| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $524 | $524 | $524 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $111 | $123 | $134 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $159 | $159 | $159 |
| EMG needle each extremity complete CPT 95886 • Neurology | $118 | $118 | $118 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $108 | $108 | $108 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $109 | $122 | $135 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $212 | $212 | $212 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $344 | $344 | $344 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $79 | $85 | $91 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $138 | $138 | $138 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $210 | $210 | $210 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $246 | $246 | $246 |
| Office visit established patient minimal CPT 99211 • Office Visits | $23 | $23 | $23 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $48 | $51 | $54 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $95 | $95 | $95 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $138 | $149 | $160 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $185 | $185 | $185 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $141 | $141 | $141 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $146 | $146 | $146 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $164 | $190 | $216 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $110 | $110 | $110 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $110 | $110 | $110 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $111 | $111 | $111 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $110 | $110 | $110 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $109 | $111 | $113 |
| Consultation office low complexity CPT 99243 • Office Visits | $129 | $129 | $129 |
| Consultation office high complexity CPT 99245 • Office Visits | $236 | $237 | $238 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $634 | $634 | $634 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $53 | $53 | $53 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $1,474 | $1,474 | $1,474 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $648 | $664 | $680 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $939 | $939 | $939 |
| Retinal photocoagulation treatment CPT 67210 • Ophthalmology | $697 | $697 | $697 |
| Retinal treatment extensive photocoagulation CPT 67228 • Ophthalmology | $432 | $445 | $459 |
| Strabismus surgery one horizontal muscle CPT 67311 • Ophthalmology | $650 | $650 | $650 |
| Blepharoptosis repair levator resection CPT 67901 • Ophthalmology | $1,039 | $1,039 | $1,039 |
| Eye exam new patient intermediate CPT 92002 • Ophthalmology | $106 | $106 | $106 |
| Retinal imaging OCT posterior segment CPT 92134 • Ophthalmology | $51 | $51 | $51 |
| Ophthalmic biometry IOL power calculation CPT 92136 • Ophthalmology | $61 | $61 | $61 |
| Arthrocentesis aspiration intermediate joint CPT 20605 • Orthopedics | $64 | $64 | $64 |
| Arthrocentesis aspiration major joint CPT 20610 • Orthopedics | $68 | $68 | $68 |
| Cervical spine fusion anterior approach CPT 22551 • Orthopedics | $1,983 | $1,983 | $1,983 |
| Lumbar spine fusion posterior approach CPT 22612 • Orthopedics | $1,855 | $1,855 | $1,855 |
| Lumbar spine fusion combined approach CPT 22633 • Orthopedics | $1,884 | $1,884 | $1,884 |
| Tendon sheath incision trigger finger CPT 26055 • Orthopedics | $313 | $313 | $313 |
| Total hip replacement CPT 27130 • Orthopedics | $1,510 | $1,510 | $1,510 |
| Hip replacement conversion to total CPT 27132 • Orthopedics | $1,963 | $1,963 | $1,963 |
| Open treatment femoral fracture CPT 27236 • Orthopedics | $1,405 | $1,405 | $1,405 |
| Partial knee replacement medial or lateral CPT 27446 • Orthopedics | $1,358 | $1,358 | $1,358 |
| Total knee replacement CPT 27447 • Orthopedics | $1,328 | $1,418 | $1,509 |