| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
84,769 |
75,971 |
$11.63M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
57,260 |
50,751 |
$8.46M |
| 96361 |
Intravenous infusion, hydration; each additional hour |
15,896 |
12,574 |
$5.69M |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
34,203 |
31,442 |
$4.18M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
28,910 |
24,692 |
$4.10M |
| 70450 |
Computed tomography, head or brain; without contrast material |
7,837 |
6,459 |
$2.18M |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
6,714 |
5,467 |
$1.88M |
| 59025 |
Fetal non-stress test |
7,183 |
3,130 |
$1.28M |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
7,777 |
6,610 |
$1.15M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
9,683 |
8,353 |
$1.14M |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
2,986 |
2,478 |
$911K |
| C9803 |
Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
24,049 |
21,667 |
$910K |
| 80053 |
Comprehensive metabolic panel |
48,842 |
42,927 |
$859K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
8,394 |
6,813 |
$814K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
6,868 |
6,175 |
$785K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
9,443 |
2,927 |
$738K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
6,246 |
5,773 |
$673K |
| 81513 |
|
4,409 |
3,863 |
$644K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
1,966 |
1,620 |
$566K |
| G0378 |
Hospital observation service, per hour |
7,560 |
3,453 |
$535K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
2,736 |
2,151 |
$530K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
1,955 |
1,746 |
$476K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
1,747 |
1,101 |
$456K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
3,752 |
3,418 |
$446K |
| 84443 |
Thyroid stimulating hormone (TSH) |
24,051 |
22,451 |
$427K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
16,518 |
15,694 |
$416K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
881 |
771 |
$403K |
| 80061 |
Lipid panel |
26,697 |
25,337 |
$381K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
108,152 |
91,262 |
$367K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
3,408 |
2,099 |
$364K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
2,751 |
2,531 |
$357K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
3,281 |
1,473 |
$340K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
15,195 |
13,196 |
$321K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
72,868 |
60,276 |
$311K |
| 82607 |
|
13,637 |
12,845 |
$286K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
588 |
489 |
$280K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
11,501 |
10,332 |
$265K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
23,869 |
22,589 |
$255K |
| 45385 |
Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) |
392 |
330 |
$251K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
2,788 |
1,909 |
$229K |
| 36415 |
Collection of venous blood by venipuncture |
144,395 |
118,816 |
$226K |
| 95886 |
|
1,027 |
534 |
$211K |
| 76642 |
|
1,459 |
1,332 |
$201K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
3,956 |
1,272 |
$189K |
| 70496 |
|
756 |
615 |
$181K |
| 43235 |
|
319 |
276 |
$177K |
| 93975 |
|
1,138 |
948 |
