All 2,220 procedure codes billed by Medicaid providers in Hawaii, ranked by total spending.
| # | Code | Description | Total Paid |
|---|---|---|---|
| 1 | 99283 | Emergency department visit for the evaluation and management, moderate severity | $232.62M |
| 2 | 99213 | Office or other outpatient visit for the evaluation and management of an established patient, low complexity | $193.81M |
| 3 | 99284 | Emergency department visit for the evaluation and management, high severity | $179.47M |
| 4 | 99214 | Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity | $162.45M |
| 5 | 90999 | Unlisted dialysis procedure, inpatient or outpatient | $148.73M |
| 6 | 99285 | Emergency department visit for the evaluation and management, high severity with immediate threat to life | $129.95M |
| 7 | J0887 | Injection, epoetin beta, 1 microgram, (for esrd on dialysis) | $96.86M |
| 8 | H2021 | Community-based wrap-around services, per 15 minutes | $82.86M |
| 9 | S9122 | Home health aide or certified nurse assistant, providing care in the home; per hour | $80.90M |
| 10 | T2016 | Habilitation, residential, waiver; per diem | $77.71M |
| 11 | S5130 | Homemaker service, nos; per 15 minutes | $64.46M |
| 12 | 90837 | Psychotherapy, 53 minutes with patient | $51.12M |
| 13 | S5125 | Attendant care services; per 15 minutes | $50.06M |
| 14 | 99282 | Emergency department visit for the evaluation and management, low to moderate severity | $46.73M |
| 15 | 74177 | Computed tomography, abdomen and pelvis; with contrast material | $45.60M |
| 16 | J3490 | Unclassified drugs | $36.28M |
| 17 | 90832 | Psychotherapy, 30 minutes with patient | $33.84M |
| 18 | D9999 | Unspecified adjunctive procedure, by report | $32.29M |
| 19 | J3590 | Unclassified biologics | $31.94M |
| 20 | A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | $30.15M |
| 21 | G0378 | Hospital observation service, per hour | $30.06M |
| 22 | S9123 | Nursing care, in the home; by registered nurse, per hour (use for general nursing care only, not to be used when cpt codes 99500-99602 can be used) | $25.09M |
| 23 | H2032 | Activity therapy, per 15 minutes | $23.08M |
| 24 | 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | $22.88M |
| 25 | T2022 | Case management, per month | $22.77M |
| 26 | S5140 | Foster care, adult; per diem | $22.30M |
| 27 | H2015 | Comprehensive community support services, per 15 minutes | $19.66M |
| 28 | D0140 | Limited oral evaluation - problem focused | $17.87M |
| 29 | T2021 | Day habilitation, waiver; per 15 minutes | $17.60M |
| 30 | H2019 | Therapeutic behavioral services, per 15 minutes | $17.57M |
| 31 | 74176 | Computed tomography, abdomen and pelvis; without contrast material | $15.03M |
| 32 | S5170 | Home delivered meals, including preparation; per meal | $14.94M |
| 33 | D0120 | Periodic oral evaluation - established patient | $13.39M |
| 34 | D1120 | Prophylaxis - child | $13.06M |
| 35 | A0430 | Ambulance service, conventional air services, transport, one way (fixed wing) | $12.89M |
| 36 | Q4081 | Injection, epoetin alfa, 100 units (for esrd on dialysis) | $12.13M |
| 37 | 97110 | Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion | $11.94M |
| 38 | 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | $11.91M |
| 39 | 80307 | Drug test(s), presumptive, any number of drug classes; immunoassay | $11.84M |
| 40 | 99281 | Emergency department visit for the evaluation and management, self-limited or minor | $11.72M |
| 41 | 99291 | Critical care, evaluation and management of the critically ill patient, first 30-74 minutes | $11.19M |
| 42 | 77067 | Screening mammography, bilateral, including computer-aided detection | $11.02M |
| 43 | 99509 | Home visit for assistance with activities of daily living and personal care | $10.73M |
| 44 | A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | $10.60M |
| 45 | 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | $10.35M |
| 46 | 80061 | Lipid panel | $9.81M |
| 47 | 90834 | Psychotherapy, 45 minutes with patient | $9.62M |
| 48 | 88305 | Level IV - Surgical pathology, gross and microscopic examination | $9.45M |
| 49 | T1002 | Rn services, up to 15 minutes | $9.31M |
