| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 96361 |
Intravenous infusion, hydration; each additional hour |
43,381 |
31,443 |
$13.59M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
84,009 |
77,497 |
$12.51M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
66,281 |
59,455 |
$12.19M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
34,176 |
30,238 |
$7.11M |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
23,506 |
21,832 |
$2.75M |
| G0378 |
Hospital observation service, per hour |
25,172 |
10,399 |
$1.92M |
| 70450 |
Computed tomography, head or brain; without contrast material |
7,186 |
6,102 |
$1.78M |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
5,605 |
4,744 |
$1.63M |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
8,081 |
5,739 |
$1.22M |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
1,932 |
1,807 |
$1.07M |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
4,994 |
4,146 |
$1.04M |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
7,455 |
5,447 |
$975K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
4,052 |
2,028 |
$928K |
| 80053 |
Comprehensive metabolic panel |
54,682 |
44,955 |
$669K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
2,301 |
1,845 |
$624K |
| 59025 |
Fetal non-stress test |
3,685 |
2,125 |
$599K |
| 93976 |
|
3,433 |
2,700 |
$551K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
1,482 |
1,226 |
$453K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
914 |
858 |
$405K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
1,226 |
1,078 |
$367K |
| 70496 |
|
1,009 |
807 |
$312K |
| 52356 |
|
106 |
80 |
$300K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
1,527 |
1,263 |
$292K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
35,542 |
27,152 |
$283K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
35,170 |
26,742 |
$269K |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
15,832 |
13,859 |
$248K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
1,453 |
713 |
$242K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
471 |
407 |
$234K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
1,245 |
640 |
$231K |
| 71046 |
Radiologic examination, chest; 2 views |
18,849 |
16,984 |
$224K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
45,491 |
39,546 |
$215K |
| 84484 |
|
24,294 |
18,372 |
$198K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
1,613 |
1,323 |
$156K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
5,187 |
4,587 |
$150K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
2,313 |
765 |
$144K |
| 45385 |
Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) |
227 |
215 |
$139K |
| C8929 |
Transthoracic echocardiography with contrast, or without contrast followed by with contrast, real-time with image documentation (2d), includes m-mode recording, when performed, complete, with spectral doppler echocardiography, and with color flow doppler echocardiography |
615 |
531 |
$137K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
470 |
400 |
$136K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
49,113 |
42,300 |
$131K |
| 93458 |
|
127 |
90 |
$131K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
661 |
580 |
$130K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
28,349 |
17,894 |
$129K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
2,285 |
2,045 |
$128K |
| 36415 |
Collection of venous blood by venipuncture |
102,363 |
74,221 |
$126K |
| 71045 |
Radiologic examination, chest; single view |
19,784 |
17,451 |
$118K |
| 70491 |
|
351 |
290 |
$113K |
| 76642 |
|
721 |
643 |
$107K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
