| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $99 | $99 | $99 |
| EMG needle each extremity complete CPT 95886 • Neurology | $73 | $73 | $73 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $79 | $79 | $80 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $98 | $98 | $98 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $117 | $117 | $118 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $155 | $155 | $155 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $255 | $255 | $256 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $72 | $72 | $73 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $107 | $107 | $107 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $127 | $127 | $127 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $160 | $182 | $203 |
| Office visit established patient minimal CPT 99211 • Office Visits | $40 | $40 | $40 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $40 | $40 | $40 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $59 | $59 | $59 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $82 | $93 | $104 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $140 | $140 | $140 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $146 | $146 | $146 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $146 | $146 | $146 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $146 | $160 | $173 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $64 | $64 | $64 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $64 | $64 | $64 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $90 | $90 | $90 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $64 | $64 | $64 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $89 | $89 | $90 |
| Consultation office low complexity CPT 99243 • Office Visits | $124 | $124 | $124 |
| Consultation office high complexity CPT 99245 • Office Visits | $206 | $206 | $206 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $544 | $544 | $544 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $40 | $40 | $40 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $811 | $811 | $812 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $262 | $318 | $374 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $405 | $405 | $405 |
| Intravitreal injection therapeutic agent CPT 67028 • Ophthalmology | $69 | $77 | $85 |
| Retinal detachment repair with vitrectomy CPT 67108 • Ophthalmology | $40 | $464 | $888 |
| 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 | $96 | $96 | $96 |
| Blepharoptosis repair levator resection CPT 67901 • Ophthalmology | $596 | $596 | $596 |
| Lacrimal punctum closure by plug CPT 68761 • Ophthalmology | $86 | $86 | $86 |
| Eye exam new patient intermediate CPT 92002 • Ophthalmology | $62 | $62 | $62 |
| Eye exam established patient intermediate CPT 92012 • Ophthalmology | $65 | $65 | $65 |
| Eye exam established patient comprehensive CPT 92014 • Ophthalmology | $94 | $94 | $94 |
| Retinal imaging OCT posterior segment CPT 92134 • Ophthalmology | $31 | $31 | $31 |
| Ophthalmic biometry IOL power calculation CPT 92136 • Ophthalmology | $58 | $58 | $58 |
| Fundus photography CPT 92250 • Ophthalmology | $40 | $41 | $42 |
| Arthrocentesis aspiration intermediate joint CPT 20605 • Orthopedics | $33 | $39 | $46 |
| Arthrocentesis aspiration major joint CPT 20610 • Orthopedics | $41 | $41 | $41 |
| 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 | $1,685 | $1,685 | $1,685 |