| 50 | 87491 | Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe | $9.30M |
| 51 | S5105 | Day care services, center-based; services not included in program fee, per diem | $9.21M |
| 52 | T2046 | Hospice long term care, room and board only; per diem | $9.13M |
| 53 | 99233 | Prolong inpt eval add15 m | $9.03M |
| 54 | 93306 | Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete | $8.98M |
| 55 | T2025 | Waiver services; not otherwise specified (nos) | $8.65M |
| 56 | H2011 | Crisis intervention service, per 15 minutes | $8.65M |
| 57 | 84443 | Thyroid stimulating hormone (TSH) | $8.27M |
| 58 | G0467 | Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a fqhc visit | $8.21M |
| 59 | H0019 | Behavioral health; long-term residential (non-medical, non-acute care in a residential treatment program where stay is typically longer than 30 days), without room and board, per diem | $7.71M |
| 60 | 92014 | Ophthalmological services: medical examination and evaluation, comprehensive, established patient | $7.58M |
| 61 | 87591 | Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe | $7.49M |
| 62 | H0018 | Behavioral health; short-term residential (non-hospital residential treatment program), without room and board, per diem | $7.39M |
| 63 | H0020 | Alcohol and/or drug services; methadone administration and/or service (provision of the drug by a licensed program) | $6.66M |
| 64 | H2012 | Behavioral health day treatment, per hour | $6.61M |
| 65 | 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 | $6.57M |
| 66 | 99232 | Subsequent hospital care, per day, moderate complexity | $6.26M |
| 67 | 99203 | Office or other outpatient visit for the evaluation and management of a new patient, low complexity | $6.14M |
| 68 | 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | $5.96M |
| 69 | 99215 | Prolong outpt/office vis | $5.89M |
| 70 | D2930 | Prefabricated stainless steel crown - primary tooth | $5.73M |
| 71 | G0483 | 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; 22 or more drug class(es), including metabolite(s) if performed | $5.68M |
| 72 | 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | $5.58M |
| 73 | D1206 | Topical application of fluoride varnish | $5.29M |
| 74 | 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | $5.11M |
| 75 | 87502 | Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets | $5.03M |
| 76 | 78815 | Positron emission tomography (PET) for limited area imaging | $4.91M |
| 77 | 82306 | Vitamin D; 25 hydroxy, includes fraction(s), if performed | $4.83M |
| 78 | 90833 | Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) | $4.80M |
| 79 | 83036 | Hemoglobin; glycosylated (A1C) | $4.79M |
| 80 | 11042 | Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm | $4.62M |
| 81 | D0220 | Intraoral - periapical first radiographic image | $4.56M |
| 82 | 80053 | Comprehensive metabolic panel | $4.43M |
| 83 | D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | $4.39M |
| 84 | D0274 | Bitewings - four radiographic images | $4.32M |
| 85 | 87389 | Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies | $4.30M |
| 86 | D0272 | Bitewings - two radiographic images | $4.25M |
| 87 | D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | $4.25M |
| 88 | 45385 | Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) | $4.22M |
| 89 | 97140 | Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) | $4.16M |
| 90 | D7210 | Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth | $4.10M |
| 91 | G0481 | 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; 8-14 drug class(es), including metabolite(s) if performed | $4.04M |
| 92 | G0482 | 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; 15-21 drug class(es), including metabolite(s) if performed | $3.99M |
| 93 | 99204 | Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity | $3.97M |
| 94 | G2025 | Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only | $3.86M |
| 95 | J0882 | Injection, darbepoetin alfa, 1 microgram (for esrd on dialysis) | $3.84M |
| 96 | G0463 | Hospital outpatient clinic visit for assessment and management of a patient | $3.81M |
| 97 | L8699 | Prosthetic implant, not otherwise specified | $3.78M |
