| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
Emergency department visit for the evaluation and management, high severity |
39,111 |
34,300 |
$8.15M |
| 41899 |
Unlisted procedure, dentoalveolar structures |
6,131 |
4,632 |
$7.10M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
42,968 |
37,637 |
$6.24M |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
5,145 |
4,542 |
$3.34M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
8,447 |
7,230 |
$2.66M |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
7,627 |
6,807 |
$2.52M |
| G0330 |
Facility services for dental rehabilitation procedure(s) performed on a patient who requires monitored anesthesia (e.g., general, intravenous sedation (monitored anesthesia care) and use of an operating room |
984 |
907 |
$2.40M |
| 93303 |
Transthoracic echocardiography for congenital cardiac anomalies, follow-up or limited study |
6,375 |
5,666 |
$2.10M |
| 70450 |
Computed tomography, head or brain; without contrast material |
5,264 |
4,673 |
$1.35M |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
40,057 |
35,809 |
$973K |
| 93320 |
|
7,065 |
6,286 |
$924K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
21,833 |
19,932 |
$917K |
| 93325 |
|
7,311 |
6,485 |
$863K |
| G0378 |
Hospital observation service, per hour |
4,893 |
4,258 |
$802K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
10,060 |
9,126 |
$706K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
1,196 |
1,082 |
$614K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
16,156 |
13,637 |
$601K |
| 80053 |
Comprehensive metabolic panel |
68,529 |
57,848 |
$579K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
19,034 |
16,036 |
$557K |
| C1713 |
Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) |
787 |
610 |
$546K |
| 85027 |
|
86,782 |
70,418 |
$513K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
1,991 |
1,750 |
$507K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
1,251 |
1,143 |
$500K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
634 |
598 |
$499K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
791 |
669 |
$468K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
1,398 |
1,202 |
$375K |
| 95810 |
Polysomnography; sleep staging with 4 or more additional parameters |
845 |
799 |
$375K |
| 71046 |
Radiologic examination, chest; 2 views |
6,934 |
6,253 |
$350K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
7,204 |
6,191 |
$332K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
7,095 |
5,219 |
$321K |
| 71045 |
Radiologic examination, chest; single view |
7,939 |
7,032 |
$321K |
| 84443 |
Thyroid stimulating hormone (TSH) |
20,452 |
18,636 |
$316K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
8,977 |
3,866 |
$298K |
| 81229 |
|
392 |
301 |
$296K |
| 78815 |
Positron emission tomography (PET) for limited area imaging |
493 |
422 |
$296K |
| 95816 |
|
1,679 |
1,605 |
$289K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
9,428 |
8,818 |
$278K |
| 87801 |
Infectious agent detection by nucleic acid; amplified probe, multiple organisms |
5,949 |
5,406 |
$272K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