$176K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
662 |
558 |
$173K |
| 70491 |
|
517 |
425 |
$168K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
1,945 |
1,619 |
$163K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
11,484 |
10,319 |
$161K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
3,143 |
2,773 |
$157K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
865 |
755 |
$154K |
| J0561 |
Injection, penicillin g benzathine, 100,000 units |
624 |
444 |
$150K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
248 |
219 |
$150K |
| 10060 |
|
802 |
710 |
$145K |
| 47562 |
|
62 |
48 |
$140K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
2,673 |
2,524 |
$139K |
| 86480 |
|
2,648 |
2,531 |
$136K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
844 |
787 |
$134K |
| 82728 |
|
7,276 |
6,673 |
$130K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
3,649 |
1,441 |
$127K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
871 |
734 |
$127K |
| 71046 |
Radiologic examination, chest; 2 views |
17,369 |
15,230 |
$126K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
777 |
641 |
$115K |
| 86850 |
|
5,354 |
4,320 |
$115K |
| 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 |
1,078 |
1,005 |
$113K |
| 85055 |
|
2,402 |
2,016 |
$110K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
4,128 |
3,935 |
$107K |
| 93970 |
|
707 |
629 |
$107K |
| 93971 |
|
1,295 |
1,159 |
$106K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
7,851 |
6,880 |
$105K |
| 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 |
749 |
599 |
$102K |
| 12001 |
|
573 |
507 |
$98K |
| 83013 |
|
2,116 |
2,047 |
$98K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
9,372 |
8,230 |
$96K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
4,913 |
4,170 |
$94K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
1,165 |
874 |
$92K |
| 87481 |
|
4,397 |
3,855 |
$91K |
| 82570 |
|
7,850 |
7,094 |
$88K |
| 71250 |
|
857 |
767 |
$86K |
| 93356 |
|
2,138 |
1,872 |
$85K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
564 |
496 |
$83K |
| 83540 |
|
8,376 |
7,840 |
$81K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
2,470 |
1,997 |
$81K |
| 93017 |
|
978 |
849 |
$75K |
| 86803 |
|
3,303 |
3,096 |
$74K |
| 70498 |
|
880 |
692 |
$72K |
| 76801 |
|
2,073 |
1,700 |
$71K |
| 83735 |
|
14,022 |
10,835 |
$70K |
| 71271 |
|
363 |
350 |
$70K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
36,755 |
30,992 |
$69K |
| 97161 |
|
1,607 |
1,303 |
$69K |
| 86780 |
|
4,716 |
4,364 |
$67K |
| 84439 |
|
4,245 |
3,916 |
$67K |
| 85027 |
|
12,602 |
9,816 |
$67K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
28,977 |
25,759 |
$64K |
| 83550 |
|
6,442 |
6,038 |
$63K |
| 86900 |
|
5,464 |
4,431 |
$62K |
| 81001 |
|
38,931 |
34,458 |
$61K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
3,266 |
3,074 |
$61K |
| G0472 |
Hepatitis c antibody screening, for individual at high risk and other covered indication(s) |
2,036 |
1,930 |
$60K |
| 82043 |
|
7,092 |
6,755 |
$60K |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
2,022 |
1,882 |
$58K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
2,704 |
2,226 |
$57K |
| 76820 |
|
914 |
553 |
$57K |
| P9016 |
Red blood cells, leukocytes reduced, each unit |
232 |
169 |
$56K |
| 72131 |
|
1,360 |
1,106 |
