| Code | Description | Claims | Beneficiaries | Total Paid |
| H0035 |
Mental health partial hospitalization, treatment, less than 24 hours |
65,710 |
7,500 |
$6.40M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
12,496 |
11,362 |
$3.73M |
| 90832 |
Psychotherapy, 30 minutes with patient |
27,865 |
15,979 |
$3.30M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
11,462 |
10,746 |
$3.07M |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
2,189 |
2,127 |
$1.85M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
6,326 |
5,669 |
$1.83M |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
1,149 |
1,104 |
$1.60M |
| A0427 |
Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) |
6,991 |
6,417 |
$1.49M |
| S9480 |
Intensive outpatient psychiatric services, per diem |
3,837 |
2,336 |
$1.43M |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
2,415 |
2,323 |
$1.23M |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
40,163 |
11,724 |
$1.15M |
| G0378 |
Hospital observation service, per hour |
2,812 |
2,311 |
$1.05M |
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
25,754 |
3,841 |
$575K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
362 |
350 |
$540K |
| 90791 |
Psychiatric diagnostic evaluation |
4,718 |
4,591 |
$533K |
| OP272 |
|
11,537 |
9,392 |
$531K |
| 93017 |
|
842 |
802 |
$436K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
9,705 |
3,412 |
$432K |
| C1713 |
Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) |
322 |
289 |
$403K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
9,938 |
3,343 |
$384K |
| OP270 |
|
10,023 |
9,143 |
$379K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
2,126 |
2,076 |
$346K |
| 93970 |
|
1,069 |
1,019 |
$339K |
| 70450 |
Computed tomography, head or brain; without contrast material |
3,221 |
2,967 |
$320K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
2,620 |
2,475 |
$311K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
3,034 |
3,012 |
$295K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
1,167 |
1,102 |
$281K |
| A0425 |
Ground mileage, per statute mile |
7,586 |
6,965 |
$248K |
| 93971 |
|
1,036 |
980 |
$229K |
| 97803 |
|
2,877 |
2,323 |
$209K |
| 71046 |
Radiologic examination, chest; 2 views |
4,535 |
4,360 |
$209K |
| 97161 |
|
4,064 |
3,913 |
$195K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
4,465 |
3,955 |
$188K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
11,840 |
10,428 |
$177K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
3,963 |
3,741 |
$176K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
617 |
293 |
$170K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
4,304 |
3,855 |
$148K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
20,912 |
17,189 |
$147K |
| C1776 |
Joint device (implantable) |
28 |
26 |
$139K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
25,181 |
21,065 |
$138K |
| 71045 |
Radiologic examination, chest; single view |
6,003 |
5,456 |
$138K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
127 |
117 |
$125K |
| 76536 |
|
663 |
659 |
$121K |
| 76642 |
|
1,248 |
1,234 |
$112K |
| OP710 |
|
2,917 |
2,754 |
$111K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
5,938 |
4,709 |
$106K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
304 |
301 |
$101K |
| 92507 |
Treatment of speech, language, voice, communication, and/or auditory processing disorder |
1,965 |
736 |
$99K |
| 97802 |
|
657 |
