| Office visit established patient straightforward CPT 99212 • Office Visits | $57 | $57 | $57 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $30 | $59 | $88 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $30 | $30 | $30 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $176 | $176 | $176 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $171 | $171 | $171 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $171 | $171 | $171 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $198 | $198 | $198 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $130 | $130 | $130 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $130 | $130 | $130 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $130 | $130 | $130 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $130 | $130 | $130 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $130 | $130 | $130 |
| Consultation office low complexity CPT 99243 • Office Visits | $128 | $149 | $171 |
| Consultation office high complexity CPT 99245 • Office Visits | $255 | $255 | $255 |