 $91K
96409 773 447 $90K
81001 35,945 31,576 $90K
82803 3,189 2,625 $89K
C1760 Closure device, vascular (implantable/insertable) 223 188 $87K
95874 578 532 $85K
73200 252 218 $84K
J2469 Injection, palonosetron hcl, 25 mcg 2,285 1,333 $84K
95911 351 275 $82K
29580 1,920 580 $81K
77075 261 247 $81K
J2323 Injection, natalizumab, 1 mg 14 12 $80K
95819 372 334 $80K
10005 191 151 $80K
42830 169 165 $79K
70543 107 95 $79K
95816 389 353 $79K
82306 Vitamin D; 25 hydroxy, includes fraction(s), if performed 3,358 3,046 $79K
64483 168 122 $79K
84439 5,932 5,261 $78K
96401 1,518 337 $78K
84702 6,045 4,979 $77K
Q9969 Tc-99m from non-highly enriched uranium source, full cost recovery add-on, per study dose 3,521 3,273 $76K
92610 644 592 $76K
77001 499 406 $75K
94010 1,130 786 $75K
91200 618 584 $74K
72072 854 668 $74K
C1788 Port, indwelling (implantable) 198 184 $73K
87040 7,148 5,644 $73K
83036 Hemoglobin; glycosylated (A1C) 6,752 5,963 $73K
96402 872 659 $72K
73140 1,201 1,099 $72K
67311 90 78 $72K
J0696 Injection, ceftriaxone sodium, per 250 mg 9,938 6,308 $71K
54163 119 113 $70K
82565 5,030 3,244 $70K
J2795 Injection, ropivacaine hydrochloride, 1 mg 8,532 4,540 $70K
A4648 Tissue marker, implantable, any type, each 766 485 $67K
77301 35 28 $67K
80069 6,950 4,931 $64K
J3370 Injection, vancomycin hcl, 500 mg 4,618 2,201 $64K
95806 549 479 $63K
64493 133 99 $63K
51741 485 471 $63K
84112 900 797 $62K
C1751 Catheter, infusion, inserted peripherally, centrally or midline (other than hemodialysis) 379 296 $62K
82607 3,646 3,124 $61K
93226 1,285 1,191 $61K
72050 628 469 $61K
12002 565 524 $60K
86481 788 723 $59K
73718 119 106 $59K
90677 198 183 $58K
86140 12,730 10,926 $58K
84100 10,220 6,472 $57K
84145 2,715 2,422 $56K
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 2,555 2,146 $56K
86901 15,849 12,935 $56K
J0690 Injection, cefazolin sodium, 500 mg 18,807 11,662 $56K
76937 584 483 $56K
95885 503 478 $54K
10061 240 187 $54K
72070 611 506 $54K
85007 16,128 13,372 $53K
83540 7,732 7,004 $53K
90715 1,882 1,751 $53K
94760 2,062 1,354 $53K
J1885 Injection, ketorolac tromethamine, per 15 mg 36,240 22,354 $52K
29125 579 511 $52K
80074 1,131 963 $51K
86902 1,394 754 $51K
70480 134 121 $51K
70360 821 780 $50K
54304 68 68 $50K
76000 437 358 $50K
97166 776 662 $50K
76800 282 275 $50K
J1100 Injection, dexamethasone sodium phosphate, 1 mg 44,638 30,469 $49K
J1459 Injection, immune globulin (privigen), intravenous, non-lyophilized (e.g., liquid), 500 mg 22 12 $49K
J3489 Injection, zoledronic acid, 1 mg 585 496 $49K
94644 1,563 1,476 $49K
86003 627 582 $48K
43762 188 169 $48K
97165 776 643 $48K
72170 973 701 $48K
99153 Mod sedat endo service >5yrs 600 516 $47K
81003 25,319 22,742 $46K
87536 741 662 $46K
82330 2,286 1,739 $45K
G1004 Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program 4,219 710 $45K
77280 691 179 $45K
64645 60 53 $44K
