| Code | Description | Claims | Beneficiaries | Total Paid |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
34,706 |
30,409 |
$6.39M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
25,484 |
23,089 |
$2.10M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
15,735 |
14,260 |
$1.92M |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
11,998 |
4,366 |
$1.88M |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
29,183 |
22,357 |
$815K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
29,198 |
22,346 |
$810K |
| 16020 |
|
3,168 |
1,651 |
$638K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
9,453 |
8,709 |
$601K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
20,946 |
18,435 |
$580K |
| 80053 |
Comprehensive metabolic panel |
81,315 |
69,653 |
$568K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
19,058 |
15,102 |
$456K |
| 87536 |
|
7,060 |
5,732 |
$450K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
19,386 |
15,230 |
$395K |
| 11043 |
|
3,365 |
1,429 |
$388K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
76,750 |
65,136 |
$377K |
| 80050 |
General health panel |
9,734 |
8,028 |
$339K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
11,608 |
8,447 |
$330K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
790 |
665 |
$314K |
| 19318 |
|
704 |
530 |
$306K |
| 80061 |
Lipid panel |
29,377 |
24,421 |
$305K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
16,490 |
13,463 |
$297K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
12,559 |
9,911 |
$259K |
| 71045 |
Radiologic examination, chest; single view |
10,221 |
8,924 |
$228K |
| 70450 |
Computed tomography, head or brain; without contrast material |
1,586 |
1,404 |
$214K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
11,943 |
9,612 |
$183K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
24,432 |
20,388 |
$180K |
| 92507 |
Treatment of speech, language, voice, communication, and/or auditory processing disorder |
4,847 |
1,767 |
$180K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
6,277 |
5,425 |
$167K |
| 80074 |
|
4,164 |
3,413 |
$129K |
| 86361 |
|
5,970 |
5,019 |
$125K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
3,543 |
828 |
$114K |
| 71046 |
Radiologic examination, chest; 2 views |
3,746 |
3,279 |
$110K |
| 84703 |
|
17,548 |
15,389 |
$97K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
365 |
274 |
$94K |
| 84443 |
Thyroid stimulating hormone (TSH) |
7,317 |
6,182 |
$89K |
| 84484 |
|
13,274 |
11,106 |
$83K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
685 |
379 |
$79K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
3,314 |
2,335 |
$77K |
| 86480 |
|
1,473 |
1,243 |
$71K |
| 78264 |
|
345 |
334 |
$68K |
| 87801 |
Infectious agent detection by nucleic acid; amplified probe, multiple organisms |
1,918 |
1,201 |
$66K |
| 81001 |
|
28,472 |
24,554 |
$60K |
| 81513 |
|
1,016 |
863 |
$57K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
582 |
534 |
$56K |
| 86592 |
|
16,242 |
13,426 |
$55K |
| 86803 |
|
5,418 |
4,219 |
$54K |
| 86708 |
|
5,675 |
4,624 |
$54K |
| 87522 |
Neg quan hep c or qual rna |
1,560 |
1,309 |
$53K |
| 87481 |
|
2,197 |
1,680 |
$52K |
| 76981 |
|
386 |
348 |
$47K |
| 87400 |
|
3,731 |
3,162 |
$45K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
573 |
433 |
$39K |
| 83690 |
|
8,711 |
7,532 |
$38K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
771 |
707 |
$35K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
707 |
666 |
$34K |
| 86706 |
|
4,028 |
3,358 |
$34K |
| 86780 |
|
3,852 |
2,802 |
$34K |
| 85730 |
|
10,126 |
8,938 |
$31K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
735 |
657 |
