| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
105,193 |
97,895 |
$12.26M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
70,022 |
63,380 |
$8.86M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
27,398 |
23,187 |
$3.66M |
| 96361 |
Intravenous infusion, hydration; each additional hour |
10,123 |
8,151 |
$2.20M |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
8,634 |
7,296 |
$2.19M |
| 70450 |
Computed tomography, head or brain; without contrast material |
8,594 |
7,449 |
$1.98M |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
10,664 |
10,099 |
$1.07M |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
17,933 |
5,158 |
$907K |
| 95810 |
Polysomnography; sleep staging with 4 or more additional parameters |
1,210 |
1,159 |
$759K |
| 95811 |
|
1,073 |
1,027 |
$650K |
| 80053 |
Comprehensive metabolic panel |
64,850 |
56,781 |
$648K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
4,093 |
3,159 |
$550K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
2,084 |
1,747 |
$537K |
| G0378 |
Hospital observation service, per hour |
7,040 |
2,687 |
$515K |
| 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 |
2,983 |
2,868 |
$471K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
2,045 |
1,126 |
$446K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
2,609 |
2,186 |
$403K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
3,891 |
2,569 |
$401K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
7,556 |
2,402 |
$399K |
| 84443 |
Thyroid stimulating hormone (TSH) |
9,679 |
8,780 |
$197K |
| 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) |
2,333 |
2,310 |
$191K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
564 |
444 |
$190K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
3,204 |
2,178 |
$188K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
911 |
795 |
$181K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
89,475 |
76,315 |
$179K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
8,094 |
3,516 |
$177K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
474 |
408 |
$176K |
| 70496 |
|
819 |
672 |
$168K |
| 45385 |
Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) |
301 |
231 |
$159K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
7,436 |
2,282 |
$158K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
22,898 |
18,764 |
$145K |
| 80061 |
Lipid panel |
10,260 |
9,279 |
$139K |
| 66984 |
Extracapsular cataract removal with insertion of intraocular lens prosthesis |
300 |
201 |
$133K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
13,379 |
12,080 |
$128K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
1,542 |
704 |
$123K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
945 |
797 |
$118K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
659 |
584 |
$110K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
8,435 |
7,550 |
$107K |
| 70491 |
|
374 |
310 |
$101K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
15,149 |
13,451 |
$101K |
| 84484 |
|
27,669 |
19,205 |
$101K |
| 71046 |
Radiologic examination, chest; 2 views |
22,967 |
20,821 |
$98K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
