| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
52,970 |
50,680 |
$4.18M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
50,305 |
47,529 |
$3.81M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
23,378 |
21,867 |
$1.79M |
| 96361 |
Intravenous infusion, hydration; each additional hour |
6,190 |
5,287 |
$1.68M |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
6,068 |
5,829 |
$1.00M |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
7,804 |
5,384 |
$709K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
10,595 |
10,258 |
$707K |
| 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 |
8,365 |
8,009 |
$666K |
| 70450 |
Computed tomography, head or brain; without contrast material |
4,985 |
4,750 |
$532K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
2,643 |
1,688 |
$486K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
4,351 |
4,224 |
$356K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
2,046 |
1,972 |
$330K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
3,456 |
2,900 |
$228K |
| 59025 |
Fetal non-stress test |
1,722 |
1,420 |
$209K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
3,123 |
3,088 |
$200K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
4,401 |
4,270 |
$195K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
1,870 |
1,677 |
$194K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
1,485 |
1,420 |
$179K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
8,703 |
3,834 |
$178K |
| 76830 |
Ultrasound, transvaginal |
2,740 |
2,695 |
$157K |
| 71046 |
Radiologic examination, chest; 2 views |
7,731 |
7,378 |
$154K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
1,005 |
976 |
$153K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
2,714 |
1,480 |
$151K |
| 80053 |
Comprehensive metabolic panel |
36,517 |
32,102 |
$149K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
999 |
983 |
$145K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
2,257 |
2,214 |
$129K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
2,404 |
2,211 |
$122K |
| 64483 |
|
302 |
299 |
$120K |
| 76642 |
|
1,452 |
1,321 |
$103K |
| 12001 |
|
533 |
525 |
$101K |
| 97161 |
|
2,423 |
2,220 |
$101K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
1,624 |
1,513 |
$97K |
| 76801 |
|
2,054 |
1,816 |
$91K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
2,153 |
1,895 |
$84K |
| 76770 |
|
881 |
870 |
$79K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
1,530 |
1,378 |
$74K |
| 73630 |
|
3,632 |
3,270 |
$74K |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
2,883 |
1,194 |
$70K |
| 36415 |
Collection of venous blood by venipuncture |
59,330 |
48,165 |
$68K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
858 |
834 |
$65K |
| 93971 |
|
777 |
749 |
$55K |
| 99233 |
Prolong inpt eval add15 m |
1,659 |
775 |
$52K |
| 73610 |
|
2,495 |
2,324 |
$52K |
| 73110 |
|
2,063 |
1,800 |
$51K |
| G0378 |
Hospital observation service, per hour |
1,476 |
1,118 |
$49K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
39,423 |
34,133 |
$48K |
| 74018 |
|
2,724 |
2,611 |
$46K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
1,699 |
1,687 |
$44K |
| 84443 |
Thyroid stimulating hormone (TSH) |
7,593 |
7,358 |
$42K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
263 |
256 |
$41K |
| 84484 |
|
10,804 |
8,053 |
$37K |
| 99239 |
