| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 0450 |
Emergency room services |
50,310 |
43,914 |
$3.73M |
| 0519 |
|
52,058 |
43,260 |
$2.48M |
| G0378 |
Hospital observation service, per hour |
32,280 |
25,067 |
$1.65M |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
4,284 |
4,115 |
$1.16M |
| 80053 |
Comprehensive metabolic panel |
56,931 |
51,329 |
$951K |
| 99199 |
Unlisted special service, procedure or report |
16,158 |
14,005 |
$947K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
9,126 |
7,855 |
$750K |
| 0250 |
|
36,693 |
20,464 |
$746K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
5,354 |
5,342 |
$630K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
14,264 |
6,368 |
$605K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
53,486 |
47,357 |
$601K |
| 0760 |
|
11,098 |
10,215 |
$564K |
| 70450 |
Computed tomography, head or brain; without contrast material |
3,234 |
3,040 |
$546K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
2,513 |
2,492 |
$528K |
| 84443 |
Thyroid stimulating hormone (TSH) |
19,346 |
18,854 |
$472K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
8,402 |
6,669 |
$449K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
14,301 |
12,880 |
$448K |
| 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 |
5,912 |
5,221 |
$438K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
6,541 |
6,261 |
$403K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
3,949 |
3,021 |
$366K |
| 87631 |
|
3,894 |
3,812 |
$364K |
| C9803 |
Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
9,197 |
8,866 |
$354K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
6,416 |
6,316 |
$347K |
| 80061 |
Lipid panel |
19,949 |
19,791 |
$342K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
9,298 |
7,836 |
$334K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
5,885 |
5,793 |
$319K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
1,328 |
1,278 |
$315K |
| 71046 |
Radiologic examination, chest; 2 views |
9,753 |
9,308 |
$300K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
739 |
734 |
$294K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
3,641 |
3,413 |
$286K |
| 76830 |
Ultrasound, transvaginal |
3,055 |
2,985 |
$273K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
1,138 |
1,127 |
$262K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
5,771 |
4,591 |
$255K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
572 |
570 |
$243K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
6,465 |
6,404 |
$237K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
2,370 |
2,346 |
$236K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
2,813 |
2,782 |
$236K |
| Z7500 |
|
6,396 |
5,514 |
$210K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
1,182 |
1,144 |
$207K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
6,685 |
6,343 |
$196K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
1,402 |
1,276 |
$189K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
13,458 |
13,339 |
$182K |
| U0001 |
Cdc 2019 novel coronavirus (2019-ncov) real-time rt-pcr diagnostic panel |
3,281 |
3,195 |
$173K |
| 93971 |
|
1,269 |
1,248 |
$172K |
| 84439 |
|
13,177 |
12,929 |
$172K |
| 0761 |
|
3,290 |
1,823 |
$165K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
795 |
717 |
$156K |
| 97139 |
|
3,624 |
1,251 |
$154K |
| 73630 |
|
3,766 |
3,615 |
$142K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
1,853 |
1,811 |
$141K |
| 97161 |
|
2,480 |
2,474 |
$133K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
