All 2,913 procedure codes billed by Medicaid providers in South Carolina, ranked by total spending.
| # | Code | Description | Total Paid |
|---|---|---|---|
| 1 | T2016 | Habilitation, residential, waiver; per diem | $801.34M |
| 2 | 99213 | Office or other outpatient visit for the evaluation and management of an established patient, low complexity | $703.80M |
| 3 | 99214 | Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity | $610.88M |
| 4 | T1019 | Personal care services, per 15 minutes, not for an inpatient or resident of a hospital, nursing facility, icf/mr or imd, part of the individualized plan of treatment (code may not be used to identify services provided by home health aide or certified nurse assistant) | $443.00M |
| 5 | 90837 | Psychotherapy, 53 minutes with patient | $267.07M |
| 6 | T2046 | Hospice long term care, room and board only; per diem | $249.45M |
| 7 | 92507 | Treatment of speech, language, voice, communication, and/or auditory processing disorder | $241.88M |
| 8 | 97530 | Therapeutic activities, direct patient contact, each 15 minutes | $190.03M |
| 9 | T1015 | Clinic visit/encounter, all-inclusive | $185.57M |
| 10 | 36415 | Collection of venous blood by venipuncture | $176.29M |
| 11 | 99284 | Emergency department visit for the evaluation and management, high severity | $157.81M |
| 12 | 99283 | Emergency department visit for the evaluation and management, moderate severity | $153.63M |
| 13 | 90834 | Psychotherapy, 45 minutes with patient | $147.96M |
| 14 | 80053 | Comprehensive metabolic panel | $130.37M |
| 15 | 97110 | Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion | $118.09M |
| 16 | H0031 | Mental health assessment, by non-physician | $97.49M |
| 17 | S5102 | Day care services, adult; per diem | $91.15M |
| 18 | 99285 | Emergency department visit for the evaluation and management, high severity with immediate threat to life | $88.21M |
| 19 | 92508 | Group treatment of speech, language, voice, communication, and/or auditory processing disorder | $85.91M |
| 20 | 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | $85.52M |
| 21 | 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | $84.93M |
| 22 | H2017 | Psychosocial rehabilitation services, per 15 minutes | $75.82M |
| 23 | D1120 | Prophylaxis - child | $74.11M |
| 24 | S9126 | Hospice care, in the home, per diem | $73.65M |
| 25 | T2020 | Day habilitation, waiver; per diem | $73.24M |
| 26 | T1027 | Family training and counseling for child development, per 15 minutes | $69.49M |
| 27 | T1017 | Targeted case management, each 15 minutes | $69.09M |
| 28 | 90460 | Immunization administration through 18 years of age via any route, first or only component | $63.96M |
| 29 | S5130 | Homemaker service, nos; per 15 minutes | $63.65M |
| 30 | T2014 | Habilitation, prevocational, waiver; per diem | $63.18M |
| 31 | T1016 | Case management, each 15 minutes | $62.71M |
| 32 | 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | $62.42M |
| 33 | T1002 | Rn services, up to 15 minutes | $62.34M |
| 34 | D1110 | Prophylaxis - adult | $62.17M |
| 35 | D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | $61.02M |
| 36 | 90847 | Family psychotherapy with the patient present, 50 minutes | $60.86M |
| 37 | D0120 | Periodic oral evaluation - established patient | $60.66M |
| 38 | 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | $59.71M |
| 39 | 90792 | Psychiatric diagnostic evaluation with medical services | $58.54M |
| 40 | 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | $57.68M |
| 41 | 99282 | Emergency department visit for the evaluation and management, low to moderate severity | $57.32M |
| 42 | D2930 | Prefabricated stainless steel crown - primary tooth | $49.71M |
| 43 | 80048 | Basic metabolic panel (calcium, ionized) | $49.71M |
| 44 | A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | $49.07M |
| 45 | A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | $47.33M |
| 46 | S5145 | Foster care, therapeutic, child; per diem | $44.99M |
| 47 | Q9967 | Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml | $44.72M |