648 |
$97K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
3,565 |
3,083 |
$84K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
3,110 |
2,728 |
$82K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
1,618 |
1,489 |
$80K |
| OP250 |
|
31,646 |
14,719 |
$79K |
| 45378 |
Colonoscopy, flexible; diagnostic, including collection of specimen(s) |
48 |
47 |
$79K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
3,254 |
3,133 |
$78K |
| 90834 |
Psychotherapy, 45 minutes with patient |
5,006 |
2,917 |
$77K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
737 |
705 |
$76K |
| 71250 |
|
240 |
222 |
$76K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
4,471 |
3,938 |
$68K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
1,310 |
1,189 |
$62K |
| 80076 |
|
11,270 |
9,968 |
$60K |
| 76830 |
Ultrasound, transvaginal |
594 |
575 |
$56K |
| 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 |
3,053 |
2,732 |
$54K |
| OP258 |
|
9,254 |
8,128 |
$52K |
| 87631 |
|
1,381 |
1,364 |
$51K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
506 |
496 |
$48K |
| T2034 |
Crisis intervention, waiver; per diem |
64 |
60 |
$48K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
3,523 |
2,790 |
$47K |
| 81001 |
|
10,267 |
9,331 |
$45K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
2,402 |
1,214 |
$44K |
| 77066 |
Tomosynthesis, mammo |
401 |
397 |
$44K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
2,169 |
2,147 |
$43K |
| 80053 |
Comprehensive metabolic panel |
9,042 |
8,168 |
$43K |
| G0279 |
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) |
983 |
973 |
$42K |
| 83735 |
|
9,384 |
7,719 |
$39K |
| 77065 |
Tomosynthesis, mammo |
426 |
415 |
$39K |
| OP259 |
|
26,771 |
9,217 |
$38K |
| 76770 |
|
276 |
270 |
$38K |
| 83605 |
|
3,181 |
2,867 |
$34K |
| 85610 |
|
7,060 |
6,043 |
$32K |
| 85730 |
|
6,031 |
5,476 |
$29K |
| 80320 |
|
3,195 |
2,808 |
$29K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
4,937 |
4,528 |
$29K |
| 84484 |
|
5,675 |
4,889 |
$29K |
| 84443 |
Thyroid stimulating hormone (TSH) |
5,994 |
5,624 |
$27K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
1,103 |
975 |
$27K |
| J3490 |
Unclassified drugs |
6,106 |
3,189 |
$26K |
| 87040 |
|
2,269 |
2,093 |
$26K |
| 82948 |
|
5,670 |
4,262 |
$25K |
| 83690 |
|
5,914 |
5,309 |
$25K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
6,272 |
5,192 |
$22K |
| 36415 |
Collection of venous blood by venipuncture |
11,395 |
7,946 |
$21K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
3,428 |
3,062 |
$20K |
| 94060 |
|
39 |
39 |
$20K |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
2,152 |
1,906 |
$20K |
| 90839 |
|
794 |
702 |
$19K |
| 74018 |
|
395 |
368 |
$18K |
| J2704 |
Injection, propofol, 10 mg |
4,882 |
4,502 |
$18K |
| 45385 |
Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) |
15 |
14 |
$18K |
| 77080 |
|
256 |
253 |
$18K |
| 73630 |
|
324 |
314 |
$18K |
| J2060 |
Injection, lorazepam, 2 mg |
1,236 |
978 |
$16K |
| 73562 |
|
283 |
276 |
$16K |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
2,204 |
1,915 |
$15K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
82 |
76 |
$15K |
| 97162 |
|
368 |
346 |
$15K |
| 94729 |
|
71 |
71 |
$14K |
| 72110 |
|
121 |
119 |
$14K |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
3,258 |
2,934 |
$13K |
| 85027 |
|
5,003 |
4,306 |
$13K |
| J0690 |
Injection, cefazolin sodium, 500 mg |
1,908 |
1,416 |