11,358 |
9,928 |
$133K |
| 76770 |
|
1,339 |
1,323 |
$130K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
2,994 |
1,455 |
$128K |
| 0710 |
|
3,002 |
2,811 |
$128K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
2,317 |
2,221 |
$120K |
| J3490 |
Unclassified drugs |
7,736 |
4,574 |
$118K |
| 80306 |
|
3,820 |
3,546 |
$116K |
| 85027 |
|
11,816 |
11,054 |
$114K |
| 59025 |
Fetal non-stress test |
3,357 |
1,713 |
$113K |
| 0750 |
|
507 |
507 |
$112K |
| Z7502 |
|
3,010 |
2,909 |
$111K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
3,960 |
3,922 |
$108K |
| 81025 |
|
7,494 |
6,895 |
$105K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
119 |
119 |
$105K |
| 73130 |
|
2,457 |
2,312 |
$103K |
| 73610 |
|
2,596 |
2,476 |
$103K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
7,008 |
6,378 |
$102K |
| 76641 |
|
1,196 |
1,097 |
$101K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
3,383 |
3,380 |
$101K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
4,721 |
3,830 |
$100K |
| 73564 |
|
2,123 |
2,037 |
$98K |
| 73030 |
|
2,780 |
2,682 |
$97K |
| 83880 |
|
2,623 |
2,433 |
$96K |
| 90715 |
|
1,980 |
1,966 |
$95K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
8,829 |
8,046 |
$95K |
| G0422 |
Intensive cardiac rehabilitation; with or without continuous ecg monitoring with exercise, per session |
1,253 |
187 |
$94K |
| 76536 |
|
1,289 |
1,281 |
$93K |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
806 |
761 |
$92K |
| 84484 |
|
6,432 |
5,058 |
$92K |
| 71045 |
Radiologic examination, chest; single view |
4,723 |
4,517 |
$90K |
| 97597 |
|
1,689 |
906 |
$89K |
| 73110 |
|
2,099 |
1,988 |
$87K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
412 |
396 |
$86K |
| 86803 |
|
3,876 |
3,831 |
$86K |
| 81001 |
|
15,045 |
13,577 |
$82K |
| 84466 |
|
4,679 |
4,602 |
$82K |
| 82728 |
|
4,442 |
4,366 |
$81K |
| 83690 |
|
7,168 |
6,435 |
$80K |
| 83735 |
|
7,666 |
6,348 |
$76K |
| 0370 |
|
937 |
932 |
$76K |
| 78815 |
Positron emission tomography (PET) for limited area imaging |
52 |
52 |
$76K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
1,907 |
1,141 |
$75K |
| G0108 |
Diabetes outpatient self-management training services, individual, per 30 minutes |
877 |
837 |
$74K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
2,714 |
2,267 |
$73K |
| 87480 |
|
2,064 |
2,035 |
$72K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
635 |
580 |
$71K |
| 73502 |
|
1,450 |
1,415 |
$69K |
| 82607 |
|
3,162 |
3,112 |
$66K |
| 73221 |
|
173 |
172 |
$65K |
| 82746 |
|
3,039 |
2,992 |
$64K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
845 |
630 |
$62K |
| 72100 |
|
1,487 |
1,467 |
$62K |
| 87660 |
|
2,588 |
2,548 |
$61K |
| 0360 |
|
255 |
255 |
$61K |
| 72110 |
|
884 |
878 |
$57K |
| 84153 |
|
2,036 |
2,015 |
$57K |
| 87340 |
|
3,285 |
3,246 |
$56K |
| 93017 |
|
848 |
840 |
$55K |
| 76642 |
|
758 |
744 |
$53K |
| 87040 |
|
3,239 |
1,698 |
$52K |
| 83605 |
|
3,169 |
2,500 |
$52K |
| 73562 |
|
1,539 |
1,505 |
$51K |
| 0272 |
|
5,066 |
2,939 |
$50K |
| A6210 |
Foam dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing |
1,034 |
393 |
$49K |
| A9500 |
Technetium tc-99m sestamibi, diagnostic, per study dose |
403 |
392 |
$45K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
251 |
245 |
$45K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
7,862 |
7,190 |
$45K |
| 0270 |
|
2,737 |
2,295 |
$45K |
| 84403 |
|
1,457 |
1,409 |
$45K |
| 83540 |
|
4,806 |
4,708 |
$45K |
| 87510 |
|
1,263 |
1,244 |
$45K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