6,806 |
5,653 |
$101K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
95,527 |
75,799 |
$98K |
| 96367 |
|
1,425 |
906 |
$97K |
| 93970 |
|
593 |
506 |
$96K |
| 82805 |
|
3,298 |
2,527 |
$91K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
1,170 |
809 |
$90K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
521 |
470 |
$88K |
| 93971 |
|
1,083 |
929 |
$88K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
765 |
660 |
$85K |
| 10060 |
|
449 |
376 |
$83K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
720 |
556 |
$82K |
| J3490 |
Unclassified drugs |
11,179 |
6,876 |
$79K |
| 76830 |
Ultrasound, transvaginal |
1,793 |
1,503 |
$77K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
278 |
250 |
$76K |
| 71271 |
|
371 |
337 |
$73K |
| 29848 |
|
45 |
43 |
$73K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
2,331 |
963 |
$72K |
| 74174 |
|
719 |
579 |
$69K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
357 |
311 |
$67K |
| 76770 |
|
369 |
320 |
$64K |
| 96376 |
|
6,636 |
3,698 |
$62K |
| 12001 |
|
389 |
325 |
$62K |
| 93017 |
|
657 |
586 |
$62K |
| J0561 |
Injection, penicillin g benzathine, 100,000 units |
281 |
169 |
$61K |
| 72100 |
|
1,064 |
968 |
$60K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
452 |
402 |
$60K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
402 |
379 |
$60K |
| 76536 |
|
454 |
421 |
$58K |
| 70498 |
|
1,065 |
853 |
$57K |
| 71250 |
|
593 |
530 |
$56K |
| J1756 |
Injection, iron sucrose, 1 mg |
1,318 |
600 |
$56K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
1,549 |
1,236 |
$54K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
1,209 |
487 |
$52K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
2,012 |
1,550 |
$50K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
242 |
222 |
$49K |
| 73130 |
|
2,055 |
1,738 |
$49K |
| 70486 |
|
539 |
450 |
$48K |
| 36591 |
|
1,067 |
483 |
$48K |
| 73030 |
|
1,685 |
1,437 |
$47K |
| 86900 |
|
2,082 |
1,671 |
$47K |
| S0166 |
Injection, olanzapine, 2.5 mg |
351 |
224 |
$47K |
| 76801 |
|
1,507 |
1,125 |
$46K |
| 96368 |
|
715 |
448 |
$45K |
| 73560 |
|
2,033 |
1,732 |
$45K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
367 |
325 |
$41K |
| 94060 |
|
296 |
274 |
$41K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
2,472 |
2,213 |
$40K |
| 81001 |
|
64,807 |
58,178 |
$39K |
| 93296 |
|
1,697 |
1,594 |
$39K |
| 74420 |
|
295 |
224 |
$39K |
| 73610 |
|
1,764 |
1,466 |
$39K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
27,330 |
19,736 |
$36K |
| 47562 |
|
17 |
12 |
$35K |
| 73630 |
|
1,965 |
1,698 |
$33K |
| 97162 |
|
889 |
713 |
$33K |
| 84703 |
|
27,984 |
25,433 |
$32K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
1,559 |
1,488 |
$31K |
| 93922 |
|
376 |
358 |
$31K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
4,077 |
3,423 |
$31K |
| 73221 |
|
134 |
126 |
$30K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
903 |
702 |
$30K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
9,479 |
8,945 |
$29K |
| 97116 |
|
802 |
436 |
$27K |
| 78815 |
Positron emission tomography (PET) for limited area imaging |
37 |
37 |
$27K |
| 97597 |
|
222 |
107 |
$27K |
| 64415 |
|
48 |
25 |
$26K |
| 97166 |
|
664 |
512 |
$26K |
| 12011 |
|
155 |
129 |
$24K |
| 82248 |
|
18,361 |
15,621 |
$24K |
| 84702 |
|
14,691 |
12,756 |
$24K |
| 83690 |
|
22,241 |
19,458 |
$23K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
5,786 |
4,928 |
$22K |
| 85027 |
|
5,397 |
3,561 |
$22K |
| 74018 |
|
633 |
527 |
$21K |
| 86850 |
|
2,049 |
1,640 |
$21K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
3,971 |
3,357 |
$21K |
| 94727 |
|
345 |
319 |
$21K |
