| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
Emergency department visit for the evaluation and management, high severity |
46,277 |
35,401 |
$9.63M |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
13,047 |
10,190 |
$7.67M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
26,412 |
17,685 |
$7.18M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
43,806 |
37,835 |
$6.22M |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
6,213 |
4,791 |
$3.32M |
| 70450 |
Computed tomography, head or brain; without contrast material |
11,065 |
8,353 |
$2.99M |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
7,799 |
6,551 |
$2.90M |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
33,937 |
25,219 |
$1.80M |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
7,606 |
3,015 |
$1.64M |
| G0378 |
Hospital observation service, per hour |
5,876 |
4,072 |
$1.50M |
| C1713 |
Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) |
1,697 |
1,327 |
$958K |
| 71045 |
Radiologic examination, chest; single view |
31,307 |
21,518 |
$915K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
31,060 |
12,036 |
$915K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
51,427 |
24,257 |
$896K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
3,483 |
2,968 |
$877K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
3,860 |
3,437 |
$869K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
27,190 |
9,950 |
$859K |
| 71046 |
Radiologic examination, chest; 2 views |
18,472 |
14,077 |
$823K |
| 87633 |
Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets |
2,270 |
2,155 |
$804K |
| 80053 |
Comprehensive metabolic panel |
81,465 |
60,664 |
$803K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
2,703 |
2,375 |
$775K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
3,293 |
2,362 |
$758K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
30,254 |
5,393 |
$750K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
22,952 |
17,767 |
$684K |
| 95810 |
Polysomnography; sleep staging with 4 or more additional parameters |
1,858 |
1,584 |
$683K |
| 36415 |
Collection of venous blood by venipuncture |
153,281 |
73,307 |
$678K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
2,240 |
1,893 |
$675K |
| 72131 |
|
2,644 |
2,174 |
$667K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
86,606 |
67,587 |
$649K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
22,330 |
4,693 |
$644K |
| 0202U |
Oncology (prostate), multianalyte, gene expression profiling |
2,038 |
1,732 |
$633K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
1,679 |
1,081 |
$595K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
2,074 |
1,857 |
$581K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
2,821 |
1,250 |
$563K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
1,849 |
1,412 |
$556K |
| 73630 |
|
7,292 |
6,115 |
$546K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
2,528 |
1,852 |
$546K |
| 93017 |
|
3,677 |
3,102 |
$525K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
18,367 |
4,389 |
$512K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
7,098 |
6,470 |
$507K |
| 69436 |
Tympanostomy (requiring insertion of ventilating tube), general anesthesia |
388 |
352 |
$504K |
| 71250 |
|
2,408 |
1,946 |
$437K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
14,658 |
12,696 |
$437K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
1,716 |
1,522 |