993 |
968 |
$44K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
686 |
669 |
$44K |
| 90686 |
|
1,560 |
1,551 |
$42K |
| 87186 |
|
3,164 |
3,005 |
$40K |
| 85652 |
|
6,238 |
5,988 |
$39K |
| 77065 |
Tomosynthesis, mammo |
375 |
370 |
$39K |
| 86140 |
|
5,082 |
4,849 |
$38K |
| J2704 |
Injection, propofol, 10 mg |
2,898 |
2,241 |
$37K |
| 81003 |
|
9,098 |
7,984 |
$36K |
| 72141 |
|
68 |
68 |
$36K |
| 86850 |
|
2,538 |
2,445 |
$36K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,861 |
1,832 |
$35K |
| 87077 |
|
3,700 |
3,503 |
$34K |
| 92557 |
|
596 |
587 |
$34K |
| 71250 |
|
186 |
185 |
$33K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
79 |
79 |
$32K |
| 87081 |
|
3,088 |
3,000 |
$32K |
| 85610 |
|
5,630 |
4,447 |
$31K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
5,792 |
4,852 |
$31K |
| 86038 |
|
1,766 |
1,742 |
$31K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
390 |
377 |
$31K |
| 82043 |
|
3,563 |
3,445 |
$30K |
| 81513 |
|
176 |
174 |
$29K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
655 |
587 |
$28K |
| 84481 |
|
1,213 |
1,196 |
$27K |
| 86762 |
|
1,285 |
1,267 |
$26K |
| 86592 |
|
3,968 |
3,930 |
$25K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
83 |
83 |
$25K |
| 0949 |
|
519 |
501 |
$25K |
| A9579 |
Injection, gadolinium-based magnetic resonance contrast agent, not otherwise specified (nos), per ml |
591 |
578 |
$24K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
1,971 |
997 |
$24K |
| 85379 |
|
1,519 |
1,467 |
$24K |
| 0942 |
|
334 |
303 |
$22K |
| 86787 |
|
1,121 |
1,097 |
$22K |
| 70486 |
|
96 |
96 |
$22K |
| 77066 |
Tomosynthesis, mammo |
165 |
165 |
$21K |
| 83970 |
|
332 |
323 |
$21K |
| 82550 |
|
2,256 |
1,971 |
$21K |
| 87810 |
|
1,262 |
1,246 |
$21K |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
2,557 |
2,095 |
$20K |
| 85007 |
|
3,900 |
3,542 |
$20K |
| 82962 |
|
3,380 |
2,508 |
$19K |
| 87070 |
|
1,502 |
1,402 |
$19K |
| 36415 |
Collection of venous blood by venipuncture |
1,576 |
1,419 |
$19K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
2,771 |
2,309 |
$18K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
2,371 |
1,928 |
$18K |
| G0423 |
Intensive cardiac rehabilitation; with or without continuous ecg monitoring; without exercise, per session |
363 |
58 |
$17K |
| 84702 |
|
775 |
600 |
$17K |
| J2785 |
Injection, regadenoson, 0.1 mg |
131 |
127 |
$17K |
| 86901 |
|
2,759 |
2,638 |
$17K |
| 74018 |
|
507 |
491 |
$16K |
| 99000 |
|
3,318 |
2,906 |
$16K |
| 90651 |
|
58 |
58 |
$16K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
217 |
204 |
$16K |
| 72052 |
|
250 |
247 |
$15K |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
2,127 |
1,872 |
$14K |
| 73080 |
|
377 |
364 |
$14K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
126 |
125 |
$14K |
| 97750 |
|
202 |
202 |
$13K |
| 86900 |
|
2,760 |
2,639 |
$13K |
| 87493 |
|
197 |
185 |
$13K |
| 85730 |
|
1,499 |
1,430 |
$13K |
| 82670 |
|
285 |
280 |
$13K |
| 45385 |
Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) |
100 |
92 |
$13K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
1,834 |
1,620 |
$12K |
| T1999 |
Miscellaneous therapeutic items and supplies, retail purchases, not otherwise classified; identify product in "remarks" |
528 |
320 |
$12K |
| 87481 |
|
176 |
174 |
$12K |
| 82248 |
|
1,594 |
1,506 |
$11K |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
729 |
630 |
$11K |
| J2060 |
Injection, lorazepam, 2 mg |
1,800 |
1,545 |
$11K |
| A9552 |
Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries |
39 |
39 |
$11K |
| 87147 |
|
1,697 |
1,097 |
$11K |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
1,473 |
1,230 |
$11K |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
1,814 |
1,383 |
$11K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
140 |
133 |
$11K |
| 86709 |
|
622 |
618 |
$10K |
| 86431 |
|
1,179 |
1,169 |
$10K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
438 |
430 |
$10K |
| 84550 |
|
1,503 |
1,443 |
$10K |
| 96367 |
|
241 |
161 |
$10K |
| 83516 |
|
868 |
634 |
$9K |
| 72040 |
|
251 |
251 |
$8K |
| 77080 |
|
305 |
305 |
$8K |
| 94729 |
|
172 |
171 |
$8K |
| 87522 |
Neg quan hep c or qual rna |
176 |
175 |
$8K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
177 |
175 |
$8K |
| 86376 |
|
498 |
459 |
$8K |
| 87205 |
|
1,293 |
1,207 |
$8K |
| 86705 |
|
436 |
434 |
$8K |
| 97010 |
|
175 |
103 |
$8K |
| 83001 |
|
242 |
237 |
$7K |
| 82950 |
|
927 |
912 |
$7K |
| 82803 |
|
257 |
246 |
$7K |
| J1170 |
Injection, hydromorphone, up to 4 mg |
833 |
647 |
$7K |
| 84402 |
|
410 |
400 |
$7K |
| J2550 |
Injection, promethazine hcl, up to 50 mg |
785 |
624 |
$7K |
| 0510 |
|
153 |
149 |
$6K |
| Z7610 |
|
1,248 |
856 |
$6K |
| 93226 |
|
85 |
85 |
$6K |
| 0636 |
|
836 |
412 |
$6K |
| 94726 |
|
133 |
132 |
$6K |
| 92507 |
Treatment of speech, language, voice, communication, and/or auditory processing disorder |
131 |
74 |
$6K |
| 93970 |
|
27 |
27 |
$5K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
65 |
63 |
$5K |
| 87015 |
|
427 |
238 |
$5K |
| 74021 |
|
151 |
138 |
$5K |
| 96523 |
|
319 |
188 |
$5K |
| J1030 |
Injection, methylprednisolone acetate, 40 mg |
480 |
465 |
$5K |
| 84100 |
|
726 |
560 |
$5K |
| 87045 |
|
331 |
320 |
$4K |
| 93225 |
|
85 |
85 |
$4K |
| 76870 |
|
60 |
58 |
$4K |
| 90662 |
|
133 |
130 |
$4K |
| 20610 |
|
206 |
191 |
$4K |
| 92587 |
|
56 |
56 |
$4K |
| 73590 |
|
156 |
152 |
$4K |
| 86625 |
|
136 |
132 |
$4K |
| 73140 |
|
129 |
126 |
$4K |
| 81002 |
|
1,088 |
1,045 |
$4K |
| 84270 |
|
203 |
201 |
$4K |
| 12001 |
|
78 |
78 |
$4K |
| 90688 |
|
140 |
136 |
$4K |
| 87899 |
|
206 |
134 |
$4K |
| 86481 |
|
38 |
38 |
$3K |
| 87280 |
|
183 |
166 |
$3K |
| 73090 |
|
76 |
70 |
$3K |
| 83615 |
|
400 |
366 |
$3K |
| 71101 |
|
45 |
45 |
$3K |
| J7611 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, concentrated form, 1 mg |
1,104 |
958 |
$3K |
| 82274 |
|
146 |
144 |
$3K |
| 86141 |
|
237 |
237 |
$3K |
| 93922 |
|
63 |
63 |
$3K |
| 80076 |
|
239 |
233 |
$3K |
| 86356 |
|
36 |
34 |
$3K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
106 |
76 |
$3K |
| 82533 |
|
104 |
98 |
$3K |
| 93246 |
|
144 |
144 |
$2K |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
25 |
25 |
$2K |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
480 |
405 |
$2K |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
368 |
363 |
$2K |
| 29125 |
|
54 |
52 |
$2K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
13 |
13 |
$2K |
| 71271 |
|
28 |
28 |
$2K |
| 82553 |
|
154 |
140 |
$2K |
| 86328 |
|
39 |
39 |
$2K |
| 99201 |
|
64 |
55 |
$2K |
| 90677 |
|
12 |
12 |
$2K |
| 92551 |
|
103 |
103 |
$2K |
| 94060 |
|
51 |
51 |
$2K |
| 83520 |
|
123 |
70 |
$2K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
29 |
26 |
$2K |
| 93321 |
|
43 |
43 |
$2K |
| 0258 |
|
153 |
144 |
$2K |
| 86706 |
|
82 |
82 |
$2K |
| 86147 |
|
33 |
33 |
$2K |
| 77061 |
|
42 |
42 |
$2K |
| 97802 |
|
14 |
14 |
$2K |
| 82784 |
|
107 |
102 |
$1K |
| 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 |
350 |
250 |
$1K |
| 93356 |
|
26 |
26 |
$1K |
