Fee Schedules & Code Directory
Standard UCR Fee Schedule | 1,341 CPT codes | 38,545 ICD-10 codes
| CPT Code | Description | Allowed Amount | Medicare Ref. | Region |
|---|---|---|---|---|
| 00100 | Anesthesia for procedures on salivary glands | $129.60 | $108.00 | National |
| 00140 | Anesthesia for procedures on eye | $129.60 | $108.00 | National |
| 00300 | Anesthesia for procedures on head | $129.60 | $108.00 | National |
| 00400 | Anesthesia for procedures on integumentary system, extremities | $129.60 | $108.00 | National |
| 00520 | Anesthesia for closed chest procedures | $129.60 | $108.00 | National |
| 00740 | Anesthesia for upper GI endoscopic procedures | $129.60 | $108.00 | National |
| 00810 | Anesthesia for lower GI endoscopic procedures | $129.60 | $108.00 | National |
| 00840 | Anesthesia for intraperitoneal procedures, lower abdomen | $129.60 | $108.00 | National |
| 01210 | Anesthesia for open procedures on hip joint | $129.60 | $108.00 | National |
| 01400 | Anesthesia for open procedures on knee joint | $129.60 | $108.00 | National |
| 01480 | Anesthesia for open procedures on bones of lower leg | $129.60 | $108.00 | National |
| 01996 | Daily hospital management of epidural/subarachnoid drug admin | $129.60 | $108.00 | National |
| 10060 | Incision and drainage of abscess, simple | $138.00 | $115.00 | National |
| 10061 | Incision and drainage of abscess, complicated | $255.60 | $213.00 | National |
| 10120 | Removal of foreign body, subcutaneous, simple | $153.60 | $128.00 | National |
| 10160 | Puncture aspiration of abscess, hematoma, bulla | $98.40 | $82.00 | National |
| 11042 | Debridement, subcutaneous tissue, first 20 sq cm | $124.80 | $104.00 | National |
| 11043 | Debridement, muscle/fascia, first 20 sq cm | $199.20 | $166.00 | National |
| 11102 | Tangential biopsy of skin, single lesion | $90.00 | $75.00 | National |
| 11104 | Punch biopsy of skin, single lesion | $90.00 | $75.00 | National |
| 11200 | Removal of skin tags, up to 15 | $110.40 | $92.00 | National |
| 11300 | Shaving of lesion, trunk/arms/legs, 0.5 cm or less | $81.60 | $68.00 | National |
| 11400 | Excision benign lesion, trunk/arms/legs, 0.5 cm or less | $128.40 | $107.00 | National |
| 11600 | Excision malignant lesion, trunk/arms/legs, 0.5 cm or less | $157.20 | $131.00 | National |
| 11720 | Debridement of nails, 1-5 | $34.80 | $29.00 | National |
| 11721 | Debridement of nails, 6 or more | $54.00 | $45.00 | National |
| 11730 | Avulsion of nail plate, partial or complete, single | $80.40 | $67.00 | National |
| 11750 | Excision of nail and nail matrix, permanent removal | $198.00 | $165.00 | National |
| 12001 | Simple repair superficial wound, 2.5 cm or less | $144.00 | $120.00 | National |
| 12002 | Simple repair superficial wound, 2.6-7.5 cm | $165.60 | $138.00 | National |
| 12011 | Simple repair face/ears/eyelids/nose/lips, 2.5 cm or less | $158.40 | $132.00 | National |
| 12031 | Intermediate repair wound, 2.5 cm or less | $226.80 | $189.00 | National |
| 12051 | Intermediate repair face/ears/eyelids/nose/lips, 2.5 cm or less | $256.80 | $214.00 | National |
| 13100 | Complex repair trunk, 1.1-2.5 cm | $368.40 | $307.00 | National |
| 13131 | Complex repair forehead/cheeks/chin/mouth, 1.1-2.5 cm | $414.00 | $345.00 | National |
| 17000 | Destruction benign/premalignant lesion, first | $72.00 | $60.00 | National |
| 17003 | Destruction benign/premalignant lesion, 2-14, each | $14.40 | $12.00 | National |
| 17110 | Destruction benign lesions (e.g., warts), up to 14 | $96.00 | $80.00 | National |
| 17250 | Chemical cauterization of granulation tissue | $36.00 | $30.00 | National |
| 20550 | Injection, tendon sheath/ligament | $63.60 | $53.00 | National |
| 20551 | Injection, tendon origin/insertion | $66.00 | $55.00 | National |