733 |
651 |
$269K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
2,987 |
2,353 |
$268K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
556 |
467 |
$242K |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
8,950 |
8,354 |
$242K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
6,461 |
5,110 |
$238K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
3,468 |
2,865 |
$213K |
| 93017 |
|
1,519 |
1,322 |
$212K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
2,640 |
1,646 |
$206K |
| 74018 |
|
3,591 |
3,290 |
$199K |
| 81220 |
CFTR (cystic fibrosis transmembrane conductance regulator) gene analysis; common variants |
520 |
450 |
$193K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
7,066 |
6,671 |
$188K |
| 96376 |
|
3,407 |
2,383 |
$177K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
2,167 |
1,719 |
$169K |
| 69436 |
Tympanostomy (requiring insertion of ventilating tube), general anesthesia |
291 |
271 |
$156K |
| 93976 |
|
996 |
884 |
$151K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
1,452 |
1,307 |
$150K |
| 99152 |
|
1,978 |
1,775 |
$148K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
7,057 |
5,586 |
$142K |
| 99153 |
Mod sedat endo service >5yrs |
1,091 |
978 |
$139K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
5,355 |
4,243 |
$136K |
| J1453 |
Injection, fosaprepitant, 1 mg |
496 |
292 |
$134K |
| 93922 |
|
3,398 |
2,756 |
$128K |
| 64483 |
|
656 |
581 |
$126K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
13,119 |
12,243 |
$124K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
1,179 |
1,127 |
$124K |
| 36415 |
Collection of venous blood by venipuncture |
52,130 |
45,039 |
$123K |
| 42820 |
Tonsillectomy and adenoidectomy; younger than age 12 |
140 |
136 |
$121K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
9,789 |
6,639 |
$118K |
| 92507 |
Treatment of speech, language, voice, communication, and/or auditory processing disorder |
4,488 |
2,027 |
$118K |
| 93880 |
|
1,445 |
1,197 |
$116K |
| 93971 |
|
1,128 |
1,008 |
$113K |
| C1769 |
Guide wire |
2,588 |
2,230 |
$113K |
| 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 |
3,084 |
2,580 |
$108K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,867 |
2,518 |
$107K |
| 80061 |
Lipid panel |
8,148 |
7,619 |
$95K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
1,732 |
1,585 |
$93K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
12,459 |
11,076 |
$92K |
| 72081 |
|
1,099 |
956 |
$92K |
| Q5104 |
Injection, infliximab-abda, biosimilar, (renflexis), 10 mg |
42 |
39 |
$90K |
| 83880 |
|
3,969 |
3,524 |
$89K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
1,990 |
1,701 |
$88K |
| 59025 |
Fetal non-stress test |
3,259 |
2,404 |
$87K |
| 72170 |
|
1,422 |
1,231 |
$83K |
| 73610 |
|
1,739 |
1,512 |
$81K |
| J0897 |
Injection, denosumab, 1 mg |
112 |
91 |
$80K |
| 93970 |
|
548 |
473 |
$79K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
3,845 |
3,379 |
$77K |
| 93351 |
|
272 |
246 |
$74K |
| 73630 |
|
1,529 |
1,376 |
$74K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
11,858 |
9,722 |