Hospital discharge day management, more than 30 minutes |
954 |
929 |
$36K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
3,125 |
3,038 |
$36K |
| 73130 |
|
1,834 |
1,709 |
$36K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
11,307 |
10,466 |
$33K |
| 73030 |
|
1,958 |
1,827 |
$32K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
1,697 |
1,687 |
$31K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
5,830 |
5,148 |
$29K |
| 84439 |
|
3,504 |
3,376 |
$29K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
242 |
241 |
$28K |
| 70498 |
|
182 |
173 |
$27K |
| 73564 |
|
1,013 |
939 |
$27K |
| 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 |
4,849 |
4,250 |
$26K |
| 80061 |
Lipid panel |
4,879 |
4,817 |
$24K |
| 87040 |
|
5,440 |
2,959 |
$24K |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
7,700 |
7,404 |
$24K |
| 83605 |
|
6,689 |
5,453 |
$24K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
3,116 |
3,037 |
$23K |
| 76536 |
|
300 |
296 |
$22K |
| 71045 |
Radiologic examination, chest; single view |
11,766 |
10,680 |
$21K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
316 |
313 |
$19K |
| 99223 |
Prolong inpt eval add15 m |
309 |
296 |
$19K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
15,675 |
13,880 |
$18K |
| 90715 |
|
1,101 |
1,083 |
$17K |
| 73562 |
|
1,163 |
1,105 |
$17K |
| 73140 |
|
715 |
689 |
$16K |
| 84702 |
|
3,358 |
2,622 |
$16K |
| 86780 |
|
1,848 |
1,813 |
$16K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
4,381 |
4,322 |
$16K |
| 01967 |
Neuraxial labor analgesia/anesthesia for planned vaginal delivery |
41 |
39 |
$16K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
1,995 |
1,645 |
$15K |
| 87400 |
|
9,531 |
4,613 |
$15K |
| 83880 |
|
3,151 |
2,817 |
$14K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
14,947 |
13,189 |
$14K |
| 72100 |
|
813 |
796 |
$13K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
1,857 |
1,791 |
$13K |
| 85027 |
|
5,481 |
5,063 |
$12K |
| 80050 |
General health panel |
2,528 |
2,448 |
$12K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
1,214 |
1,174 |
$12K |
| 45385 |
Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) |
28 |
28 |
$11K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
491 |
480 |
$11K |
| 99460 |
|
128 |
125 |
$10K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
89 |
89 |
$9K |
| 87186 |
|
4,178 |
3,977 |
$9K |
| 82728 |
|
1,659 |
1,621 |
$9K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
2,440 |
2,408 |
$9K |
| 12011 |
|
40 |
40 |
$9K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
1,852 |
1,820 |
$8K |
| 86803 |
|
1,243 |
1,231 |
$8K |
| 73080 |
|
417 |
393 |
$8K |
| 87070 |
|
2,366 |
2,222 |
$8K |
| G0279 |
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) |
872 |
837 |
$7K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
11,935 |
10,250 |
$7K |
| 73502 |
|
492 |
474 |
$7K |
| 87081 |
|
2,654 |
2,614 |
$7K |
| 83690 |
|
12,790 |
11,549 |
$7K |
| 82570 |
|
1,647 |
1,524 |
$7K |
| 77066 |
Tomosynthesis, mammo |
293 |
291 |
$7K |
| 73090 |
|
424 |
379 |
$7K |
| 85379 |
|
1,706 |
1,659 |
$7K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
7,328 |
5,946 |
$6K |
| 86140 |
|
2,932 |
2,705 |
$6K |
| 87077 |
|
3,159 |
3,016 |
$6K |
| 82607 |
|
801 |
788 |
$6K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
688 |
677 |