13,396 |
12,095 |
$93K |
| 64721 |
|
130 |
122 |
$89K |
| 36415 |
Collection of venous blood by venipuncture |
66,153 |
54,996 |
$80K |
| 97161 |
|
2,472 |
2,112 |
$79K |
| 12001 |
|
484 |
438 |
$75K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
3,336 |
2,998 |
$74K |
| 87801 |
Infectious agent detection by nucleic acid; amplified probe, multiple organisms |
1,590 |
1,413 |
$74K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
15,938 |
14,344 |
$57K |
| 72131 |
|
632 |
547 |
$57K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
2,355 |
2,009 |
$56K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
33,797 |
28,908 |
$54K |
| 71250 |
|
793 |
686 |
$53K |
| 97113 |
|
776 |
203 |
$51K |
| 10060 |
|
326 |
292 |
$50K |
| 82607 |
|
2,564 |
2,272 |
$50K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
376 |
309 |
$49K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
1,118 |
1,017 |
$48K |
| 86701 |
|
2,092 |
1,898 |
$46K |
| 76642 |
|
395 |
352 |
$45K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
556 |
476 |
$45K |
| 87480 |
|
2,146 |
1,991 |
$45K |
| 93017 |
|
626 |
545 |
$44K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
3,187 |
2,653 |
$44K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
281 |
249 |
$41K |
| 87390 |
|
2,074 |
1,888 |
$41K |
| 71271 |
|
302 |
277 |
$41K |
| 74174 |
|
179 |
146 |
$39K |
| 84439 |
|
2,096 |
1,874 |
$38K |
| 86702 |
|
2,086 |
1,894 |
$37K |
| 86803 |
|
1,797 |
1,617 |
$36K |
| 70486 |
|
696 |
594 |
$36K |
| 71045 |
Radiologic examination, chest; single view |
11,035 |
9,643 |
$34K |
| 93975 |
|
319 |
274 |
$32K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
28,787 |
24,816 |
$32K |
| 86900 |
|
2,078 |
1,663 |
$31K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
171 |
152 |
$30K |
| 87660 |
|
2,146 |
1,991 |
$30K |
| 93971 |
|
374 |
322 |
$30K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
18,845 |
14,702 |
$30K |
| 84703 |
|
44,022 |
39,558 |
$29K |
| 87510 |
|
2,146 |
1,991 |
$28K |
| 85027 |
|
4,581 |
3,862 |
$27K |
| 12011 |
|
172 |
154 |
$26K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
63 |
49 |
$26K |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
1,602 |
1,499 |
$25K |
| 76830 |
Ultrasound, transvaginal |
712 |
614 |
$24K |
| 76770 |
|
170 |
153 |
$23K |
| 86780 |
|
1,203 |
1,102 |
$23K |
| 81001 |
|
45,465 |
40,688 |
$23K |
| 72100 |
|
1,013 |
902 |
$23K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
18,651 |
15,304 |
$23K |
| 86850 |
|
1,661 |
1,330 |
$21K |
| 90715 |
|
1,385 |
1,115 |
$20K |
| 97116 |
|
842 |
504 |
$19K |
| 82746 |
|
2,132 |
1,885 |
$19K |
| 95806 |
|
28 |
28 |
$19K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
26,459 |
12,080 |
$19K |
| 82728 |
|
1,156 |
1,010 |
$18K |
| 83880 |
|
5,010 |
4,124 |
$18K |
| 12002 |
|
116 |
106 |
$17K |
| 82570 |
|
1,671 |
1,487 |
$17K |
| 87340 |
|
812 |
755 |
$16K |
| 80069 |
|
1,121 |
866 |
$16K |
| 80076 |
|
4,481 |
3,752 |
$15K |
| 83605 |
|
6,196 |
4,403 |
$15K |
| 73130 |
|
1,868 |
1,625 |
$15K |
| 97166 |
|
542 |
428 |
$15K |
| 73630 |
|
2,059 |
1,805 |
$14K |
| 97162 |
|
826 |
671 |
$14K |
| 97165 |
|
370 |