| 48 | G2067 | Medication assisted treatment, methadone; weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing, if performed (provision of the services by a medicare-enrolled opioid treatment program) | $43.86M |
| 49 | 90832 | Psychotherapy, 30 minutes with patient | $43.70M |
| 50 | D1206 | Topical application of fluoride varnish | $38.85M |
| 51 | T1502 | Administration of oral, intramuscular and/or subcutaneous medication by health care agency/professional, per visit | $37.43M |
| 52 | 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | $36.48M |
| 53 | D7140 | Extraction, erupted tooth or exposed root | $36.42M |
| 54 | 99203 | Office or other outpatient visit for the evaluation and management of a new patient, low complexity | $35.02M |
| 55 | 81025 | $34.38M | |
| 56 | D2391 | Resin-based composite - one surface, posterior, primary or permanent | $33.19M |
| 57 | 99204 | Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity | $30.94M |
| 58 | 99232 | Subsequent hospital care, per day, moderate complexity | $29.47M |
| 59 | H2026 | Ongoing support to maintain employment, per diem | $29.14M |
| 60 | 90846 | Family psychotherapy without the patient present, 50 minutes | $28.34M |
| 61 | 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | $27.85M |
| 62 | T1030 | Nursing care, in the home, by registered nurse, per diem | $27.83M |
| 63 | 99215 | Prolong outpt/office vis | $27.62M |
| 64 | 81001 | $27.39M | |
| 65 | 90935 | Hemodialysis procedure with single evaluation by a physician | $27.17M |
| 66 | S3870 | Comparative genomic hybridization (cgh) microarray testing for developmental delay, autism spectrum disorder and/or intellectual disability | $26.40M |
| 67 | D0150 | Comprehensive oral evaluation - new or established patient | $26.38M |
| 68 | D0272 | Bitewings - two radiographic images | $26.26M |
| 69 | 92014 | Ophthalmological services: medical examination and evaluation, comprehensive, established patient | $25.84M |
| 70 | D0330 | Panoramic radiographic image | $25.01M |
| 71 | 96365 | Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour | $24.90M |
| 72 | 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | $24.88M |
| 73 | 96361 | Intravenous infusion, hydration; each additional hour | $24.51M |
| 74 | J2350 | Injection, ocrelizumab, 1 mg | $24.46M |
| 75 | D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | $24.25M |
| 76 | 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 | $23.99M |
| 77 | J7030 | Infusion, normal saline solution , 1000 cc | $23.95M |
| 78 | 70553 | Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences | $23.92M |
| 79 | 88305 | Level IV - Surgical pathology, gross and microscopic examination | $23.89M |
| 80 | E1390 | Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate | $23.33M |
| 81 | D0274 | Bitewings - four radiographic images | $23.17M |
| 82 | H2014 | Skills training and development, per 15 minutes | $22.77M |
| 83 | A4554 | Disposable underpads, all sizes | $22.67M |
| 84 | E1399 | Durable medical equipment, miscellaneous | $22.59M |
| 85 | 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | $22.36M |
| 86 | 93306 | Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete | $21.97M |
| 87 | 59409 | Vaginal delivery only (with or without episiotomy and/or forceps) | $21.74M |
| 88 | D1351 | Sealant - per tooth | $21.48M |
| 89 | D7240 | Removal of impacted tooth - completely bony | $21.46M |
| 90 | 87636 | Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B | $21.20M |
| 91 | A0425 | Ground mileage, per statute mile | $20.93M |
| 92 | B4035 | Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape | $20.85M |
| 93 | T1005 | Respite care services, up to 15 minutes | $20.54M |
| 94 | 96374 | Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance | $20.45M |
| 95 | 80307 | Drug test(s), presumptive, any number of drug classes; immunoassay | $19.72M |
| 96 | 87491 | Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe | $19.60M |
| 97 | 76816 | Ultrasound, pregnant uterus, real time with image documentation, follow-up | $19.29M |
| 98 | 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | $19.14M |
