| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
35,772 |
27,112 |
$10.05M |
| 87637 |
Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV |
31,624 |
28,270 |
$4.14M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
18,398 |
14,936 |
$3.77M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
26,574 |
22,299 |
$3.17M |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
6,330 |
4,963 |
$2.59M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
67,228 |
60,749 |
$2.07M |
| G0378 |
Hospital observation service, per hour |
7,494 |
5,178 |
$1.99M |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
43,225 |
12,168 |
$1.29M |
| 71046 |
Radiologic examination, chest; 2 views |
22,831 |
18,480 |
$1.04M |
| 70450 |
Computed tomography, head or brain; without contrast material |
7,589 |
5,716 |
$993K |
| 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 |
11,188 |
9,177 |
$908K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
31,471 |
28,535 |
$815K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
21,030 |
15,414 |
$743K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
5,317 |
4,284 |
$730K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
21,948 |
20,336 |
$625K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
1,355 |
1,078 |
$593K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
12,885 |
9,615 |
$592K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
24,731 |
18,194 |
$553K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
9,340 |
2,648 |
$547K |
| 80053 |
Comprehensive metabolic panel |
81,078 |
59,954 |
$542K |
| 95810 |
Polysomnography; sleep staging with 4 or more additional parameters |
667 |
519 |
$527K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
1,656 |
1,238 |
$524K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
71,922 |
40,901 |
$508K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
1,014 |
808 |
$507K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
15,097 |
11,399 |
$479K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
3,221 |
2,470 |
$427K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
20,318 |
6,513 |
$408K |
| 93975 |
|
2,177 |
1,740 |
$401K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
78,896 |
56,426 |
$378K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
1,571 |
1,124 |
$361K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
5,950 |
3,670 |
$360K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
1,048 |
800 |
$355K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
2,205 |
1,703 |
$353K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
1,076 |
868 |
$338K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
2,796 |
2,249 |
$338K |
| 93971 |
|
2,958 |
2,280 |
$332K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
2,827 |
2,158 |
$330K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
10,929 |
7,783 |
$313K |
| 90378 |
|
231 |
92 |
$308K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
4,307 |
3,786 |
$300K |
| 76770 |
|
2,181 |
1,761 |
$296K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
2,972 |
2,459 |
$279K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
5,787 |
5,179 |
$274K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
