| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $255 | $255 | $255 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $99 | $106 | $109 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $138 | $141 | $143 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $185 | $197 | $210 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $201 | $231 | $274 |
| Office visit established patient minimal CPT 99211 • Office Visits | $24 | $44 | $53 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $51 | $60 | $65 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $81 | $98 | $107 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $115 | $143 | $160 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $164 | $188 | $208 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $114 | $130 | $146 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $136 | $141 | $146 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $146 | $196 | $269 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $44 | $54 | $64 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $64 | $80 | $97 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $90 | $104 | $118 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $64 | $81 | $97 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $89 | $100 | $122 |
| Consultation office straightforward CPT 99241 • Office Visits | $63 | $63 | $63 |
| Consultation office low complexity CPT 99243 • Office Visits | $124 | $143 | $162 |
| Consultation office high complexity CPT 99245 • Office Visits | $206 | $236 | $295 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $544 | $544 | $544 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $40 | $40 | $40 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $876 | $876 | $876 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $811 | $811 | $811 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $374 | $374 | $374 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $175 | $175 | $175 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $40 | $40 | $40 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $40 | $40 | $40 |
| Intravitreal injection therapeutic agent CPT 67028 • Ophthalmology | $69 | $69 | $69 |
| Retinal detachment repair with vitrectomy CPT 67108 • Ophthalmology | $887 | $887 | $887 |
| Retinal photocoagulation treatment CPT 67210 • Ophthalmology | $384 | $384 | $384 |
| Retinal treatment extensive photocoagulation CPT 67228 • Ophthalmology | $254 | $254 | $254 |
| Strabismus surgery one horizontal muscle CPT 67311 • Ophthalmology | $444 | $444 | $444 |
| Excision chalazion single CPT 67800 • Ophthalmology | $95 | $95 | $95 |
| Blepharoptosis repair levator resection CPT 67901 • Ophthalmology | $437 | $517 | $596 |
| Eye exam new patient intermediate CPT 92002 • Ophthalmology | $62 | $62 | $62 |
| Eye exam established patient comprehensive CPT 92014 • Ophthalmology | $60 | $60 | $60 |
| Visual field examination CPT 92083 • Ophthalmology | $47 | $47 | $47 |
| Retinal imaging OCT posterior segment CPT 92134 • Ophthalmology | $19 | $19 | $19 |
| Ophthalmic biometry IOL power calculation CPT 92136 • Ophthalmology | $58 | $58 | $58 |
| Arthrocentesis aspiration small joint CPT 20600 • Orthopedics | $42 | $42 | $42 |
| Arthrocentesis aspiration major joint CPT 20610 • Orthopedics | $41 | $51 | $60 |
| Cervical spine fusion anterior approach CPT 22551 • Orthopedics | $1,602 | $1,602 | $1,602 |
| Lumbar spine fusion posterior approach CPT 22612 • Orthopedics | $1,340 | $1,340 | $1,340 |
| Lumbar spine fusion combined approach CPT 22633 • Orthopedics | $1,684 | $1,684 | $1,685 |
| Lateral epicondylitis open treatment CPT 24357 • Orthopedics | $351 | $351 | $351 |
| Total hip replacement CPT 27130 • Orthopedics | $1,193 | $1,193 | $1,193 |
| Hip replacement conversion to total CPT 27132 • Orthopedics | $1,396 | $1,396 | $1,396 |
| Open treatment femoral fracture CPT 27236 • Orthopedics | $981 | $981 | $981 |