71101 720 518 $44K
70250 379 312 $44K
31575 394 286 $44K
94729 721 690 $44K
J9202 Goserelin acetate implant, per 3.6 mg 86 79 $42K
C1729 Catheter, drainage 830 323 $42K
73080 701 513 $41K
88313 545 450 $41K
72195 72 66 $41K
73000 618 548 $40K
29581 781 191 $39K
86922 625 436 $39K
86870 557 384 $39K
75565 94 89 $39K
J7060 5% dextrose/water (500 ml = 1 unit) 20,214 7,484 $38K
95909 333 248 $38K
93321 336 301 $38K
31624 54 40 $38K
25605 114 85 $37K
36600 1,386 1,178 $37K
82550 3,814 3,083 $37K
J3480 Injection, potassium chloride, per 2 meq 3,101 1,594 $37K
49500 12 12 $37K
82784 2,605 2,131 $36K
87070 4,140 3,339 $36K
29881 57 28 $36K
76857 420 320 $36K
76942 221 178 $35K
J1650 Injection, enoxaparin sodium, 10 mg 6,591 2,775 $35K
Q9958 High osmolar contrast material, up to 149 mg/ml iodine concentration, per ml 2,033 1,599 $35K
83970 995 863 $35K
J2405 Injection, ondansetron hydrochloride, per 1 mg 51,227 35,791 $35K
83516 1,189 1,084 $35K
86945 751 415 $35K
99155 993 921 $34K
G0121 Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk 55 44 $33K
86923 1,063 768 $33K
82150 2,770 2,404 $33K
78708 111 99 $32K
87077 4,699 4,226 $32K
85379 4,298 3,969 $32K
38222 205 55 $32K
76805 Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation 189 179 $31K
86360 815 718 $31K
72081 209 203 $30K
29105 262 241 $30K
77373 40 12 $30K
64616 117 56 $30K
94762 444 327 $30K
72126 126 64 $29K
97750 992 777 $29K
J2250 Injection, midazolam hydrochloride, per 1 mg 41,260 26,079 $29K
G0257 Unscheduled or emergency dialysis treatment for an esrd patient in a hospital outpatient department that is not certified as an esrd facility 353 106 $28K
95912 104 78 $28K
97168 607 562 $28K
99152 545 467 $28K
87186 3,930 3,563 $28K
82746 1,868 1,715 $27K
83021 1,792 1,164 $27K
72020 244 212 $27K
97164 657 600 $26K
J1170 Injection, hydromorphone, up to 4 mg 15,652 9,996 $26K
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg 2,451 2,310 $26K
70470 87 49 $26K
20930 44 37 $25K
76604 234 210 $25K
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 991 855 $25K
64494 76 53 $25K
26055 58 37 $25K
96368 937 348 $25K
76827 436 415 $25K
87522 Neg quan hep c or qual rna 708 656 $24K
72083 184 162 $24K
86664 1,251 1,020 $23K
J0330 Injection, succinylcholine chloride, up to 20 mg 6,481 5,124 $23K
90651 126 114 $23K
85652 8,831 7,901 $23K
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 3,087 2,825 $23K
J1596 Injection, glycopyrrolate, 0.1 mg 2,883 2,323 $22K
J3010 Injection, fentanyl citrate, 0.1 mg 30,793 23,127 $22K
J9045 Injection, carboplatin, 50 mg 811 446 $22K
62328 52 50 $22K
Q9966 Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml 1,698 1,105 $22K
73620 366 277 $22K
11043 86 52 $22K
84132 3,584 2,961 $22K
83615 2,907 2,418 $21K
86780 2,128 1,733 $21K
87205 6,008 5,373 $21K
94664 3,740 2,628 $21K
J1750 Injection, iron dextran, 50 mg 132 111 $21K
