| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $85 | $85 | $85 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $106 | $106 | $106 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $115 | $115 | $116 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $114 | $134 | $153 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $88 | $88 | $88 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $122 | $122 | $122 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $80 | $80 | $80 |
| Consultation office low complexity CPT 99243 • Office Visits | $68 | $92 | $115 |
| Consultation office high complexity CPT 99245 • Office Visits | $216 | $216 | $216 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $1,170 | $1,170 | $1,170 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $243 | $243 | $243 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $497 | $497 | $497 |
| Retinal treatment extensive photocoagulation CPT 67228 • Ophthalmology | $337 | $337 | $337 |
| Blepharoptosis repair levator resection CPT 67901 • Ophthalmology | $787 | $787 | $787 |
| Eye exam established patient intermediate CPT 92012 • Ophthalmology | $39 | $39 | $39 |
| Visual field examination CPT 92083 • Ophthalmology | $47 | $47 | $47 |
| Retinal imaging OCT posterior segment CPT 92134 • Ophthalmology | $30 | $30 | $30 |
| Arthrocentesis aspiration small joint CPT 20600 • Orthopedics | $32 | $32 | $32 |
| Arthrocentesis aspiration major joint CPT 20610 • Orthopedics | $59 | $59 | $59 |
| Cervical spine fusion anterior approach CPT 22551 • Orthopedics | $1,633 | $1,633 | $1,633 |
| Lumbar spine fusion combined approach CPT 22633 • Orthopedics | $1,730 | $1,730 | $1,730 |
| Lateral epicondylitis open treatment CPT 24357 • Orthopedics | $385 | $385 | $385 |
| Treatment intertrochanteric femoral fracture CPT 27244 • Orthopedics | $1,148 | $1,148 | $1,148 |
| Treatment intertrochanteric fracture with plate/screw CPT 27245 • Orthopedics | $1,146 | $1,146 | $1,146 |
| Total knee replacement CPT 27447 • Orthopedics | $1,202 | $1,202 | $1,202 |
| Open treatment tibial shaft fracture CPT 27756 • Orthopedics | $539 | $539 | $539 |
| Bunionectomy with osteotomy CPT 28296 • Orthopedics | $789 | $789 | $789 |
| Arthroscopy knee with meniscectomy CPT 29881 • Orthopedics | $505 | $505 | $505 |
| Sacroiliac joint injection CPT 27096 • Pain Management | $146 | $146 | $146 |
| Epidural injection cervical or thoracic with imaging CPT 62321 • Pain Management | $215 | $215 | $216 |
| Plantar common digital nerve injection CPT 64455 • Pain Management | $41 | $41 | $41 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $145 | $145 | $145 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $75 | $75 | $75 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $363 | $363 | $363 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $197 | $197 | $197 |
| Molecular cytogenetics DNA probe each CPT 88271 • Pathology | $18 | $18 | $18 |
| Surgical pathology gross and micro exam level V CPT 88307 • Pathology | $235 | $235 | $235 |
| Frozen section pathology first specimen CPT 88331 • Pathology | $51 | $51 | $51 |
| Morphometric analysis tumor quantitative CPT 88360 • Pathology | $34 | $34 | $34 |
| Microdissection manual CPT 88381 • Pathology | $161 | $161 | $161 |
| Hot or cold packs application CPT 97010 • Physical Therapy | $4 | $4 | $5 |
| Electrical stimulation unattended CPT 97014 • Physical Therapy | $9 | $9 | $9 |
| Vasopneumatic device therapy CPT 97016 • Physical Therapy | $8 | $8 | $8 |
| Electrical stimulation attended each 15 minutes CPT 97032 • Physical Therapy | $10 | $10 | $10 |
| Ultrasound therapy each 15 minutes CPT 97035 • Physical Therapy | $10 | $10 | $10 |
| Therapeutic exercises each 15 minutes CPT 97110 • Physical Therapy | $21 | $21 | $21 |
| Neuromuscular reeducation each 15 minutes CPT 97112 • Physical Therapy | $24 | $24 | $24 |
| Gait training each 15 minutes CPT 97116 • Physical Therapy | $21 | $21 | $21 |
| Manual therapy one or more regions each 15 min CPT 97140 • Physical Therapy | $19 | $19 | $19 |
| Group therapeutic procedures CPT 97150 • Physical Therapy | $13 | $13 | $13 |