1,178 |
916 |
$270K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
9,109 |
5,151 |
$264K |
| 84443 |
Thyroid stimulating hormone (TSH) |
23,803 |
18,687 |
$264K |
| 76830 |
Ultrasound, transvaginal |
1,984 |
1,596 |
$259K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
11,770 |
10,060 |
$252K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
542 |
440 |
$251K |
| 76801 |
|
1,558 |
1,210 |
$251K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
11,762 |
10,056 |
$251K |
| 97597 |
|
5,622 |
2,086 |
$236K |
| 73610 |
|
3,785 |
3,028 |
$230K |
| 71045 |
Radiologic examination, chest; single view |
5,854 |
4,238 |
$210K |
| 80061 |
Lipid panel |
20,270 |
16,702 |
$205K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
4,561 |
3,368 |
$202K |
| 73564 |
|
3,473 |
2,738 |
$197K |
| 87631 |
|
2,487 |
2,132 |
$196K |
| 73630 |
|
4,065 |
3,236 |
$193K |
| 73110 |
|
2,951 |
2,255 |
$185K |
| 73130 |
|
3,000 |
2,283 |
$182K |
| 92507 |
Treatment of speech, language, voice, communication, and/or auditory processing disorder |
3,935 |
1,279 |
$178K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
741 |
536 |
$175K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
600 |
420 |
$172K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
9,502 |
6,717 |
$172K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
688 |
603 |
$169K |
| 73030 |
|
3,173 |
2,420 |
$167K |
| 74018 |
|
3,311 |
2,596 |
$164K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
21,983 |
18,082 |
$156K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
3,726 |
3,318 |
$156K |
| 93970 |
|
828 |
661 |
$150K |
| 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 |
5,540 |
4,175 |
$147K |
| 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 |
6,208 |
5,195 |
$142K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
2,880 |
2,692 |
$142K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
6,610 |
5,355 |
$141K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
784 |
712 |
$140K |
| 72100 |
|
2,268 |
1,834 |
$136K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
1,241 |
661 |
$134K |
| 76642 |
|
1,492 |
1,204 |
$127K |
| 83789 |
|
10,067 |
7,723 |
$125K |
| 74019 |
|
2,314 |
1,754 |
$124K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
4,757 |
3,951 |
$122K |
| 96376 |
|
4,241 |
2,419 |
$122K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
708 |
586 |
$120K |
| 76536 |
|
1,115 |
922 |
$119K |
| 71250 |
|
843 |
640 |
$119K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
1,003 |
701 |
$118K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
3,904 |
3,259 |
$109K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
808 |
492 |
$106K |
| 73080 |
|
1,610 |
1,218 |
$103K |
| 20610 |
|
2,638 |
1,801 |
$102K |
| 84484 |
|
14,916 |
10,195 |
$102K |
| 97161 |
|
3,628 |
2,981 |
$95K |
| 99215 |
Prolong outpt/office vis |
1,091 |
1,017 |
$95K |
| 80074 |
|
2,399 |
1,935 |
$90K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
19,998 |
15,946 |
$88K |
| H2036 |
Alcohol and/or other drug treatment program, per diem |
461 |
57 |
$86K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
8,892 |
6,733 |
$82K |
| 73502 |
|
1,846 |
1,397 |
$81K |
| 70486 |
|