| 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 |
107 |
107 |
$21K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
29,460 |
22,439 |
$20K |
| 77062 |
|
362 |
325 |
$19K |
| 83735 |
|
4,532 |
2,314 |
$19K |
| 73502 |
|
829 |
705 |
$19K |
| 82077 |
|
3,643 |
2,852 |
$19K |
| 72050 |
|
251 |
226 |
$18K |
| 72141 |
|
104 |
94 |
$18K |
| 73110 |
|
1,127 |
900 |
$18K |
| 83880 |
|
2,829 |
2,249 |
$18K |
| 97535 |
Self-care/home management training, each 15 minutes |
636 |
361 |
$17K |
| 94729 |
|
348 |
321 |
$17K |
| J0690 |
Injection, cefazolin sodium, 500 mg |
4,290 |
2,931 |
$17K |
| 84443 |
Thyroid stimulating hormone (TSH) |
5,576 |
4,744 |
$17K |
| 88307 |
|
120 |
88 |
$17K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
4,077 |
3,423 |
$17K |
| 90715 |
|
1,006 |
824 |
$16K |
| 97161 |
|
285 |
222 |
$16K |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
7,297 |
4,571 |
$16K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
24,992 |
20,242 |
$15K |
| J2704 |
Injection, propofol, 10 mg |
12,802 |
9,643 |
$15K |
| J3535 |
Drug administered through a metered dose inhaler |
1,280 |
882 |
$15K |
| 87040 |
|
1,414 |
1,064 |
$14K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
505 |
423 |
$13K |
| 83605 |
|
3,790 |
2,680 |
$13K |
| 64493 |
|
21 |
16 |
$13K |
| 72131 |
|
409 |
335 |
$13K |
| 82607 |
|
965 |
781 |
$13K |
| 85610 |
|
4,210 |
2,953 |
$13K |
| 88304 |
|
516 |
403 |
$12K |
| 80320 |
|
762 |
692 |
$11K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
3,098 |
2,555 |
$11K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
144 |
105 |
$11K |
| 72128 |
|
257 |
212 |
$10K |
| 82728 |
|
1,066 |
842 |
$10K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
17,997 |
15,432 |
$10K |
| 93308 |
|
30 |
24 |
$10K |
| 80069 |
|
1,481 |
674 |
$10K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
69 |
52 |
$9K |
| 80051 |
|
6,524 |
5,896 |
$9K |
| 73080 |
|
557 |
468 |
$9K |
| 97165 |
|
168 |
134 |
$8K |
| J1170 |
Injection, hydromorphone, up to 4 mg |
4,065 |
2,186 |
$8K |
| 99152 |
|
566 |
441 |
$8K |
| 80076 |
|
1,292 |
1,071 |
$8K |
| 93880 |
|
69 |
64 |
$8K |
| J1815 |
Injection, insulin, per 5 units |
2,223 |
907 |
$8K |
| 87077 |
|
1,500 |
1,197 |
$7K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
1,965 |
1,552 |
$7K |
| 75574 |
|
35 |
26 |
$7K |
| 73590 |
|
457 |
369 |
$7K |
| 77066 |
Tomosynthesis, mammo |
398 |
359 |
$7K |
| J0574 |
Buprenorphine/naloxone, oral, greater than 6 mg, but less than or equal to 10 mg buprenorphine |
466 |
190 |
$7K |
| J1750 |
Injection, iron dextran, 50 mg |
49 |
25 |
$7K |
| 80143 |
|
1,638 |
1,268 |
$6K |
| 83540 |
|
1,071 |
851 |
$6K |
| 80179 |
|
1,628 |
1,258 |
$6K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
6,288 |
4,724 |
$6K |
| 36416 |
|
1,697 |
1,161 |
$6K |
| 94660 |
|
54 |
25 |
$6K |
| 85379 |
|
1,448 |
1,154 |
$6K |
| 82746 |
|
912 |
735 |
$6K |
| 72072 |
|
91 |
84 |
$6K |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
4,156 |
1,668 |
$6K |
| 87210 |
|
1,224 |
996 |
$6K |
| 72040 |
|
83 |
76 |
$5K |
| 83550 |
|
1,064 |
846 |
$5K |
| 97167 |
|
119 |
91 |
$5K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
5,821 |
3,903 |
$5K |
| 71101 |
|
251 |
219 |
$5K |
| 97129 |
|
142 |
66 |
$5K |
| 86140 |
|
877 |
652 |
$5K |
| 73562 |
|
73 |
64 |
$5K |
| 80061 |
Lipid panel |
937 |
751 |
$5K |
| 76870 |
|
229 |
187 |
$4K |
| 12002 |
|
33 |
27 |
$4K |
| 87186 |
|
1,291 |
1,030 |
$4K |
| 73100 |
|
35 |
30 |
$4K |
| 86901 |
|
2,082 |
1,671 |
$4K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
95 |
84 |
$4K |
| 97163 |
|
137 |
103 |
$4K |
| 81002 |
|
1,088 |
875 |
$4K |
| 76377 |
|