303 |
$14K |
| 86140 |
|
1,501 |
1,235 |
$14K |
| 83690 |
|
24,110 |
20,969 |
$14K |
| 76536 |
|
141 |
136 |
$14K |
| 83540 |
|
1,489 |
1,303 |
$14K |
| 64718 |
|
15 |
13 |
$13K |
| 73610 |
|
1,677 |
1,489 |
$13K |
| 73560 |
|
1,533 |
1,344 |
$13K |
| 70498 |
|
838 |
693 |
$13K |
| 87070 |
|
1,170 |
945 |
$12K |
| 93458 |
|
14 |
12 |
$12K |
| 83550 |
|
1,424 |
1,242 |
$12K |
| 83735 |
|
7,606 |
5,752 |
$12K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
597 |
494 |
$12K |
| 10061 |
|
68 |
58 |
$11K |
| 85652 |
|
2,246 |
1,908 |
$11K |
| 73030 |
|
1,512 |
1,297 |
$11K |
| 97150 |
Therapeutic procedure(s), group (2 or more individuals) |
334 |
98 |
$11K |
| 97535 |
Self-care/home management training, each 15 minutes |
688 |
415 |
$11K |
| 87522 |
Neg quan hep c or qual rna |
315 |
294 |
$11K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
260 |
253 |
$10K |
| 11045 |
|
31 |
12 |
$10K |
| 84403 |
|
421 |
402 |
$10K |
| 87077 |
|
3,029 |
2,406 |
$10K |
| 99152 |
|
423 |
334 |
$10K |
| 84153 |
|
640 |
576 |
$10K |
| 84702 |
|
2,121 |
1,663 |
$10K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
760 |
695 |
$10K |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
226 |
192 |
$9K |
| 11043 |
|
80 |
51 |
$9K |
| 94060 |
|
233 |
204 |
$9K |
| 97035 |
|
95 |
28 |
$9K |
| 72040 |
|
332 |
300 |
$9K |
| 82043 |
|
1,285 |
1,181 |
$9K |
| 86038 |
|
324 |
288 |
$9K |
| 73562 |
|
795 |
701 |
$9K |
| 96368 |
|
163 |
106 |
$9K |
| 74018 |
|
374 |
322 |
$9K |
| 87081 |
|
4,806 |
4,240 |
$8K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
2,871 |
1,652 |
$8K |
| 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 |
2,018 |
1,952 |
$8K |
| 96376 |
|
3,014 |
1,601 |
$8K |
| 73502 |
|
818 |
717 |
$8K |
| 73110 |
|
1,052 |
917 |
$8K |
| 84270 |
|
347 |
334 |
$7K |
| 59025 |
Fetal non-stress test |
40 |
27 |
$7K |
| 83001 |
|
240 |
226 |
$7K |
| 82565 |
|
744 |
651 |
$7K |
| 96367 |
|
666 |
484 |
$7K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
49 |
42 |
$7K |
| 86901 |
|
2,065 |
1,662 |
$7K |
| 86762 |
|
318 |
303 |
$7K |
| 81003 |
|
14,268 |
12,724 |
$6K |
| 87563 |
|
162 |
140 |
$6K |
| 85610 |
|
3,780 |
2,862 |
$6K |
| 87186 |
|
2,425 |
1,998 |
$6K |
| 87210 |
|
7,508 |
6,621 |
$6K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
90 |
69 |
$6K |
| S9472 |
Cardiac rehabilitation program, non-physician provider, per diem |
84 |
12 |
$6K |
| 83970 |
|
214 |
183 |
$6K |
| 73700 |
|
43 |
42 |
$5K |
| 36430 |
|
16 |
12 |
$5K |
| 86480 |
|
101 |
87 |
$5K |
| 85379 |
|
2,804 |
2,376 |
$4K |
| 64400 |
|
17 |
12 |
$4K |
| 84146 |
|
203 |
187 |
$4K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,482 |
1,158 |
$4K |
| 94726 |
|
190 |
164 |
$4K |
| 20610 |
|
31 |
24 |
$4K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
5,789 |
5,166 |
$4K |
| 77065 |
Tomosynthesis, mammo |
131 |
109 |
$4K |
| 83516 |
|
118 |
96 |
$4K |
| 76801 |
|
122 |
112 |
$4K |
| G0279 |
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) |
453 |
402 |
$4K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
13 |
13 |
$4K |
| 86706 |
|
163 |
137 |
$4K |
| 87481 |
|
83 |
73 |
$3K |
| 71101 |
|
383 |