565 |
440 |
$80K |
| 76882 |
|
1,016 |
834 |
$80K |
| 81025 |
|
17,709 |
14,033 |
$80K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
6,601 |
4,026 |
$79K |
| 83880 |
|
4,593 |
3,384 |
$78K |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
3,532 |
3,188 |
$78K |
| 97162 |
|
3,086 |
2,403 |
$76K |
| 95957 |
|
641 |
540 |
$74K |
| 10061 |
|
542 |
462 |
$72K |
| 73140 |
|
1,789 |
1,445 |
$72K |
| 76870 |
|
640 |
542 |
$71K |
| 45385 |
Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) |
239 |
162 |
$71K |
| 82728 |
|
6,477 |
5,246 |
$70K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
2,485 |
746 |
$68K |
| 71271 |
|
192 |
158 |
$67K |
| 93017 |
|
1,013 |
730 |
$67K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
1,653 |
959 |
$66K |
| 73590 |
|
1,127 |
864 |
$65K |
| 83690 |
|
15,120 |
11,219 |
$65K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
2,930 |
2,428 |
$65K |
| 97113 |
|
1,461 |
435 |
$64K |
| 72141 |
|
202 |
158 |
$59K |
| 92526 |
|
1,035 |
442 |
$55K |
| 12001 |
|
985 |
878 |
$54K |
| 94729 |
|
956 |
754 |
$51K |
| 73090 |
|
785 |
616 |
$50K |
| 97116 |
|
2,570 |
892 |
$50K |
| 83655 |
|
4,744 |
4,104 |
$50K |
| 62323 |
|
291 |
205 |
$49K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
10,382 |
6,804 |
$49K |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
2,422 |
2,172 |
$49K |
| 12011 |
|
780 |
677 |
$48K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
1,721 |
1,652 |
$48K |
| 73562 |
|
1,065 |
838 |
$47K |
| 94060 |
|
802 |
628 |
$45K |
| 10060 |
|
482 |
408 |
$45K |
| 87522 |
Neg quan hep c or qual rna |
1,302 |
963 |
$44K |
| A9500 |
Technetium tc-99m sestamibi, diagnostic, per study dose |
644 |
449 |
$42K |
| 80081 |
|
689 |
600 |
$42K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
1,114 |
1,042 |
$40K |
| G0390 |
Trauma response team associated with hospital critical care service |
55 |
51 |
$40K |
| 87070 |
|
6,800 |
5,364 |
$40K |
| 87186 |
|
6,826 |
5,331 |
$39K |
| 70496 |
|
243 |
182 |
$38K |
| 86618 |
|
1,766 |
1,412 |
$38K |
| 87081 |
|
7,605 |
6,851 |
$38K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
2,470 |
1,837 |
$37K |
| 97533 |
|
1,009 |
375 |
$37K |
| 83550 |
|
5,351 |
4,348 |
$37K |
| 71101 |
|
561 |
465 |
$35K |
| 84702 |
|
2,865 |
1,961 |
$35K |
| 73221 |
|
74 |
56 |
$35K |
| C9290 |
Injection, bupivacaine liposome, 1 mg |
539 |
396 |
$34K |
| 84439 |
|
5,126 |
4,063 |
$34K |
| 86481 |
|
667 |
567 |
$33K |
| 88341 |
|
619 |
468 |
$33K |
| 85027 |
|
7,266 |
5,433 |
$33K |
| 70498 |
|
217 |
165 |
$32K |
| 81001 |
|
16,553 |
12,629 |
$32K |
| 86803 |
|
3,062 |
2,467 |
$32K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
2,679 |
1,546 |
$30K |
| 87040 |
|
2,931 |
2,071 |
$30K |
| 77002 |
|
436 |
340 |
$30K |
| 83540 |
|
5,802 |
4,716 |
$30K |
| 88312 |
|
1,756 |
1,373 |
$29K |
| H0015 |
Alcohol and/or drug services; intensive outpatient (treatment program that operates at least 3 hours/day and at least 3 days/week and is based on an individualized treatment plan), including assessment, counseling; crisis intervention, and activity therapies or education |
293 |
39 |
$29K |
| 77066 |
Tomosynthesis, mammo |
303 |
249 |
$29K |
| 97165 |
|
924 |
712 |
$28K |
| 97803 |
