| Travel allowance one way in connection with medically necessary laboratory specimen collection drawn from home bound or nursing home bound patient; prorated miles actually travelled | $2.14 | $1.08 | 2.0x | 1.23x |
| Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more | $275.22 | $121.17 | 2.3x | 1.00x |
| Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | $189.86 | $85.72 | 2.2x | 1.01x |
| Ground mileage, per statute mile | $15.70 | $9.02 | 1.7x | 0.59x |
| Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes | $71.97 | $22.04 | 3.3x | 1.04x |
| Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes | $192.08 | $77.01 | 2.5x | 0.94x |
| Insertion of needle into vein for collection of blood sample | $22.47 | $8.47 | 2.7x | 1.03x |
| Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count | $35.70 | $7.60 | 4.7x | 0.96x |
| Blood test, comprehensive group of blood chemicals | $70.61 | $10.34 | 6.8x | 1.15x |
| Therapy procedure using functional activities | $76.15 | $29.72 | 2.6x | 1.02x |
| Destruction of precancer skin growth, 2-14 growths | $16.57 | $6.05 | 2.7x | 0.75x |
| Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes | $309.07 | $116.20 | 2.7x | 0.95x |
| Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes | $72.33 | $25.95 | 2.8x | 1.00x |
| Pathology examination of tissue using a microscope, intermediate complexity | $158.46 | $53.31 | 3.0x | 0.85x |
| Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's | $42.64 | $16.02 | 2.7x | 0.98x |
| Blood test, lipids (cholesterol and triglycerides) | $112.39 | $13.11 | 8.6x | 1.17x |
| Therapy procedure using manual technique, each 15 minutes | $66.48 | $19.91 | 3.3x | 0.98x |
| Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes | $211.21 | $95.88 | 2.2x | 1.00x |
| Blood test, thyroid stimulating hormone (tsh) | $103.85 | $16.45 | 6.3x | 1.08x |
| Hemoglobin a1c level | $65.39 | $9.51 | 6.9x | 1.13x |
| Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more | $156.24 | $68.17 | 2.3x | 1.01x |
| New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more | $418.47 | $160.81 | 2.6x | 1.02x |
| Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes | $532.98 | $168.41 | 3.2x | 0.94x |
| Injection, bupivacaine liposome, 1 mg | $5.29 | $1.40 | 3.8x | 1.08x |
| Detection test by nucleic acid for organism, amplified probe technique | $78.37 | $34.34 | 2.3x | 1.24x |
| Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only | $45.66 | $7.95 | 5.7x | 1.02x |
| Administration of influenza virus vaccine | $49.42 | $28.17 | 1.8x | 1.21x |
| Injection, fosaprepitant (focinvez), 1 mg | $8.99 | $2.85 | 3.1x | 1.02x |
| X-ray of chest, 1 view | $61.13 | $8.66 | 7.1x | 1.17x |
| Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report | $48.48 | $14.01 | 3.5x | 0.70x |
| Test for allergy using allergenic extract | $11.83 | $3.67 | 3.2x | 0.89x |
| Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | $276.19 | $121.07 | 2.3x | 0.99x |
| Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more | $389.74 | $168.85 | 2.3x | 0.96x |
| Destruction of precancer skin growth, 1 growth | $132.95 | $47.14 | 2.8x | 0.86x |
| Cyanocobalamin (vitamin b-12) level | $91.47 | $14.77 | 6.2x | 1.04x |
| Chiropractic manipulative treatment, 3-4 spinal regions | $72.03 | $37.87 | 1.9x | 1.19x |
| Manual urinalysis test with examination using microscope, automated | $37.98 | $3.11 | 12.2x | 1.19x |
| New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more | $273.73 | $105.17 | 2.6x | 1.03x |
| Established patient complete exam of visual system | $214.37 | $122.07 | 1.8x | 0.94x |
| Vitamin d-3 level | $201.81 | $28.98 | 7.0x | 1.10x |