$73K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
182 |
149 |
$73K |
| 84484 |
|
10,032 |
8,072 |
$71K |
| 81001 |
|
24,884 |
21,696 |
$70K |
| 86780 |
|
5,224 |
4,745 |
$69K |
| 76830 |
Ultrasound, transvaginal |
781 |
691 |
$66K |
| 73564 |
|
1,214 |
1,065 |
$65K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
2,692 |
2,534 |
$65K |
| 70486 |
|
227 |
199 |
$63K |
| 97165 |
|
2,229 |
2,050 |
$63K |
| 87633 |
Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets |
294 |
270 |
$62K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
674 |
564 |
$61K |
| 29581 |
|
1,873 |
572 |
$61K |
| 84439 |
|
6,323 |
5,949 |
$60K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
406 |
359 |
$58K |
| A9500 |
Technetium tc-99m sestamibi, diagnostic, per study dose |
758 |
674 |
$57K |
| A0431 |
Ambulance service, conventional air services, transport, one way (rotary wing) |
616 |
404 |
$54K |
| A9552 |
Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries |
567 |
483 |
$54K |
| 83690 |
|
9,628 |
8,254 |
$54K |
| 73100 |
|
1,132 |
805 |
$53K |
| 44970 |
|
16 |
13 |
$53K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
2,022 |
1,740 |
$52K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
1,912 |
990 |
$52K |
| 92610 |
|
730 |
652 |
$51K |
| 76770 |
|
471 |
419 |
$50K |
| J3490 |
Unclassified drugs |
10,139 |
5,944 |
$50K |
| 73502 |
|
736 |
618 |
$50K |
| 92523 |
|
1,250 |
1,159 |
$48K |
| 73030 |
|
1,220 |
1,075 |
$48K |
| 87070 |
|
5,314 |
4,886 |
$48K |
| C1894 |
Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser |
1,856 |
1,539 |
$47K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
1,133 |
1,077 |
$47K |
| 73130 |
|
1,024 |
916 |
$47K |
| 73090 |
|
1,142 |
821 |
$47K |
| 82728 |
|
3,590 |
3,285 |
$46K |
| 86850 |
|
4,925 |
4,104 |
$46K |
| 88307 |
|
513 |
414 |
$46K |
| 87653 |
|
1,855 |
1,650 |
$44K |
| 84466 |
|
3,397 |
3,147 |
$44K |
| 73110 |
|
765 |
675 |
$44K |
| 96417 |
|
594 |
395 |
$43K |
| 96131 |
|
882 |
723 |
$42K |
| 36902 |
|
103 |
98 |
$41K |
| 12001 |
|
341 |
308 |
$41K |
| 77334 |
|
144 |
93 |
$40K |
| 84703 |
|
5,385 |
4,769 |
$40K |
| 97161 |
|
1,465 |
1,351 |
$40K |
| 76642 |
|
972 |
828 |
$40K |
| 87077 |
|
4,719 |
4,260 |
$40K |
| 0240U |
|
644 |
624 |
$39K |
| 87186 |
|
4,591 |
4,152 |
$39K |
| 94010 |
|
1,436 |
1,398 |
$38K |
| 83735 |
|
7,427 |
5,922 |
$37K |
| 73560 |
|
860 |
693 |
$37K |
| 81025 |
|
5,917 |
5,143 |
$37K |
| 93458 |
|
15 |
15 |
$36K |
| 82607 |
|
2,950 |
2,726 |
$36K |
| 86803 |
|
2,768 |
2,494 |
$35K |
| 73590 |
|
1,001 |
779 |
$35K |
| 96367 |
|
686 |
418 |
$32K |
| 86703 |
|
2,962 |
2,641 |
$32K |
| C1776 |
Joint device (implantable) |
20 |
13 |
$31K |
| 73080 |
|
606 |
519 |
$31K |
| J2785 |
Injection, regadenoson, 0.1 mg |
459 |
424 |
$30K |
| 76942 |
|
306 |
249 |
$30K |
| 82784 |
|
2,274 |
2,137 |
$30K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
1,096 |
1,020 |
$30K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
1,095 |
1,019 |
$30K |
| 97162 |
|
1,128 |
1,015 |
$29K |
| 72100 |
|
821 |
744 |
$29K |
| C1725 |
Catheter, transluminal angioplasty, non-laser (may include guidance, infusion/perfusion capability) |