$432K |
| 73610 |
|
5,741 |
4,667 |
$404K |
| 70486 |
|
1,538 |
1,378 |
$398K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
8,358 |
6,375 |
$392K |
| 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 |
6,048 |
5,206 |
$355K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
22,801 |
11,345 |
$314K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
15,293 |
3,693 |
$302K |
| 0240U |
|
5,541 |
4,163 |
$299K |
| 84484 |
|
25,251 |
18,957 |
$296K |
| 72100 |
|
4,638 |
3,973 |
$287K |
| 72141 |
|
1,043 |
885 |
$282K |
| 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 |
3,598 |
2,824 |
$279K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
3,947 |
2,466 |
$276K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
10,899 |
4,430 |
$266K |
| 73130 |
|
4,277 |
3,587 |
$261K |
| 74018 |
|
3,348 |
3,007 |
$248K |
| 76536 |
|
2,076 |
1,803 |
$243K |
| 93971 |
|
2,080 |
1,796 |
$241K |
| 73564 |
|
3,173 |
2,603 |
$237K |
| 72110 |
|
2,217 |
1,926 |
$235K |
| 94060 |
|
3,470 |
1,981 |
$229K |
| 73030 |
|
4,105 |
3,358 |
$219K |
| 71271 |
|
833 |
744 |
$216K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
3,952 |
1,489 |
$199K |
| J2785 |
Injection, regadenoson, 0.1 mg |
1,885 |
1,615 |
$189K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
2,810 |
1,965 |
$189K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
14,693 |
9,748 |
$188K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
7,529 |
6,171 |
$183K |
| 82553 |
|
17,236 |
12,132 |
$179K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
6,655 |
3,943 |
$173K |
| 96367 |
|
4,159 |
1,574 |
$172K |
| A9502 |
Technetium tc-99m tetrofosmin, diagnostic, per study dose |
2,479 |
2,003 |
$169K |
| 72128 |
|
857 |
702 |
$154K |
| 83880 |
|
5,359 |
4,501 |
$151K |
| 84443 |
Thyroid stimulating hormone (TSH) |
10,258 |
9,242 |
$149K |
| 76775 |
|
1,296 |
1,072 |
$148K |
| 72050 |
|
1,489 |
1,211 |
$147K |
| 73221 |
|
501 |
452 |
$140K |
| 96376 |
|
6,507 |
4,306 |
$137K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
9,439 |
8,681 |
$135K |
| 83874 |
|
11,588 |
8,959 |
$133K |
| 11043 |
|
1,046 |
471 |
$128K |
| 83690 |
|
21,370 |
18,380 |
$127K |
| 84145 |
|
5,925 |
5,168 |
$124K |
| 73110 |
|
2,208 |
1,819 |
$121K |
| 72040 |
|
1,969 |
1,626 |
$118K |
| 87507 |
|
398 |
370 |
$114K |
| 81001 |
|
40,911 |
34,660 |
$114K |
| 76641 |
|
652 |
480 |
$112K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
1,979 |
1,877 |
$111K |
| 82550 |
|
18,648 |
13,289 |
$109K |
| 73562 |
|
1,635 |
1,344 |
$103K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
2,987 |
2,007 |
$102K |
| 73502 |
|
2,318 |
1,890 |
$101K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
14,893 |
9,875 |
$100K |
| 83605 |
|
10,122 |
8,411 |
$99K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
14,266 |
12,249 |
$98K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
4,281 |
3,807 |
$96K |
| 73590 |
|
1,767 |
1,450 |
$96K |
| 84703 |
|
13,977 |
12,148 |
$94K |
| 73080 |
|
1,422 |
1,187 |
$93K |
| 73700 |
|
622 |
540 |
$89K |
| 12001 |
|
1,136 |
1,025 |
$88K |
| 87040 |
|
7,256 |
5,693 |
$87K |
| 72070 |
|
1,422 |
1,206 |
$84K |
| 73090 |
|
1,466 |
1,180 |
$84K |
| 93225 |
|
1,265 |
1,079 |
$82K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
7,142 |
5,209 |
$78K |
| G0297 |
Low dose ct scan (ldct) for lung cancer screening |
361 |
334 |
$76K |
| 93880 |
|
257 |
208 |
$72K |
| 80061 |