$5K |
| 83735 |
|
8,222 |
6,817 |
$5K |
| 76882 |
|
86 |
81 |
$5K |
| 76942 |
|
88 |
82 |
$5K |
| 83540 |
|
1,446 |
1,406 |
$4K |
| 86850 |
|
2,327 |
2,239 |
$4K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
9,424 |
8,974 |
$4K |
| 84466 |
|
1,086 |
1,057 |
$4K |
| 12002 |
|
24 |
24 |
$4K |
| 86885 |
|
1,352 |
1,266 |
$4K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
12 |
12 |
$4K |
| 86762 |
|
899 |
881 |
$4K |
| 86900 |
|
3,125 |
2,940 |
$4K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
67 |
65 |
$3K |
| 87420 |
|
1,510 |
1,459 |
$3K |
| 80305 |
|
3,969 |
3,713 |
$3K |
| 83655 |
|
329 |
323 |
$3K |
| 76870 |
|
42 |
41 |
$3K |
| 87510 |
|
483 |
471 |
$3K |
| 86901 |
|
3,311 |
3,104 |
$3K |
| 87340 |
|
1,151 |
1,130 |
$3K |
| 84403 |
|
343 |
336 |
$3K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
13,716 |
11,672 |
$3K |
| 85652 |
|
1,868 |
1,748 |
$3K |
| 81001 |
|
13,582 |
12,459 |
$3K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
151 |
86 |
$3K |
| 77065 |
Tomosynthesis, mammo |
116 |
109 |
$3K |
| 10060 |
|
12 |
12 |
$3K |
| 87480 |
|
483 |
471 |
$2K |
| 73590 |
|
160 |
149 |
$2K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
12 |
12 |
$2K |
| 86787 |
|
780 |
762 |
$2K |
| 84112 |
|
240 |
208 |
$2K |
| 96376 |
|
3,159 |
2,568 |
$2K |
| 84703 |
|
7,249 |
6,753 |
$2K |
| 87801 |
Infectious agent detection by nucleic acid; amplified probe, multiple organisms |
175 |
174 |
$2K |
| 82950 |
|
702 |
690 |
$2K |
| 82043 |
|
946 |
923 |
$2K |
| 70496 |
|
207 |
198 |
$2K |
| 83001 |
|
226 |
223 |
$2K |
| 82670 |
|
138 |
132 |
$2K |
| 93976 |
|
23 |
22 |
$2K |
| 87660 |
|
469 |
457 |
$2K |
| 85007 |
|
2,590 |
2,406 |
$2K |
| 97802 |
|
54 |
54 |
$2K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
100 |
53 |
$2K |
| 85610 |
|
5,540 |
5,006 |
$2K |
| 96367 |
|
243 |
226 |
$2K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
7,190 |
6,841 |
$2K |
| 70486 |
|
59 |
58 |
$2K |
| 73560 |
|
185 |
174 |
$1K |
| 94664 |
|
612 |
578 |
$1K |
| 82962 |
|
4,115 |
3,180 |
$1K |
| 81000 |
|
4,041 |
3,749 |
$1K |
| 72040 |
|
100 |
99 |
$1K |
| 80074 |
|
244 |
240 |
$1K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
6,285 |
3,136 |
$1K |
| J3490 |
Unclassified drugs |
1,546 |
1,389 |
$1K |
| 87088 |
|
951 |
906 |
$1K |
| J7050 |
Infusion, normal saline solution, 250 cc |
7,163 |
4,030 |
$1K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,460 |
1,437 |
$1K |
| 87481 |
|
136 |
66 |
$1K |
| 84402 |
|
167 |
165 |
$1K |
| 83516 |
|
174 |
102 |
$1K |
| 99222 |
Initial hospital care, per day, moderate complexity |
25 |
25 |
$985.18 |
| 85378 |
|
143 |
141 |
$866.63 |
| 99231 |
Subsequent hospital care, per day, straightforward or low complexity |
100 |
25 |
$860.10 |
| A9577 |
Injection, gadobenate dimeglumine (multihance), per ml |
597 |
580 |
$838.23 |
| 72110 |
|
28 |
28 |
$821.07 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
10,986 |
9,981 |
$813.31 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
4,169 |
4,026 |
$737.88 |
| 85730 |
|
3,079 |
2,874 |
$728.42 |
| 82784 |
|
60 |
57 |
$720.27 |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
51 |
50 |
$687.61 |
| 0202U |
Oncology (prostate), multianalyte, gene expression profiling |
1,040 |
1,017 |
$666.84 |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
139 |
56 |