| 20552 | Injection, trigger point, 1-2 muscles | $58.80 | $49.00 | National |
| 20553 | Injection, trigger point, 3 or more muscles | $66.00 | $55.00 | National |
| 20600 | Arthrocentesis, small joint/bursa | $50.40 | $42.00 | National |
| 20605 | Arthrocentesis, intermediate joint/bursa | $57.60 | $48.00 | National |
| 20610 | Arthrocentesis, major joint/bursa | $66.00 | $55.00 | National |
| 20611 | Arthrocentesis, major joint with ultrasound guidance | $102.00 | $85.00 | National |
| 23350 | Injection for shoulder arthrography | $81.60 | $68.00 | National |
| 25600 | Closed treatment, distal radius fracture | $420.00 | $350.00 | National |
| 26600 | Closed treatment, metacarpal fracture | $336.00 | $280.00 | National |
| 27130 | Total hip arthroplasty (replacement) | $19,440.00 | $16,200.00 | National |
| 27236 | Open treatment, femoral fracture, internal fixation | $10,200.00 | $8,500.00 | National |
| 27244 | Open treatment, intertrochanteric fracture | $10,680.00 | $8,900.00 | National |
| 27245 | Open treatment, intertrochanteric fracture with plate/screw | $11,040.00 | $9,200.00 | National |
| 27447 | Total knee arthroplasty (replacement) | $18,504.00 | $15,420.00 | National |
| 27750 | Closed treatment, tibial shaft fracture | $456.00 | $380.00 | National |
| 27786 | Closed treatment, distal fibula fracture | $384.00 | $320.00 | National |
| 27792 | Open treatment, distal fibula fracture | $5,760.00 | $4,800.00 | National |
| 28285 | Hammertoe correction | $2,640.00 | $2,200.00 | National |
| 28296 | Bunionectomy with osteotomy | $4,320.00 | $3,600.00 | National |
| 29125 | Application of short arm splint | $69.60 | $58.00 | National |
| 29130 | Application of finger splint | $40.80 | $34.00 | National |
| 29405 | Application of short leg cast | $86.40 | $72.00 | National |
| 29515 | Application of short leg splint | $69.60 | $58.00 | National |
| 29580 | Strapping, Unna boot | $43.20 | $36.00 | National |
| 29881 | Knee arthroscopy with meniscectomy | $3,204.00 | $2,670.00 | National |
| 29882 | Knee arthroscopy with meniscus repair | $4,080.00 | $3,400.00 | National |
| 29888 | Knee arthroscopy, ACL reconstruction | $6,240.00 | $5,200.00 | National |
| 30300 | Removal of foreign body, nose, office | $98.40 | $82.00 | National |
| 30520 | Septoplasty/submucous resection | $4,200.00 | $3,500.00 | National |
| 31231 | Nasal endoscopy, diagnostic | $150.00 | $125.00 | National |
| 31237 | Nasal/sinus endoscopy with biopsy | $300.00 | $250.00 | National |
| 31575 | Laryngoscopy, flexible, diagnostic | $138.00 | $115.00 | National |
| 33208 | Insertion permanent pacemaker, dual chamber | $9,000.00 | $7,500.00 | National |
| 33249 | Insertion/replacement cardioverter-defibrillator | $17,040.00 | $14,200.00 | National |
| 33533 | Coronary artery bypass, single graft | $26,400.00 | $22,000.00 | National |
| 36000 | Introduction of needle/catheter, vein | $16.80 | $14.00 | National |
| 36400 | Venipuncture, under age 3, femoral or jugular | $21.60 | $18.00 | National |
| 36410 | Venipuncture, age 3+, routine | $12.00 | $10.00 | National |
| 36415 | Routine venipuncture for collection of specimen | $7.20 | $6.00 | National |
| 36416 | Collection of capillary blood specimen | $7.20 | $6.00 | National |
| 36556 | Insertion non-tunneled central venous catheter, age 5+ | $336.00 | $280.00 | National |
| 36569 | Insertion peripherally inserted central catheter (PICC) | $372.00 | $310.00 | National |
| 36600 | Arterial puncture for blood withdrawal | $21.60 | $18.00 | National |
| 42820 | Tonsillectomy and adenoidectomy, under age 12 | $2,880.00 | $2,400.00 | National |
| 43235 | Upper GI endoscopy, diagnostic | $456.00 | $380.00 | National |
| 43239 | Upper GI endoscopy with biopsy | $504.00 | $420.00 | National |
