| Cytopathology cell enhancement technique CPT 88112 • Pathology | $49 | $55 | $61 |
| Cytopathology cervical/vaginal interpretation physician CPT 88141 • Pathology | $26 | $26 | $26 |
| Cytopathology cervical/vaginal manual screen CPT 88164 • Pathology | $15 | $15 | $15 |
| Cytopathology cervical/vaginal automated thin layer CPT 88175 • Pathology | $26 | $26 | $27 |
| Molecular cytogenetics DNA probe each CPT 88271 • Pathology | $20 | $21 | $21 |
| Cytogenetics molecular interpretation CPT 88291 • Pathology | $35 | $35 | $35 |
| Surgical pathology gross and micro exam level II CPT 88302 • Pathology | $22 | $23 | $23 |
| Surgical pathology gross and micro exam level III CPT 88304 • Pathology | $38 | $44 | $49 |
| Surgical pathology gross and micro exam level IV CPT 88305 • Pathology | $35 | $42 | $49 |
| Surgical pathology gross and micro exam level V CPT 88307 • Pathology | $262 | $269 | $283 |
| Surgical pathology gross and micro exam level VI CPT 88309 • Pathology | $628 | $628 | $628 |
| Special stain group I for microorganisms CPT 88312 • Pathology | $25 | $37 | $49 |
| Special stain group II CPT 88313 • Pathology | $33 | $60 | $74 |
| Frozen section pathology first specimen CPT 88331 • Pathology | $144 | $144 | $144 |
| Frozen section pathology each additional CPT 88332 • Pathology | $23 | $23 | $23 |
| Immunohistochemistry each antibody CPT 88341 • Pathology | $65 | $76 | $81 |
| Immunohistochemistry first antibody CPT 88342 • Pathology | $93 | $110 | $144 |
| Morphometric analysis tumor quantitative CPT 88360 • Pathology | $72 | $109 | $144 |
| Microdissection manual CPT 88381 • Pathology | $157 | $157 | $157 |
| Hot or cold packs application CPT 97010 • Physical Therapy | $55 | $55 | $55 |
| Electrical stimulation unattended CPT 97014 • Physical Therapy | $55 | $55 | $55 |
| Vasopneumatic device therapy CPT 97016 • Physical Therapy | $55 | $55 | $55 |
| Electrical stimulation attended each 15 minutes CPT 97032 • Physical Therapy | $55 | $55 | $55 |
| Ultrasound therapy each 15 minutes CPT 97035 • Physical Therapy | $55 | $55 | $55 |
| Therapeutic exercises each 15 minutes CPT 97110 • Physical Therapy | $55 | $55 | $55 |
| Neuromuscular reeducation each 15 minutes CPT 97112 • Physical Therapy | $55 | $55 | $55 |
| Gait training each 15 minutes CPT 97116 • Physical Therapy | $55 | $55 | $55 |
| Manual therapy one or more regions each 15 min CPT 97140 • Physical Therapy | $27 | $27 | $27 |
| Group therapeutic procedures CPT 97150 • Physical Therapy | $55 | $55 | $55 |
| Physical therapy evaluation low complexity CPT 97161 • Physical Therapy | $101 | $101 | $101 |
| Physical therapy evaluation moderate complexity CPT 97162 • Physical Therapy | $101 | $101 | $101 |
| Physical therapy evaluation high complexity CPT 97163 • Physical Therapy | $55 | $55 | $55 |
| Physical therapy re-evaluation CPT 97164 • Physical Therapy | $55 | $62 | $69 |
| Therapeutic activities each 15 minutes CPT 97530 • Physical Therapy | $37 | $37 | $37 |
| Self-care/home management training each 15 min CPT 97535 • Physical Therapy | $55 | $55 | $55 |
| Wheelchair management training each 15 minutes CPT 97542 • Physical Therapy | $55 | $55 | $55 |
| Orthotic management and training each 15 min CPT 97760 • Physical Therapy | $55 | $55 | $55 |
| Prosthetic training each 15 minutes CPT 97761 • Physical Therapy | $55 | $55 | $55 |
| Immunization admin injection single CPT 90471 • Preventive Care | $12 | $12 | $12 |
| Tdap vaccine age 7 years or older CPT 90715 • Preventive Care | $45 | $45 | $45 |
| Colorectal cancer screening colonoscopy not high risk HCPCS G0121 • Preventive Care | $406 | $406 | $406 |
| Annual wellness visit initial HCPCS G0438 • Preventive Care | $196 | $196 | $196 |
| Nebulizer inhalation treatment CPT 94640 • Pulmonology | $36 | $36 | $36 |
| Cystourethroscopy with tumor fulguration small CPT 52234 • Urology | $286 | $286 | $286 |
| Cystourethroscopy with tumor fulguration medium CPT 52235 • Urology | $335 | $335 | $335 |
| Cystourethroscopy with dilation of ureteral stricture CPT 52260 • Urology | $245 | $245 | $245 |
| Cystourethroscopy with ureteral stent insertion CPT 52332 • Urology | $478 | $478 | $478 |
| TURP transurethral resection of prostate CPT 52601 • Urology | $853 | $853 | $853 |
| Orchiectomy radical inguinal CPT 54530 • Urology | $595 | $595 | $595 |
| Vasectomy CPT 55250 • Urology | $266 | $330 | $394 |