341 |
$3K |
| 82550 |
|
1,038 |
786 |
$3K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
16 |
13 |
$3K |
| 94664 |
|
94 |
89 |
$3K |
| 82077 |
|
1,992 |
1,581 |
$3K |
| 86787 |
|
121 |
105 |
$3K |
| 73140 |
|
439 |
382 |
$3K |
| 94729 |
|
225 |
197 |
$3K |
| 73080 |
|
557 |
473 |
$3K |
| 86431 |
|
154 |
143 |
$3K |
| 80074 |
|
172 |
151 |
$3K |
| 73590 |
|
582 |
505 |
$3K |
| C1713 |
Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) |
356 |
271 |
$3K |
| 87088 |
|
828 |
701 |
$3K |
| 87641 |
|
90 |
82 |
$3K |
| 84550 |
|
407 |
365 |
$3K |
| 85730 |
|
992 |
783 |
$3K |
| 86696 |
|
130 |
113 |
$2K |
| 76870 |
|
36 |
24 |
$2K |
| 84481 |
|
142 |
130 |
$2K |
| 99153 |
Mod sedat endo service >5yrs |
137 |
118 |
$2K |
| 77066 |
Tomosynthesis, mammo |
74 |
67 |
$2K |
| 88341 |
|
21 |
12 |
$2K |
| 84450 |
|
218 |
200 |
$2K |
| 97016 |
|
91 |
28 |
$2K |
| 87808 |
|
719 |
588 |
$2K |
| 84460 |
|
220 |
202 |
$2K |
| 83721 |
|
136 |
108 |
$2K |
| J3490 |
Unclassified drugs |
307 |
135 |
$2K |
| 88304 |
|
246 |
188 |
$2K |
| 82784 |
|
71 |
61 |
$2K |
| 84156 |
|
313 |
258 |
$2K |
| 82803 |
|
2,095 |
1,621 |
$2K |
| J0500 |
Injection, dicyclomine hcl, up to 20 mg |
180 |
151 |
$1K |
| 82670 |
|
48 |
44 |
$1K |
| 73090 |
|
314 |
268 |
$1K |
| 86200 |
|
63 |
61 |
$1K |
| 87205 |
|
826 |
585 |
$1K |
| 87040 |
|
2,328 |
1,085 |
$1K |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
3,220 |
1,380 |
$1K |
| 86695 |
|
123 |
106 |
$1K |
| 83002 |
|
58 |
52 |
$1K |
| 84100 |
|
722 |
489 |
$1K |
| 82950 |
|
82 |
76 |
$1K |
| 72128 |
|
49 |
45 |
$1K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
17,682 |
14,585 |
$1K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
17,025 |
14,386 |
$1K |
| 88342 |
|
348 |
254 |
$973.48 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
2,837 |
1,809 |
$971.41 |
| 80143 |
|
669 |
551 |
$967.15 |
| 93970 |
|
15 |
15 |
$952.54 |
| 82248 |
|
84 |
63 |
$946.37 |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
225 |
217 |
$914.49 |
| 84145 |
|
640 |
496 |
$895.46 |
| J1953 |
Injection, levetiracetam, 10 mg |
235 |
136 |
$894.44 |
| 82533 |
|
24 |
14 |
$884.02 |
| 72110 |
|
13 |
12 |
$883.54 |
| 86376 |
|
38 |
33 |
$800.61 |
| 00731 |
|
545 |
422 |
$799.49 |
| 84480 |
|
49 |
40 |
$798.67 |
| 94760 |
|
4,668 |
2,557 |
$780.30 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
3,039 |
1,648 |
$759.98 |
| 00812 |
|
366 |
281 |
$706.08 |
| 86705 |
|
28 |
28 |
$700.00 |
| 84144 |
|
23 |
15 |
$598.62 |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
26 |
19 |
$587.32 |
| 97014 |
|
19 |
13 |
$576.89 |
| 82627 |
|
16 |
13 |
$566.63 |
| 86003 |
|
15 |
14 |
$558.44 |
| 86923 |
|
17 |
12 |
$557.25 |
| 80179 |
|
661 |
546 |
$550.82 |
| 86735 |
|
13 |
12 |
$538.94 |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
17 |
16 |
$516.55 |
| 29125 |
|
356 |
320 |
$484.04 |
| 86592 |
|
32 |
30 |
$479.97 |
| J7030 |
Infusion, normal saline solution , 1000 cc |
4,158 |
3,461 |
$478.43 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
15,675 |
12,288 |
$463.83 |
| 80177 |
|
244 |
188 |
$462.48 |
| 73552 |
|
123 |
105 |
$461.59 |
| 86039 |
|
14 |
14 |