|
1,405 |
1,026 |
$28K |
| 85610 |
|
12,120 |
6,995 |
$27K |
| 77336 |
|
329 |
119 |
$27K |
| 72070 |
|
490 |
403 |
$27K |
| 82607 |
|
3,275 |
2,560 |
$27K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
207 |
166 |
$26K |
| 94726 |
|
445 |
353 |
$26K |
| 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 |
304 |
270 |
$26K |
| 81003 |
|
20,420 |
16,812 |
$25K |
| J2785 |
Injection, regadenoson, 0.1 mg |
496 |
346 |
$25K |
| 80050 |
General health panel |
3,269 |
3,152 |
$24K |
| 93351 |
|
89 |
70 |
$24K |
| 86850 |
|
3,208 |
2,262 |
$24K |
| 83735 |
|
6,298 |
4,376 |
$24K |
| A9585 |
Injection, gadobutrol, 0.1 ml |
1,726 |
1,328 |
$23K |
| 88304 |
|
1,093 |
841 |
$23K |
| 97163 |
|
852 |
617 |
$22K |
| 70491 |
|
107 |
85 |
$22K |
| 95819 |
|
69 |
63 |
$22K |
| 88342 |
|
1,756 |
1,320 |
$22K |
| 87205 |
|
7,081 |
5,559 |
$21K |
| 86140 |
|
5,524 |
4,037 |
$21K |
| 97535 |
Self-care/home management training, each 15 minutes |
824 |
407 |
$21K |
| 0202U |
Oncology (prostate), multianalyte, gene expression profiling |
70 |
69 |
$21K |
| 97035 |
|
1,770 |
578 |
$20K |
| 59025 |
Fetal non-stress test |
600 |
405 |
$20K |
| 82805 |
|
863 |
599 |
$20K |
| 90715 |
|
1,668 |
1,339 |
$19K |
| 83605 |
|
3,125 |
2,183 |
$19K |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
4,863 |
3,309 |
$19K |
| 83516 |
|
1,562 |
1,262 |
$18K |
| 85379 |
|
2,714 |
2,074 |
$18K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,980 |
1,609 |
$18K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
5,967 |
3,794 |
$17K |
| 76813 |
|
128 |
116 |
$16K |
| 86364 |
|
281 |
211 |
$16K |
| 64493 |
|
86 |
51 |
$16K |
| 72050 |
|
197 |
176 |
$15K |
| 77065 |
Tomosynthesis, mammo |
234 |
166 |
$15K |
| 84403 |
|
724 |
586 |
$15K |
| 97166 |
|
520 |
371 |
$15K |
| G0103 |
Prostate cancer screening; prostate specific antigen test (psa) |
977 |
833 |
$14K |
| 80047 |
|
2,889 |
2,323 |
$14K |
| 86038 |
|
1,582 |
1,262 |
$14K |
| 82746 |
|
1,389 |
1,078 |
$14K |
| 82784 |
|
1,470 |
1,162 |
$14K |
| 95811 |
|
15 |
14 |
$14K |
| J2704 |
Injection, propofol, 10 mg |
9,654 |
6,359 |
$13K |
| 82043 |
|
3,389 |
2,750 |
$13K |
| 87427 |
|
923 |
680 |
$13K |
| 72110 |
|
154 |
124 |
$13K |
| 80076 |
|
2,041 |
1,573 |
$13K |
| 82962 |
|
5,630 |
3,442 |
$13K |
| 93325 |
|
159 |
121 |
$13K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
45 |
29 |
$12K |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
469 |
307 |
$12K |
| 87075 |
|
1,965 |
1,450 |
$12K |
| 93880 |
|
145 |
102 |
$12K |
| 97802 |
|
279 |
221 |
$12K |
| 93296 |
|
683 |
493 |
$11K |
| 85652 |
|
5,911 |
4,359 |
$11K |
| 93320 |
|
141 |
109 |
$11K |
| 87633 |
Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets |
58 |
57 |
$11K |
| 86592 |
|
2,928 |
2,397 |
$10K |
| 29125 |
|
269 |
232 |
$10K |
| 72040 |
|
168 |
147 |
$10K |
| 82550 |
|
2,239 |
1,572 |
$10K |
| 86376 |
|
865 |
698 |
$10K |
| 82570 |
|
2,699 |
2,068 |
$10K |
| 83970 |
|
332 |
251 |
$9K |
| 85018 |
|
4,823 |
3,782 |
$9K |
| 87493 |
|
505 |
389 |
$9K |
| 85014 |
|
4,732 |
3,724 |
$9K |
| 84481 |
|
676 |
524 |
$9K |
| 87077 |
|
1,361 |
1,040 |
$9K |
| 77334 |
|
24 |
12 |
$9K |
| 97016 |
|
620 |
224 |
$9K |
| 87340 |
|
1,073 |
899 |
$9K |
| J0690 |
