| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 96361 |
Intravenous infusion, hydration; each additional hour |
4,955 |
3,810 |
$2.35M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
12,733 |
10,872 |
$1.63M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
9,291 |
7,715 |
$1.48M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
6,308 |
5,201 |
$1.27M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
10,165 |
8,701 |
$1.12M |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
3,788 |
2,821 |
$975K |
| 70450 |
Computed tomography, head or brain; without contrast material |
2,074 |
1,843 |
$566K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
1,857 |
1,683 |
$514K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
5,376 |
4,682 |
$499K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
1,281 |
1,106 |
$341K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
10,328 |
3,803 |
$333K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,546 |
2,236 |
$302K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
1,850 |
1,646 |
$288K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
2,202 |
1,753 |
$280K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
692 |
501 |
$268K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
1,807 |
1,548 |
$196K |
| 87631 |
|
1,340 |
1,231 |
$134K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
825 |
624 |
$131K |
| 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 |
1,232 |
1,112 |
$112K |
| C9803 |
Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
5,623 |
4,911 |
$109K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
5,479 |
2,105 |
$108K |
| 80053 |
Comprehensive metabolic panel |
10,926 |
8,931 |
$99K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
334 |
306 |
$90K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
2,073 |
1,840 |
$81K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
976 |
888 |
$77K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
980 |
817 |
$76K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
13,898 |
10,990 |
$74K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
1,946 |
907 |
$73K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
2,039 |
1,842 |
$70K |
| 96367 |
|
403 |
297 |
$67K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
2,332 |
1,064 |
$65K |
| 97161 |
|
1,491 |
1,357 |
$65K |
| 87632 |
|
399 |
364 |
$64K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
181 |
161 |
$45K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
2,898 |
2,281 |
$42K |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
6,989 |
5,558 |
$37K |
| 80306 |
|
2,295 |
2,012 |
$33K |
| 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 |
733 |
624 |
$32K |
| 84484 |
|
4,725 |
3,224 |
$31K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
304 |
275 |
$29K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
114 |
105 |
$27K |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
1,056 |
356 |
$25K |
| 84443 |
Thyroid stimulating hormone (TSH) |
2,135 |
1,898 |
$23K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
2,762 |
2,293 |
$22K |
| G0378 |
Hospital observation service, per hour |
406 |
329 |
$22K |
| 83605 |
|
3,138 |
2,573 |
$21K |
| 84703 |
|
2,635 |
2,287 |
$20K |
| 83735 |
|
4,726 |
3,947 |
$19K |
| 81001 |
|
4,687 |
4,067 |
$19K |
| 86140 |
|
5,560 |
4,683 |
$18K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
162 |
141 |
$16K |
| 83880 |
|
1,129 |
990 |
$15K |
| 82803 |
|
1,112 |
911 |
$15K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
465 |
419 |
$15K |
| 83690 |
|
2,872 |
2,458 |
$15K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
4,800 |
3,741 |
$14K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
271 |
255 |
$13K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
617 |
585 |
$12K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
266 |
251 |
$12K |
| 71046 |
Radiologic examination, chest; 2 views |
1,220 |
1,119 |
$11K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
151 |
56 |
$11K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
1,894 |
1,688 |
$11K |
| 85379 |
|
1,540 |
1,394 |
$9K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
180 |
170 |
$9K |
| 84145 |
|
731 |
652 |
$9K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
603 |
294 |
$9K |
| 87040 |
|
1,775 |
1,042 |
$8K |
| 87070 |
|
579 |
517 |
$8K |
| 80320 |
|
1,915 |
1,608 |
$8K |
| 81003 |
|
2,642 |
2,336 |
$8K |
| 87486 |
|
236 |
216 |
$8K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
44 |
40 |
$7K |
| 87077 |
|
1,571 |
1,101 |
$7K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
2,443 |
2,067 |
$7K |
| 87581 |
|
236 |
216 |
$7K |
| 87186 |
|
1,321 |
1,022 |
$6K |
| 20610 |
|
39 |
27 |
$6K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
223 |
179 |
$6K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
223 |
179 |
$6K |
| 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 |
409 |
366 |
$6K |
| 85610 |
|
2,194 |
1,733 |
$6K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
6,914 |
5,394 |
$5K |
| 76801 |
|
30 |
24 |
$5K |
| 82962 |
|
2,231 |
871 |
$5K |
| 71045 |
Radiologic examination, chest; single view |
4,810 |