| 83002 |
|
37 |
37 |
$1K |
| 86003 |
|
13 |
12 |
$1K |
| 86308 |
|
90 |
90 |
$1K |
| 86160 |
|
54 |
39 |
$1K |
| 97799 |
|
26 |
12 |
$1K |
| 83655 |
|
104 |
102 |
$977.92 |
| 72072 |
|
29 |
29 |
$924.42 |
| 82105 |
|
12 |
12 |
$919.40 |
| 83630 |
|
42 |
40 |
$892.72 |
| J3420 |
Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg |
170 |
136 |
$872.22 |
| 72050 |
|
15 |
15 |
$842.25 |
| 96376 |
|
145 |
115 |
$819.17 |
| 82947 |
|
158 |
158 |
$812.40 |
| 80164 |
|
38 |
38 |
$809.24 |
| J3360 |
Injection, diazepam, up to 5 mg |
75 |
69 |
$795.45 |
| 82787 |
|
18 |
18 |
$769.86 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
99 |
99 |
$765.92 |
| G0381 |
Level 2 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room or emergency department; (2) it is held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment; or (3) during the calendar year immediately preceding the calendar year in which a determination under 42 cfr 489.24 is being made, based on a representative sample of patient visits that occurred during that calendar year, it provides at least one-third of all of its outpatient visits for the treatment of emergency medical conditions on an urgent basis without requiring a previously scheduled appointment) |
39 |
39 |
$735.88 |
| G0279 |
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) |
28 |
28 |
$727.95 |
| 97803 |
|
14 |
14 |
$705.00 |
| 82542 |
|
45 |
42 |
$703.50 |
| 86800 |
|
73 |
67 |
$700.69 |
| 45378 |
Colonoscopy, flexible; diagnostic, including collection of specimen(s) |
16 |
16 |
$685.86 |
| 82565 |
|
109 |
109 |
$653.41 |
| 86039 |
|
64 |
62 |
$634.65 |
| 99173 |
|
124 |
124 |
$628.99 |
| 84146 |
|
25 |
25 |
$609.87 |
| 93925 |
|
12 |
12 |
$609.84 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
74 |
68 |
$603.28 |
| J8499 |
Prescription drug, oral, non chemotherapeutic, nos |
453 |
354 |
$602.37 |
| Q0111 |
Wet mounts, including preparations of vaginal, cervical or skin specimens |
115 |
111 |
$601.81 |
| 84425 |
|
39 |
38 |
$599.46 |
| 93296 |
|
26 |
26 |
$574.18 |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
24 |
12 |
$554.10 |
| 83993 |
|
37 |
37 |
$548.72 |
| Q3014 |
Telehealth originating site facility fee |
90 |
78 |
$520.14 |
| 10060 |
|
24 |
24 |
$494.24 |
| 86225 |
|
54 |
54 |
$457.04 |
| 77062 |
|
12 |
12 |
$425.07 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
28 |
24 |
$421.13 |
| 86200 |
|
53 |
52 |
$370.88 |
| 82785 |
|
39 |
35 |
$336.43 |
| Q9963 |
High osmolar contrast material, 350-399 mg/ml iodine concentration, per ml |
72 |
72 |
$323.22 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
63 |
50 |
$313.21 |
| 82977 |
|
25 |
25 |
$300.74 |
| 86703 |
|
24 |
24 |
$291.40 |
| 84145 |
|
15 |
15 |
$290.16 |
| 99070 |
|
73 |
56 |
$281.27 |
| 87209 |
|
12 |
12 |
$211.42 |
| 87075 |
|
15 |
14 |
$177.29 |
| 84630 |
|
14 |
12 |
$156.64 |
| 80178 |
|
13 |
13 |
$138.78 |
| 83550 |
|
54 |
54 |
$131.03 |
| J1630 |
Injection, haloperidol, up to 5 mg |
17 |
15 |
$123.76 |
| J7050 |
Infusion, normal saline solution, 250 cc |
18 |
12 |
$115.00 |
| 90716 |
|
12 |
12 |
$108.00 |
| 0255 |
|
12 |
12 |
$101.35 |
| 90707 |
|
12 |
12 |
$99.00 |
| 82150 |
|
12 |
12 |
$95.06 |
| 86258 |
|
26 |
14 |
$66.18 |
| 87177 |
|
12 |
12 |
$59.29 |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
46 |
45 |
$36.93 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
130 |
119 |
$30.22 |
| J1010 |
Injection, methylprednisolone acetate, 1 mg |
13 |
13 |
$21.60 |
| 0250R |
|
127 |
65 |
$0.00 |
| 0272R |
|
520 |
210 |
$0.00 |