| 99 | 87426 | Infectious agent antigen detection, SARS-CoV-2 (COVID-19) | $18.51M |
| 100 | T1024 | Evaluation and treatment by an integrated, specialty team contracted to provide coordinated care to multiple or severely handicapped children, per encounter | $18.35M |
| 101 | T1023 | Screening to determine the appropriateness of consideration of an individual for participation in a specified program, project or treatment protocol, per encounter | $18.15M |
| 102 | 92004 | Ophthalmological services: medical examination and evaluation, comprehensive, new patient | $17.39M |
| 103 | S9131 | Physical therapy; in the home, per diem | $17.33M |
| 104 | 99244 | Office or other outpatient consultation, moderate to high complexity | $17.31M |
| 105 | T1003 | Lpn/lvn services, up to 15 minutes | $17.10M |
| 106 | H2030 | Mental health clubhouse services, per 15 minutes | $17.06M |
| 107 | 97153 | Adaptive behavior treatment by protocol, administered by technician, each 15 minutes | $17.00M |
| 108 | H2016 | Comprehensive community support services, per diem | $16.83M |
| 109 | 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 | $16.79M |
| 110 | 90791 | Psychiatric diagnostic evaluation | $16.66M |
| 111 | 81003 | $16.35M | |
| 112 | 87637 | Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV | $16.29M |
| 113 | E0466 | Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) | $16.28M |
| 114 | J7050 | Infusion, normal saline solution, 250 cc | $16.08M |
| 115 | J3490 | Unclassified drugs | $15.94M |
| 116 | 95165 | Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy, multiple dose vials | $15.83M |
| 117 | 0241U | Neonatal screening for hereditary disorders, genomic sequence analysis panel | $15.74M |
| 118 | D0140 | Limited oral evaluation - problem focused | $15.44M |
| 119 | 71046 | Radiologic examination, chest; 2 views | $15.33M |
| 120 | 99281 | Emergency department visit for the evaluation and management, self-limited or minor | $14.94M |
| 121 | D7210 | Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth | $14.76M |
| 122 | 70450 | Computed tomography, head or brain; without contrast material | $14.63M |
| 123 | V2020 | Frames, purchases | $14.37M |
| 124 | 90461 | $14.17M | |
| 125 | 87502 | Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets | $14.15M |
| 126 | 96413 | Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance | $14.15M |
| 127 | D0220 | Intraoral - periapical first radiographic image | $14.07M |
| 128 | 74177 | Computed tomography, abdomen and pelvis; with contrast material | $13.65M |
| 129 | 96375 | Therapeutic injection; each additional sequential IV push | $13.46M |
| 130 | C9803 | Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source | $13.35M |
| 131 | J7189 | Factor viia (antihemophilic factor, recombinant), (novoseven rt), 1 microgram | $13.31M |
| 132 | S5125 | Attendant care services; per 15 minutes | $13.15M |
| 133 | 11042 | Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm | $13.14M |
| 134 | D1208 | Topical application of fluoride, excluding varnish | $13.12M |
| 135 | J7120 | Ringers lactate infusion, up to 1000 cc | $13.10M |
| 136 | G9153 | Mapcp demonstration - physician incentive pool | $13.05M |
| 137 | J7040 | Infusion, normal saline solution, sterile (500 ml = 1 unit) | $12.89M |
| 138 | X1939 | $12.77M | |
| 139 | 87428 | $12.65M | |
| 140 | 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 | $12.58M |
| 141 | A9552 | Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries | $12.42M |
| 142 | 87070 | $12.36M | |
| 143 | J2357 | Injection, omalizumab, 5 mg | $12.09M |
| 144 | B9998 | Noc for enteral supplies | $12.08M |
| 145 | T5999 | Supply, not otherwise specified | $12.04M |
| 146 | J1745 | Injection, infliximab, excludes biosimilar, 10 mg | $12.02M |
| 147 | H2037 | Developmental delay prevention activities, dependent child of client, per 15 minutes | $11.53M |
| 148 | 71045 | Radiologic examination, chest; single view | $11.47M |
| 149 | H0020 | Alcohol and/or drug services; methadone administration and/or service (provision of the drug by a licensed program) | $11.33M |