87529 525 432 $20K
92523 209 176 $20K
J0171 Injection, adrenalin, epinephrine, 0.1 mg 3,496 1,899 $20K
J0780 Injection, prochlorperazine, up to 10 mg 4,696 3,678 $20K
36591 987 707 $20K
74170 31 25 $20K
43245 75 29 $20K
93976 161 144 $19K
J2930 Injection, methylprednisolone sodium succinate, up to 125 mg 3,074 2,274 $19K
76816 Ultrasound, pregnant uterus, real time with image documentation, follow-up 177 167 $19K
62304 31 25 $18K
74328 161 141 $18K
C9113 Injection, pantoprazole sodium, per vial 4,412 2,420 $18K
J9070 Cyclophosphamide, 100 mg 35 27 $18K
85045 4,889 3,470 $17K
72202 240 190 $17K
J0295 Injection, ampicillin sodium/sulbactam sodium, per 1.5 gm 2,828 708 $17K
88377 116 78 $17K
95873 141 134 $17K
82947 2,990 1,281 $17K
64718 28 27 $16K
J9263 Injection, oxaliplatin, 0.5 mg 278 75 $16K
C1763 Connective tissue, non-human (includes synthetic) 27 24 $16K
84156 2,615 2,175 $16K
82810 185 130 $16K
82378 741 560 $16K
73720 18 14 $16K
96450 80 54 $16K
88302 511 440 $15K
A9562 Technetium tc-99m mertiatide, diagnostic, per study dose, up to 15 millicuries 180 174 $15K
P9041 Infusion, albumin (human), 5%, 50 ml 241 189 $15K
Q9965 Low osmolar contrast material, 100-199 mg/ml iodine concentration, per ml 674 544 $15K
J3475 Injection, magnesium sulfate, per 500 mg 5,057 3,516 $15K
J2543 Injection, piperacillin sodium/tazobactam sodium, 1 gram/0.125 grams (1.125 grams) 3,084 1,019 $15K
J0500 Injection, dicyclomine hcl, up to 20 mg 415 383 $15K
J9190 Injection, fluorouracil, 500 mg 1,302 327 $15K
80197 950 615 $15K
64635 20 12 $15K
A9537 Technetium tc-99m mebrofenin, diagnostic, per study dose, up to 15 millicuries 369 340 $15K
86038 995 885 $15K
86665 1,115 1,023 $14K
88184 652 386 $14K
74181 27 26 $14K
93923 108 97 $14K
87902 69 67 $14K
J2274 Injection, morphine sulfate, preservative-free for epidural or intrathecal use, 10 mg 8,705 6,515 $14K
88312 296 259 $14K
82785 609 571 $14K
94645 370 345 $14K
73660 249 227 $13K
77338 35 28 $13K
G0279 Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) 835 545 $13K
87340 1,728 1,508 $13K
43275 14 13 $13K
82140 735 591 $13K
C2628 Catheter, occlusion 117 100 $13K
82570 2,538 2,225 $12K
86803 1,151 1,063 $12K
J2270 Injection, morphine sulfate, up to 10 mg 7,554 5,947 $12K
70260 83 81 $12K
A9541 Technetium tc-99m sulfur colloid, diagnostic, per study dose, up to 20 millicuries 580 549 $12K
94621 33 25 $12K
J7042 5% dextrose/normal saline (500 ml = 1 unit) 3,626 2,467 $12K
86147 293 241 $12K
C1758 Catheter, ureteral 444 378 $12K
J9267 Injection, paclitaxel, 1 mg 307 161 $12K
J1453 Injection, fosaprepitant, 1 mg 66 47 $11K
93312 66 28 $11K
84460 2,159 1,974 $11K
94618 342 301 $11K
99156 511 448 $11K
87075 1,199 1,036 $11K
J1644 Injection, heparin sodium, per 1000 units 4,197 2,163 $11K
20610 52 40 $11K
83655 865 828 $11K
86706 1,223 1,125 $11K
88112 256 197 $10K
86663 1,110 1,020 $10K