$454.95 |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
18 |
17 |
$449.75 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
4,952 |
3,804 |
$423.64 |
| 84132 |
|
263 |
195 |
$421.53 |
| 86235 |
|
14 |
12 |
$390.59 |
| 86800 |
|
15 |
12 |
$325.28 |
| 86225 |
|
14 |
13 |
$321.52 |
| 86765 |
|
13 |
12 |
$318.88 |
| 82652 |
|
12 |
12 |
$318.39 |
| 80050 |
General health panel |
71 |
62 |
$315.62 |
| J2785 |
Injection, regadenoson, 0.1 mg |
242 |
219 |
$297.30 |
| J2919 |
Injection, methylprednisolone sodium succinate, 5 mg |
293 |
232 |
$282.10 |
| 86694 |
|
17 |
12 |
$279.16 |
| 87075 |
|
87 |
63 |
$264.60 |
| C1769 |
Guide wire |
636 |
489 |
$264.46 |
| J2272 |
Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg |
552 |
413 |
$264.31 |
| 81015 |
|
60 |
46 |
$245.19 |
| 85018 |
|
178 |
101 |
$241.51 |
| 82040 |
|
28 |
24 |
$234.22 |
| 84155 |
|
34 |
29 |
$227.31 |
| 84165 |
|
18 |
16 |
$224.55 |
| 84425 |
|
16 |
16 |
$223.30 |
| J2360 |
Injection, orphenadrine citrate, up to 60 mg |
559 |
442 |
$222.83 |
| 84134 |
|
12 |
12 |
$213.62 |
| 82270 |
|
231 |
181 |
$213.28 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
2,448 |
1,844 |
$211.90 |
| G0475 |
Hiv antigen/antibody, combination assay, screening |
49 |
40 |
$201.40 |
| 86308 |
|
49 |
38 |
$198.41 |
| 00142 |
|
259 |
177 |
$192.86 |
| J2704 |
Injection, propofol, 10 mg |
9,014 |
5,420 |
$191.84 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
5,446 |
3,508 |
$179.66 |
| 85045 |
|
29 |
19 |
$178.59 |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
770 |
580 |
$162.11 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
638 |
430 |
$158.30 |
| 73060 |
|
33 |
25 |
$157.04 |
| 84466 |
|
12 |
12 |
$143.46 |
| J1644 |
Injection, heparin sodium, per 1000 units |
1,127 |
466 |
$143.02 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
4,528 |
3,460 |
$141.42 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
1,386 |
1,107 |
$138.19 |
| J2060 |
Injection, lorazepam, 2 mg |
1,025 |
724 |
$135.56 |
| 85014 |
|
83 |
56 |
$132.37 |
| 00813 |
|
110 |
85 |
$130.24 |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
756 |
582 |
$128.19 |
| J2800 |
Injection, methocarbamol, up to 10 ml |
73 |
58 |
$126.73 |
| 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 |
12 |
12 |
$122.79 |
| A9502 |
Technetium tc-99m tetrofosmin, diagnostic, per study dose |
500 |
388 |
$110.89 |
| 87807 |
|
115 |
105 |
$99.12 |
| C1887 |
Catheter, guiding (may include infusion/perfusion capability) |
16 |
12 |
$96.02 |
| C1894 |
Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser |
449 |
353 |
$93.00 |
| J1790 |
Injection, droperidol, up to 5 mg |
733 |
549 |
$87.37 |
| J8540 |
Dexamethasone, oral, 0.25 mg |
749 |
618 |
$82.92 |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
1,282 |
1,003 |
$79.52 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
1,561 |
884 |
$76.58 |
| 94761 |
|
709 |
484 |
$75.21 |
| J1630 |
Injection, haloperidol, up to 5 mg |
402 |
286 |
$73.88 |
| J1940 |
Injection, furosemide, up to 20 mg |
374 |
187 |
$64.05 |
| J0688 |
Injection, cefazolin sodium (hikma), not therapeutically equivalent to j0690, 500 mg |