Lipid panel |
6,474 |
5,146 |
$67K |
| 94664 |
|
2,952 |
2,497 |
$62K |
| 93970 |
|
258 |
233 |
$59K |
| 85379 |
|
6,653 |
6,051 |
$58K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
1,858 |
1,760 |
$55K |
| C1776 |
Joint device (implantable) |
50 |
42 |
$55K |
| 93925 |
|
310 |
274 |
$54K |
| 94726 |
|
1,409 |
1,290 |
$53K |
| 70498 |
|
196 |
161 |
$52K |
| 82728 |
|
4,478 |
4,002 |
$52K |
| 84439 |
|
6,301 |
5,610 |
$51K |
| 36600 |
|
3,008 |
1,978 |
$51K |
| 87081 |
|
8,488 |
7,904 |
$51K |
| 80074 |
|
1,367 |
1,234 |
$51K |
| 83735 |
|
8,691 |
6,612 |
$47K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
190 |
152 |
$47K |
| 76000 |
|
1,742 |
1,437 |
$46K |
| 86140 |
|
10,292 |
8,821 |
$46K |
| Q9962 |
High osmolar contrast material, 300-349 mg/ml iodine concentration, per ml |
1,794 |
1,577 |
$46K |
| 84702 |
|
3,479 |
2,742 |
$45K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
17,848 |
14,981 |
$45K |
| 97162 |
|
1,916 |
1,090 |
$45K |
| 85027 |
|
6,912 |
5,426 |
$45K |
| 87077 |
|
6,542 |
4,911 |
$44K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
1,085 |
976 |
$44K |
| 70496 |
|
226 |
178 |
$43K |
| 87186 |
|
5,110 |
4,430 |
$43K |
| 97161 |
|
2,245 |
1,222 |
$43K |
| Q9963 |
High osmolar contrast material, 350-399 mg/ml iodine concentration, per ml |
1,688 |
1,485 |
$41K |
| 94010 |
|
1,318 |
1,003 |
$40K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
21,642 |
16,030 |
$40K |
| A9577 |
Injection, gadobenate dimeglumine (multihance), per ml |
1,659 |
1,410 |
$39K |
| 82607 |
|
3,208 |
2,811 |
$38K |
| J0690 |
Injection, cefazolin sodium, 500 mg |
5,427 |
3,743 |
$38K |
| 82803 |
|
2,013 |
1,614 |
$38K |
| 90715 |
|
1,729 |
1,561 |
$37K |
| J1756 |
Injection, iron sucrose, 1 mg |
743 |
299 |
$37K |
| J2795 |
Injection, ropivacaine hydrochloride, 1 mg |
3,344 |
2,462 |
$36K |
| 85610 |
|
9,657 |
7,936 |
$35K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
499 |
414 |
$35K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
4,751 |
4,270 |
$33K |
| J2704 |
Injection, propofol, 10 mg |
9,520 |
7,071 |
$33K |
| 82805 |
|
645 |
468 |
$32K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
1,030 |
944 |
$31K |
| 87070 |
|
5,485 |
3,399 |
$31K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
991 |
933 |
$31K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
27,235 |
20,176 |
$30K |
| 76830 |
Ultrasound, transvaginal |
194 |
176 |
$30K |
| 10060 |
|
433 |
375 |
$29K |
| 85730 |
|
6,331 |
5,383 |
$29K |
| 76870 |
|
180 |
166 |
$29K |
| 45385 |
Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) |
79 |
65 |
$28K |
| M0243 |
Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring |
274 |
259 |
$27K |
| 93226 |
|
451 |
409 |
$27K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
12,188 |
9,035 |
$27K |
| 59025 |
Fetal non-stress test |
508 |
409 |
$26K |
| 81025 |
|
3,667 |
3,155 |
$26K |
| 77080 |
|
458 |
381 |
$26K |
| 83550 |
|
3,465 |
3,204 |
$25K |
| 85652 |
|
7,738 |
5,664 |
$24K |
| 73718 |
|
96 |
81 |
$23K |
| 82962 |
|
7,559 |
3,531 |
$23K |
| J3370 |
Injection, vancomycin hcl, 500 mg |
2,822 |
1,641 |
$22K |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
11,133 |
7,571 |
$22K |
| 29125 |
|
517 |
460 |
$22K |
| 94729 |
|
1,446 |
1,367 |
$22K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
124 |
77 |
$21K |
| C1788 |
Port, indwelling (implantable) |
369 |
160 |
$21K |
| 83540 |
|
