| Office visit new patient moderate complexity CPT 99204 • Office Visits | $206 | $237 | $264 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $252 | $281 | $332 |
| Office visit established patient minimal CPT 99211 • Office Visits | $14 | $25 | $37 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $38 | $44 | $54 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $76 | $107 | $126 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $134 | $155 | $175 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $182 | $209 | $234 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $130 | $148 | $163 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $175 | $200 | $221 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $259 | $296 | $326 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $50 | $57 | $63 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $92 | $106 | $117 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $133 | $152 | $168 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $93 | $106 | $118 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $136 | $156 | $173 |
| Consultation office low complexity CPT 99243 • Office Visits | $140 | $165 | $197 |
| Consultation office high complexity CPT 99245 • Office Visits | $279 | $308 | $360 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $991 | $1,114 | $1,328 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $78 | $88 | $94 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $1,921 | $2,177 | $2,612 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $193 | $336 | $414 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $256 | $1,291 | $1,841 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $938 | $1,021 | $1,081 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $345 | $443 | $500 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $735 | $1,120 | $1,338 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $590 | $901 | $1,076 |
| Intravitreal injection therapeutic agent CPT 67028 • Ophthalmology | $148 | $161 | $171 |
| Retinal detachment repair with vitrectomy CPT 67108 • Ophthalmology | $1,113 | $1,694 | $2,023 |
| Retinal photocoagulation treatment CPT 67210 • Ophthalmology | $732 | $814 | $870 |
| Retinal treatment extensive photocoagulation CPT 67228 • Ophthalmology | $285 | $472 | $576 |
| Strabismus surgery one horizontal muscle CPT 67311 • Ophthalmology | $874 | $949 | $1,004 |
| Excision chalazion single CPT 67800 • Ophthalmology | $152 | $191 | $215 |
| Blepharoptosis repair levator resection CPT 67901 • Ophthalmology | $1,250 | $1,269 | $1,289 |
| Lacrimal punctum closure by plug CPT 68761 • Ophthalmology | $241 | $250 | $260 |
| Eye exam new patient intermediate CPT 92002 • Ophthalmology | $71 | $114 | $136 |
| Eye exam new patient comprehensive CPT 92004 • Ophthalmology | $147 | $212 | $245 |
| Eye exam established patient intermediate CPT 92012 • Ophthalmology | $126 | $137 | $143 |
| Eye exam established patient comprehensive CPT 92014 • Ophthalmology | $118 | $176 | $205 |
| Visual field examination CPT 92083 • Ophthalmology | $58 | $84 | $103 |
| Retinal imaging OCT posterior segment CPT 92134 • Ophthalmology | $24 | $43 | $67 |
| Ophthalmic biometry IOL power calculation CPT 92136 • Ophthalmology | $51 | $110 | $167 |
| Fundus photography CPT 92250 • Ophthalmology | $46 | $59 | $82 |
| Arthrocentesis aspiration small joint CPT 20600 • Orthopedics | $34 | $65 | $81 |
| Arthrocentesis aspiration intermediate joint CPT 20605 • Orthopedics | $47 | $71 | $85 |
| Arthrocentesis aspiration major joint CPT 20610 • Orthopedics | $44 | $73 | $97 |
| Cervical spine fusion anterior approach CPT 22551 • Orthopedics | $367 | $2,010 | $2,855 |
| Lumbar spine fusion posterior approach CPT 22612 • Orthopedics | $388 | $1,887 | $2,665 |
| Lumbar spine fusion combined approach CPT 22633 • Orthopedics | $398 | $2,184 | $3,107 |
| Total shoulder replacement CPT 23472 • Orthopedics | $308 | $1,714 | $2,453 |
| Reverse total shoulder replacement CPT 23473 • Orthopedics | $2,658 | $3,027 | $3,686 |