Injection, cefazolin sodium, 500 mg |
3,220 |
1,989 |
$8K |
| 84480 |
|
744 |
580 |
$8K |
| G0297 |
Low dose ct scan (ldct) for lung cancer screening |
31 |
25 |
$8K |
| 29580 |
|
154 |
50 |
$8K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
6,371 |
4,915 |
$8K |
| 88307 |
|
280 |
185 |
$7K |
| 86900 |
|
3,744 |
2,676 |
$7K |
| 86901 |
|
3,744 |
2,676 |
$7K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
2,528 |
1,558 |
$7K |
| J1040 |
Injection, methylprednisolone acetate, 80 mg |
3,499 |
2,517 |
$7K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
13,010 |
9,362 |
$7K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
826 |
560 |
$7K |
| 36415 |
Collection of venous blood by venipuncture |
69,247 |
44,711 |
$7K |
| 82105 |
|
496 |
438 |
$7K |
| 73660 |
|
124 |
107 |
$6K |
| G0379 |
Direct admission of patient for hospital observation care |
232 |
164 |
$6K |
| 87328 |
|
565 |
466 |
$6K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
139 |
127 |
$6K |
| 87430 |
|
655 |
554 |
$6K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
2,314 |
1,751 |
$6K |
| 87045 |
|
859 |
709 |
$6K |
| 64494 |
|
74 |
39 |
$5K |
| 86706 |
|
617 |
482 |
$5K |
| 93226 |
|
96 |
78 |
$5K |
| 78264 |
|
19 |
12 |
$5K |
| 82950 |
|
1,251 |
1,051 |
$5K |
| 97010 |
|
1,144 |
454 |
$5K |
| 87329 |
|
584 |
480 |
$5K |
| J1170 |
Injection, hydromorphone, up to 4 mg |
3,697 |
2,086 |
$5K |
| 73560 |
|
52 |
42 |
$5K |
| 94375 |
|
111 |
90 |
$5K |
| 82248 |
|
1,218 |
733 |
$4K |
| 80164 |
|
551 |
383 |
$4K |
| 96367 |
|
120 |
81 |
$4K |
| 86308 |
|
971 |
836 |
$4K |
| 77080 |
|
44 |
36 |
$4K |
| 73552 |
|
66 |
54 |
$4K |
| 36416 |
|
1,468 |
1,075 |
$4K |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
1,928 |
1,386 |
$4K |
| 87046 |
|
862 |
709 |
$4K |
| 84100 |
|
1,122 |
728 |
$4K |
| 87902 |
|
51 |
43 |
$4K |
| 76376 |
|
32 |
26 |
$3K |
| 96401 |
|
62 |
18 |
$3K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
69 |
55 |
$3K |
| G2066 |
Interrogation device evaluation(s), (remote) up to 30 days; implantable cardiovascular physiologic monitor system, implantable loop recorder system, or subcutaneous cardiac rhythm monitor system, remote data acquisition(s), receipt of transmissions and technician review, technical support and distribution of results |
207 |
146 |
$3K |
| 93308 |
|
23 |
17 |
$3K |
| 82247 |
|
871 |
383 |
$3K |
| J7050 |
Infusion, normal saline solution, 250 cc |
1,737 |
815 |
$3K |
| 95816 |
|
14 |
13 |
$3K |
| 70360 |
|
44 |
40 |
$3K |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
760 |
514 |
$3K |
| 87015 |
|
538 |
404 |
$3K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
6,743 |
4,650 |
$3K |
| 74246 |
|
19 |
12 |
$3K |
| 76857 |
|
22 |
14 |
$2K |
| 83001 |
|
176 |
137 |
$2K |
| 86762 |
|
294 |
242 |
$2K |
| 82274 |
|
211 |
181 |
$2K |
| 84703 |
|
377 |
341 |
$2K |
| 82565 |
|
916 |
679 |
$2K |
| 12002 |
|
33 |
31 |
$2K |
| 74230 |
|
21 |
12 |
$2K |
| 92610 |
|
29 |
25 |
$2K |
| 86430 |
|
534 |
402 |
$2K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
12,045 |
8,604 |
$2K |
| 86003 |
|
38 |
37 |
$2K |
| 77061 |
|
75 |
62 |
$2K |
| 96415 |
|
42 |
25 |
$2K |
| 84146 |
|
138 |
104 |
$2K |
| 84156 |
|
766 |
523 |
$2K |
| 93225 |
|
58 |