3,762 |
3,477 |
$21K |
| 72072 |
|
947 |
802 |
$21K |
| 87420 |
|
1,542 |
1,445 |
$20K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
1,470 |
1,215 |
$20K |
| 80050 |
General health panel |
645 |
550 |
$20K |
| C1769 |
Guide wire |
406 |
303 |
$19K |
| 93270 |
|
1,042 |
910 |
$19K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
2,240 |
1,963 |
$19K |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
2,910 |
2,274 |
$19K |
| 82150 |
|
3,131 |
2,739 |
$19K |
| 93798 |
|
872 |
179 |
$19K |
| 86850 |
|
2,389 |
1,750 |
$18K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
10,250 |
6,830 |
$18K |
| 93303 |
Transthoracic echocardiography for congenital cardiac anomalies, follow-up or limited study |
105 |
99 |
$18K |
| J1170 |
Injection, hydromorphone, up to 4 mg |
5,925 |
3,333 |
$18K |
| 83615 |
|
2,236 |
1,968 |
$16K |
| A9579 |
Injection, gadolinium-based magnetic resonance contrast agent, not otherwise specified (nos), per ml |
475 |
448 |
$16K |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
470 |
432 |
$16K |
| 45378 |
Colonoscopy, flexible; diagnostic, including collection of specimen(s) |
69 |
45 |
$16K |
| 12002 |
|
135 |
112 |
$15K |
| 87486 |
|
453 |
414 |
$15K |
| 97165 |
|
417 |
349 |
$15K |
| 87581 |
|
449 |
414 |
$15K |
| J2469 |
Injection, palonosetron hcl, 25 mcg |
107 |
65 |
$14K |
| 84112 |
|
158 |
142 |
$14K |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
8,367 |
6,204 |
$14K |
| 96415 |
|
146 |
88 |
$14K |
| 36591 |
|
738 |
376 |
$14K |
| 70491 |
|
57 |
37 |
$13K |
| 87205 |
|
3,265 |
2,836 |
$13K |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
8,820 |
6,663 |
$13K |
| 64721 |
|
33 |
12 |
$12K |
| 54160 |
|
40 |
39 |
$12K |
| 73060 |
|
221 |
172 |
$12K |
| 83516 |
|
638 |
451 |
$12K |
| 82731 |
|
175 |
157 |
$11K |
| C9113 |
Injection, pantoprazole sodium, per vial |
2,321 |
1,724 |
$11K |
| 94760 |
|
1,524 |
941 |
$11K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
407 |
369 |
$11K |
| 78227 |
|
105 |
69 |
$10K |
| 82746 |
|
846 |
760 |
$10K |
| 74178 |
|
16 |
12 |
$10K |
| 81003 |
|
4,558 |
4,015 |
$9K |
| J0171 |
Injection, adrenalin, epinephrine, 0.1 mg |
917 |
667 |
$9K |
| 82565 |
|
1,170 |
960 |
$9K |
| 73560 |
|
136 |
112 |
$8K |
| 84100 |
|
2,147 |
1,616 |
$8K |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
5,054 |
2,585 |
$8K |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
1,878 |
964 |
$8K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
74 |
67 |
$8K |
| 80320 |
|
257 |
215 |
$8K |
| 82570 |
|
1,891 |
1,672 |
$8K |
| 86900 |
|
3,030 |
2,501 |
$8K |
| 72170 |
|
167 |
135 |
$8K |
| 86901 |
|
2,921 |
2,488 |
$8K |
| 73552 |
|
130 |
116 |
$7K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
404 |
333 |
$7K |
| 82784 |
|
678 |
577 |
$7K |
| 99152 |
|
332 |
273 |
$7K |
| 82140 |
|
572 |
460 |
$7K |
| M0245 |
Intravenous infusion, bamlanivimab and etesevimab, includes infusion and post administration monitoring |
60 |
56 |
$7K |
| 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 |
13 |
13 |
$7K |
| 83518 |
|
766 |
654 |
$7K |
| 12011 |
|
58 |
49 |
$6K |
| J0897 |
Injection, denosumab, 1 mg |
14 |
13 |
$6K |
| 95811 |
|
31 |
26 |
$6K |
| J2543 |
Injection, piperacillin sodium/tazobactam sodium, 1 gram/0.125 grams (1.125 grams) |
521 |
322 |
$6K |
| 83520 |
|
360 |
286 |
$6K |
| M0247 |
Intravenous infusion, sotrovimab, includes infusion and post administration monitoring |