449 |
402 |
$28K |
| 85610 |
|
9,309 |
6,542 |
$27K |
| J2323 |
Injection, natalizumab, 1 mg |
13 |
12 |
$27K |
| 83605 |
|
3,339 |
2,826 |
$26K |
| 76937 |
|
845 |
751 |
$26K |
| A0436 |
Rotary wing air mileage, per statute mile |
615 |
404 |
$26K |
| 83540 |
|
3,987 |
3,692 |
$26K |
| 86140 |
|
4,762 |
4,229 |
$25K |
| 12011 |
|
208 |
187 |
$24K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
714 |
580 |
$23K |
| 96112 |
|
460 |
427 |
$23K |
| 73070 |
|
510 |
393 |
$22K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
303 |
267 |
$22K |
| 10060 |
|
116 |
101 |
$21K |
| 86762 |
|
1,510 |
1,333 |
$21K |
| 87040 |
|
2,190 |
1,723 |
$21K |
| 77073 |
|
534 |
486 |
$20K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
940 |
861 |
$20K |
| 73552 |
|
508 |
439 |
$20K |
| 87340 |
|
2,196 |
1,986 |
$20K |
| 83516 |
|
1,436 |
1,350 |
$19K |
| 77336 |
|
363 |
160 |
$19K |
| 73140 |
|
488 |
403 |
$19K |
| 88304 |
|
513 |
460 |
$18K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
525 |
391 |
$18K |
| 96415 |
|
934 |
684 |
$18K |
| 96130 |
|
908 |
734 |
$17K |
| 29065 |
|
435 |
320 |
$17K |
| 84702 |
|
2,141 |
1,509 |
$17K |
| 82746 |
|
1,411 |
1,302 |
$17K |
| 77300 |
|
97 |
81 |
$16K |
| 82951 |
|
1,205 |
1,099 |
$16K |
| 87634 |
|
801 |
730 |
$16K |
| 83970 |
|
452 |
399 |
$16K |
| 80050 |
General health panel |
1,398 |
1,339 |
$15K |
| 97166 |
|
599 |
544 |
$15K |
| 80074 |
|
323 |
297 |
$15K |
| 87522 |
Neg quan hep c or qual rna |
492 |
445 |
$15K |
| 86738 |
|
857 |
812 |
$15K |
| 36430 |
|
125 |
84 |
$15K |
| 84403 |
|
549 |
510 |
$15K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
467 |
451 |
$14K |
| 85730 |
|
3,070 |
2,679 |
$13K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,102 |
1,032 |
$13K |
| 77072 |
|
337 |
312 |
$13K |
| 80164 |
|
1,059 |
939 |
$13K |
| 86901 |
|
5,262 |
4,376 |
$13K |
| 86900 |
|
5,261 |
4,376 |
$13K |
| 77066 |
Tomosynthesis, mammo |
463 |
418 |
$13K |
| 72141 |
|
32 |
30 |
$12K |
| 88342 |
|
412 |
365 |
$12K |
| 71250 |
|
172 |
133 |
$12K |
| 85379 |
|
1,576 |
1,424 |
$11K |
| C1887 |
Catheter, guiding (may include infusion/perfusion capability) |
207 |
180 |
$11K |
| G0379 |
Direct admission of patient for hospital observation care |
94 |
82 |
$11K |
| 84146 |
|
531 |
504 |
$11K |
| 87210 |
|
2,684 |
2,362 |
$11K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
544 |
371 |
$10K |
| 99406 |
|
1,016 |
863 |
$10K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
828 |
731 |
$10K |
| 86923 |
|
130 |
102 |
$10K |
| 87205 |
|
2,595 |
2,350 |
$10K |
| 83001 |
|
514 |
475 |
$10K |
| 90834 |
Psychotherapy, 45 minutes with patient |
617 |
562 |
$9K |
| 92567 |
|
442 |
400 |
$9K |
| 88341 |
|
114 |
104 |
$9K |
| 90847 |
Family psychotherapy with the patient present, 50 minutes |
1,504 |
1,193 |
$9K |
| 87449 |
|
622 |
556 |
$8K |
| 82077 |
|
2,667 |
2,241 |
$8K |
| 86038 |
|
677 |
617 |
$8K |
| C1751 |
Catheter, infusion, inserted peripherally, centrally or midline (other than hemodialysis) |
599 |
534 |
$8K |
| 76818 |
|
108 |
73 |
$8K |
| 87581 |
|
294 |
270 |