| 98 | 99442 | $3.73M | |
| 99 | 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | $3.71M |
| 100 | G0299 | Direct skilled nursing services of a registered nurse (rn) in the home health or hospice setting, each 15 minutes | $3.67M |
| 101 | 76811 | Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed | $3.65M |
| 102 | 70450 | Computed tomography, head or brain; without contrast material | $3.64M |
| 103 | 01967 | Neuraxial labor analgesia/anesthesia for planned vaginal delivery | $3.62M |
| 104 | H0015 | Alcohol and/or drug services; intensive outpatient (treatment program that operates at least 3 hours/day and at least 3 days/week and is based on an individualized treatment plan), including assessment, counseling; crisis intervention, and activity therapies or education | $3.60M |
| 105 | D1110 | Prophylaxis - adult | $3.57M |
| 106 | D0230 | Intraoral - periapical each additional radiographic image | $3.56M |
| 107 | 45380 | Colonoscopy, flexible; with biopsy, single or multiple | $3.55M |
| 108 | D7240 | Removal of impacted tooth - completely bony | $3.49M |
| 109 | 87624 | Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types | $3.46M |
| 110 | 97530 | Therapeutic activities, direct patient contact, each 15 minutes | $3.44M |
| 111 | 43239 | Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple | $3.44M |
| 112 | H0046 | Mental health services, not otherwise specified | $3.42M |
| 113 | 86003 | $3.37M | |
| 114 | 71046 | Radiologic examination, chest; 2 views | $3.27M |
| 115 | E0601 | Continuous positive airway pressure (cpap) device | $3.25M |
| 116 | 92012 | Ophthalmological services: medical examination and evaluation, intermediate, established patient | $3.21M |
| 117 | 70553 | Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences | $3.05M |
| 118 | D0330 | Panoramic radiographic image | $3.05M |
| 119 | 41899 | Unlisted procedure, dentoalveolar structures | $3.01M |
| 120 | 99223 | Prolong inpt eval add15 m | $2.97M |
| 121 | J7307 | Etonogestrel (contraceptive) implant system, including implant and supplies | $2.94M |
| 122 | 87481 | $2.88M | |
| 123 | 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | $2.86M |
| 124 | A0425 | Ground mileage, per statute mile | $2.82M |
| 125 | J0585 | Injection, onabotulinumtoxina, 1 unit | $2.81M |
| 126 | H0032 | Mental health service plan development by non-physician | $2.77M |
| 127 | 92250 | $2.72M | |
| 128 | 90960 | End-stage renal disease related services monthly, for patients 20 years and older, with 4 or more face-to-face visits | $2.67M |
| 129 | S0215 | Non-emergency transportation; mileage, per mile | $2.66M |
| 130 | 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 | $2.65M |
| 131 | A9276 | Sensor; invasive (e.g., subcutaneous), disposable, for use with non-durable medical equipment interstitial continuous glucose monitoring system, one unit = 1 day supply | $2.64M |
| 132 | 99441 | $2.63M | |
| 133 | D1351 | Sealant - per tooth | $2.62M |
| 134 | S9342 | Home therapy; enteral nutrition via pump; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (enteral formula and nursing visits coded separately), per diem | $2.61M |
| 135 | 11045 | $2.61M | |
| 136 | 80050 | General health panel | $2.55M |
| 137 | J9271 | Injection, pembrolizumab, 1 mg | $2.52M |
| 138 | S9088 | Services provided in an urgent care center (list in addition to code for service) | $2.51M |
| 139 | V2020 | Frames, purchases | $2.47M |
| 140 | S5102 | Day care services, adult; per diem | $2.44M |
| 141 | J1756 | Injection, iron sucrose, 1 mg | $2.43M |
| 142 | 90853 | Group psychotherapy (other than of a multiple-family group) | $2.42M |
| 143 | 98968 | $2.41M | |
| 144 | E1390 | Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate | $2.38M |
| 145 | D1208 | Topical application of fluoride, excluding varnish | $2.36M |
| 146 | H0044 | Supported housing, per month | $2.34M |
| 147 | G0151 | Services performed by a qualified physical therapist in the home health or hospice setting, each 15 minutes | $2.23M |
| 148 | 78452 | Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress | $2.23M |