$31K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
258 |
254 |
$30K |
| 36415 |
Collection of venous blood by venipuncture |
16,258 |
12,124 |
$30K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
2,599 |
1,136 |
$29K |
| 85610 |
|
12,042 |
10,618 |
$27K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,808 |
875 |
$26K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
692 |
478 |
$22K |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
1,141 |
953 |
$22K |
| 86317 |
|
1,396 |
1,083 |
$22K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
3,307 |
2,706 |
$20K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
7,851 |
6,757 |
$19K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
6,626 |
5,166 |
$18K |
| 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 |
248 |
210 |
$17K |
| G0378 |
Hospital observation service, per hour |
263 |
191 |
$16K |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
607 |
257 |
$16K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
3,473 |
2,538 |
$14K |
| 83605 |
|
2,152 |
1,838 |
$13K |
| 17111 |
|
19 |
12 |
$12K |
| 86704 |
|
1,347 |
1,040 |
$12K |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
405 |
358 |
$12K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
1,837 |
1,628 |
$12K |
| 45385 |
Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) |
57 |
55 |
$11K |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
4,336 |
3,622 |
$11K |
| 17110 |
|
13 |
12 |
$10K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
88 |
84 |
$10K |
| 74246 |
|
100 |
93 |
$10K |
| 81003 |
|
5,955 |
5,054 |
$10K |
| 84153 |
|
717 |
564 |
$9K |
| A9541 |
Technetium tc-99m sulfur colloid, diagnostic, per study dose, up to 20 millicuries |
360 |
334 |
$8K |
| 83735 |
|
2,336 |
1,968 |
$8K |
| 84439 |
|
1,096 |
918 |
$8K |
| 83880 |
|
456 |
383 |
$8K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
7,429 |
6,128 |
$7K |
| 86705 |
|
786 |
612 |
$7K |
| 87430 |
|
461 |
384 |
$5K |
| 76830 |
Ultrasound, transvaginal |
52 |
52 |
$5K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
879 |
728 |
$5K |
| 82043 |
|
1,068 |
855 |
$5K |
| 86593 |
|
1,558 |
1,152 |
$5K |
| 85027 |
|
846 |
757 |
$5K |
| 84403 |
|
207 |
181 |
$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 |
96 |
76 |
$4K |
| 82607 |
|
421 |
302 |
$4K |
| 82728 |
|
432 |
324 |
$4K |
| 82570 |
|
828 |
697 |
$3K |
| 83540 |
|
748 |
587 |
$3K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
238 |
202 |
$3K |
| 78227 |
|
14 |
12 |
$3K |
| 80081 |
|
39 |
39 |
$3K |
| 83550 |
|
453 |
347 |
$3K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
107 |
89 |
$3K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
14 |
13 |
$3K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
13 |
13 |
$2K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
53 |
38 |
$2K |
| C1894 |
Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser |
52 |
49 |
$2K |
| 80076 |
|
249 |
236 |
$2K |
| 87653 |
|
81 |
68 |
$2K |
| J7050 |
Infusion, normal saline solution, 250 cc |
561 |
389 |
$2K |
| 87081 |
|
399 |
342 |
$2K |
| 86140 |
|
877 |
744 |
$2K |
| A4467 |
Belt, strap, sleeve, garment, or covering, any type |
17 |
13 |
$2K |
| C1887 |
Catheter, guiding (may include infusion/perfusion capability) |
38 |
36 |
$2K |
| 87340 |
|
160 |
143 |
$1K |
| 83013 |
|
50 |
38 |
$1K |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
829 |
674 |
$1K |
| 84154 |
|
79 |
77 |
$1K |
| C1769 |
Guide wire |
40 |
37 |
$1K |
| 72100 |
|
31 |
24 |
$1K |
| 84481 |
|
104 |
98 |
$1K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
49 |
24 |
$1K |
| 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 |
112 |
48 |
$1K |