40 |
$2K |
| P9604 |
Travel allowance one way in connection with medically necessary laboratory specimen collection drawn from home bound or nursing home bound patient; prorated trip charge |
2,527 |
955 |
$2K |
| 69209 |
|
68 |
57 |
$2K |
| 77062 |
|
65 |
58 |
$2K |
| 36591 |
|
231 |
109 |
$2K |
| 87581 |
|
58 |
57 |
$2K |
| 87486 |
|
58 |
57 |
$2K |
| 86431 |
|
390 |
306 |
$2K |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
2,181 |
1,423 |
$2K |
| 90686 |
|
1,383 |
983 |
$2K |
| G0008 |
Administration of influenza virus vaccine |
1,574 |
1,151 |
$2K |
| 82553 |
|
322 |
231 |
$2K |
| 84153 |
|
125 |
85 |
$1K |
| 73060 |
|
35 |
27 |
$1K |
| J1030 |
Injection, methylprednisolone acetate, 40 mg |
834 |
607 |
$1K |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
237 |
161 |
$1K |
| 74240 |
|
15 |
12 |
$1K |
| 93976 |
|
12 |
12 |
$1K |
| 88313 |
|
94 |
64 |
$1K |
| 82272 |
|
688 |
514 |
$1K |
| 93299 |
|
68 |
60 |
$1K |
| 88112 |
|
60 |
39 |
$1K |
| 59020 |
|
15 |
13 |
$1K |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
400 |
266 |
$1K |
| 85730 |
|
243 |
212 |
$1K |
| 94150 |
|
47 |
35 |
$1K |
| 84402 |
|
57 |
39 |
$1K |
| J3370 |
Injection, vancomycin hcl, 500 mg |
354 |
165 |
$1K |
| 84550 |
|
378 |
266 |
$1K |
| 85007 |
|
862 |
457 |
$1K |
| 99152 |
|
41 |
27 |
$1K |
| 94762 |
|
24 |
15 |
$1K |
| J0171 |
Injection, adrenalin, epinephrine, 0.1 mg |
189 |
116 |
$988.86 |
| Q9966 |
Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml |
384 |
300 |
$977.40 |
| 87807 |
|
93 |
66 |
$937.48 |
| 99153 |
Mod sedat endo service >5yrs |
17 |
12 |
$928.73 |
| 83721 |
|
180 |
147 |
$919.29 |
| J2060 |
Injection, lorazepam, 2 mg |
2,438 |
1,676 |
$903.68 |
| A9541 |
Technetium tc-99m sulfur colloid, diagnostic, per study dose, up to 20 millicuries |
33 |
24 |
$799.32 |
| 87634 |
|
21 |
13 |
$794.39 |
| 51798 |
|
39 |
24 |
$781.68 |
| 73000 |
|
13 |
12 |
$769.04 |
| 80178 |
|
213 |
142 |
$745.24 |
| J1815 |
Injection, insulin, per 5 units |
104 |
66 |
$705.00 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
1,884 |
1,403 |
$700.50 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
3,249 |
2,382 |
$693.35 |
| 86480 |
|
12 |
12 |
$684.96 |
| 86617 |
|
33 |
24 |
$657.64 |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
349 |
254 |
$656.76 |
| 83615 |
|
175 |
121 |
$633.94 |
| 87176 |
|
160 |
116 |
$596.44 |
| Q3014 |
Telehealth originating site facility fee |
233 |
144 |
$580.97 |
| 86787 |
|
29 |
29 |
$547.59 |
| 81015 |
|
206 |
159 |
$522.93 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
1,798 |
1,317 |
$467.05 |
| 97760 |
|
15 |
12 |
$464.22 |
| J2543 |
Injection, piperacillin sodium/tazobactam sodium, 1 gram/0.125 grams (1.125 grams) |
105 |
52 |
$399.50 |
| C1769 |
Guide wire |
15 |
12 |
$399.39 |
| J1010 |
Injection, methylprednisolone acetate, 1 mg |
352 |
243 |
$362.44 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
1,252 |
712 |
$328.69 |
| 86702 |
|
23 |
12 |
$326.88 |
| J1790 |
Injection, droperidol, up to 5 mg |
127 |
92 |
$325.72 |
| 86800 |
|
31 |
29 |
$318.94 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
1,941 |
1,356 |
$286.16 |
| 82010 |
|
33 |
27 |
$284.62 |
| 86708 |
|
35 |
25 |
$280.85 |
| 86701 |
|