$8K |
| 87486 |
|
294 |
270 |
$8K |
| 83002 |
|
378 |
351 |
$8K |
| 86304 |
|
534 |
422 |
$8K |
| 82565 |
|
2,093 |
1,754 |
$8K |
| 82670 |
|
301 |
275 |
$7K |
| 87427 |
|
469 |
360 |
$7K |
| 81243 |
|
183 |
146 |
$7K |
| 29075 |
|
483 |
363 |
$7K |
| G0279 |
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) |
1,901 |
1,747 |
$7K |
| 87075 |
|
809 |
708 |
$7K |
| 82140 |
|
576 |
476 |
$7K |
| 72050 |
|
84 |
69 |
$7K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
2,459 |
2,230 |
$7K |
| 85652 |
|
2,649 |
2,381 |
$7K |
| 88185 |
|
18 |
14 |
$6K |
| 80076 |
|
910 |
841 |
$6K |
| 96137 |
|
618 |
510 |
$6K |
| 85651 |
|
1,702 |
1,519 |
$6K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
3,021 |
2,817 |
$6K |
| 80177 |
|
467 |
418 |
$6K |
| 96040 |
|
873 |
664 |
$6K |
| 74230 |
|
89 |
81 |
$6K |
| 12002 |
|
42 |
39 |
$6K |
| 95819 |
|
43 |
42 |
$6K |
| 82550 |
|
982 |
842 |
$6K |
| 76870 |
|
72 |
65 |
$6K |
| J2795 |
Injection, ropivacaine hydrochloride, 1 mg |
237 |
223 |
$6K |
| 86364 |
|
937 |
903 |
$6K |
| 84436 |
|
901 |
832 |
$5K |
| 82533 |
|
285 |
259 |
$5K |
| 95782 |
|
12 |
12 |
$5K |
| 82330 |
|
598 |
519 |
$5K |
| 84270 |
|
193 |
182 |
$5K |
| 45385 |
Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) |
15 |
15 |
$5K |
| 77290 |
|
15 |
12 |
$5K |
| Q9957 |
Injection, perflutren lipid microspheres, per ml |
115 |
112 |
$5K |
| 87116 |
|
402 |
367 |
$5K |
| 82274 |
|
274 |
262 |
$5K |
| 77001 |
|
109 |
103 |
$4K |
| 84100 |
|
1,274 |
993 |
$4K |
| 90791 |
Psychiatric diagnostic evaluation |
185 |
161 |
$4K |
| 36591 |
|
100 |
69 |
$4K |
| 82043 |
|
827 |
779 |
$4K |
| 84156 |
|
1,170 |
932 |
$4K |
| 84305 |
|
264 |
253 |
$4K |
| 84481 |
|
261 |
240 |
$4K |
| 82947 |
|
1,229 |
1,152 |
$4K |
| 82570 |
|
878 |
825 |
$4K |
| 86665 |
|
148 |
119 |
$4K |
| 87046 |
|
386 |
360 |
$4K |
| 82247 |
|
831 |
575 |
$4K |
| 82977 |
|
709 |
661 |
$4K |
| 80178 |
|
574 |
496 |
$4K |
| 82105 |
|
274 |
228 |
$4K |
| C1768 |
Graft, vascular |
75 |
61 |
$4K |
| 97116 |
|
488 |
303 |
$4K |
| 87045 |
|
383 |
360 |
$4K |
| 85049 |
|
976 |
735 |
$4K |
| 92579 |
|
215 |
197 |
$4K |
| 73060 |
|
110 |
90 |
$4K |
| 99215 |
Prolong outpt/office vis |
70 |
52 |
$4K |
| 87102 |
|
404 |
366 |
$4K |
| 96136 |
|
833 |
698 |
$4K |
| 86300 |
|
96 |
87 |
$4K |
| 85046 |
|
577 |
502 |
$4K |
| 87641 |
|
300 |
254 |
$3K |
| 80069 |
|
493 |
424 |
$3K |
| 84112 |
|
52 |
45 |
$3K |
| 86039 |
|
299 |
272 |
$3K |
| J2704 |
Injection, propofol, 10 mg |
2,304 |
2,132 |
$3K |
| 96127 |
|
3,679 |
3,550 |
$3K |
| 83655 |
|
281 |
258 |
$3K |
| 71101 |
|
49 |
40 |
$3K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
31 |
26 |
$3K |
| 82375 |
|
356 |
319 |
$3K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
622 |
596 |
$3K |
| 87015 |
|
376 |
342 |
$3K |
| 76885 |
|
148 |
112 |
$3K |
| 82677 |
|
146 |
119 |
$3K |
| 86787 |
|
209 |
178 |
$3K |
| 82248 |
|
913 |
757 |
$3K |
| 82150 |
|
406 |
379 |
$3K |
| 86376 |
|
168 |
161 |
$3K |
| 74240 |
|
13 |
13 |
$3K |
| 49083 |
|
26 |
14 |
$3K |
| 77075 |
|
14 |
12 |
$2K |
| 84153 |
|
168 |
151 |
$2K |
| 87206 |
|
402 |
367 |
$2K |