51 |
49 |
$6K |
| 86038 |
|
607 |
554 |
$6K |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
247 |
212 |
$6K |
| 84156 |
|
1,370 |
1,012 |
$6K |
| 96368 |
|
210 |
153 |
$6K |
| 78264 |
|
15 |
13 |
$6K |
| J1644 |
Injection, heparin sodium, per 1000 units |
1,826 |
800 |
$6K |
| 97163 |
|
144 |
131 |
$5K |
| 82948 |
|
1,018 |
502 |
$5K |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
3,034 |
2,390 |
$5K |
| J1815 |
Injection, insulin, per 5 units |
671 |
242 |
$5K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
202 |
188 |
$5K |
| 82947 |
|
1,731 |
968 |
$5K |
| 71111 |
|
70 |
44 |
$5K |
| 80076 |
|
646 |
567 |
$5K |
| J2550 |
Injection, promethazine hcl, up to 50 mg |
3,250 |
2,371 |
$4K |
| 82043 |
|
772 |
563 |
$4K |
| 84550 |
|
1,201 |
1,030 |
$4K |
| 84436 |
|
809 |
745 |
$4K |
| 97597 |
|
201 |
125 |
$4K |
| 45384 |
|
28 |
13 |
$4K |
| M0222 |
Intravenous injection, bebtelovimab, includes injection and post administration monitoring |
27 |
25 |
$4K |
| J0561 |
Injection, penicillin g benzathine, 100,000 units |
33 |
29 |
$4K |
| A9537 |
Technetium tc-99m mebrofenin, diagnostic, per study dose, up to 15 millicuries |
234 |
200 |
$4K |
| 82248 |
|
750 |
557 |
$4K |
| J3490 |
Unclassified drugs |
648 |
210 |
$4K |
| 72082 |
|
26 |
26 |
$3K |
| J2710 |
Injection, neostigmine methylsulfate, up to 0.5 mg |
1,546 |
1,181 |
$3K |
| 86200 |
|
297 |
272 |
$3K |
| J1453 |
Injection, fosaprepitant, 1 mg |
20 |
12 |
$3K |
| 73200 |
|
12 |
12 |
$3K |
| 84480 |
|
276 |
231 |
$3K |
| 83921 |
|
169 |
160 |
$3K |
| J7050 |
Infusion, normal saline solution, 250 cc |
1,544 |
1,209 |
$3K |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
2,197 |
1,864 |
$3K |
| 64450 |
|
61 |
40 |
$3K |
| 36416 |
|
506 |
393 |
$3K |
| 76770 |
|
17 |
15 |
$3K |
| 86480 |
|
46 |
44 |
$3K |
| 94681 |
|
31 |
26 |
$2K |
| 82009 |
|
646 |
550 |
$2K |
| 86431 |
|
516 |
475 |
$2K |
| 73620 |
|
41 |
37 |
$2K |
| 86403 |
|
235 |
214 |
$2K |
| 73140 |
|
44 |
38 |
$2K |
| J2060 |
Injection, lorazepam, 2 mg |
1,348 |
1,003 |
$2K |
| 99153 |
Mod sedat endo service >5yrs |
84 |
63 |
$2K |
| 86003 |
|
28 |
28 |
$2K |
| 78226 |
|
18 |
16 |
$2K |
| 71101 |
|
25 |
25 |
$2K |
| 86920 |
|
64 |
38 |
$2K |
| P9016 |
Red blood cells, leukocytes reduced, each unit |
32 |
25 |
$2K |
| 10061 |
|
17 |
14 |
$2K |
| 77065 |
Tomosynthesis, mammo |
64 |
55 |
$2K |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
496 |
289 |
$2K |
| J2919 |
Injection, methylprednisolone sodium succinate, 5 mg |
307 |
223 |
$2K |
| 72020 |
|
55 |
40 |
$1K |
| J2360 |
Injection, orphenadrine citrate, up to 60 mg |
128 |
119 |
$1K |
| J7070 |
Infusion, d5w, 1000 cc |
559 |
249 |
$1K |
| 82247 |
|
307 |
206 |
$1K |
| 86665 |
|
39 |
36 |
$1K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
222 |
168 |
$1K |
| J0689 |
Injection, cefazolin sodium (baxter), not therapeutically equivalent to j0690, 500 mg |
258 |
164 |
$1K |
| 72202 |
|
13 |
13 |
$1K |
| 82747 |
|
65 |
61 |
$1K |
| 84238 |
|
37 |
23 |
$1K |
| 80179 |
|
104 |
93 |
$1K |
| 84520 |
|
135 |
119 |
$1K |
| 97116 |
|
64 |
26 |
$1K |
| 87210 |
|
207 |
195 |
$980.17 |
| 86803 |
|
89 |
80 |
$971.14 |
| 36430 |
|
15 |
14 |
$969.84 |
| 90714 |
|
59 |
52 |
$937.68 |
| M0239 |
Intravenous infusion, bamlanivimab-xxxx, includes infusion and post administration monitoring |
23 |
22 |
$870.16 |
| J3480 |
Injection, potassium chloride, per 2 meq |