| 43249 | Upper GI endoscopy with dilation | $576.00 | $480.00 | National |
| 43259 | Upper GI endoscopy with ultrasound | $744.00 | $620.00 | National |
| 44388 | Colonoscopy through stoma, diagnostic | $504.00 | $420.00 | National |
| 45378 | Colonoscopy, diagnostic | $540.00 | $450.00 | National |
| 45380 | Colonoscopy with biopsy | $624.00 | $520.00 | National |
| 45385 | Colonoscopy with polypectomy | $672.00 | $560.00 | National |
| 46600 | Anoscopy, diagnostic | $62.40 | $52.00 | National |
| 47562 | Laparoscopic cholecystectomy | $6,240.00 | $5,200.00 | National |
| 47563 | Laparoscopic cholecystectomy with cholangiography | $6,720.00 | $5,600.00 | National |
| 49505 | Inguinal hernia repair, age 5+ | $4,560.00 | $3,800.00 | National |
| 49650 | Laparoscopic inguinal hernia repair | $5,040.00 | $4,200.00 | National |
| 50590 | Lithotripsy (kidney stone) | $5,760.00 | $4,800.00 | National |
| 51798 | Post-void residual ultrasound | $25.20 | $21.00 | National |
| 52000 | Cystourethroscopy | $384.00 | $320.00 | National |
| 52601 | Transurethral resection of prostate (TURP) | $6,600.00 | $5,500.00 | National |
| 57454 | Colposcopy with cervical biopsy | $222.00 | $185.00 | National |
| 58100 | Endometrial biopsy | $126.00 | $105.00 | National |
| 58150 | Total abdominal hysterectomy | $9,840.00 | $8,200.00 | National |
| 58260 | Vaginal hysterectomy | $8,160.00 | $6,800.00 | National |
| 58558 | Hysteroscopy with biopsy | $2,160.00 | $1,800.00 | National |
| 58661 | Laparoscopy with removal of adnexa | $5,040.00 | $4,200.00 | National |
| 59400 | Routine obstetric care, vaginal delivery | $4,800.00 | $4,000.00 | National |
| 59510 | Routine obstetric care, cesarean delivery | $5,760.00 | $4,800.00 | National |
| 59610 | Routine obstetric care, VBAC | $5,280.00 | $4,400.00 | National |
| 62322 | Lumbar/sacral epidural injection, without imaging | $174.00 | $145.00 | National |
| 62323 | Lumbar/sacral epidural injection, with imaging | $264.00 | $220.00 | National |
| 63030 | Laminotomy, single lumbar interspace | $8,160.00 | $6,800.00 | National |
| 63047 | Laminectomy, single lumbar segment | $8,640.00 | $7,200.00 | National |
| 64483 | Transforaminal epidural injection, lumbar/sacral | $288.00 | $240.00 | National |
| 64493 | Facet joint injection, lumbar/sacral, first level | $210.00 | $175.00 | National |
| 64615 | Chemodenervation of muscle(s), migraine | $174.00 | $145.00 | National |
| 64721 | Neuroplasty, carpal tunnel release | $2,640.00 | $2,200.00 | National |
| 65855 | Laser trabeculoplasty | $540.00 | $450.00 | National |
| 66821 | YAG laser capsulotomy | $432.00 | $360.00 | National |
| 66984 | Cataract surgery with IOL insertion | $3,840.00 | $3,200.00 | National |
| 67028 | Intravitreal injection | $132.00 | $110.00 | National |
| 67210 | Retinal laser photocoagulation | $624.00 | $520.00 | National |
| 67228 | Treatment of retinal lesion, photodynamic therapy | $744.00 | $620.00 | National |
| 69210 | Removal impacted cerumen, unilateral | $45.60 | $38.00 | National |
| 69436 | Tympanostomy (ear tube insertion) | $1,440.00 | $1,200.00 | National |
| 70030 | Radiologic exam, eye | $24.00 | $20.00 | National |
| 70100 | Radiologic exam, mandible | $28.80 | $24.00 | National |
| 70110 | Radiologic exam, mandible, complete | $36.00 | $30.00 | National |
| 70140 | Radiologic exam, facial bones, less than 3 views | $28.80 | $24.00 | National |
| 70150 | Radiologic exam, facial bones, complete | $36.00 | $30.00 | National |
| 70220 | Radiologic exam, sinuses, complete | $33.60 | $28.00 | National |
| 70260 | Radiologic exam, skull, complete | $38.40 | $32.00 | National |
| 70336 | MRI, temporomandibular joint | $336.00 | $280.00 | National |