$643.50 |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
1,902 |
1,693 |
$618.65 |
| 86038 |
|
107 |
107 |
$617.60 |
| 83550 |
|
203 |
198 |
$614.10 |
| 84146 |
|
43 |
43 |
$573.60 |
| 84481 |
|
125 |
123 |
$569.09 |
| 97803 |
|
15 |
12 |
$567.64 |
| 81003 |
|
6,165 |
5,851 |
$507.93 |
| 81025 |
|
4,871 |
4,641 |
$476.94 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
13,358 |
11,182 |
$467.79 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
5,574 |
4,483 |
$462.22 |
| 76857 |
|
13 |
12 |
$459.99 |
| 82247 |
|
72 |
59 |
$445.74 |
| J1756 |
Injection, iron sucrose, 1 mg |
114 |
56 |
$438.55 |
| 87807 |
|
962 |
942 |
$437.79 |
| 74021 |
|
38 |
38 |
$409.87 |
| 73660 |
|
13 |
13 |
$387.45 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
3,452 |
3,039 |
$365.86 |
| 88304 |
|
622 |
593 |
$354.76 |
| 87075 |
|
238 |
206 |
$348.94 |
| 96368 |
|
138 |
96 |
$328.46 |
| 84145 |
|
1,117 |
1,042 |
$319.60 |
| 82805 |
|
300 |
254 |
$317.94 |
| 71250 |
|
14 |
14 |
$308.18 |
| 97116 |
|
50 |
24 |
$261.22 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
5,637 |
5,363 |
$257.84 |
| 81002 |
|
1,253 |
1,195 |
$251.08 |
| 82803 |
|
614 |
529 |
$242.17 |
| 86703 |
|
46 |
46 |
$238.86 |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
1,186 |
1,053 |
$238.41 |
| 80076 |
|
41 |
38 |
$215.63 |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
8,910 |
7,395 |
$207.72 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
3,500 |
2,746 |
$203.22 |
| 94761 |
|
385 |
370 |
$198.91 |
| 82550 |
|
451 |
390 |
$191.40 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
1,886 |
1,744 |
$189.76 |
| 87205 |
|
263 |
224 |
$186.26 |
| 82746 |
|
40 |
40 |
$173.45 |
| G1004 |
Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program |
10,306 |
8,068 |
$168.15 |
| 80306 |
|
541 |
519 |
$167.82 |
| 72020 |
|
100 |
97 |
$159.95 |
| J2919 |
Injection, methylprednisolone sodium succinate, 5 mg |
79 |
66 |
$157.71 |
| 71101 |
|
14 |
14 |
$147.46 |
| 84100 |
|
189 |
167 |
$136.60 |
| 84436 |
|
15 |
15 |
$127.42 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
2,501 |
2,269 |
$124.87 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
587 |
564 |
$123.00 |
| 80069 |
|
48 |
42 |
$118.56 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
2,912 |
2,579 |
$91.76 |
| 82565 |
|
58 |
57 |
$83.27 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
275 |
239 |
$72.12 |
| 87210 |
|
50 |
39 |
$68.45 |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
1,345 |
1,316 |
$67.24 |
| J0171 |
Injection, adrenalin, epinephrine, 0.1 mg |
381 |
356 |
$67.00 |
| 73552 |
|
14 |
13 |
$57.32 |
| 36600 |
|
102 |
96 |
$56.64 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
6,117 |
5,347 |
$55.74 |
| J2060 |
Injection, lorazepam, 2 mg |
1,651 |
1,460 |
$54.14 |
| J2704 |
Injection, propofol, 10 mg |
6,578 |
6,228 |
$54.09 |
| 86364 |
|
12 |
12 |
$49.23 |
| J2550 |
Injection, promethazine hcl, up to 50 mg |
960 |
696 |
$48.49 |
| 82948 |
|
1,030 |
920 |
$48.37 |
| 84156 |
|
47 |
39 |
$44.08 |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
1,474 |
1,007 |
$41.48 |
| J2272 |
Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg |
270 |
241 |
$41.14 |
| J1630 |
Injection, haloperidol, up to 5 mg |
1,421 |
1,188 |
$37.37 |
| 87427 |
|
26 |
25 |
$35.81 |
| 87045 |
|
26 |
25 |
$35.81 |
| 87046 |
|
13 |
12 |