$55K |
| 74174 |
|
399 |
322 |
$53K |
| 72100 |
|
2,102 |
1,847 |
$52K |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
3,051 |
2,835 |
$52K |
| 82746 |
|
6,281 |
5,877 |
$51K |
| 76830 |
Ultrasound, transvaginal |
1,584 |
1,348 |
$51K |
| 76770 |
|
320 |
282 |
$49K |
| 82805 |
|
1,806 |
1,376 |
$48K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
1,650 |
813 |
$47K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
504 |
460 |
$47K |
| G0121 |
Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk |
62 |
54 |
$47K |
| 94060 |
|
324 |
298 |
$46K |
| 70486 |
|
1,025 |
884 |
$44K |
| 76536 |
|
370 |
350 |
$43K |
| 86706 |
|
2,182 |
2,010 |
$43K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
537 |
463 |
$42K |
| 12002 |
|
271 |
238 |
$42K |
| 12011 |
|
266 |
226 |
$42K |
| 71045 |
Radiologic examination, chest; single view |
14,131 |
11,929 |
$40K |
| 83970 |
|
1,154 |
1,074 |
$40K |
| 72141 |
|
285 |
237 |
$39K |
| 87340 |
|
3,303 |
3,075 |
$39K |
| 84146 |
|
1,165 |
1,116 |
$37K |
| 94726 |
|
476 |
439 |
$36K |
| 93880 |
|
506 |
439 |
$36K |
| 99215 |
Prolong outpt/office vis |
381 |
332 |
$35K |
| 94729 |
|
542 |
500 |
$35K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
702 |
599 |
$33K |
| 90715 |
|
2,100 |
1,760 |
$33K |
| 73030 |
|
2,406 |
2,032 |
$33K |
| 78815 |
Positron emission tomography (PET) for limited area imaging |
47 |
40 |
$33K |
| 84484 |
|
21,171 |
16,120 |
$33K |
| 78264 |
|
129 |
123 |
$33K |
| 86039 |
|
990 |
956 |
$31K |
| 93922 |
|
383 |
349 |
$30K |
| 83880 |
|
4,348 |
3,571 |
$28K |
| 86038 |
|
1,101 |
1,024 |
$28K |
| 82248 |
|
11,283 |
9,137 |
$28K |
| 97165 |
|
679 |
529 |
$27K |
| 73560 |
|
788 |
673 |
$27K |
| 84702 |
|
3,808 |
2,884 |
$26K |
| 94762 |
|
651 |
363 |
$26K |
| 97162 |
|
691 |
593 |
$26K |
| 0042T |
|
137 |
100 |
$25K |
| 87077 |
|
2,979 |
2,576 |
$25K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
294 |
251 |
$25K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
18,282 |
14,088 |
$24K |
| 77062 |
|
641 |
586 |
$24K |
| 86140 |
|
2,869 |
2,380 |
$24K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
32,617 |
26,839 |
$24K |
| 80069 |
|
1,014 |
819 |
$23K |
| 72040 |
|
488 |
408 |
$22K |
| 73630 |
|
2,740 |
2,351 |
$22K |
| 84207 |
|
1,326 |
1,273 |
$21K |
| 84153 |
|
1,336 |
1,256 |
$21K |
| 74183 |
|
79 |
69 |
$21K |
| 62323 |
|
43 |
41 |
$20K |
| 97535 |
Self-care/home management training, each 15 minutes |
695 |
492 |
$20K |
| 73130 |
|
2,649 |
2,201 |
$20K |
| 36430 |
|
157 |
111 |
$19K |
| 86762 |
|
1,142 |
1,067 |
$19K |
| 97116 |
|
745 |
331 |
$18K |
| 72128 |
|
850 |
690 |
$18K |
| 77061 |
|
548 |
485 |
$17K |
| 88307 |
|
148 |
97 |
$17K |
| 74018 |
|
1,065 |
883 |
$17K |
| 11045 |
|
56 |
24 |
$16K |
| 73610 |
|
2,764 |
2,287 |
$15K |
| 84425 |
|
1,081 |
1,016 |
$15K |
| 86901 |
|
5,465 |
4,430 |
$15K |
| 85652 |
|
3,334 |
2,898 |
$15K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
3,268 |
2,747 |
$15K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
3,267 |
2,757 |
$15K |
| 80076 |
|
2,658 |
2,424 |
$14K |
| 85610 |
|
7,112 |
5,391 |
$14K |
| 73502 |
|
1,286 |
1,086 |
$14K |
| 72050 |
|
341 |
307 |
$13K |
| 84403 |
|
613 |
576 |
$13K |
| 73564 |
|
2,342 |
1,991 |
$12K |
| 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 |
440 |
425 |
$12K |