540 |
388 |
$63.89 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
3,519 |
2,657 |
$63.19 |
| 82140 |
|
45 |
30 |
$57.90 |
| 82010 |
|
387 |
319 |
$57.54 |
| J3480 |
Injection, potassium chloride, per 2 meq |
416 |
258 |
$56.32 |
| J3370 |
Injection, vancomycin hcl, 500 mg |
528 |
258 |
$54.30 |
| 77002 |
|
18 |
12 |
$51.37 |
| J2550 |
Injection, promethazine hcl, up to 50 mg |
511 |
370 |
$50.51 |
| A9577 |
Injection, gadobenate dimeglumine (multihance), per ml |
276 |
222 |
$50.42 |
| J2470 |
Injection, pantoprazole sodium, 40 mg |
74 |
38 |
$31.85 |
| J0171 |
Injection, adrenalin, epinephrine, 0.1 mg |
420 |
296 |
$23.95 |
| J0360 |
Injection, hydralazine hcl, up to 20 mg |
154 |
95 |
$22.97 |
| J1171 |
Injection, hydromorphone, 0.1 mg |
172 |
106 |
$7.99 |
| J1921 |
Injection, labetalol hydrochloride (hikma), not therapeutically equivalent to j1920, 5 mg |
17 |
16 |
$7.78 |
| J1596 |
Injection, glycopyrrolate, 0.1 mg |
541 |
463 |
$7.27 |
| J0692 |
Injection, cefepime hydrochloride, 500 mg |
249 |
98 |
$6.28 |
| J7050 |
Infusion, normal saline solution, 250 cc |
448 |
302 |
$6.10 |
| A9579 |
Injection, gadolinium-based magnetic resonance contrast agent, not otherwise specified (nos), per ml |
280 |
254 |
$4.95 |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
270 |
227 |
$3.83 |
| A4217 |
Sterile water/saline, 500 ml |
69 |
54 |
$2.72 |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
36 |
29 |
$2.57 |
| J0744 |
Injection, ciprofloxacin for intravenous infusion, 200 mg |
30 |
15 |
$2.26 |
| J1920 |
Injection, labetalol hydrochloride, 5 mg |
54 |
40 |
$1.80 |
| J2371 |
Injection, phenylephrine hydrochloride, 20 micrograms |
621 |
375 |
$1.77 |
| J2003 |
Injection, lidocaine hydrochloride, 1 mg |
49 |
44 |
$0.08 |
| 01810 |
|
378 |
347 |
$0.00 |
| 00811 |
|
18 |
12 |
$0.00 |
| J1580 |
Injection, garamycin, gentamicin, up to 80 mg |
76 |
52 |
$0.00 |
| 00910 |
|
37 |
25 |
$0.00 |
| 76376 |
|
13 |
13 |
$0.00 |
| 93356 |
|
32 |
30 |
$0.00 |
| 80164 |
|
17 |
13 |
$0.00 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
30 |
25 |
$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 |
15 |
12 |
$0.00 |
| 00840 |
|
34 |
12 |
$0.00 |
| C1776 |
Joint device (implantable) |
32 |
28 |
$0.00 |
| Q9966 |
Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml |
13 |
13 |
$0.00 |
| G8978 |
Mobility: walking & moving around functional limitation, current status, at therapy episode outset and at reporting intervals |
14 |
12 |
$0.00 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
18 |
16 |
$0.00 |
| C9399 |
Unclassified drugs or biologicals |
87 |
67 |
$0.00 |
| 51798 |
|
66 |
43 |
$0.00 |
| J2795 |
Injection, ropivacaine hydrochloride, 1 mg |
68 |
54 |
$0.00 |
| J2543 |
Injection, piperacillin sodium/tazobactam sodium, 1 gram/0.125 grams (1.125 grams) |
38 |
13 |
$0.00 |
| 00790 |
|
28 |
24 |
$0.00 |
| J2305 |
Injection, nitroglycerin, 5 mg |
19 |
14 |
$0.00 |
| 87449 |
|
13 |
12 |
$0.00 |
| A9500 |
Technetium tc-99m sestamibi, diagnostic, per study dose |
26 |
21 |
$0.00 |
| Q9963 |
High osmolar contrast material, 350-399 mg/ml iodine concentration, per ml |
13 |
12 |
$0.00 |