J2919 Injection, methylprednisolone sodium succinate, 5 mg 1,637 1,001 $10K
84403 432 408 $10K
90686 776 722 $10K
77076 81 72 $10K
43249 13 13 $10K
86160 623 562 $10K
86704 880 782 $10K
87046 838 689 $10K
86304 508 394 $10K
64484 29 26 $10K
85240 567 527 $10K
80076 694 592 $10K
J1200 Injection, diphenhydramine hcl, up to 50 mg 8,964 6,746 $9K
23350 40 40 $9K
J2916 Injection, sodium ferric gluconate complex in sucrose injection, 12.5 mg 256 141 $9K
27096 15 15 $9K
J1626 Injection, granisetron hydrochloride, 100 mcg 1,137 543 $9K
74270 41 39 $9K
97167 125 107 $9K
J1610 Injection, glucagon hydrochloride, per 1 mg 64 58 $9K
88173 151 127 $9K
82010 1,162 998 $9K
J0360 Injection, hydralazine hcl, up to 20 mg 1,870 1,293 $9K
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) 72 72 $8K
75573 15 15 $8K
29826 17 12 $8K
82533 471 383 $8K
24640 64 62 $8K
36416 1,613 1,155 $8K
36590 21 12 $8K
83550 1,069 986 $8K
76506 48 42 $8K
85576 265 227 $8K
91320 95 84 $8K
87210 3,850 3,593 $8K
G0283 Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care 361 166 $8K
76820 47 38 $8K
84450 1,706 1,624 $8K
72192 29 24 $7K
84295 1,313 1,116 $7K
85384 971 818 $7K
Q0222 Injection, bebtelovimab, 175 mg 21 12 $7K
84550 1,425 1,097 $7K
87088 1,177 1,067 $7K
82247 1,032 707 $7K
87799 337 222 $7K
86146 263 233 $7K
83520 335 274 $7K
A9585 Injection, gadobutrol, 0.1 ml 208 112 $7K
J1953 Injection, levetiracetam, 10 mg 1,463 934 $7K
72220 106 88 $7K
86301 443 302 $7K
10120 33 30 $7K
90460 Immunization administration through 18 years of age via any route, first or only component 1,022 950 $7K
75625 22 17 $7K
85347 600 502 $7K
J2710 Injection, neostigmine methylsulfate, up to 0.5 mg 645 563 $6K
96523 333 262 $6K
J0640 Injection, leucovorin calcium, per 50 mg 222 78 $6K
22853 14 13 $6K
86334 397 359 $6K
J2310 Injection, naloxone hydrochloride, per 1 mg 407 292 $6K
73222 16 12 $6K
87045 792 742 $6K
72052 47 42 $6K
80164 431 353 $6K
83521 321 235 $6K
85014 2,220 1,559 $6K
87427 699 656 $6K
19081 35 12 $6K
84165 702 613 $6K
90688 577 520 $6K
80143 364 323 $6K
82248 1,191 870 $6K
J3411 Injection, thiamine hcl, 100 mg 1,437 1,015 $5K
86800 450 423 $5K
83010 387 340 $5K
82435 855 735 $5K
59820 12 12 $5K
86308 1,355 1,264 $5K
J0692 Injection, cefepime hydrochloride, 500 mg 973 276 $5K
J9370 Vincristine sulfate, 1 mg 769 431 $5K
82945 686 545 $5K
29827 17 12 $5K
85660 886 563 $5K
82977 705 589 $5K
85018 2,424 1,788 $5K
86235 88 77 $5K
P9073 Platelets, pheresis, pathogen-reduced, each unit 23 12 $5K
82270 1,445 796 $5K
84153 195 175 $5K
80179 360 320 $5K
73100 97 71 $5K
83921 293 269 $5K
99195 149 110 $5K
J3420 Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg 1,110 830 $5K
88182 125 95 $5K
A9503 Technetium tc-99m medronate, diagnostic, per study dose, up to 30 millicuries 195 185 $4K
J2920 Injection, methylprednisolone sodium succinate, up to 40 mg 840 348 $4K