| 70450 | CT head/brain without contrast | $150.00 | $125.00 | National |
| 70460 | CT head/brain with contrast | $192.00 | $160.00 | National |
| 70470 | CT head/brain without contrast, then with | $228.00 | $190.00 | National |
| 70486 | CT maxillofacial without contrast | $156.00 | $130.00 | National |
| 70490 | CT soft tissue neck without contrast | $162.00 | $135.00 | National |
| 70551 | MRI brain without contrast | $282.00 | $235.00 | National |
| 70553 | MRI brain without contrast, then with | $420.00 | $350.00 | National |
| 71045 | Chest X-ray, single view | $26.40 | $22.00 | National |
| 71046 | Chest X-ray, 2 views | $33.60 | $28.00 | National |
| 71047 | Chest X-ray, 3 views | $38.40 | $32.00 | National |
| 71048 | Chest X-ray, 4+ views | $43.20 | $36.00 | National |
| 71250 | CT chest without contrast | $168.00 | $140.00 | National |
| 71260 | CT chest with contrast | $204.00 | $170.00 | National |
| 71275 | CT angiography, chest | $300.00 | $250.00 | National |
| 72040 | Radiologic exam, cervical spine, 2-3 views | $33.60 | $28.00 | National |
| 72050 | Radiologic exam, cervical spine, 4-5 views | $40.80 | $34.00 | National |
| 72070 | Radiologic exam, thoracic spine, 2 views | $33.60 | $28.00 | National |
| 72100 | Radiologic exam, lumbar spine, 2-3 views | $38.40 | $32.00 | National |
| 72110 | Radiologic exam, lumbar spine, 4+ views | $45.60 | $38.00 | National |
| 72125 | CT cervical spine without contrast | $168.00 | $140.00 | National |
| 72131 | CT lumbar spine without contrast | $168.00 | $140.00 | National |
| 72141 | MRI cervical spine without contrast | $288.00 | $240.00 | National |
| 72148 | MRI lumbar spine without contrast | $288.00 | $240.00 | National |
| 72149 | MRI lumbar spine with contrast | $360.00 | $300.00 | National |
| 72156 | MRI cervical spine without contrast, then with | $432.00 | $360.00 | National |
| 72158 | MRI lumbar spine without contrast, then with | $432.00 | $360.00 | National |
| 72170 | Radiologic exam, pelvis, 1-2 views | $28.80 | $24.00 | National |
| 72192 | CT pelvis without contrast | $168.00 | $140.00 | National |
| 72193 | CT pelvis with contrast | $204.00 | $170.00 | National |
| 72197 | MRI pelvis without contrast, then with | $456.00 | $380.00 | National |
| 73000 | Radiologic exam, clavicle | $24.00 | $20.00 | National |
| 73010 | Radiologic exam, scapula | $26.40 | $22.00 | National |
| 73030 | Radiologic exam, shoulder, 2+ views | $28.80 | $24.00 | National |
| 73060 | Radiologic exam, humerus, 2+ views | $26.40 | $22.00 | National |
| 73070 | Radiologic exam, elbow, 2 views | $26.40 | $22.00 | National |
| 73080 | Radiologic exam, elbow, 3+ views | $31.20 | $26.00 | National |
| 73090 | Radiologic exam, forearm, 2 views | $24.00 | $20.00 | National |
| 73100 | Radiologic exam, wrist, 2 views | $26.40 | $22.00 | National |
| 73110 | Radiologic exam, wrist, 3+ views | $31.20 | $26.00 | National |
| 73120 | Radiologic exam, hand, 2 views | $26.40 | $22.00 | National |
| 73130 | Radiologic exam, hand, 3+ views | $31.20 | $26.00 | National |
| 73140 | Radiologic exam, finger(s) | $24.00 | $20.00 | National |
| 73218 | MRI upper extremity without contrast | $288.00 | $240.00 | National |
| 73221 | MRI shoulder without contrast | $288.00 | $240.00 | National |
| 73502 | Radiologic exam, hip, 2-3 views | $31.20 | $26.00 | National |
| 73552 | Radiologic exam, femur, 2+ views | $26.40 | $22.00 | National |
| 73560 | Radiologic exam, knee, 1-2 views | $26.40 | $22.00 | National |
| 73562 | Radiologic exam, knee, 3 views | $31.20 | $26.00 | National |
| 73564 | Radiologic exam, knee, 4+ views | $36.00 | $30.00 | National |
| 73590 | Radiologic exam, tibia/fibula, 2 views | $26.40 | $22.00 | National |
| 73600 | Radiologic exam, ankle, 2 views | $26.40 | $22.00 | National |
