| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
128,427 |
113,433 |
$7.08M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
173,634 |
152,414 |
$6.36M |
| 99215 |
Prolong outpt/office vis |
10,517 |
9,681 |
$804K |
| X5622 |
|
16,352 |
12,839 |
$783K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
17,888 |
17,253 |
$741K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
10,951 |
10,359 |
$523K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
11,460 |
10,639 |
$420K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
5,043 |
4,972 |
$363K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
7,338 |
7,040 |
$346K |
| 59426 |
|
896 |
873 |
$334K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
7,217 |
6,897 |
$316K |
| 90834 |
Psychotherapy, 45 minutes with patient |
6,965 |
4,716 |
$313K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
24,359 |
23,328 |
$278K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
3,249 |
3,146 |
$271K |
| 99309 |
Subsequent nursing facility care, per day, low to moderate complexity |
5,116 |
3,861 |
$215K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
16,211 |
15,466 |
$194K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
3,684 |
3,523 |
$194K |
| 90837 |
Psychotherapy, 53 minutes with patient |
2,154 |
1,529 |
$188K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
2,543 |
2,456 |
$166K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
9,284 |
8,720 |
$155K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
2,240 |
2,159 |
$128K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,777 |
1,737 |
$127K |
| 90791 |
Psychiatric diagnostic evaluation |
1,057 |
1,025 |
$108K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
808 |
786 |
$103K |
| 99243 |
|
1,533 |
1,466 |
$101K |
| 92015 |
Determination of refractive state |
8,867 |
8,120 |
$97K |
| 99442 |
|
3,025 |
2,639 |
$94K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
3,893 |
3,807 |
$84K |
| 99308 |
Subsequent nursing facility care, per day, straightforward |
2,895 |
2,281 |
$82K |
| 92551 |
|
11,529 |
11,125 |
$70K |
| G0108 |
Diabetes outpatient self-management training services, individual, per 30 minutes |
1,550 |
1,250 |
$69K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
2,805 |
2,649 |
$66K |
| 99443 |
|
1,346 |
1,152 |
$59K |
| 99188 |
|
6,815 |
6,517 |
$57K |
| 97802 |
|
952 |
908 |
$46K |
| 99244 |
Office or other outpatient consultation, moderate to high complexity |
420 |
388 |
$43K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
2,148 |
2,125 |
$40K |
| 71046 |
Radiologic examination, chest; 2 views |
5,376 |
5,140 |
$37K |
| 20610 |
|
1,354 |
1,230 |
$35K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
855 |
701 |
$33K |
| 99310 |
Prolong nursin fac eval 15m |
502 |
402 |
$31K |
| 64615 |
|
504 |
496 |
$31K |
| 97803 |
|
1,140 |
1,052 |
$31K |
| 11721 |
|
2,269 |
2,214 |
$28K |
| 90474 |
|
3,341 |
3,224 |
$27K |
| E0604 |
Breast pump, hospital grade, electric (ac and / or dc), any type |
353 |
331 |
$23K |
| 17110 |
|
608 |
527 |
$23K |
| 73630 |
|
4,275 |
3,516 |