4,160 |
$4K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
15 |
13 |
$4K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
60 |
53 |
$3K |
| 81025 |
|
324 |
294 |
$3K |
| M0247 |
Intravenous infusion, sotrovimab, includes infusion and post administration monitoring |
15 |
13 |
$3K |
| 87634 |
|
37 |
37 |
$3K |
| 73630 |
|
335 |
280 |
$3K |
| 86618 |
|
214 |
94 |
$2K |
| 87081 |
|
108 |
106 |
$2K |
| 81002 |
|
284 |
267 |
$2K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
13 |
13 |
$2K |
| 90686 |
|
73 |
60 |
$2K |
| M0243 |
Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring |
13 |
13 |
$2K |
| 73562 |
|
221 |
192 |
$2K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
60 |
49 |
$2K |
| 73030 |
|
123 |
102 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
151 |
134 |
$1K |
| 36415 |
Collection of venous blood by venipuncture |
9,929 |
7,649 |
$1K |
| 73610 |
|
83 |
65 |
$1K |
| 71250 |
|
16 |
14 |
$1K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
4,232 |
3,494 |
$1K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
3,331 |
2,981 |
$1K |
| 85027 |
|
208 |
191 |
$990.80 |
| 80329 |
|
989 |
454 |
$754.16 |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
10,611 |
5,371 |
$671.46 |
| 97162 |
|
21 |
18 |
$667.71 |
| 87420 |
|
35 |
33 |
$509.36 |
| 74018 |
|
26 |
26 |
$446.12 |
| J7030 |
Infusion, normal saline solution , 1000 cc |
3,712 |
2,724 |
$444.01 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
45 |
42 |
$437.16 |
| 85730 |
|
113 |
86 |
$378.81 |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
284 |
136 |
$350.78 |
| 96376 |
|
985 |
729 |
$336.30 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
3,609 |
3,010 |
$307.44 |
| 86780 |
|
40 |
26 |
$292.67 |
| 73110 |
|
133 |
106 |
$260.41 |
| 84460 |
|
78 |
65 |
$252.08 |
| 84075 |
|
78 |
65 |
$246.10 |
| 82040 |
|
79 |
66 |
$229.95 |
| 90461 |
|
15 |
14 |
$218.56 |
| 86850 |
|
67 |
51 |
$212.46 |
| 87205 |
|
73 |
61 |
$198.45 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
910 |
679 |
$196.63 |
| 82247 |
|
78 |
65 |
$195.04 |
| 82800 |
|
25 |
24 |
$182.44 |
| 84155 |
|
78 |
65 |
$174.34 |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
1,636 |
1,419 |
$167.89 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
2,147 |
1,812 |
$155.67 |
| 86900 |
|
78 |
59 |
$146.55 |
| 86901 |
|
78 |
59 |
$145.89 |
| 73502 |
|
32 |
26 |
$134.82 |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
13 |
12 |
$108.00 |
| 87210 |
|
15 |
13 |
$104.00 |
| 85018 |
|
30 |
27 |
$90.35 |
| 73130 |
|
16 |
12 |
$80.65 |
| J2704 |
Injection, propofol, 10 mg |
1,731 |
1,494 |
$74.71 |
| 94761 |
|
528 |
473 |
$73.79 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
3,376 |
2,726 |
$65.78 |
| Q9966 |
Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml |
66 |
58 |
$60.66 |
| J3490 |
Unclassified drugs |
460 |
398 |
$57.75 |
| 0202U |
Oncology (prostate), multianalyte, gene expression profiling |
75 |
63 |
$51.46 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
119 |
99 |
$48.92 |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
383 |
328 |
$46.68 |
| 85651 |
|
12 |
12 |
$28.98 |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
125 |
105 |
$20.92 |
| 80050 |
General health panel |
13 |
12 |
$14.88 |
| A9576 |
Injection, gadoteridol, (prohance multipack), per ml |
17 |
17 |
$10.61 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
737 |
603 |
$9.60 |
| J2060 |
Injection, lorazepam, 2 mg |
417 |
342 |
$9.06 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
797 |
568 |
$8.71 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
462 |
391 |
$6.51 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
57 |
54 |
$6.05 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
13 |
12 |
$5.77 |
| A9270 |
Non-covered item or service |
4,355 |
1,417 |
$3.52 |
| C9113 |
Injection, pantoprazole sodium, per vial |
312 |
231 |
$1.11 |
| G8978 |
Mobility: walking & moving around functional limitation, current status, at therapy episode outset and at reporting intervals |
20 |
19 |
$0.02 |
| S0119 |
Ondansetron, oral, 4 mg (for circumstances falling under the medicare statute, use hcpcs q code) |
294 |
252 |
$0.00 |
| J0702 |
Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg |
12 |
12 |
$0.00 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
75 |
66 |
$0.00 |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
46 |
38 |
$0.00 |
| E0445 |
Oximeter device for measuring blood oxygen levels non-invasively |
49 |
46 |
$0.00 |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
17 |
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 |
21 |
20 |
$0.00 |
| J1815 |
Injection, insulin, per 5 units |
54 |
29 |
$0.00 |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
16 |
12 |
$0.00 |
| J2003 |
Injection, lidocaine hydrochloride, 1 mg |
15 |
14 |
$0.00 |
| 94760 |
|
17 |
12 |
$0.00 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
123 |
95 |
$0.00 |
| G0379 |
Direct admission of patient for hospital observation care |
15 |
12 |
$0.00 |
| J3480 |
Injection, potassium chloride, per 2 meq |
114 |
71 |
$0.00 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
21 |
12 |
$0.00 |