| 73610 | Radiologic exam, ankle, 3+ views | $31.20 | $26.00 | National |
| 73620 | Radiologic exam, foot, 2 views | $26.40 | $22.00 | National |
| 73630 | Radiologic exam, foot, 3+ views | $31.20 | $26.00 | National |
| 73650 | Radiologic exam, calcaneus (heel), 2+ views | $26.40 | $22.00 | National |
| 73660 | Radiologic exam, toes | $24.00 | $20.00 | National |
| 73718 | MRI lower extremity without contrast | $288.00 | $240.00 | National |
| 73721 | MRI knee without contrast | $288.00 | $240.00 | National |
| 73723 | MRI knee without contrast, then with | $432.00 | $360.00 | National |
| 74018 | Radiologic exam, abdomen, 1 view | $26.40 | $22.00 | National |
| 74019 | Radiologic exam, abdomen, 2 views | $33.60 | $28.00 | National |
| 74150 | CT abdomen without contrast | $168.00 | $140.00 | National |
| 74160 | CT abdomen with contrast | $204.00 | $170.00 | National |
| 74170 | CT abdomen without contrast, then with | $252.00 | $210.00 | National |
| 74176 | CT abdomen and pelvis without contrast | $234.00 | $195.00 | National |
| 74177 | CT abdomen and pelvis with contrast | $276.00 | $230.00 | National |
| 74178 | CT abdomen and pelvis without contrast, then with | $330.00 | $275.00 | National |
| 76536 | Ultrasound, head and neck soft tissue | $86.40 | $72.00 | National |
| 76604 | Ultrasound, chest | $78.00 | $65.00 | National |
| 76641 | Ultrasound, breast, unilateral, complete | $96.00 | $80.00 | National |
| 76700 | Ultrasound, abdomen, complete | $120.00 | $100.00 | National |
| 76770 | Ultrasound, retroperitoneal, complete | $114.00 | $95.00 | National |
| 76805 | Ultrasound, obstetric, after first trimester | $144.00 | $120.00 | National |
| 76817 | Ultrasound, transvaginal | $114.00 | $95.00 | National |
| 76830 | Ultrasound, transvaginal, non-obstetric | $114.00 | $95.00 | National |
| 76856 | Ultrasound, pelvic, complete | $108.00 | $90.00 | National |
| 76881 | Ultrasound, extremity, complete | $96.00 | $80.00 | National |
| 76882 | Ultrasound, extremity, limited | $60.00 | $50.00 | National |
| 77065 | Screening mammography, unilateral | $74.40 | $62.00 | National |
| 77066 | Screening mammography, bilateral | $92.40 | $77.00 | National |
| 77067 | Screening mammography, bilateral, including CAD | $100.80 | $84.00 | National |
| 77080 | DXA bone density, axial | $49.20 | $41.00 | National |
| 77385 | Radiation treatment delivery, IMRT, simple | $240.00 | $200.00 | National |
| 77386 | Radiation treatment delivery, IMRT, complex | $420.00 | $350.00 | National |
| 80048 | Basic metabolic panel (BMP) | $13.20 | $11.00 | National |
| 80050 | General health panel | $38.40 | $32.00 | National |
| 80053 | Comprehensive metabolic panel (CMP) | $16.80 | $14.00 | National |
| 80061 | Lipid panel | $21.60 | $18.00 | National |
| 80069 | Renal function panel | $13.20 | $11.00 | National |
| 80074 | Acute hepatitis panel | $62.40 | $52.00 | National |
| 80076 | Hepatic function panel | $13.20 | $11.00 | National |
| 81001 | Urinalysis with microscopy | $4.80 | $4.00 | National |
| 81002 | Urinalysis without microscopy | $3.60 | $3.00 | National |
| 81003 | Urinalysis, automated | $3.60 | $3.00 | National |
| 81025 | Urine pregnancy test | $9.60 | $8.00 | National |
| 82043 | Urine albumin, quantitative | $9.60 | $8.00 | National |
| 82150 | Amylase | $10.80 | $9.00 | National |
| 82247 | Bilirubin, total | $8.40 | $7.00 | National |
| 82248 | Bilirubin, direct | $8.40 | $7.00 | National |
| 82306 | Vitamin D, 25-hydroxy | $48.00 | $40.00 | National |
| 82310 | Calcium, total | $8.40 | $7.00 | National |
| 82375 | Carbon dioxide (bicarbonate) | $7.20 | $6.00 | National |
| 82465 | Cholesterol, serum, total | $7.20 | $6.00 | National |
| 82550 | Creatine kinase (CK) | $10.80 | $9.00 | National |