$22K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
1,042 |
503 |
$22K |
| 36415 |
Collection of venous blood by venipuncture |
8,703 |
7,084 |
$21K |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
3,537 |
3,404 |
$17K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
260 |
254 |
$16K |
| 73564 |
|
1,997 |
1,956 |
$16K |
| 99441 |
|
860 |
778 |
$16K |
| 99177 |
|
3,332 |
3,284 |
$15K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
472 |
419 |
$13K |
| 99205 |
Prolong outpt/office vis |
118 |
115 |
$13K |
| 92557 |
|
659 |
647 |
$12K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
265 |
258 |
$11K |
| 99173 |
|
8,659 |
8,244 |
$11K |
| 73110 |
|
1,648 |
1,355 |
$10K |
| 73030 |
|
1,503 |
1,365 |
$9K |
| 73610 |
|
1,623 |
1,485 |
$9K |
| 95251 |
|
446 |
438 |
$9K |
| L4386 |
Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
82 |
78 |
$9K |
| 96127 |
|
2,767 |
2,673 |
$9K |
| L3908 |
Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf |
366 |
282 |
$9K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
160 |
160 |
$8K |
| 90670 |
|
6,791 |
6,477 |
$8K |
| L3020 |
Foot, insert, removable, molded to patient model, longitudinal/ metatarsal support, each |
78 |
36 |
$8K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
330 |
195 |
$8K |
| 95125 |
|
851 |
385 |
$8K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
514 |
489 |
$8K |
| 99245 |
|
57 |
57 |
$8K |
| 92567 |
|
1,181 |
1,151 |
$7K |
| 20611 |
|
187 |
157 |
$7K |
| 90832 |
Psychotherapy, 30 minutes with patient |
169 |
154 |
$7K |
| 76642 |
|
299 |
261 |
$6K |
| 83655 |
|
667 |
645 |
$6K |
| 59025 |
Fetal non-stress test |
311 |
139 |
$6K |
| 96161 |
|
3,982 |
3,783 |
$6K |
| 76801 |
|
164 |
158 |
$5K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
181 |
169 |
$5K |
| 99242 |
|
101 |
98 |
$5K |
| 90686 |
|
5,267 |
5,112 |
$5K |
| 99384 |
|
59 |
55 |
$5K |
| 88141 |
|
214 |
212 |
$5K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
77 |
77 |
$4K |
| 90651 |
|
1,591 |
1,509 |
$4K |
| 73130 |
|
579 |
472 |
$3K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
40 |
40 |
$3K |
| 72110 |
|
323 |
320 |
$3K |
| 99383 |
|
58 |
53 |
$3K |
| 0071A |
|
59 |
59 |
$2K |
| 99201 |
|
229 |
219 |
$2K |
| 92002 |
|
50 |
49 |
$2K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
406 |
383 |
$2K |
| 73502 |
|
214 |
209 |
$2K |
| 0072A |
|
46 |
46 |
$2K |
| 36416 |
|
911 |
874 |
$2K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
70 |
70 |
$2K |
| G2211 |
Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established) |
158 |
136 |
$2K |
| L1902 |
Ankle orthosis, ankle gauntlet or similar, with or without joints, prefabricated, off-the-shelf |
28 |
28 |
$1K |
| 58300 |
|
52 |
52 |
$1K |
| 73140 |
|
285 |
260 |
$1K |
| 80061 |
Lipid panel |
131 |
128 |
$1K |
| 91320 |
|
14 |
14 |
$1K |
| 90473 |
|
653 |
561 |
$1K |
| 69210 |
|
72 |
71 |
$1K |
| 85018 |
|
757 |
726 |
$1K |
| 72100 |
|
192 |
191 |
$1K |
| 31575 |
|
28 |
28 |
$1K |
| 99454 |
|
42 |
41 |
$1K |
| 90715 |
|
902 |
859 |
$1K |
| 76830 |
Ultrasound, transvaginal |
54 |
54 |
$1K |
| 74018 |
|
153 |
150 |
$939.55 |
