| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $158 | $158 | $158 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $206 | $206 | $206 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $214 | $214 | $214 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $84 | $84 | $84 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $30 | $63 | $96 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $155 | $155 | $155 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $211 | $211 | $211 |
| Office visit established patient minimal CPT 99211 • Office Visits | $10 | $10 | $10 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $30 | $36 | $42 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $30 | $53 | $77 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $147 | $147 | $147 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $167 | $167 | $167 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $114 | $114 | $114 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $154 | $154 | $154 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $225 | $225 | $225 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $44 | $44 | $44 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $81 | $81 | $81 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $116 | $116 | $116 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $82 | $82 | $82 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $119 | $119 | $119 |
| Consultation office low complexity CPT 99243 • Office Visits | $0 | $0 | $0 |
| Consultation office high complexity CPT 99245 • Office Visits | $0 | $0 | $0 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $735 | $735 | $735 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $26 | $26 | $26 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $2,064 | $2,064 | $2,064 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $359 | $359 | $359 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $806 | $806 | $806 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $890 | $890 | $890 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $276 | $276 | $276 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $1,303 | $1,303 | $1,303 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $30 | $491 | $951 |
| Intravitreal injection therapeutic agent CPT 67028 • Ophthalmology | $67 | $67 | $67 |
| Retinal detachment repair with vitrectomy CPT 67108 • Ophthalmology | $1,383 | $1,383 | $1,383 |
| Retinal photocoagulation treatment CPT 67210 • Ophthalmology | $582 | $582 | $582 |
| Retinal treatment extensive photocoagulation CPT 67228 • Ophthalmology | $222 | $222 | $222 |
| Strabismus surgery one horizontal muscle CPT 67311 • Ophthalmology | $533 | $533 | $533 |
| Excision chalazion single CPT 67800 • Ophthalmology | $179 | $179 | $179 |
| Blepharoptosis repair levator resection CPT 67901 • Ophthalmology | $434 | $434 | $434 |
| Lacrimal punctum closure by plug CPT 68761 • Ophthalmology | $30 | $58 | $86 |
| Eye exam new patient intermediate CPT 92002 • Ophthalmology | $53 | $53 | $53 |
| Eye exam new patient comprehensive CPT 92004 • Ophthalmology | $93 | $101 | $109 |
| Eye exam established patient intermediate CPT 92012 • Ophthalmology | $58 | $58 | $58 |
| Eye exam established patient comprehensive CPT 92014 • Ophthalmology | $88 | $105 | $122 |
| Visual field examination CPT 92083 • Ophthalmology | $44 | $52 | $60 |
| Retinal imaging OCT posterior segment CPT 92134 • Ophthalmology | $15 | $43 | $71 |
| Ophthalmic biometry IOL power calculation CPT 92136 • Ophthalmology | $35 | $35 | $35 |
| Fundus photography CPT 92250 • Ophthalmology | $30 | $48 | $65 |
| Arthrocentesis aspiration small joint CPT 20600 • Orthopedics | $64 | $64 | $64 |
| Arthrocentesis aspiration intermediate joint CPT 20605 • Orthopedics | $41 | $41 | $41 |
| Arthrocentesis aspiration major joint CPT 20610 • Orthopedics | $77 | $77 | $77 |