| 149 | J7298 | Levonorgestrel-releasing intrauterine contraceptive system (mirena), 52 mg | $2.22M |
| 150 | T4527 | Adult sized disposable incontinence product, protective underwear/pull-on, large size, each | $2.08M |
| 151 | 66984 | Extracapsular cataract removal with insertion of intraocular lens prosthesis | $2.07M |
| 152 | 59025 | Fetal non-stress test | $2.01M |
| 153 | 92015 | Determination of refractive state | $2.00M |
| 154 | B4161 | Enteral formula, for pediatrics, hydrolyzed/amino acids and peptide chain proteins, includes fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit | $1.93M |
| 155 | 76815 | Ultrasound, pregnant uterus, real time with image documentation, limited | $1.93M |
| 156 | 76805 | Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation | $1.89M |
| 157 | 87651 | Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe | $1.88M |
| 158 | 92004 | Ophthalmological services: medical examination and evaluation, comprehensive, new patient | $1.87M |
| 159 | D7140 | Extraction, erupted tooth or exposed root | $1.86M |
| 160 | 86803 | $1.86M | |
| 161 | 36415 | Collection of venous blood by venipuncture | $1.85M |
| 162 | 76816 | Ultrasound, pregnant uterus, real time with image documentation, follow-up | $1.83M |
| 163 | T1015 | Clinic visit/encounter, all-inclusive | $1.83M |
| 164 | 99601 | $1.81M | |
| 165 | 90791 | Psychiatric diagnostic evaluation | $1.80M |
| 166 | 0241U | Neonatal screening for hereditary disorders, genomic sequence analysis panel | $1.80M |
| 167 | 90792 | Psychiatric diagnostic evaluation with medical services | $1.76M |
| 168 | 96361 | Intravenous infusion, hydration; each additional hour | $1.75M |
| 169 | D3330 | Endodontic therapy, molar tooth (excluding final restoration) | $1.69M |
| 170 | 97112 | Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination | $1.69M |
| 171 | T2020 | Day habilitation, waiver; per diem | $1.68M |
| 172 | T4526 | Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each | $1.67M |
| 173 | D2391 | Resin-based composite - one surface, posterior, primary or permanent | $1.67M |
| 174 | A9274 | External ambulatory insulin delivery system, disposable, each, includes all supplies and accessories | $1.61M |
| 175 | 83970 | $1.60M | |
| 176 | 98967 | $1.60M | |
| 177 | A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | $1.59M |
| 178 | 97153 | Adaptive behavior treatment by protocol, administered by technician, each 15 minutes | $1.57M |
| 179 | S9126 | Hospice care, in the home, per diem | $1.57M |
| 180 | G0470 | Federally qualified health center (fqhc) visit, mental health, established patient; a medically-necessary, face-to-face mental health encounter (one-on-one) between an established patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a mental health visit | $1.56M |
| 181 | A7030 | Full face mask used with positive airway pressure device, each | $1.56M |
| 182 | 96365 | Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour | $1.55M |
| 183 | 70551 | Magnetic resonance imaging, brain; without contrast material | $1.54M |
| 184 | D2150 | Silver amalgam - two surfaces, primary or permanent | $1.53M |
| 185 | 0002A | $1.52M | |
| 186 | 95811 | $1.52M | |
| 187 | 90472 | Immunization administration, each additional vaccine (list separately) | $1.49M |
| 188 | A0130 | Non-emergency transportation: wheelchair van | $1.49M |
| 189 | 0001A | $1.47M | |
| 190 | 87186 | $1.47M | |
| 191 | D0150 | Comprehensive oral evaluation - new or established patient | $1.47M |
| 192 | 84153 | $1.46M | |
| 193 | E2402 | Negative pressure wound therapy electrical pump, stationary or portable | $1.46M |
| 194 | 76856 | Ultrasound, pelvic (nonobstetric), real time with image documentation; complete | $1.44M |
| 195 | 71045 | Radiologic examination, chest; single view | $1.44M |
| 196 | 96413 | Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance | $1.42M |
| 197 | 87633 | Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets | $1.41M |
| 198 | 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | $1.40M |
| 199 | 76700 | Ultrasound, abdominal, real time with image documentation; complete | $1.39M |
| 200 | A0435 | Fixed wing air mileage, per statute mile | $1.37M |