$13K |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
1,844 |
1,664 |
$12K |
| 82550 |
|
2,810 |
2,562 |
$12K |
| 94727 |
|
71 |
71 |
$11K |
| J2710 |
Injection, neostigmine methylsulfate, up to 0.5 mg |
1,309 |
1,202 |
$11K |
| 73610 |
|
243 |
235 |
$11K |
| 84439 |
|
3,052 |
2,870 |
$11K |
| G0108 |
Diabetes outpatient self-management training services, individual, per 30 minutes |
56 |
49 |
$10K |
| 86900 |
|
1,623 |
1,495 |
$10K |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
314 |
297 |
$10K |
| 00731 |
|
330 |
320 |
$10K |
| 59025 |
Fetal non-stress test |
33 |
26 |
$10K |
| 83880 |
|
1,789 |
1,608 |
$9K |
| 97597 |
|
103 |
54 |
$8K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
386 |
326 |
$8K |
| S9484 |
Crisis intervention mental health services, per hour |
36 |
12 |
$8K |
| 73030 |
|
164 |
164 |
$8K |
| 86850 |
|
1,568 |
1,438 |
$7K |
| 93041 |
|
763 |
493 |
$7K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
886 |
868 |
$7K |
| 84702 |
|
1,662 |
1,519 |
$7K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
4,074 |
3,453 |
$7K |
| 76942 |
|
193 |
180 |
$7K |
| 81025 |
|
3,769 |
3,532 |
$6K |
| J1170 |
Injection, hydromorphone, up to 4 mg |
2,243 |
1,743 |
$6K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
1,121 |
667 |
$6K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
22 |
19 |
$6K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
3,279 |
2,851 |
$6K |
| 73130 |
|
137 |
135 |
$6K |
| 90715 |
|
315 |
312 |
$5K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
684 |
498 |
$5K |
| 97116 |
|
398 |
269 |
$5K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
49 |
41 |
$5K |
| 73110 |
|
76 |
72 |
$5K |
| 96376 |
|
388 |
339 |
$5K |
| 80061 |
Lipid panel |
3,223 |
3,109 |
$4K |
| 90840 |
|
107 |
58 |
$4K |
| 94375 |
|
27 |
27 |
$4K |
| 85379 |
|
1,647 |
1,573 |
$4K |
| 87186 |
|
859 |
801 |
$4K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
488 |
436 |
$4K |
| 00812 |
|
196 |
193 |
$4K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
3,976 |
3,748 |
$4K |
| 97165 |
|
166 |
150 |
$4K |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
1,709 |
1,306 |
$4K |
| 64447 |
|
14 |
12 |
$4K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
221 |
217 |
$4K |
| 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 |
262 |
172 |
$3K |
| 92587 |
|
26 |
26 |
$3K |
| J1644 |
Injection, heparin sodium, per 1000 units |
1,127 |
513 |
$3K |
| 81003 |
|
695 |
677 |
$3K |
| J3535 |
Drug administered through a metered dose inhaler |
154 |
46 |
$2K |
| J0330 |
Injection, succinylcholine chloride, up to 20 mg |
639 |
549 |
$2K |
| 86618 |
|
410 |
389 |
$2K |
| 73590 |
|
13 |
12 |
$2K |
| 84100 |
|
1,043 |
792 |
$1K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
44 |
39 |
$1K |
| 92588 |
|
12 |
12 |
$1K |
| 86317 |
|
138 |
134 |
$1K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
889 |
844 |
$1K |
| 71271 |
|
13 |
13 |
$1K |
| 00811 |
|
31 |
26 |
$1K |
| 82150 |
|
265 |
254 |
$1K |
| 00813 |
|
41 |
39 |
$867.00 |
| A9502 |
Technetium tc-99m tetrofosmin, diagnostic, per study dose |
120 |
107 |
$809.30 |
| 95800 |
|
28 |
28 |
$792.36 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
605 |
436 |
$787.52 |
| C9113 |
Injection, pantoprazole sodium, per vial |
387 |
300 |
$778.79 |
| 84703 |
|
604 |
570 |
$763.76 |
| 73140 |
|
13 |
13 |
$705.85 |
| J0689 |
Injection, cefazolin sodium (baxter), not therapeutically equivalent to j0690, 500 mg |