188 |
115 |
$847.64 |
| A9270 |
Non-covered item or service |
1,611 |
385 |
$841.01 |
| 82272 |
|
225 |
206 |
$788.99 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
2,311 |
1,785 |
$772.45 |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
65 |
58 |
$752.87 |
| 0012A |
|
59 |
57 |
$717.06 |
| J2371 |
Injection, phenylephrine hydrochloride, 20 micrograms |
321 |
239 |
$715.77 |
| 87390 |
|
30 |
28 |
$664.67 |
| J1598 |
Injection, glycopyrrolate (fresenius kabi), not therapeutically equivalent to j1596, 0.1 mg |
125 |
99 |
$663.26 |
| 51701 |
|
13 |
13 |
$649.88 |
| 80143 |
|
46 |
44 |
$644.89 |
| 84481 |
|
52 |
47 |
$644.33 |
| 87340 |
|
79 |
73 |
$639.03 |
| 96523 |
|
172 |
110 |
$618.91 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
50 |
46 |
$617.03 |
| J0592 |
Injection, buprenorphine hydrochloride, 0.1 mg |
118 |
89 |
$610.81 |
| G0279 |
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) |
77 |
59 |
$571.60 |
| 86160 |
|
31 |
25 |
$570.29 |
| 87522 |
Neg quan hep c or qual rna |
15 |
14 |
$566.90 |
| 86664 |
|
39 |
36 |
$552.47 |
| J1953 |
Injection, levetiracetam, 10 mg |
55 |
41 |
$541.09 |
| A9541 |
Technetium tc-99m sulfur colloid, diagnostic, per study dose, up to 20 millicuries |
13 |
12 |
$509.62 |
| 73100 |
|
19 |
12 |
$502.97 |
| J1720 |
Injection, hydrocortisone sodium succinate, up to 100 mg |
34 |
25 |
$475.77 |
| 86663 |
|
39 |
36 |
$473.99 |
| 97166 |
|
28 |
25 |
$465.49 |
| 86704 |
|
47 |
44 |
$449.83 |
| 88304 |
|
14 |
13 |
$431.64 |
| J1171 |
Injection, hydromorphone, 0.1 mg |
88 |
80 |
$421.66 |
| J2470 |
Injection, pantoprazole sodium, 40 mg |
106 |
92 |
$409.37 |
| 73522 |
|
20 |
17 |
$393.15 |
| 99406 |
|
39 |
37 |
$378.88 |
| G0379 |
Direct admission of patient for hospital observation care |
93 |
81 |
$372.67 |
| J0330 |
Injection, succinylcholine chloride, up to 20 mg |
102 |
77 |
$371.89 |
| 84153 |
|
27 |
25 |
$345.78 |
| J1642 |
Injection, heparin sodium, (heparin lock flush), per 10 units |
594 |
349 |
$343.09 |
| 85018 |
|
208 |
133 |
$324.88 |
| 84132 |
|
56 |
36 |
$318.20 |
| 86780 |
|
25 |
24 |
$314.24 |
| J1596 |
Injection, glycopyrrolate, 0.1 mg |
55 |
47 |
$310.11 |
| J2272 |
Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg |
357 |
278 |
$307.21 |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
589 |
498 |
$294.86 |
| 0011A |
|
36 |
35 |
$289.28 |
| 85014 |
|
170 |
109 |
$276.23 |
| J2920 |
Injection, methylprednisolone sodium succinate, up to 40 mg |
122 |
54 |
$267.30 |
| 83525 |
|
26 |
26 |
$232.50 |
| J7060 |
5% dextrose/water (500 ml = 1 unit) |
90 |
57 |
$193.21 |
| 86308 |
|
41 |
40 |
$181.62 |
| 86039 |
|
13 |
12 |
$144.79 |
| J0702 |
Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg |
14 |
12 |
$135.56 |
| J2370 |
Injection, phenylephrine hcl, up to 1 ml |
230 |
159 |
$124.82 |
| 81015 |
|
514 |
438 |
$114.56 |
| 82270 |
|
27 |
24 |
$105.24 |
| G8978 |
Mobility: walking & moving around functional limitation, current status, at therapy episode outset and at reporting intervals |
65 |
30 |
$99.73 |
| J2003 |
Injection, lidocaine hydrochloride, 1 mg |
175 |
168 |
$81.71 |
| 89055 |
|
18 |
17 |
$79.71 |
| J1940 |
Injection, furosemide, up to 20 mg |
35 |
25 |
$64.10 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
77 |
64 |
$21.03 |
| G8979 |
Mobility: walking & moving around functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting |
28 |
25 |
$0.00 |