| Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more | $278.40 | $120.18 | 2.3x | 1.01x |
| Ground mileage, per statute mile | $14.86 | $9.08 | 1.6x | 0.56x |
| Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | $189.96 | $88.03 | 2.2x | 1.01x |
| Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes | $64.83 | $23.19 | 2.8x | 0.94x |
| Therapy procedure using functional activities | $73.81 | $33.37 | 2.2x | 0.99x |
| Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes | $69.24 | $27.83 | 2.5x | 0.95x |
| Therapy procedure using manual technique, each 15 minutes | $64.06 | $20.96 | 3.1x | 0.94x |
| 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 | $38.46 | $16.55 | 2.3x | 0.88x |
| Insertion of needle into vein for collection of blood sample | $24.39 | $8.54 | 2.9x | 1.12x |
| Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count | $35.40 | $7.59 | 4.7x | 0.95x |
| Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes | $213.08 | $78.23 | 2.7x | 1.05x |
| Blood test, comprehensive group of blood chemicals | $61.80 | $10.34 | 6.0x | 1.01x |
| Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes | $200.98 | $99.77 | 2.0x | 0.95x |
| Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes | $360.99 | $118.49 | 3.0x | 1.11x |
| 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 | $1.15 | $1.10 | 1.0x | 0.66x |
| Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report | $60.79 | $14.72 | 4.1x | 0.88x |
| Pathology examination of tissue using a microscope, intermediate complexity | $179.72 | $56.35 | 3.2x | 0.97x |
| Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more | $150.06 | $70.22 | 2.1x | 0.97x |
| Destruction of precancer skin growth, 2-14 growths | $21.99 | $6.78 | 3.2x | 1.00x |
| X-ray of chest, 1 view | $35.35 | $9.87 | 3.6x | 0.68x |
| Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more | $366.56 | $165.07 | 2.2x | 0.90x |
| Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only | $34.66 | $8.16 | 4.2x | 0.77x |
| Detection test by nucleic acid for organism, amplified probe technique | $83.82 | $34.36 | 2.4x | 1.32x |
| New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more | $399.47 | $166.91 | 2.4x | 0.98x |
| X-ray of chest, 2 views | $52.07 | $17.80 | 2.9x | 0.72x |
| Set-up portable x-ray equipment | $58.94 | $24.67 | 2.4x | 1.16x |
| Blood test, lipids (cholesterol and triglycerides) | $103.88 | $13.10 | 7.9x | 1.08x |
| Administration of influenza virus vaccine | $42.29 | $31.50 | 1.3x | 1.04x |
| Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | $271.79 | $131.03 | 2.1x | 0.98x |
| Hemoglobin a1c level | $52.65 | $9.49 | 5.5x | 0.91x |
| Established patient complete exam of visual system | $264.14 | $132.05 | 2.0x | 1.16x |
| Imaging of retina | $199.51 | $41.59 | 4.8x | 1.61x |
| New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more | $259.30 | $110.14 | 2.4x | 0.97x |
| Admn sarscov2 vacc 1 dose | $51.67 | $41.09 | 1.3x | 1.02x |
| Blood test, thyroid stimulating hormone (tsh) | $99.21 | $16.44 | 6.0x | 1.03x |
| Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes | $630.06 | $170.84 | 3.7x | 1.11x |
| Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care | $36.98 | $8.99 | 4.1x | 0.95x |
| Psychotherapy, 1 hour | $188.48 | $124.32 | 1.5x | 0.90x |
| Test for allergy using allergenic extract | $13.52 | $3.86 | 3.5x | 1.02x |
| Emergency department visit with high level of medical decision making | $1,242.13 | $173.84 | 7.1x | 1.01x |