281 |
159 |
$670.81 |
| A4649 |
Surgical supply; miscellaneous |
34 |
34 |
$613.43 |
| 86140 |
|
530 |
475 |
$603.73 |
| 87641 |
|
26 |
26 |
$587.06 |
| J7620 |
Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme |
248 |
192 |
$568.91 |
| 90837 |
Psychotherapy, 53 minutes with patient |
16 |
13 |
$550.00 |
| 82728 |
|
257 |
245 |
$482.44 |
| 85651 |
|
884 |
809 |
$441.64 |
| J8501 |
Aprepitant, oral, 5 mg |
26 |
25 |
$438.42 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
82 |
78 |
$434.94 |
| 73560 |
|
12 |
12 |
$431.96 |
| 82607 |
|
504 |
474 |
$421.74 |
| J1815 |
Injection, insulin, per 5 units |
300 |
94 |
$418.12 |
| Q0162 |
Ondansetron 1 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen |
550 |
484 |
$416.45 |
| A9585 |
Injection, gadobutrol, 0.1 ml |
343 |
326 |
$388.25 |
| 87070 |
|
168 |
153 |
$381.35 |
| 73502 |
|
15 |
14 |
$369.76 |
| 90686 |
|
70 |
70 |
$360.70 |
| 82565 |
|
67 |
50 |
$348.40 |
| 84145 |
|
17 |
17 |
$335.14 |
| J7070 |
Infusion, d5w, 1000 cc |
21 |
12 |
$333.06 |
| 88342 |
|
28 |
26 |
$318.08 |
| G0008 |
Administration of influenza virus vaccine |
293 |
286 |
$298.77 |
| 80329 |
|
14 |
13 |
$198.19 |
| 87899 |
|
14 |
14 |
$182.54 |
| 82570 |
|
877 |
833 |
$176.07 |
| 88304 |
|
12 |
12 |
$175.11 |
| 87205 |
|
121 |
110 |
$172.48 |
| 87430 |
|
58 |
58 |
$171.78 |
| 87077 |
|
84 |
78 |
$156.49 |
| 82043 |
|
663 |
644 |
$152.68 |
| 90682 |
|
168 |
160 |
$146.99 |
| 83550 |
|
263 |
253 |
$141.48 |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
25 |
25 |
$121.57 |
| 83540 |
|
335 |
320 |
$117.52 |
| J3360 |
Injection, diazepam, up to 5 mg |
26 |
24 |
$114.70 |
| J2795 |
Injection, ropivacaine hydrochloride, 1 mg |
98 |
83 |
$110.63 |
| 99152 |
|
26 |
26 |
$106.11 |
| J3480 |
Injection, potassium chloride, per 2 meq |
37 |
27 |
$97.59 |
| 84153 |
|
141 |
139 |
$87.14 |
| J1596 |
Injection, glycopyrrolate, 0.1 mg |
39 |
38 |
$77.25 |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
393 |
340 |
$72.35 |
| 85008 |
|
520 |
468 |
$64.00 |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
150 |
110 |
$58.99 |
| 82553 |
|
27 |
26 |
$52.34 |
| 87500 |
|
13 |
13 |
$38.51 |
| 85014 |
|
88 |
60 |
$36.20 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
15 |
14 |
$35.10 |
| 85018 |
|
88 |
60 |
$31.90 |
| J1630 |
Injection, haloperidol, up to 5 mg |
14 |
12 |
$30.15 |
| J1171 |
Injection, hydromorphone, 0.1 mg |
13 |
12 |
$21.26 |
| Q4051 |
Splint supplies, miscellaneous (includes thermoplastics, strapping, fasteners, padding and other supplies) |
13 |
13 |
$11.95 |
| 87015 |
|
12 |
12 |
$10.20 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
16 |
12 |
$8.45 |
| 84550 |
|
55 |
40 |
$6.27 |
| 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 |
158 |
132 |
$1.00 |
| 87147 |
|
12 |
12 |
$0.00 |
| J1010 |
Injection, methylprednisolone acetate, 1 mg |
16 |
14 |
$0.00 |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
13 |
12 |
$0.00 |
| 85007 |
|
127 |
114 |
$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 |
30 |
29 |
$0.00 |
| J0171 |
Injection, adrenalin, epinephrine, 0.1 mg |
19 |
13 |
$0.00 |
| G8978 |
Mobility: walking & moving around functional limitation, current status, at therapy episode outset and at reporting intervals |
26 |
26 |
$0.00 |
| G1004 |
Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program |
32 |
28 |
$0.00 |
| 80164 |
|
17 |
14 |
$0.00 |