| 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 | $2.08 | $1.10 | 1.9x | 1.20x |
| Ground mileage, per statute mile | $30.04 | $9.44 | 3.2x | 1.14x |
| Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more | $262.15 | $119.51 | 2.2x | 0.95x |
| Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes | $75.37 | $22.33 | 3.4x | 1.09x |
| Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | $179.62 | $84.38 | 2.1x | 0.95x |
| Therapy procedure using functional activities | $79.48 | $31.37 | 2.5x | 1.07x |
| Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes | $76.61 | $26.57 | 2.9x | 1.05x |
| Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes | $198.02 | $78.01 | 2.5x | 0.97x |
| Insertion of needle into vein for collection of blood sample | $24.36 | $8.55 | 2.9x | 1.12x |
| Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes | $291.67 | $118.60 | 2.5x | 0.90x |
| 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 | $48.34 | $16.27 | 3.0x | 1.11x |
| Therapy procedure using manual technique, each 15 minutes | $74.09 | $20.38 | 3.6x | 1.09x |
| Removal of cataract with insertion of prosthetic lens | $426.84 | $84.40 | 5.1x | 0.42x |
| Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only | $47.91 | $8.11 | 5.9x | 1.07x |
| Blood test, comprehensive group of blood chemicals | $77.95 | $10.33 | 7.5x | 1.27x |
| Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count | $43.81 | $7.60 | 5.8x | 1.18x |
| Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more | $145.05 | $67.77 | 2.1x | 0.94x |
| Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes | $204.04 | $97.48 | 2.1x | 0.97x |
| Chiropractic manipulative treatment, 3-4 spinal regions | $56.38 | $37.82 | 1.5x | 0.93x |
| Pathology examination of tissue using a microscope, intermediate complexity | $219.29 | $45.17 | 4.9x | 1.18x |
| Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more | $380.15 | $167.08 | 2.3x | 0.93x |
| Destruction of precancer skin growth, 2-14 growths | $31.00 | $5.97 | 5.2x | 1.41x |
| X-ray of chest, 1 view | $54.81 | $8.63 | 6.4x | 1.05x |
| Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes | $534.47 | $172.42 | 3.1x | 0.94x |
| New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more | $395.83 | $159.18 | 2.5x | 0.97x |
| Blood test, lipids (cholesterol and triglycerides) | $124.19 | $13.10 | 9.5x | 1.29x |
| Emergency department visit with high level of medical decision making | $1,125.34 | $175.82 | 6.4x | 0.91x |
| Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | $280.64 | $129.90 | 2.2x | 1.01x |
| Administration of influenza virus vaccine | $39.72 | $29.80 | 1.3x | 0.97x |
| Detection test by nucleic acid for organism, amplified probe technique | $72.88 | $34.34 | 2.1x | 1.15x |
| Established patient complete exam of visual system | $218.78 | $122.29 | 1.8x | 0.96x |
| Hemoglobin a1c level | $63.23 | $9.49 | 6.7x | 1.09x |
| Psychotherapy, 1 hour | $212.78 | $123.71 | 1.7x | 1.02x |
| Blood test, thyroid stimulating hormone (tsh) | $112.33 | $16.45 | 6.8x | 1.17x |
| Imaging of retina | $122.03 | $38.85 | 3.1x | 0.98x |
| New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more | $256.29 | $104.62 | 2.4x | 0.96x |
| Admn sarscov2 vacc 1 dose | $47.05 | $38.04 | 1.2x | 0.93x |
| Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes | $371.16 | $130.02 | 2.9x | 1.01x |
| X-ray of chest, 2 views | $78.60 | $14.21 | 5.5x | 1.09x |
| Removal of fingernails or toenails, 6 or more nails | $83.30 | $42.51 | 2.0x | 0.97x |