| 82565 | Creatinine, blood | $8.40 | $7.00 | National |
| 82607 | Cyanocobalamin (Vitamin B-12) | $21.60 | $18.00 | National |
| 82670 | Estradiol | $36.00 | $30.00 | National |
| 82728 | Ferritin | $16.80 | $14.00 | National |
| 82746 | Folic acid, serum | $20.40 | $17.00 | National |
| 82947 | Glucose, blood (except reagent strip) | $6.00 | $5.00 | National |
| 82962 | Glucose, blood by reagent strip | $4.80 | $4.00 | National |
| 83036 | Hemoglobin A1c | $15.60 | $13.00 | National |
| 83540 | Iron, serum | $9.60 | $8.00 | National |
| 83550 | Iron binding capacity (TIBC) | $10.80 | $9.00 | National |
| 83615 | Lactate dehydrogenase (LDH) | $9.60 | $8.00 | National |
| 83718 | HDL cholesterol | $9.60 | $8.00 | National |
| 83721 | LDL cholesterol, direct | $14.40 | $12.00 | National |
| 83735 | Magnesium | $9.60 | $8.00 | National |
| 84100 | Phosphorus (inorganic) | $7.20 | $6.00 | National |
| 84132 | Potassium, serum | $7.20 | $6.00 | National |
| 84153 | PSA (prostate specific antigen) | $30.00 | $25.00 | National |
| 84295 | Sodium, serum | $7.20 | $6.00 | National |
| 84403 | Testosterone, total | $30.00 | $25.00 | National |
| 84436 | Thyroxine, total (T4) | $9.60 | $8.00 | National |
| 84439 | Thyroxine, free (FT4) | $14.40 | $12.00 | National |
| 84443 | Thyroid stimulating hormone (TSH) | $26.40 | $22.00 | National |
| 84450 | AST (SGOT) | $8.40 | $7.00 | National |
| 84460 | ALT (SGPT) | $8.40 | $7.00 | National |
| 84478 | Triglycerides | $9.60 | $8.00 | National |
| 84484 | Troponin, quantitative | $15.60 | $13.00 | National |
| 84520 | BUN (blood urea nitrogen) | $6.00 | $5.00 | National |
| 84550 | Uric acid, blood | $7.20 | $6.00 | National |
| 85007 | Blood smear, manual differential | $6.00 | $5.00 | National |
| 85014 | Hematocrit | $3.60 | $3.00 | National |
| 85018 | Hemoglobin | $3.60 | $3.00 | National |
| 85025 | Complete blood count (CBC) with differential | $13.20 | $11.00 | National |
| 85027 | Complete blood count (CBC), automated | $9.60 | $8.00 | National |
| 85379 | D-dimer, quantitative | $15.60 | $13.00 | National |
| 85610 | Prothrombin time (PT) | $6.00 | $5.00 | National |
| 85652 | Sedimentation rate (ESR), automated | $6.00 | $5.00 | National |
| 85730 | Partial thromboplastin time (PTT) | $9.60 | $8.00 | National |
| 86038 | Antinuclear antibody (ANA) | $16.80 | $14.00 | National |
| 86140 | C-reactive protein (CRP) | $7.20 | $6.00 | National |
| 86200 | Cyclic citrullinated peptide (CCP) antibody | $21.60 | $18.00 | National |
| 86235 | Nuclear antigen antibody (ENA) | $18.00 | $15.00 | National |
| 86431 | Rheumatoid factor, quantitative | $10.80 | $9.00 | National |
| 86580 | Tuberculosis skin test (PPD) | $9.60 | $8.00 | National |
| 86592 | Syphilis test, qualitative (RPR) | $6.00 | $5.00 | National |
| 86703 | HIV-1/HIV-2 antibody | $16.80 | $14.00 | National |
| 86762 | Rubella antibody | $16.80 | $14.00 | National |
| 86765 | Rubeola (measles) antibody | $16.80 | $14.00 | National |
| 86787 | Varicella-zoster antibody | $16.80 | $14.00 | National |
| 86803 | Hepatitis C antibody | $16.80 | $14.00 | National |
| 87040 | Blood culture | $13.20 | $11.00 | National |
| 87070 | Culture, wound/abscess/other | $10.80 | $9.00 | National |
| 87077 | Culture, aerobic | $9.60 | $8.00 | National |
| 87081 | Culture, screening only | $7.20 | $6.00 | National |
| 87086 | Urine culture, colony count | $10.80 | $9.00 | National |
| 87088 | Urine culture with antibiotic susceptibility | $10.80 | $9.00 | National |
| 87110 | Culture, chlamydia | $26.40 | $22.00 | National |
| 87186 | Culture susceptibility, MIC | $12.00 | $10.00 | National |
| 87205 | Gram stain | $6.00 | $5.00 | National |
| 87210 | Wet mount/KOH preparation | $6.00 | $5.00 | National |