| 84480 |
|
1,028 |
951 |
$12K |
| 99152 |
|
577 |
441 |
$12K |
| 75574 |
|
26 |
25 |
$11K |
| 86705 |
|
502 |
467 |
$11K |
| 86696 |
|
701 |
656 |
$11K |
| 87186 |
|
2,220 |
1,911 |
$11K |
| 83001 |
|
532 |
500 |
$11K |
| 96367 |
|
264 |
192 |
$10K |
| 86431 |
|
676 |
637 |
$10K |
| 86695 |
|
675 |
632 |
$10K |
| 87081 |
|
1,067 |
970 |
$10K |
| 86003 |
|
239 |
224 |
$10K |
| 96376 |
|
4,683 |
2,514 |
$9K |
| 73110 |
|
1,704 |
1,386 |
$9K |
| 83721 |
|
793 |
698 |
$9K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
151 |
80 |
$9K |
| 87070 |
|
1,389 |
1,131 |
$9K |
| 84100 |
|
2,399 |
1,581 |
$9K |
| 81025 |
|
15,948 |
14,140 |
$9K |
| 77065 |
Tomosynthesis, mammo |
635 |
554 |
$8K |
| 73700 |
|
71 |
59 |
$8K |
| 80197 |
|
298 |
178 |
$8K |
| 86235 |
|
283 |
253 |
$8K |
| 82947 |
|
829 |
774 |
$8K |
| 77066 |
Tomosynthesis, mammo |
696 |
632 |
$8K |
| 82550 |
|
1,253 |
951 |
$8K |
| S9445 |
Patient education, not otherwise classified, non-physician provider, individual, per session |
175 |
166 |
$8K |
| 81003 |
|
11,124 |
9,357 |
$8K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
17,535 |
13,379 |
$7K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
123 |
98 |
$7K |
| 73562 |
|
226 |
198 |
$7K |
| 83690 |
|
9,550 |
7,786 |
$7K |
| 84550 |
|
1,174 |
1,038 |
$7K |
| 82077 |
|
3,807 |
3,021 |
$7K |
| 82330 |
|
603 |
476 |
$7K |
| 90686 |
|
315 |
266 |
$7K |
| 84156 |
|
1,663 |
1,344 |
$6K |
| 87522 |
Neg quan hep c or qual rna |
182 |
156 |
$6K |
| 84460 |
|
3,892 |
3,177 |
$6K |
| 86787 |
|
796 |
735 |
$6K |
| 88341 |
|
109 |
86 |
$6K |
| 73590 |
|
1,007 |
840 |
$6K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
6,916 |
5,968 |
$6K |
| 83002 |
|
339 |
316 |
$6K |
| 20610 |
|
29 |
26 |
$6K |
| 72072 |
|
242 |
223 |
$6K |
| 76818 |
|
43 |
25 |
$5K |
| 82950 |
|
656 |
623 |
$5K |
| 85730 |
|
3,192 |
2,399 |
$5K |
| 95816 |
|
37 |
24 |
$5K |
| 82670 |
|
191 |
175 |
$5K |
| 86360 |
|
102 |
96 |
$5K |
| 92610 |
|
167 |
132 |
$5K |
| J1170 |
Injection, hydromorphone, up to 4 mg |
8,780 |
5,044 |
$5K |
| 85379 |
|
3,427 |
2,849 |
$5K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
25,147 |
18,898 |
$4K |
| 84450 |
|
3,628 |
2,927 |
$4K |
| 93325 |
|
38 |
30 |
$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 |
87 |
68 |
$4K |
| 86225 |
|
282 |
255 |
$4K |
| 76870 |
|
186 |
153 |
$4K |
| 82565 |
|
817 |
658 |
$4K |
| 87536 |
|
72 |
69 |
$4K |
| 73080 |
|
775 |
656 |
$4K |
| 72170 |
|
849 |
674 |
$4K |
| 84703 |
|
2,466 |
2,042 |
$4K |
| 71101 |
|
558 |
495 |
$4K |
| 82977 |
|
3,445 |
2,770 |
$4K |
| 73140 |
|
431 |
374 |
$4K |
| 83605 |
|
3,194 |
2,361 |
$4K |
| 72070 |
|
187 |
170 |
$4K |
| 82040 |
|
3,802 |
3,155 |
$4K |
| 86923 |
|
167 |
121 |
$4K |
| G0475 |
Hiv antigen/antibody, combination assay, screening |
1,186 |
1,061 |
$3K |
| 73090 |
|
769 |
622 |
$3K |
| 94010 |
|
18 |
18 |
$3K |
| 84165 |
|
303 |
288 |
$3K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
40 |
37 |
$3K |
| 82247 |
|
3,333 |
2,661 |
$3K |
| 82525 |
|
143 |
135 |
$3K |
| 43259 |
|
15 |
14 |
$3K |
| 85014 |
|
703 |
423 |
$3K |
| 99153 |
Mod sedat endo service >5yrs |
249 |
186 |
$3K |
| 86704 |
|
124 |
112 |
$3K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
2,706 |
2,544 |
$3K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