| 83615 |
|
444 |
370 |
$2K |
| 86336 |
|
166 |
136 |
$2K |
| 92611 |
|
43 |
39 |
$2K |
| 86003 |
|
49 |
37 |
$2K |
| 82010 |
|
292 |
244 |
$2K |
| 97163 |
|
126 |
107 |
$2K |
| P9016 |
Red blood cells, leukocytes reduced, each unit |
16 |
15 |
$2K |
| 87329 |
|
160 |
153 |
$2K |
| 93926 |
|
65 |
54 |
$2K |
| 72131 |
|
15 |
14 |
$2K |
| 74019 |
|
48 |
41 |
$2K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
75 |
57 |
$2K |
| 81003 |
|
869 |
792 |
$2K |
| 83050 |
|
354 |
318 |
$2K |
| 84402 |
|
59 |
58 |
$2K |
| 87147 |
|
352 |
323 |
$2K |
| 87328 |
|
141 |
135 |
$2K |
| 86431 |
|
324 |
295 |
$2K |
| 29125 |
|
26 |
24 |
$2K |
| 92228 |
|
99 |
55 |
$2K |
| 76820 |
|
21 |
15 |
$2K |
| 86800 |
|
90 |
87 |
$2K |
| 83993 |
|
71 |
67 |
$2K |
| 83021 |
|
89 |
82 |
$2K |
| 86706 |
|
150 |
136 |
$2K |
| 85018 |
|
904 |
704 |
$2K |
| 74022 |
|
29 |
26 |
$2K |
| 84450 |
|
855 |
665 |
$1K |
| 72072 |
|
29 |
25 |
$1K |
| 82803 |
|
108 |
96 |
$1K |
| 76380 |
|
13 |
12 |
$1K |
| 82024 |
|
33 |
28 |
$1K |
| 88313 |
|
13 |
12 |
$1K |
| 73620 |
|
44 |
25 |
$1K |
| 97167 |
|
60 |
55 |
$1K |
| 87640 |
|
102 |
86 |
$1K |
| 84132 |
|
907 |
734 |
$1K |
| 96411 |
|
60 |
28 |
$1K |
| 93978 |
|
26 |
25 |
$1K |
| 87081 |
|
158 |
155 |
$1K |
| 84425 |
|
71 |
59 |
$1K |
| S9480 |
Intensive outpatient psychiatric services, per diem |
92 |
91 |
$1K |
| A9270 |
Non-covered item or service |
340 |
179 |
$999.85 |
| 87338 |
|
61 |
61 |
$991.98 |
| 95886 |
|
13 |
13 |
$982.94 |
| 82627 |
|
38 |
37 |
$977.36 |
| 99170 |
|
53 |
53 |
$968.45 |
| 76377 |
|
27 |
25 |
$955.32 |
| 84550 |
|
357 |
320 |
$937.73 |
| 96523 |
|
48 |
31 |
$887.01 |
| 88142 |
|
43 |
40 |
$877.90 |
| 88184 |
|
19 |
15 |
$834.86 |
| 96368 |
|
24 |
14 |
$828.59 |
| 92586 |
|
13 |
12 |
$808.51 |
| C2617 |
Stent, non-coronary, temporary, without delivery system |
12 |
12 |
$774.22 |
| 86361 |
|
28 |
27 |
$759.07 |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
105 |
54 |
$756.84 |
| 76825 |
|
18 |
13 |
$697.05 |
| J1642 |
Injection, heparin sodium, (heparin lock flush), per 10 units |
40 |
20 |
$696.12 |
| 62321 |
|
12 |
12 |
$693.80 |
| G0008 |
Administration of influenza virus vaccine |
47 |
40 |
$625.81 |
| 80143 |
|
342 |
316 |
$613.77 |
| 82785 |
|
39 |
36 |
$581.80 |
| 77065 |
Tomosynthesis, mammo |
30 |
26 |
$569.78 |
| 76827 |
|
18 |
13 |
$535.23 |
| 81002 |
|
192 |
166 |
$503.86 |
| 94664 |
|
34 |
31 |
$484.01 |
| 73000 |
|
19 |
15 |
$466.51 |
| 87324 |
|
42 |
41 |
$438.34 |
| 83498 |
|
12 |
12 |
$426.36 |
| 80183 |
|
29 |
27 |
$379.94 |
| 83883 |
|
31 |
25 |
$371.64 |
| 82040 |
|
140 |
115 |
$365.29 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
1,278 |
1,200 |
$349.07 |
| 93990 |
|
16 |
16 |
$344.57 |
| 86258 |
|
38 |
37 |
$337.97 |
| J7999 |
Compounded drug, not otherwise classified |
339 |
318 |
$329.07 |
| 80179 |
|
301 |
282 |
$326.78 |
| 85014 |
|
209 |
151 |
$308.50 |
| 86708 |
|
29 |
24 |
$293.36 |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
13 |
12 |
$287.10 |
| 82378 |
|
14 |
13 |
$260.04 |
| 84165 |
|
41 |
37 |
$245.01 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
1,351 |
