| Ground mileage, per statute mile | $23.25 | $9.02 | 2.6x | 0.88x |
| Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more | $288.98 | $116.23 | 2.5x | 1.05x |
| Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | $202.43 | $81.30 | 2.5x | 1.07x |
| Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes | $63.63 | $21.80 | 2.9x | 0.92x |
| 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 | $1.19 | $1.11 | 1.1x | 0.68x |
| Insertion of needle into vein for collection of blood sample | $26.81 | $8.57 | 3.1x | 1.23x |
| Therapy procedure using functional activities | $67.16 | $30.03 | 2.2x | 0.90x |
| Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes | $209.33 | $74.32 | 2.8x | 1.03x |
| Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes | $67.32 | $25.61 | 2.6x | 0.93x |
| Blood test, comprehensive group of blood chemicals | $81.59 | $10.33 | 7.9x | 1.33x |
| Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count | $44.72 | $7.59 | 5.9x | 1.20x |
| 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 | $40.13 | $15.54 | 2.6x | 0.92x |
| Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes | $323.04 | $112.60 | 2.9x | 0.99x |
| Destruction of precancer skin growth, 2-14 growths | $21.74 | $5.78 | 3.8x | 0.99x |
| Pathology examination of tissue using a microscope, intermediate complexity | $177.48 | $56.04 | 3.2x | 0.95x |
| Therapy procedure using manual technique, each 15 minutes | $59.42 | $19.87 | 3.0x | 0.88x |
| Blood test, lipids (cholesterol and triglycerides) | $126.75 | $13.08 | 9.7x | 1.32x |
| Hemoglobin a1c level | $61.07 | $9.46 | 6.5x | 1.05x |
| Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only | $46.45 | $7.79 | 6.0x | 1.04x |
| Blood test, thyroid stimulating hormone (tsh) | $117.87 | $16.44 | 7.2x | 1.23x |
| New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more | $431.87 | $154.23 | 2.8x | 1.06x |
| Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes | $272.25 | $92.16 | 3.0x | 1.29x |
| Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report | $69.08 | $13.42 | 5.1x | 1.00x |
| X-ray of chest, 1 view | $54.23 | $8.32 | 6.5x | 1.04x |
| Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | $290.07 | $121.06 | 2.4x | 1.04x |
| Removal of cataract with insertion of prosthetic lens | $886.26 | $182.26 | 4.9x | 0.86x |
| Injection of drug or substance under skin or into muscle | $55.12 | $12.72 | 4.3x | 1.00x |
| Chiropractic manipulative treatment, 3-4 spinal regions | $57.57 | $37.00 | 1.6x | 0.95x |
| Administration of influenza virus vaccine | $37.74 | $26.81 | 1.4x | 0.93x |
| Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month | $110.36 | $58.04 | 1.9x | 0.98x |
| Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes | $575.87 | $163.42 | 3.5x | 1.01x |
| New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more | $282.32 | $100.98 | 2.8x | 1.06x |
| Automated urinalysis test | $17.79 | $2.18 | 8.1x | 1.17x |
| Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more | $414.65 | $162.80 | 2.5x | 1.02x |
| Emergency department visit with high level of medical decision making | $1,541.48 | $167.56 | 9.2x | 1.25x |
| Ambulance service, basic life support, non-emergency transport, (bls) | $1,006.16 | $223.67 | 4.5x | 0.90x |
| Test for allergy using allergenic extract | $17.20 | $3.37 | 5.1x | 1.30x |
| Established patient complete exam of visual system | $239.67 | $119.14 | 2.0x | 1.05x |
| Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more | $170.11 | $64.10 | 2.7x | 1.10x |
| Destruction of precancer skin growth, 1 growth | $157.21 | $46.24 | 3.4x | 1.01x |