| 94010 |
|
193 |
192 |
$931.11 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
105 |
105 |
$926.83 |
| 84443 |
Thyroid stimulating hormone (TSH) |
67 |
65 |
$855.54 |
| 90734 |
|
1,299 |
1,231 |
$830.15 |
| 90480 |
|
32 |
32 |
$800.75 |
| G0279 |
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) |
45 |
45 |
$800.28 |
| 90662 |
|
14 |
14 |
$794.92 |
| 95885 |
|
40 |
39 |
$786.28 |
| 99457 |
|
42 |
41 |
$784.75 |
| 87081 |
|
114 |
112 |
$773.45 |
| 92579 |
|
25 |
24 |
$645.24 |
| 97597 |
|
54 |
36 |
$602.99 |
| 95886 |
|
14 |
14 |
$590.38 |
| 76819 |
Fetal biophysical profile; without non-stress testing |
21 |
12 |
$574.06 |
| 90698 |
|
5,269 |
4,983 |
$548.42 |
| 90710 |
|
1,701 |
1,638 |
$517.60 |
| 90680 |
|
4,219 |
4,009 |
$517.29 |
| 81001 |
|
176 |
166 |
$510.63 |
| 80053 |
Comprehensive metabolic panel |
55 |
55 |
$502.81 |
| 51798 |
|
82 |
78 |
$502.48 |
| 98967 |
|
202 |
181 |
$488.09 |
| L3040 |
Foot, arch support, removable, premolded, longitudinal, each |
13 |
13 |
$474.40 |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
13 |
13 |
$442.45 |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
12 |
12 |
$438.34 |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
12 |
12 |
$438.34 |
| 94060 |
|
68 |
66 |
$414.74 |
| 93227 |
|
42 |
41 |
$413.84 |
| 92134 |
|
25 |
25 |
$396.49 |
| 98968 |
|
115 |
108 |
$383.61 |
| 11056 |
|
52 |
50 |
$379.07 |
| 73562 |
|
84 |
80 |
$351.91 |
| 77080 |
|
54 |
54 |
$331.17 |
| 77065 |
Tomosynthesis, mammo |
12 |
12 |
$323.76 |
| G0008 |
Administration of influenza virus vaccine |
14 |
14 |
$320.47 |
| 77066 |
Tomosynthesis, mammo |
13 |
13 |
$309.17 |
| 72050 |
|
36 |
36 |
$286.64 |
| L3060 |
Foot, arch support, removable, premolded, longitudinal/ metatarsal, each |
14 |
12 |
$280.00 |
| 90619 |
|
173 |
172 |
$239.78 |
| 80048 |
Basic metabolic panel (calcium, ionized) |
38 |
38 |
$225.19 |
| 86703 |
|
15 |
15 |
$215.90 |
| 73560 |
|
25 |
25 |
$188.84 |
| 92314 |
|
14 |
13 |
$180.00 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
98 |
88 |
$178.73 |
| 92587 |
|
15 |
15 |
$177.92 |
| 90620 |
|
86 |
84 |
$171.78 |
| 90716 |
|
420 |
418 |
$148.78 |
| 90697 |
|
435 |
432 |
$144.17 |
| 90633 |
|
3,345 |
3,203 |
$143.50 |
| L3260 |
Surgical boot/shoe, each |
24 |
24 |
$128.20 |
| 90656 |
|
342 |
340 |
$115.54 |
| 90707 |
|
323 |
322 |
$86.03 |
| V5267 |
Hearing aid or assistive listening device/supplies/accessories, not otherwise specified |
14 |
13 |
$85.07 |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
12 |
12 |
$64.88 |
| 86592 |
|
14 |
14 |
$62.52 |
| V5266 |
Battery for use in hearing device |
33 |
27 |
$60.21 |
| 90744 |
|
2,438 |
2,281 |
$56.44 |
| 90696 |
|
925 |
879 |
$49.37 |
| 90688 |
|
361 |
358 |
$42.52 |
| 93325 |
|
13 |
13 |
$31.05 |
| 98966 |
|
13 |
13 |
$19.17 |
| 90677 |
|
447 |
443 |
$0.00 |
| 1123F |
|
191 |
173 |
$0.00 |
| 1157F |
|
12 |
12 |
$0.00 |
| 90685 |
|
549 |
531 |
$0.00 |
| 1124F |
|
2,260 |
2,152 |
$0.00 |
| 1158F |
|
797 |
737 |
$0.00 |
| 90687 |
|
14 |
14 |
$0.00 |
| 11981 |
|
12 |
12 |
$0.00 |
| 90658 |
|
21 |
21 |
$0.00 |
| 90672 |
|
14 |
14 |
$0.00 |