$32.52 |
| J1094 |
Injection, dexamethasone acetate, 1 mg |
2,105 |
1,984 |
$25.65 |
| J2795 |
Injection, ropivacaine hydrochloride, 1 mg |
343 |
245 |
$25.00 |
| 87641 |
|
17 |
14 |
$24.49 |
| 82150 |
|
28 |
27 |
$24.39 |
| J1644 |
Injection, heparin sodium, per 1000 units |
552 |
284 |
$23.65 |
| 82270 |
|
27 |
26 |
$20.78 |
| 86308 |
|
12 |
12 |
$15.68 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
3,481 |
3,057 |
$14.09 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
472 |
422 |
$13.00 |
| 81015 |
|
19 |
19 |
$10.14 |
| 82040 |
|
66 |
54 |
$8.42 |
| 84450 |
|
13 |
13 |
$3.20 |
| C1776 |
Joint device (implantable) |
227 |
223 |
$0.00 |
| A4649 |
Surgical supply; miscellaneous |
1,127 |
1,085 |
$0.00 |
| 81513 |
|
148 |
143 |
$0.00 |
| J1596 |
Injection, glycopyrrolate, 0.1 mg |
286 |
275 |
$0.00 |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
427 |
324 |
$0.00 |
| J0137 |
Injection, acetaminophen (hikma), not therapeutically equivalent to j0131, 10 mg |
289 |
281 |
$0.00 |
| J1020 |
Injection, methylprednisolone acetate, 20 mg |
95 |
91 |
$0.00 |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
80 |
77 |
$0.00 |
| 99152 |
|
54 |
50 |
$0.00 |
| J3370 |
Injection, vancomycin hcl, 500 mg |
126 |
82 |
$0.00 |
| J2916 |
Injection, sodium ferric gluconate complex in sucrose injection, 12.5 mg |
39 |
32 |
$0.00 |
| C1713 |
Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) |
135 |
133 |
$0.00 |
| J1171 |
Injection, hydromorphone, 0.1 mg |
112 |
94 |
$0.00 |
| 77062 |
|
52 |
52 |
$0.00 |
| J0134 |
Injection, acetaminophen (fresenius kabi), not therapeutically equivalent to j0131, 10 mg |
202 |
194 |
$0.00 |
| 77061 |
|
13 |
13 |
$0.00 |
| C9113 |
Injection, pantoprazole sodium, per vial |
68 |
26 |
$0.00 |
| 93041 |
|
33 |
28 |
$0.00 |
| C1760 |
Closure device, vascular (implantable/insertable) |
25 |
25 |
$0.00 |
| 51702 |
|
14 |
13 |
$0.00 |
| J2370 |
Injection, phenylephrine hcl, up to 1 ml |
214 |
210 |
$0.00 |
| J2371 |
Injection, phenylephrine hydrochloride, 20 micrograms |
209 |
201 |
$0.00 |
| J0330 |
Injection, succinylcholine chloride, up to 20 mg |
540 |
519 |
$0.00 |
| J2543 |
Injection, piperacillin sodium/tazobactam sodium, 1 gram/0.125 grams (1.125 grams) |
1,187 |
649 |
$0.00 |
| C9290 |
Injection, bupivacaine liposome, 1 mg |
168 |
166 |
$0.00 |
| 94644 |
|
12 |
12 |
$0.00 |
| J1790 |
Injection, droperidol, up to 5 mg |
49 |
46 |
$0.00 |
| J3480 |
Injection, potassium chloride, per 2 meq |
413 |
228 |
$0.00 |
| S2900 |
Surgical techniques requiring use of robotic surgical system (list separately in addition to code for primary procedure) |
32 |
32 |
$0.00 |
| J1940 |
Injection, furosemide, up to 20 mg |
70 |
53 |
$0.00 |
| J1815 |
Injection, insulin, per 5 units |
43 |
26 |
$0.00 |
| J2175 |
Injection, meperidine hydrochloride, per 100 mg |
13 |
12 |
$0.00 |
| J1805 |
Injection, esmolol hydrochloride, 10 mg |
19 |
19 |
$0.00 |
| 80320 |
|
71 |
65 |
$0.00 |
| J1642 |
Injection, heparin sodium, (heparin lock flush), per 10 units |
18 |
12 |
$0.00 |
| J7999 |
Compounded drug, not otherwise classified |
154 |
150 |
$0.00 |
| J2470 |
Injection, pantoprazole sodium, 40 mg |
19 |
14 |
$0.00 |
| C9399 |
Unclassified drugs or biologicals |
21 |
20 |
$0.00 |
| 80329 |
|
12 |
12 |
$0.00 |
| V2632 |
Posterior chamber intraocular lens |
12 |
12 |
$0.00 |