| J2704 |
Injection, propofol, 10 mg |
2,503 |
1,941 |
$1K |
| 86645 |
|
72 |
66 |
$1K |
| 86376 |
|
76 |
65 |
$990.12 |
| 86777 |
|
87 |
77 |
$952.05 |
| 82746 |
|
105 |
69 |
$911.40 |
| 29581 |
|
32 |
13 |
$905.48 |
| 84702 |
|
66 |
48 |
$879.09 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
68 |
67 |
$873.10 |
| 73564 |
|
14 |
14 |
$857.58 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
125 |
108 |
$823.10 |
| 84134 |
|
569 |
468 |
$796.77 |
| 29445 |
|
35 |
14 |
$755.99 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
1,380 |
1,139 |
$649.75 |
| 88112 |
|
13 |
13 |
$630.52 |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
628 |
511 |
$613.67 |
| J2360 |
Injection, orphenadrine citrate, up to 60 mg |
79 |
64 |
$543.95 |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
1,938 |
1,093 |
$531.69 |
| 82950 |
|
127 |
120 |
$518.89 |
| 84480 |
|
64 |
60 |
$461.73 |
| 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 |
44 |
38 |
$461.22 |
| 11045 |
|
2,341 |
986 |
$453.45 |
| 87077 |
|
307 |
270 |
$444.73 |
| 87186 |
|
307 |
270 |
$423.85 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
1,302 |
1,061 |
$422.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
12 |
12 |
$388.71 |
| 82150 |
|
56 |
53 |
$384.23 |
| 86850 |
|
95 |
66 |
$377.44 |
| 82550 |
|
104 |
84 |
$341.43 |
| 99152 |
|
52 |
50 |
$339.11 |
| 86644 |
|
29 |
26 |
$316.58 |
| 83525 |
|
38 |
25 |
$274.32 |
| 84460 |
|
68 |
55 |
$270.50 |
| 83516 |
|
15 |
14 |
$265.37 |
| 84450 |
|
68 |
55 |
$264.37 |
| 80055 |
|
19 |
15 |
$250.32 |
| 85652 |
|
539 |
460 |
$239.22 |
| 87070 |
|
771 |
658 |
$224.12 |
| 83001 |
|
22 |
14 |
$223.76 |
| 82164 |
|
14 |
13 |
$212.25 |
| 82747 |
|
19 |
12 |
$211.80 |
| 87075 |
|
739 |
639 |
$208.34 |
| 82103 |
|
14 |
13 |
$195.32 |
| 86901 |
|
105 |
77 |
$194.35 |
| 86900 |
|
106 |
78 |
$194.35 |
| 82077 |
|
27 |
24 |
$181.31 |
| 82390 |
|
14 |
13 |
$156.13 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
1,098 |
761 |
$155.95 |
| 83020 |
|
12 |
12 |
$154.44 |
| 87420 |
|
12 |
12 |
$153.01 |
| 99153 |
Mod sedat endo service >5yrs |
26 |
25 |
$152.28 |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
13 |
12 |
$144.80 |
| A9537 |
Technetium tc-99m mebrofenin, diagnostic, per study dose, up to 15 millicuries |
14 |
12 |
$129.28 |
| 86702 |
|
17 |
12 |
$128.70 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
418 |
338 |
$128.03 |
| 84100 |
|
37 |
30 |
$92.52 |
| 87205 |
|
749 |
641 |
$89.67 |
| 86701 |
|
17 |
12 |
$88.90 |
| 85045 |
|
49 |
25 |
$87.78 |
| 85660 |
|
15 |
14 |
$86.52 |
| 81025 |
|
404 |
329 |
$81.50 |
| J0171 |
Injection, adrenalin, epinephrine, 0.1 mg |
107 |
53 |
$77.68 |
| 87176 |
|
629 |
542 |
$70.56 |
| 87210 |
|
14 |
14 |
$66.03 |
| J3490 |
Unclassified drugs |
1,797 |
1,393 |
$65.89 |
| J0330 |
Injection, succinylcholine chloride, up to 20 mg |
825 |
555 |
$60.31 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
30 |
28 |
$59.31 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
754 |
613 |
$50.34 |
| J1644 |
Injection, heparin sodium, per 1000 units |
272 |
217 |
$44.84 |
| 82947 |
|
15 |
13 |
$39.30 |
| J2710 |
Injection, neostigmine methylsulfate, up to 0.5 mg |
312 |
216 |
$36.85 |
| 99201 |
|
30 |
24 |
$21.84 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
15 |
12 |
$12.32 |
| J1642 |
Injection, heparin sodium, (heparin lock flush), per 10 units |
32 |
12 |
$12.09 |
| 85014 |
|
26 |
12 |
$11.85 |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
382 |
262 |
$2.94 |
| A9270 |
Non-covered item or service |
366 |
237 |
$0.00 |
| 11046 |
|
270 |
107 |
$0.00 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
117 |
99 |
$0.00 |