274 |
218 |
$4K |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
5,241 |
3,988 |
$4K |
| 87070 |
|
646 |
500 |
$4K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
2,655 |
1,817 |
$4K |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
3,743 |
2,814 |
$3K |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
4,419 |
3,263 |
$3K |
| 76820 |
|
63 |
41 |
$3K |
| 99153 |
Mod sedat endo service >5yrs |
139 |
111 |
$3K |
| 74183 |
|
12 |
12 |
$3K |
| 73700 |
|
19 |
15 |
$3K |
| 87205 |
|
784 |
607 |
$3K |
| 87081 |
|
780 |
701 |
$3K |
| 84100 |
|
1,161 |
713 |
$3K |
| 51701 |
|
435 |
337 |
$3K |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
2,039 |
1,388 |
$3K |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
1,680 |
1,137 |
$3K |
| 85730 |
|
1,010 |
744 |
$3K |
| 73090 |
|
290 |
243 |
$2K |
| 87075 |
|
423 |
324 |
$2K |
| J3370 |
Injection, vancomycin hcl, 500 mg |
882 |
455 |
$2K |
| J3480 |
Injection, potassium chloride, per 2 meq |
761 |
371 |
$2K |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
1,323 |
841 |
$2K |
| C1769 |
Guide wire |
734 |
546 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,066 |
858 |
$2K |
| 82565 |
|
6,748 |
6,030 |
$2K |
| 82947 |
|
7,289 |
6,541 |
$2K |
| 82550 |
|
710 |
437 |
$2K |
| J0330 |
Injection, succinylcholine chloride, up to 20 mg |
904 |
652 |
$2K |
| J1790 |
Injection, droperidol, up to 5 mg |
1,374 |
1,005 |
$2K |
| 80329 |
|
157 |
141 |
$2K |
| J2543 |
Injection, piperacillin sodium/tazobactam sodium, 1 gram/0.125 grams (1.125 grams) |
313 |
98 |
$2K |
| 77061 |
|
51 |
44 |
$2K |
| 84439 |
|
449 |
367 |
$2K |
| J7050 |
Infusion, normal saline solution, 250 cc |
4,958 |
2,054 |
$2K |
| 85652 |
|
849 |
641 |
$2K |
| 82010 |
|
790 |
554 |
$2K |
| 72110 |
|
24 |
24 |
$2K |
| 84520 |
|
6,625 |
5,987 |
$2K |
| J2272 |
Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg |
1,341 |
963 |
$2K |
| 85018 |
|
3,659 |
2,756 |
$2K |
| 93356 |
|
178 |
169 |
$2K |
| J1644 |
Injection, heparin sodium, per 1000 units |
2,091 |
803 |
$1K |
| J1642 |
Injection, heparin sodium, (heparin lock flush), per 10 units |
2,724 |
1,018 |
$1K |
| 99215 |
Prolong outpt/office vis |
14 |
14 |
$1K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
66 |
64 |
$1K |
| 82330 |
|
523 |
390 |
$1K |
| 85045 |
|
423 |
319 |
$1K |
| 87653 |
|
262 |
224 |
$1K |
| 76821 |
|
19 |
13 |
$1K |
| 73060 |
|
87 |
68 |
$1K |
| 82375 |
|
383 |
288 |
$1K |
| J2795 |
Injection, ropivacaine hydrochloride, 1 mg |
680 |
472 |
$1K |
| 81025 |
|
400 |
311 |
$1K |
| 85007 |
|
212 |
150 |
$1K |
| C1894 |
Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser |
770 |
584 |
$1K |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
2,157 |
1,247 |
$1K |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
827 |
571 |
$1K |
| 83615 |
|
696 |
505 |
$987.98 |
| 77080 |
|
12 |
12 |
$984.18 |
| C9113 |
Injection, pantoprazole sodium, per vial |
296 |
123 |
$982.36 |
| 84550 |
|
710 |
512 |
$966.56 |
| Q9957 |
Injection, perflutren lipid microspheres, per ml |
872 |
719 |
$939.85 |
| J0736 |
Injection, clindamycin phosphate, 300 mg |
297 |
185 |
$930.21 |
| J3420 |
Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg |
807 |
553 |
$918.06 |
| J2469 |
Injection, palonosetron hcl, 25 mcg |
96 |
52 |
$908.56 |
| 88300 |
|
138 |
111 |
$859.86 |
| 73564 |
|
14 |
13 |
$820.57 |
| 82570 |
|
539 |
412 |
$810.14 |
| C1713 |
Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) |
30 |
24 |
$800.88 |
| 88342 |
|
188 |
154 |
$767.34 |
| 93299 |
|
30 |
24 |
$759.39 |
| 29125 |
|
77 |
68 |
$654.82 |
| 86703 |
|
151 |
125 |
$642.09 |
| A9575 |
Injection, gadoterate meglumine, 0.1 ml |