| 150 | S9482 | Family stabilization services, per 15 minutes | $11.30M |
| 151 | 87086 | Culture, bacterial; quantitative colony count, urine | $11.23M |
| 152 | 76811 | Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed | $11.20M |
| 153 | 70551 | Magnetic resonance imaging, brain; without contrast material | $10.91M |
| 154 | 90853 | Group psychotherapy (other than of a multiple-family group) | $10.78M |
| 155 | G0463 | Hospital outpatient clinic visit for assessment and management of a patient | $10.34M |
| 156 | 76819 | Fetal biophysical profile; without non-stress testing | $10.31M |
| 157 | 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | $10.31M |
| 158 | H0032 | Mental health service plan development by non-physician | $10.26M |
| 159 | A0120 | Non-emergency transportation: mini-bus, mountain area transports, or other transportation systems | $10.20M |
| 160 | 86850 | $10.20M | |
| 161 | T4528 | Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each | $10.06M |
| 162 | 99233 | Prolong inpt eval add15 m | $9.86M |
| 163 | 92015 | Determination of refractive state | $9.84M |
| 164 | T4527 | Adult sized disposable incontinence product, protective underwear/pull-on, large size, each | $9.81M |
| 165 | X0241 | $9.73M | |
| 166 | 87798 | Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism | $9.68M |
| 167 | 87081 | $9.63M | |
| 168 | 96360 | Intravenous infusion, hydration; initial, 31 minutes to 1 hour | $9.59M |
| 169 | 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 | $9.59M |
| 170 | A9585 | Injection, gadobutrol, 0.1 ml | $9.51M |
| 171 | X6987 | $9.45M | |
| 172 | S9445 | Patient education, not otherwise classified, non-physician provider, individual, per session | $9.38M |
| 173 | 87811 | Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) | $9.37M |
| 174 | 99309 | Subsequent nursing facility care, per day, low to moderate complexity | $9.29M |
| 175 | J0178 | Injection, aflibercept, 1 mg | $8.82M |
| 176 | J3380 | Injection, vedolizumab, intravenous, 1 mg | $8.82M |
| 177 | 99469 | Subsequent inpatient neonatal critical care, per day, 28 days or younger | $8.81M |
| 178 | B4149 | Enteral formula, manufactured blenderized natural foods with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit | $8.80M |
| 179 | 96367 | $8.72M | |
| 180 | D2393 | Resin-based composite - three surfaces, posterior, primary or permanent | $8.58M |
| 181 | A9276 | Sensor; invasive (e.g., subcutaneous), disposable, for use with non-durable medical equipment interstitial continuous glucose monitoring system, one unit = 1 day supply | $8.56M |
| 182 | 95810 | Polysomnography; sleep staging with 4 or more additional parameters | $8.47M |
| 183 | S5161 | Emergency response system; service fee, per month (excludes installation and testing) | $8.43M |
| 184 | D0230 | Intraoral - periapical each additional radiographic image | $8.42M |
| 185 | 59025 | Fetal non-stress test | $8.19M |
| 186 | D3220 | Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction | $7.97M |
| 187 | 01967 | Neuraxial labor analgesia/anesthesia for planned vaginal delivery | $7.75M |
| 188 | H0001 | Alcohol and/or drug assessment | $7.72M |
| 189 | J2323 | Injection, natalizumab, 1 mg | $7.53M |
| 190 | 92340 | Fitting of spectacles, except for aphakia; monofocal | $7.48M |
| 191 | T4534 | Youth sized disposable incontinence product, protective underwear/pull-on, each | $7.32M |
| 192 | T4543 | Adult sized disposable incontinence product, protective brief/diaper, above extra large, each | $7.16M |
| 193 | T4526 | Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each | $7.09M |
| 194 | H0005 | Alcohol and/or drug services; group counseling by a clinician | $6.88M |
| 195 | U0002 | 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc | $6.86M |
| 196 | 69436 | Tympanostomy (requiring insertion of ventilating tube), general anesthesia | $6.80M |
| 197 | 90378 | $6.80M | |
| 198 | 95004 | Percutaneous tests with allergenic extracts, immediate type reaction | $6.72M |
| 199 | 87651 | Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe | $6.72M |
| 200 | D9248 | $6.56M |