| Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more | $246.22 | $117.51 | 2.1x | 0.90x |
| Ground mileage, per statute mile | $18.53 | $9.54 | 1.9x | 0.70x |
| 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 | $1.11 | $1.09 | 1.0x | 0.64x |
| Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | $170.80 | $83.31 | 2.1x | 0.91x |
| Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes | $67.18 | $22.53 | 3.0x | 0.97x |
| Therapy procedure using functional activities | $73.45 | $31.29 | 2.3x | 0.99x |
| Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes | $69.16 | $26.50 | 2.6x | 0.95x |
| Insertion of needle into vein for collection of blood sample | $15.97 | $8.22 | 1.9x | 0.73x |
| 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 | $41.23 | $15.81 | 2.6x | 0.95x |
| Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes | $198.38 | $75.50 | 2.6x | 0.98x |
| Therapy procedure using manual technique, each 15 minutes | $67.68 | $20.48 | 3.3x | 1.00x |
| Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count | $29.65 | $7.59 | 3.9x | 0.80x |
| Destruction of precancer skin growth, 2-14 growths | $22.65 | $6.31 | 3.6x | 1.03x |
| Blood test, comprehensive group of blood chemicals | $41.60 | $10.32 | 4.0x | 0.68x |
| Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes | $319.09 | $115.14 | 2.8x | 0.98x |
| Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes | $190.10 | $93.66 | 2.0x | 0.90x |
| Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only | $41.42 | $7.89 | 5.2x | 0.93x |
| Removal of cataract with insertion of prosthetic lens | $542.22 | $154.24 | 3.5x | 0.53x |
| New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more | $367.07 | $155.09 | 2.4x | 0.90x |
| Blood test, lipids (cholesterol and triglycerides) | $44.32 | $13.08 | 3.4x | 0.46x |
| Pathology examination of tissue using a microscope, intermediate complexity | $161.35 | $48.81 | 3.3x | 0.87x |
| Administration of influenza virus vaccine | $37.38 | $28.44 | 1.3x | 0.92x |
| Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | $249.53 | $123.06 | 2.0x | 0.90x |
| Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more | $347.89 | $161.13 | 2.2x | 0.85x |
| Established patient complete exam of visual system | $220.65 | $125.13 | 1.8x | 0.97x |
| X-ray of chest, 1 view | $42.00 | $8.26 | 5.1x | 0.80x |
| Hemoglobin a1c level | $31.82 | $9.48 | 3.4x | 0.55x |
| Chiropractic manipulative treatment, 3-4 spinal regions | $53.73 | $38.24 | 1.4x | 0.88x |
| Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report | $57.10 | $14.08 | 4.1x | 0.83x |
| Professional service for preparation and provision of 1 or more antigens | $26.02 | $14.07 | 1.8x | 0.88x |
| Admn sarscov2 vacc 1 dose | $47.98 | $37.51 | 1.3x | 0.95x |
| Blood test, thyroid stimulating hormone (tsh) | $51.84 | $16.34 | 3.2x | 0.54x |
| Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes | $573.05 | $166.82 | 3.4x | 1.01x |
| New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more | $239.05 | $102.42 | 2.3x | 0.90x |
| Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month | $106.47 | $61.19 | 1.7x | 0.94x |
| Emergency department visit with high level of medical decision making | $1,148.98 | $166.35 | 6.9x | 0.93x |
| Test for allergy using allergenic extract | $12.76 | $3.50 | 3.6x | 0.97x |
| Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more | $142.94 | $65.57 | 2.2x | 0.93x |
| Imaging of retina | $146.52 | $39.70 | 3.7x | 1.18x |
| Screening mammography | $209.39 | $56.53 | 3.7x | 0.84x |