23 |
12 |
$260.34 |
| 82977 |
|
38 |
24 |
$230.72 |
| 0054A |
|
91 |
59 |
$219.18 |
| J1644 |
Injection, heparin sodium, per 1000 units |
375 |
173 |
$218.06 |
| 84520 |
|
114 |
89 |
$207.46 |
| 82947 |
|
60 |
55 |
$190.63 |
| 86704 |
|
16 |
14 |
$180.23 |
| C9113 |
Injection, pantoprazole sodium, per vial |
274 |
133 |
$174.15 |
| 82465 |
|
44 |
41 |
$163.89 |
| 83002 |
|
14 |
12 |
$150.11 |
| 82365 |
|
19 |
12 |
$142.21 |
| 81508 |
|
14 |
14 |
$134.04 |
| 84165 |
|
17 |
13 |
$130.70 |
| J3480 |
Injection, potassium chloride, per 2 meq |
82 |
59 |
$124.58 |
| 82140 |
|
15 |
13 |
$124.11 |
| 84436 |
|
38 |
29 |
$122.40 |
| 80177 |
|
16 |
12 |
$121.01 |
| 86200 |
|
12 |
12 |
$117.94 |
| G1004 |
Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program |
4,655 |
2,672 |
$112.90 |
| 84132 |
|
42 |
25 |
$108.95 |
| 82150 |
|
21 |
12 |
$103.69 |
| 83718 |
|
12 |
12 |
$86.79 |
| J1642 |
Injection, heparin sodium, (heparin lock flush), per 10 units |
435 |
223 |
$86.25 |
| 87207 |
|
13 |
13 |
$86.19 |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
28 |
24 |
$78.97 |
| 80069 |
|
13 |
12 |
$78.91 |
| 99406 |
|
44 |
27 |
$73.95 |
| J7999 |
Compounded drug, not otherwise classified |
24 |
18 |
$71.67 |
| G0009 |
Administration of pneumococcal vaccine |
71 |
49 |
$70.64 |
| 91322 |
|
12 |
12 |
$57.28 |
| J2370 |
Injection, phenylephrine hcl, up to 1 ml |
84 |
63 |
$54.91 |
| G0475 |
Hiv antigen/antibody, combination assay, screening |
21 |
13 |
$54.22 |
| 84460 |
|
14 |
13 |
$48.80 |
| J3490 |
Unclassified drugs |
27 |
18 |
$44.01 |
| 0004A |
|
27 |
19 |
$39.24 |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
30 |
13 |
$36.15 |
| J0330 |
Injection, succinylcholine chloride, up to 20 mg |
14 |
12 |
$35.28 |
| J1630 |
Injection, haloperidol, up to 5 mg |
92 |
59 |
$33.00 |
| 90732 |
|
19 |
13 |
$31.93 |
| G0279 |
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) |
20 |
13 |
$30.81 |
| 85046 |
|
18 |
12 |
$29.87 |
| 90662 |
|
105 |
93 |
$25.79 |
| J0689 |
Injection, cefazolin sodium (baxter), not therapeutically equivalent to j0690, 500 mg |
50 |
39 |
$16.43 |
| 91305 |
|
146 |
92 |
$0.00 |
| G8987 |
Self care functional limitation, current status, at therapy episode outset and at reporting intervals |
104 |
50 |
$0.00 |
| 90480 |
|
12 |
12 |
$0.00 |
| G8980 |
Mobility: walking & moving around functional limitation, discharge status, at discharge from therapy or to end reporting |
254 |
142 |
$0.00 |
| G8988 |
Self care functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting |
106 |
50 |
$0.00 |
| 90656 |
|
19 |
19 |
$0.00 |
| G8985 |
Carrying, moving and handling objects, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting |
231 |
119 |
$0.00 |
| G8984 |
Carrying, moving & handling objects functional limitation, current status, at therapy episode outset and at reporting intervals |
84 |
46 |
$0.00 |
| 80356 |
|
14 |
13 |
$0.00 |
| G8979 |
Mobility: walking & moving around functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting |
837 |
439 |
$0.00 |
| G8978 |
Mobility: walking & moving around functional limitation, current status, at therapy episode outset and at reporting intervals |
656 |
358 |
$0.00 |
| 0124A |
|
33 |
33 |
$0.00 |