12 |
12 |
$3K |
| 86701 |
|
156 |
151 |
$3K |
| 76937 |
|
172 |
126 |
$3K |
| 82784 |
|
212 |
188 |
$3K |
| 0004A |
|
87 |
75 |
$3K |
| J1815 |
Injection, insulin, per 5 units |
3,207 |
1,026 |
$3K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
29 |
25 |
$3K |
| 87040 |
|
1,659 |
1,061 |
$3K |
| 87205 |
|
1,344 |
1,061 |
$3K |
| 84270 |
|
144 |
132 |
$2K |
| 80143 |
|
1,005 |
828 |
$2K |
| 88304 |
|
587 |
459 |
$2K |
| 73060 |
|
468 |
384 |
$2K |
| 82150 |
|
3,521 |
2,861 |
$2K |
| 82140 |
|
578 |
443 |
$2K |
| 78492 |
|
14 |
13 |
$2K |
| 77080 |
|
30 |
26 |
$2K |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
9,840 |
6,370 |
$2K |
| 84145 |
|
825 |
604 |
$2K |
| 92507 |
Treatment of speech, language, voice, communication, and/or auditory processing disorder |
32 |
13 |
$2K |
| 76981 |
|
27 |
25 |
$2K |
| 86364 |
|
92 |
84 |
$2K |
| J2543 |
Injection, piperacillin sodium/tazobactam sodium, 1 gram/0.125 grams (1.125 grams) |
815 |
264 |
$2K |
| 86376 |
|
105 |
101 |
$2K |
| 88174 |
|
81 |
80 |
$2K |
| 85018 |
|
731 |
444 |
$2K |
| 88142 |
|
84 |
81 |
$2K |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
2,398 |
952 |
$2K |
| 73552 |
|
578 |
489 |
$2K |
| 93320 |
|
13 |
12 |
$2K |
| 00731 |
|
1,175 |
1,003 |
$2K |
| 80050 |
General health panel |
159 |
159 |
$2K |
| 99454 |
|
14 |
13 |
$2K |
| 84630 |
|
110 |
107 |
$2K |
| 86200 |
|
71 |
68 |
$2K |
| 80051 |
|
58 |
46 |
$2K |
| 97166 |
|
36 |
27 |
$1K |
| 86708 |
|
115 |
111 |
$1K |
| 84075 |
|
3,357 |
2,681 |
$1K |
| 87338 |
|
68 |
67 |
$1K |
| 95819 |
|
17 |
12 |
$1K |
| 82652 |
|
139 |
135 |
$1K |
| 83615 |
|
381 |
273 |
$1K |
| 82785 |
|
126 |
120 |
$1K |
| 90656 |
|
134 |
132 |
$1K |
| 84446 |
|
94 |
90 |
$1K |
| 80179 |
|
974 |
808 |
$1K |
| 84466 |
|
176 |
157 |
$1K |
| 88342 |
|
712 |
606 |
$1K |
| J1953 |
Injection, levetiracetam, 10 mg |
232 |
129 |
$1K |
| 00840 |
|
208 |
133 |
$1K |
| 84590 |
|
79 |
76 |
$1K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
15,580 |
12,318 |
$1K |
| 00811 |
|
407 |
339 |
$1K |
| 72110 |
|
13 |
12 |
$1K |
| 93990 |
|
12 |
12 |
$1K |
| 86141 |
|
43 |
40 |
$1K |
| 84436 |
|
197 |
174 |
$994.60 |
| J2791 |
Injection, rho(d) immune globulin (human), (rhophylac), intramuscular or intravenous, 100 iu |
14 |
14 |
$989.73 |
| 86592 |
|
129 |
116 |
$988.69 |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
1,537 |
943 |
$985.53 |
| 84132 |
|
202 |
160 |
$975.85 |
| 90677 |
|
66 |
65 |
$958.80 |
| 80305 |
|
419 |
354 |
$932.91 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
12,128 |
9,832 |
$922.91 |
| J2704 |
Injection, propofol, 10 mg |
7,219 |
5,303 |
$888.30 |
| 84155 |
|
3,203 |
2,595 |
$844.98 |
| 00790 |
|
140 |
105 |
$825.26 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
2,244 |
1,627 |
$810.66 |
| 87210 |
|
344 |
281 |
$798.21 |
| 84481 |
|
50 |
44 |
$785.73 |
| J3370 |
Injection, vancomycin hcl, 500 mg |
926 |
433 |
$744.65 |
| 84520 |
|
302 |
265 |
$722.53 |
| 80164 |
|
73 |
58 |
$661.96 |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
1,459 |
1,107 |
$655.33 |
| 85046 |
|
223 |
188 |
$644.24 |
| J1644 |
Injection, heparin sodium, per 1000 units |
2,269 |
958 |
$609.51 |
| 72192 |
|
14 |
14 |
$606.87 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
3,824 |
2,548 |
$603.28 |
| J2272 |
Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg |
401 |
255 |
$581.29 |
| 84402 |
|
26 |
24 |
$578.23 |
| 87480 |
|
25 |
24 |
$517.96 |
| 82533 |
|
27 |
25 |
$516.98 |
| 97750 |
|
12 |
12 |
$510.66 |
| A9541 |
Technetium tc-99m sulfur colloid, diagnostic, per study dose, up to 20 millicuries |
166 |
156 |
$495.70 |
| C9113 |
Injection, pantoprazole sodium, per vial |
335 |
131 |
$478.62 |
| 85007 |
|
152 |
112 |
$454.35 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
3,116 |
1,970 |
$448.59 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
15,607 |
11,480 |
$440.62 |
| 86258 |
|
14 |
12 |
$425.22 |
| 76376 |
|
1,945 |
1,701 |
$423.50 |
| 36410 |
|
36 |
26 |
$422.74 |
| 87529 |
|
26 |
24 |
$394.73 |
| 87510 |
|
25 |
24 |
$391.43 |
| 86870 |
|
23 |
14 |
$390.77 |
| A9575 |
Injection, gadoterate meglumine, 0.1 ml |
1,332 |
1,146 |
$385.08 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
764 |
504 |
$381.48 |
| 82310 |
|
213 |
199 |
$378.55 |
| 87625 |
|
55 |
53 |
$378.53 |
| 83921 |
|
30 |
26 |
$375.35 |
| 00812 |
|
398 |
345 |
$368.36 |
| 87660 |
|
25 |
24 |
$356.70 |
| 87045 |
|
13 |
12 |
$338.43 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
3,744 |
2,766 |
$331.26 |
| J0295 |
Injection, ampicillin sodium/sulbactam sodium, per 1.5 gm |
454 |
137 |
$328.49 |
| J2310 |
Injection, naloxone hydrochloride, per 1 mg |
15 |
12 |
$325.67 |
| 84144 |
|
15 |
15 |
$324.64 |
| 29125 |
|
455 |
390 |
$313.10 |
| 86334 |
|
12 |
12 |
$312.08 |
| 92523 |
|
16 |
13 |
$304.38 |
| J0360 |
Injection, hydralazine hcl, up to 20 mg |
382 |
236 |
$299.13 |
| 82106 |
|
15 |
12 |
$295.14 |
| 80320 |
|
12 |
12 |
$287.01 |
| 73070 |
|
17 |
14 |
$266.86 |
| 86765 |
|
14 |
12 |
$261.50 |
| 92611 |
|
13 |
13 |
$256.62 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
5,562 |
4,004 |
$255.70 |
| 82951 |
|
13 |
13 |
$254.70 |
| J2060 |
Injection, lorazepam, 2 mg |
2,019 |
1,452 |
$252.44 |
| 83020 |
|
17 |
17 |
$250.24 |
| J3480 |
Injection, potassium chloride, per 2 meq |
852 |
428 |
$245.03 |
| 84295 |
|
135 |
122 |
$213.49 |
| J1940 |
Injection, furosemide, up to 20 mg |
736 |
373 |
$202.57 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
4,628 |
3,143 |
$202.00 |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
1,974 |
1,429 |
$199.87 |
| 82803 |
|
123 |
87 |
$192.42 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
2,224 |
1,702 |
$189.23 |
| 82435 |
|
192 |
181 |
$181.07 |
| J7050 |
Infusion, normal saline solution, 250 cc |
1,940 |
980 |
$176.94 |
| J2919 |
Injection, methylprednisolone sodium succinate, 5 mg |
334 |
214 |
$167.44 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
185 |
159 |
$161.90 |
| 80074 |
|
19 |
15 |
$151.33 |
| 80177 |
|
17 |
14 |
$136.89 |
| 82952 |
|
12 |
12 |
$133.41 |
| J1630 |
Injection, haloperidol, up to 5 mg |
1,517 |
1,129 |
$131.11 |
| 82374 |
|
143 |
139 |
$129.98 |
| 70360 |
|
18 |
13 |
$114.97 |
| Q9957 |
Injection, perflutren lipid microspheres, per ml |
607 |
513 |
$103.03 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
3,092 |
2,268 |
$95.37 |
| 80377 |
|
14 |
13 |
$95.16 |
| 85049 |
|
47 |
39 |
$83.83 |
| J0171 |
Injection, adrenalin, epinephrine, 0.1 mg |
278 |
217 |
$83.28 |
| 87176 |
|
245 |
196 |
$79.82 |
| 86703 |
|
15 |
12 |
$78.56 |
| J2795 |
Injection, ropivacaine hydrochloride, 1 mg |
