| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $240 | $240 | $240 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $74 | $89 | $97 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $96 | $132 | $149 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $224 | $228 | $237 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $180 | $238 | $296 |
| Office visit established patient minimal CPT 99211 • Office Visits | $23 | $28 | $31 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $36 | $62 | $76 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $60 | $101 | $122 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $131 | $159 | $172 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $147 | $211 | $243 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $144 | $144 | $144 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $158 | $158 | $158 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $181 | $181 | $181 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $60 | $60 | $60 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $95 | $95 | $95 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $91 | $91 | $91 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $83 | $83 | $83 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $156 | $156 | $156 |
| Consultation office low complexity CPT 99243 • Office Visits | $155 | $155 | $155 |
| Consultation office high complexity CPT 99245 • Office Visits | $254 | $254 | $254 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $651 | $770 | $829 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $70 | $70 | $70 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $1,564 | $1,596 | $1,660 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $253 | $253 | $253 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $1,079 | $1,079 | $1,079 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $581 | $581 | $581 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $369 | $369 | $369 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $693 | $798 | $987 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $509 | $650 | $720 |
| Intravitreal injection therapeutic agent CPT 67028 • Ophthalmology | $301 | $301 | $301 |
| Retinal detachment repair with vitrectomy CPT 67108 • Ophthalmology | $2,192 | $2,192 | $2,192 |
| Retinal photocoagulation treatment CPT 67210 • Ophthalmology | $613 | $613 | $613 |
| Retinal treatment extensive photocoagulation CPT 67228 • Ophthalmology | $1,397 | $1,397 | $1,397 |
| Strabismus surgery one horizontal muscle CPT 67311 • Ophthalmology | $373 | $527 | $604 |
| Excision chalazion single CPT 67800 • Ophthalmology | $176 | $176 | $176 |
| Blepharoptosis repair levator resection CPT 67901 • Ophthalmology | $618 | $618 | $618 |
| Lacrimal punctum closure by plug CPT 68761 • Ophthalmology | $156 | $156 | $156 |
| Eye exam new patient intermediate CPT 92002 • Ophthalmology | $61 | $61 | $61 |
| Eye exam new patient comprehensive CPT 92004 • Ophthalmology | $61 | $61 | $61 |
| Eye exam established patient intermediate CPT 92012 • Ophthalmology | $61 | $61 | $61 |
| Eye exam established patient comprehensive CPT 92014 • Ophthalmology | $61 | $61 | $61 |
| Visual field examination CPT 92083 • Ophthalmology | $35 | $35 | $35 |
| Retinal imaging OCT posterior segment CPT 92134 • Ophthalmology | $34 | $34 | $34 |
| Ophthalmic biometry IOL power calculation CPT 92136 • Ophthalmology | $19 | $19 | $19 |
| Fundus photography CPT 92250 • Ophthalmology | $23 | $23 | $23 |
| Arthrocentesis aspiration small joint CPT 20600 • Orthopedics | $41 | $55 | $72 |
| Arthrocentesis aspiration intermediate joint CPT 20605 • Orthopedics | $47 | $65 | $73 |
| Arthrocentesis aspiration major joint CPT 20610 • Orthopedics | $86 | $95 | $113 |
| Cervical spine fusion anterior approach CPT 22551 • Orthopedics | $1,540 | $1,996 | $2,223 |
| Lumbar spine fusion posterior approach CPT 22612 • Orthopedics | $1,637 | $1,637 | $1,637 |