928 |
778 |
$626.59 |
| 86923 |
|
14 |
13 |
$619.47 |
| 83050 |
|
382 |
287 |
$619.16 |
| 84156 |
|
507 |
357 |
$594.66 |
| J1940 |
Injection, furosemide, up to 20 mg |
775 |
512 |
$559.61 |
| J1836 |
Injection, metronidazole, 10 mg |
172 |
81 |
$508.10 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
693 |
658 |
$487.60 |
| 92610 |
|
16 |
12 |
$472.06 |
| J1953 |
Injection, levetiracetam, 10 mg |
105 |
57 |
$465.06 |
| J3411 |
Injection, thiamine hcl, 100 mg |
261 |
124 |
$456.40 |
| J2310 |
Injection, naloxone hydrochloride, per 1 mg |
23 |
12 |
$447.72 |
| J3360 |
Injection, diazepam, up to 5 mg |
204 |
148 |
$432.29 |
| J0360 |
Injection, hydralazine hcl, up to 20 mg |
282 |
152 |
$427.13 |
| J2370 |
Injection, phenylephrine hcl, up to 1 ml |
379 |
236 |
$398.75 |
| 73552 |
|
16 |
13 |
$396.10 |
| 97130 |
|
23 |
13 |
$387.70 |
| 90686 |
|
17 |
12 |
$369.91 |
| G0008 |
Administration of influenza virus vaccine |
17 |
15 |
$353.01 |
| 84132 |
|
662 |
489 |
$344.82 |
| 86780 |
|
95 |
83 |
$300.50 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
2,480 |
1,656 |
$291.80 |
| J2060 |
Injection, lorazepam, 2 mg |
346 |
223 |
$268.35 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
320 |
236 |
$262.22 |
| 86308 |
|
15 |
12 |
$245.25 |
| 80074 |
|
16 |
12 |
$236.78 |
| 85384 |
|
175 |
123 |
$211.14 |
| 15853 |
|
65 |
53 |
$204.48 |
| 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 |
108 |
108 |
$200.52 |
| J1171 |
Injection, hydromorphone, 0.1 mg |
161 |
112 |
$195.46 |
| 82365 |
|
118 |
91 |
$190.08 |
| 82435 |
|
409 |
311 |
$174.40 |
| 84295 |
|
414 |
314 |
$170.66 |
| 80177 |
|
26 |
13 |
$163.75 |
| 87147 |
|
15 |
12 |
$163.08 |
| J2920 |
Injection, methylprednisolone sodium succinate, up to 40 mg |
119 |
78 |
$128.49 |
| 86803 |
|
42 |
39 |
$116.80 |
| 86592 |
|
48 |
41 |
$109.02 |
| J0295 |
Injection, ampicillin sodium/sulbactam sodium, per 1.5 gm |
25 |
13 |
$108.44 |
| J0703 |
Injection, cefepime hydrochloride (b braun), not therapeutically equivalent to maxipime, 500 mg |
48 |
28 |
$104.70 |
| J1596 |
Injection, glycopyrrolate, 0.1 mg |
301 |
274 |
$96.08 |
| 82140 |
|
56 |
42 |
$88.32 |
| J0456 |
Injection, azithromycin, 500 mg |
46 |
24 |
$85.41 |
| 87801 |
Infectious agent detection by nucleic acid; amplified probe, multiple organisms |
117 |
110 |
$77.36 |
| C1773 |
Retrieval device, insertable (used to retrieve fractured medical devices) |
46 |
45 |
$62.10 |
| A9500 |
Technetium tc-99m sestamibi, diagnostic, per study dose |
121 |
87 |
$35.64 |
| J2919 |
Injection, methylprednisolone sodium succinate, 5 mg |
179 |
149 |
$33.48 |
| 77065 |
Tomosynthesis, mammo |
70 |
58 |
$32.76 |
| J1920 |
Injection, labetalol hydrochloride, 5 mg |
21 |
16 |
$26.64 |
| J1630 |
Injection, haloperidol, up to 5 mg |
44 |
38 |
$19.17 |
| J2471 |
Injection, pantoprazole (hikma), not therapeutically equivalent to j2470, 40 mg |
46 |
29 |
$16.31 |
| J7999 |
Compounded drug, not otherwise classified |
133 |
112 |
$15.76 |
| J0612 |
Injection, calcium gluconate, not otherwise specified, 10 mg |
16 |
12 |
$13.94 |
| J7060 |
5% dextrose/water (500 ml = 1 unit) |
18 |
13 |
$5.88 |
| J1805 |
Injection, esmolol hydrochloride, 10 mg |
39 |
16 |
$1.88 |
| J2785 |
Injection, regadenoson, 0.1 mg |
362 |
308 |
$0.00 |
| C9399 |
Unclassified drugs or biologicals |
14 |
12 |
$0.00 |
| 64494 |
|
21 |
16 |
$0.00 |
| A9502 |
Technetium tc-99m tetrofosmin, diagnostic, per study dose |
314 |
282 |
$0.00 |
| A9552 |
Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries |
24 |
24 |
$0.00 |
| J7510 |
Prednisolone oral, per 5 mg |
17 |
13 |
$0.00 |
| 87420 |
|
42 |
39 |
$0.00 |