166 |
112 |
$77.39 |
| 87449 |
|
31 |
25 |
$69.88 |
| 86709 |
|
21 |
12 |
$64.65 |
| G0008 |
Administration of influenza virus vaccine |
15 |
14 |
$62.89 |
| 95909 |
|
34 |
32 |
$62.37 |
| J1642 |
Injection, heparin sodium, (heparin lock flush), per 10 units |
530 |
279 |
$60.72 |
| J0736 |
Injection, clindamycin phosphate, 300 mg |
16 |
12 |
$55.02 |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
1,612 |
966 |
$54.70 |
| J2371 |
Injection, phenylephrine hydrochloride, 20 micrograms |
712 |
548 |
$49.18 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
2,588 |
1,915 |
$48.70 |
| J3360 |
Injection, diazepam, up to 5 mg |
13 |
12 |
$45.72 |
| 0002A |
|
52 |
47 |
$37.98 |
| 82010 |
|
14 |
12 |
$33.08 |
| Q0114 |
Fern test |
211 |
188 |
$31.45 |
| J0330 |
Injection, succinylcholine chloride, up to 20 mg |
233 |
168 |
$27.84 |
| J1171 |
Injection, hydromorphone, 0.1 mg |
500 |
326 |
$26.35 |
| J1790 |
Injection, droperidol, up to 5 mg |
246 |
202 |
$22.78 |
| J1836 |
Injection, metronidazole, 10 mg |
96 |
37 |
$21.99 |
| J2370 |
Injection, phenylephrine hcl, up to 1 ml |
241 |
157 |
$19.84 |
| J1030 |
Injection, methylprednisolone acetate, 40 mg |
259 |
209 |
$18.42 |
| C1894 |
Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser |
756 |
570 |
$16.69 |
| J0456 |
Injection, azithromycin, 500 mg |
111 |
52 |
$14.18 |
| J2470 |
Injection, pantoprazole sodium, 40 mg |
93 |
58 |
$12.73 |
| 81002 |
|
291 |
260 |
$12.21 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
277 |
240 |
$9.65 |
| J3490 |
Unclassified drugs |
27 |
20 |
$7.49 |
| J1596 |
Injection, glycopyrrolate, 0.1 mg |
391 |
331 |
$6.45 |
| J8597 |
Antiemetic drug, oral, not otherwise specified |
78 |
72 |
$4.89 |
| 36416 |
|
26 |
17 |
$0.22 |
| C1887 |
Catheter, guiding (may include infusion/perfusion capability) |
392 |
284 |
$0.00 |
| 69209 |
|
13 |
13 |
$0.00 |
| G0390 |
Trauma response team associated with hospital critical care service |
204 |
155 |
$0.00 |
| H1000 |
Prenatal care, at-risk assessment |
111 |
106 |
$0.00 |
| 29515 |
|
57 |
49 |
$0.00 |
| 73000 |
|
18 |
14 |
$0.00 |
| 85384 |
|
20 |
12 |
$0.00 |
| C1729 |
Catheter, drainage |
138 |
86 |
$0.00 |
| C1713 |
Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) |
36 |
27 |
$0.00 |
| J2710 |
Injection, neostigmine methylsulfate, up to 0.5 mg |
43 |
31 |
$0.00 |
| C1751 |
Catheter, infusion, inserted peripherally, centrally or midline (other than hemodialysis) |
15 |
12 |
$0.00 |
| A9552 |
Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries |
13 |
12 |
$0.00 |
| 51702 |
|
25 |
12 |
$0.00 |
| C1758 |
Catheter, ureteral |
21 |
13 |
$0.00 |
| C1769 |
Guide wire |
888 |
663 |
$0.00 |
| J2785 |
Injection, regadenoson, 0.1 mg |
576 |
489 |
$0.00 |
| A9500 |
Technetium tc-99m sestamibi, diagnostic, per study dose |
598 |
497 |
$0.00 |
| A9270 |
Non-covered item or service |
287 |
85 |
$0.00 |
| A9555 |
Rubidium rb-82, diagnostic, per study dose, up to 60 millicuries |
14 |
13 |
$0.00 |
| A4648 |
Tissue marker, implantable, any type, each |
96 |
85 |
$0.00 |
| C1726 |
Catheter, balloon dilatation, non-vascular |
15 |
13 |
$0.00 |
| 94644 |
|
15 |
13 |
$0.00 |
| 51798 |
|
54 |
47 |
$0.00 |
| 74022 |
|
17 |
13 |
$0.00 |
| 96368 |
|
15 |
13 |
$0.00 |
| 0001A |
|
14 |
14 |
$0.00 |
| 00952 |
|
22 |
13 |
$0.00 |