83930 715 552 $4K
89051 1,070 848 $4K
84146 253 239 $4K
J9201 Injection, gemcitabine hydrochloride, not otherwise specified, 200 mg 131 39 $4K
J1040 Injection, methylprednisolone acetate, 80 mg 421 376 $4K
12013 45 41 $4K
J0694 Injection, cefoxitin sodium, 1 gm 421 311 $4K
86703 423 386 $4K
J1642 Injection, heparin sodium, (heparin lock flush), per 10 units 7,174 2,279 $4K
U0004 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc, making use of high throughput technologies as described by cms-2020-01-r 74 71 $4K
94667 155 143 $4K
J0248 Injection, remdesivir, 1 mg 51 26 $4K
74220 30 24 $4K
84157 725 583 $4K
80202 281 180 $4K
85597 488 275 $4K
J1940 Injection, furosemide, up to 20 mg 1,917 920 $4K
85245 193 184 $4K
J0456 Injection, azithromycin, 500 mg 974 598 $3K
88300 217 183 $3K
J3360 Injection, diazepam, up to 5 mg 330 165 $3K
82310 390 326 $3K
84481 182 175 $3K
88311 208 183 $3K
J2371 Injection, phenylephrine hydrochloride, 20 micrograms 2,654 1,289 $3K
G0008 Administration of influenza virus vaccine 187 172 $3K
Q3014 Telehealth originating site facility fee 182 155 $3K
90739 32 28 $3K
87497 118 91 $3K
J2370 Injection, phenylephrine hcl, up to 1 ml 2,757 1,794 $3K
87102 424 354 $3K
87635 Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe 81 79 $3K
87901 15 12 $3K
J1720 Injection, hydrocortisone sodium succinate, up to 100 mg 269 193 $3K
84305 171 166 $3K
95711 76 71 $3K
86200 243 225 $3K
76811 Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed 26 25 $3K
J2560 Injection, phenobarbital sodium, up to 120 mg 49 41 $3K
69200 40 39 $3K
86592 510 409 $3K
90461 213 197 $3K
J9060 Injection, cisplatin, powder or solution, 10 mg 136 67 $3K
86225 315 298 $3K
J2765 Injection, metoclopramide hcl, up to 10 mg 3,042 2,271 $3K
J2060 Injection, lorazepam, 2 mg 2,613 1,977 $3K
88331 49 37 $2K
J8540 Dexamethasone, oral, 0.25 mg 1,717 1,476 $2K
86762 254 230 $2K
85397 111 107 $2K
J7040 Infusion, normal saline solution, sterile (500 ml = 1 unit) 2,058 637 $2K
77399 36 32 $2K
83001 141 129 $2K
87899 189 177 $2K
81002 247 205 $2K
P9047 Infusion, albumin (human), 25%, 50 ml 32 15 $2K
J2001 Injection, lidocaine hcl for intravenous infusion, 10 mg 3,260 2,271 $2K
87015 427 338 $2K
87116 306 242 $2K
87177 270 248 $2K
J2805 Injection, sincalide, 5 micrograms 77 68 $2K
85244 126 116 $2K
80177 201 182 $2K
69209 14 14 $2K
82525 134 114 $2K
86431 442 407 $2K
J2790 Injection, rho d immune globulin, human, full dose, 300 micrograms (1500 i.u.) 27 26 $2K
86708 238 204 $2K
85613 299 274 $2K
76828 16 12 $2K
J1171 Injection, hydromorphone, 0.1 mg 1,267 523 $2K
29505 12 12 $2K
J1956 Injection, levofloxacin, 250 mg 395 276 $2K
86341 45 41 $2K
30300 27 25 $2K
76826 16 12 $2K
86757 63 51 $2K
84480 129 117 $2K
J1010 Injection, methylprednisolone acetate, 1 mg 149 138 $2K
87900 15 12 $2K
85246 101 97 $2K
J1790 Injection, droperidol, up to 5 mg 976 861 $2K