| 87491 | Chlamydia, nucleic acid amplification | $43.20 | $36.00 | National |
| 87591 | Gonorrhea, nucleic acid amplification | $43.20 | $36.00 | National |
| 87635 | SARS-CoV-2 (COVID-19), nucleic acid amplification | $61.20 | $51.00 | National |
| 87804 | Influenza rapid test | $19.20 | $16.00 | National |
| 87880 | Strep A rapid test | $19.20 | $16.00 | National |
| 88112 | Cytopathology, cell enhancement technique | $28.80 | $24.00 | National |
| 88141 | Cytopathology, cervical/vaginal, interpretation | $21.60 | $18.00 | National |
| 88175 | Cytopathology, cervical/vaginal, thin layer | $33.60 | $28.00 | National |
| 88304 | Surgical pathology, gross and micro exam, level III | $50.40 | $42.00 | National |
| 88305 | Surgical pathology, gross and micro exam, level IV | $86.40 | $72.00 | National |
| 88307 | Surgical pathology, gross and micro exam, level V | $180.00 | $150.00 | National |
| 88311 | Decalcification procedure | $18.00 | $15.00 | National |
| 88312 | Special stains, Group I | $74.40 | $62.00 | National |
| 88342 | Immunohistochemistry, per antibody | $81.60 | $68.00 | National |
| 90460 | Immunization administration, first component | $36.00 | $30.00 | National |
| 90461 | Immunization administration, each additional component | $18.00 | $15.00 | National |
| 90471 | Immunization administration, injectable | $30.00 | $25.00 | National |
| 90472 | Immunization administration, each additional injection | $21.60 | $18.00 | National |
| 90651 | HPV vaccine, 9-valent, 3-dose | $321.60 | $268.00 | National |
| 90656 | Influenza vaccine, IIV3, preservative-free | $21.60 | $18.00 | National |
| 90670 | Pneumococcal conjugate vaccine (PCV13) | $259.20 | $216.00 | National |
| 90672 | Influenza vaccine, intranasal (LAIV4) | $33.60 | $28.00 | National |
| 90681 | Rotavirus vaccine, pentavalent (RV5) | $100.80 | $84.00 | National |
| 90686 | Influenza vaccine, IIV4, preservative-free | $25.20 | $21.00 | National |
| 90696 | DTaP-IPV vaccine | $62.40 | $52.00 | National |
| 90707 | MMR vaccine | $81.60 | $68.00 | National |
| 90710 | MMRV vaccine | $237.60 | $198.00 | National |
| 90714 | Td vaccine, preservative-free | $33.60 | $28.00 | National |
| 90715 | Tdap vaccine | $50.40 | $42.00 | National |
| 90716 | Varicella vaccine | $170.40 | $142.00 | National |
| 90732 | Pneumococcal polysaccharide vaccine (PPSV23) | $134.40 | $112.00 | National |
| 90736 | Zoster (shingles) vaccine, recombinant | $210.00 | $175.00 | National |
| 90750 | Zoster (shingles) vaccine, recombinant, adjuvanted | $228.00 | $190.00 | National |
| 90785 | Interactive complexity add-on | $19.20 | $16.00 | National |
| 90791 | Psychiatric diagnostic evaluation | $206.40 | $172.00 | National |
| 90792 | Psychiatric diagnostic evaluation with medical services | $222.00 | $185.00 | National |
| 90832 | Psychotherapy, 30 minutes | $86.40 | $72.00 | National |
| 90834 | Psychotherapy, 45 minutes | $129.60 | $108.00 | National |
| 90837 | Psychotherapy, 60 minutes | $175.20 | $146.00 | National |
| 90838 | Psychotherapy, crisis, first 60 minutes | $186.00 | $155.00 | National |
| 90839 | Psychotherapy, crisis, first 60 min | $189.60 | $158.00 | National |
| 90846 | Family psychotherapy without patient, 50 min | $129.60 | $108.00 | National |
| 90847 | Family psychotherapy with patient, 50 min | $134.40 | $112.00 | National |
| 90853 | Group psychotherapy | $40.80 | $34.00 | National |
| 90935 | Hemodialysis procedure with single evaluation | $102.00 | $85.00 | National |
| 90937 | Hemodialysis procedure with repeated evaluation | $138.00 | $115.00 | National |
| 91010 | Esophageal motility study | $198.00 | $165.00 | National |
| 92002 | Ophthalmological exam, new patient, intermediate | $81.60 | $68.00 | National |
| 92004 | Ophthalmological exam, new patient, comprehensive | $138.00 | $115.00 | National |