1,150 |
$242.31 |
| 82106 |
|
13 |
13 |
$241.45 |
| 82310 |
|
108 |
85 |
$230.67 |
| 87252 |
|
15 |
15 |
$223.30 |
| 83520 |
|
12 |
12 |
$203.28 |
| 29705 |
|
18 |
18 |
$194.14 |
| J7050 |
Infusion, normal saline solution, 250 cc |
1,042 |
793 |
$188.80 |
| J2060 |
Injection, lorazepam, 2 mg |
70 |
53 |
$180.56 |
| 82397 |
|
17 |
12 |
$172.80 |
| 86200 |
|
14 |
13 |
$148.13 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
651 |
531 |
$135.99 |
| 86308 |
|
26 |
24 |
$135.45 |
| 86880 |
|
29 |
25 |
$109.83 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
1,523 |
1,399 |
$108.97 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
499 |
415 |
$99.62 |
| 84460 |
|
264 |
244 |
$92.41 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
840 |
720 |
$87.27 |
| 11719 |
|
16 |
12 |
$84.54 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
2,169 |
1,869 |
$82.93 |
| A6253 |
Specialty absorptive dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing |
737 |
572 |
$73.58 |
| 88311 |
|
25 |
15 |
$56.52 |
| J0330 |
Injection, succinylcholine chloride, up to 20 mg |
126 |
111 |
$55.47 |
| A9585 |
Injection, gadobutrol, 0.1 ml |
67 |
56 |
$53.80 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
389 |
333 |
$53.42 |
| 84295 |
|
73 |
51 |
$51.43 |
| 92587 |
|
44 |
40 |
$49.75 |
| 90715 |
|
14 |
12 |
$46.80 |
| A6222 |
Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
129 |
67 |
$43.91 |
| 95012 |
|
14 |
12 |
$40.70 |
| J2710 |
Injection, neostigmine methylsulfate, up to 0.5 mg |
13 |
12 |
$23.93 |
| J1644 |
Injection, heparin sodium, per 1000 units |
313 |
250 |
$22.14 |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
81 |
56 |
$19.33 |
| J1815 |
Injection, insulin, per 5 units |
68 |
44 |
$11.85 |
| J7030 |
Infusion, normal saline solution , 1000 cc |
30 |
18 |
$10.14 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
99 |
78 |
$6.26 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
60 |
47 |
$6.10 |
| A6223 |
Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size more than 16 sq. in., but less than or equal to 48 sq. in., without adhesive border, each dressing |
17 |
15 |
$5.50 |
| J2370 |
Injection, phenylephrine hcl, up to 1 ml |
138 |
120 |
$5.34 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
16 |
13 |
$2.16 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
16 |
12 |
$1.67 |
| J1630 |
Injection, haloperidol, up to 5 mg |
19 |
12 |
$1.45 |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
15 |
15 |
$0.73 |
| G1004 |
Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program |
924 |
891 |
$0.00 |
| 81329 |
|
56 |
50 |
$0.00 |
| G0476 |
Infectious agent detection by nucleic acid (dna or rna); human papillomavirus (hpv), high-risk types (e.g., 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68) for cervical cancer screening, must be performed in addition to pap test |
28 |
24 |
$0.00 |
| 83631 |
|
19 |
14 |
$0.00 |
| C9399 |
Unclassified drugs or biologicals |
25 |
25 |
$0.00 |
| G0145 |
Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system and manual rescreening under physician supervision |
112 |
95 |
$0.00 |