86618 100 79 $2K
87081 274 245 $2K
82043 333 309 $2K
86376 85 75 $2K
87449 204 190 $2K
83002 83 77 $1K
84270 79 77 $1K
81243 48 47 $1K
82397 89 89 $1K
88108 69 53 $1K
99215 Prolong outpt/office vis 51 44 $1K
0279U 97 93 $1K
82657 43 25 $1K
86593 246 229 $1K
84134 147 118 $1K
84432 111 91 $1K
94625 139 24 $1K
J0461 Injection, atropine sulfate, 0.01 mg 178 104 $1K
J2470 Injection, pantoprazole sodium, 40 mg 529 258 $1K
86617 65 46 $1K
84436 195 179 $1K
86812 42 41 $1K
J2598 Injection, vasopressin, 1 unit 21 12 $1K
86039 131 121 $1K
94668 19 12 $988.20
87498 40 38 $947.43
87206 300 235 $944.44
J0290 Injection, ampicillin sodium, 500 mg 201 83 $908.13
82668 61 52 $897.72
82805 13 13 $894.05
A9270 Non-covered item or service 7,805 1,573 $878.25
84681 78 69 $876.10
83525 84 81 $833.03
J0702 Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg 44 26 $798.08
86705 83 77 $781.03
84300 230 186 $757.02
86880 79 53 $748.38
82670 27 27 $748.08
87496 27 26 $701.80
83986 196 179 $689.00
90472 Immunization administration, each additional vaccine (list separately) 90 84 $686.90
83498 30 26 $671.38
87532 26 25 $666.71
86644 31 27 $660.45
82180 74 67 $628.30
82985 60 59 $621.38
85303 88 68 $595.15
83876 16 14 $559.46
82627 26 24 $545.52
J3372 Injection, vancomycin hcl (xellia), not therapeutically equivalent to j3370, 500 mg 87 42 $539.58
82365 52 50 $519.13
J7120 Ringers lactate infusion, up to 1000 cc 153 114 $480.04
84402 28 28 $479.07
90656 36 33 $462.73
0124A 20 14 $440.14
82652 12 12 $439.70
93271 18 14 $435.40
J2800 Injection, methocarbamol, up to 10 ml 95 89 $424.33
88333 14 12 $419.86
85300 55 49 $417.95
J0612 Injection, calcium gluconate, not otherwise specified, 10 mg 35 26 $410.89
J9260 Injection, methotrexate sodium, 50 mg 226 141 $403.99
82379 29 27 $392.91
82164 13 13 $378.67
84630 57 40 $368.35
90662 106 100 $357.44
84238 12 12 $329.13
86355 19 13 $301.84
86359 21 14 $301.84
J1030 Injection, methylprednisolone acetate, 40 mg 28 28 $297.41
86645 13 12 $294.70
84207 15 13 $282.41
85306 29 26 $235.00
J0610 Injection, calcium gluconate (fresenius kabi), per 10 ml 16 13 $228.23
84075 13 12 $209.88
J2003 Injection, lidocaine hydrochloride, 1 mg 278 210 $194.41
82105 13 13 $184.47
J2004 Injection, lidocaine hcl with epinephrine, 1 mg 99 84 $173.00
83993 12 12 $162.64
86682 13 12 $158.33
87106 14 12 $113.52
J1630 Injection, haloperidol, up to 5 mg 158 123 $108.34
86008 13 12 $107.58
84133 30 28 $96.68
C8937 Computer-aided detection, including computer algorithm analysis of breast mri image data for lesion detection/characterization, pharmacokinetic analysis, with further physician review for interpretation (list separately in addition to code for primary procedure) 321 288 $32.04
A0425 Ground mileage, per statute mile 42 32 $1.74
91312 20 14 $0.12
T2005 Non-emergency transportation; stretcher van 16 13 $0.00