| 92012 | Ophthalmological exam, established patient, intermediate | $66.00 | $55.00 | National |
| 92014 | Ophthalmological exam, established patient, comprehensive | $98.40 | $82.00 | National |
| 92015 | Refraction determination | $27.60 | $23.00 | National |
| 92083 | Visual field examination | $62.40 | $52.00 | National |
| 92133 | Scanning optic nerve, computerized (OCT) | $50.40 | $42.00 | National |
| 92134 | Scanning posterior segment, computerized (OCT) | $50.40 | $42.00 | National |
| 92250 | Fundus photography | $45.60 | $38.00 | National |
| 92507 | Speech/language treatment | $50.40 | $42.00 | National |
| 92521 | Evaluation of speech fluency | $81.60 | $68.00 | National |
| 92523 | Evaluation of speech and language | $117.60 | $98.00 | National |
| 92557 | Comprehensive audiometry | $45.60 | $38.00 | National |
| 93000 | Electrocardiogram (ECG/EKG), 12-lead, complete | $26.40 | $22.00 | National |
| 93005 | Electrocardiogram (ECG/EKG), tracing only | $9.60 | $8.00 | National |
| 93010 | Electrocardiogram (ECG/EKG), interpretation only | $14.40 | $12.00 | National |
| 93015 | Cardiovascular stress test | $102.00 | $85.00 | National |
| 93224 | ECG monitoring, 24 hours (Holter), complete | $78.00 | $65.00 | National |
| 93241 | External ECG monitoring, up to 7 days | $57.60 | $48.00 | National |
| 93268 | External patient activated event recorder, 30 days | $50.40 | $42.00 | National |
| 93303 | Transthoracic echocardiography, complete | $198.00 | $165.00 | National |
| 93306 | Transthoracic echocardiography with Doppler, complete | $246.00 | $205.00 | National |
| 93312 | Transesophageal echocardiography | $336.00 | $280.00 | National |
| 93350 | Stress echocardiography | $174.00 | $145.00 | National |
| 93451 | Right heart catheterization | $744.00 | $620.00 | National |
| 93452 | Left heart catheterization | $936.00 | $780.00 | National |
| 93458 | Left heart catheterization with angiography | $1,440.00 | $1,200.00 | National |
| 93922 | Bilateral noninvasive vascular study, upper extremity | $86.40 | $72.00 | National |
| 93925 | Duplex scan, lower extremity arterial | $132.00 | $110.00 | National |
| 93926 | Duplex scan, lower extremity arterial, unilateral | $86.40 | $72.00 | National |
| 93970 | Duplex scan, extremity veins, bilateral | $126.00 | $105.00 | National |
| 93971 | Duplex scan, extremity veins, unilateral | $81.60 | $68.00 | National |
| 94010 | Spirometry | $36.00 | $30.00 | National |
| 94060 | Bronchospasm evaluation (before and after bronchodilator) | $66.00 | $55.00 | National |
| 94375 | Respiratory flow-volume loop | $21.60 | $18.00 | National |
| 94640 | Nebulizer treatment (inhalation treatment) | $19.20 | $16.00 | National |
| 94664 | Demonstration/evaluation of patient use of inhaler | $26.40 | $22.00 | National |
| 94726 | Plethysmography, lung volumes | $50.40 | $42.00 | National |
| 94729 | Diffusing capacity (DLCO) | $30.00 | $25.00 | National |
| 94760 | Pulse oximetry | $6.00 | $5.00 | National |
| 95004 | Percutaneous allergy skin tests, each | $4.80 | $4.00 | National |
| 95115 | Allergen immunotherapy, single injection | $16.80 | $14.00 | National |
| 95117 | Allergen immunotherapy, two or more injections | $26.40 | $22.00 | National |
| 95165 | Allergen immunotherapy preparation, single dose | $7.20 | $6.00 | National |
| 95810 | Polysomnography (sleep study) | $504.00 | $420.00 | National |
| 95811 | Polysomnography with CPAP | $624.00 | $520.00 | National |
| 95816 | Electroencephalogram (EEG), awake and asleep | $234.00 | $195.00 | National |
| 95819 | Electroencephalogram (EEG), awake and sleep | $234.00 | $195.00 | National |
| 95860 | Needle EMG, 1 extremity | $98.40 | $82.00 | National |
| 95861 | Needle EMG, 2 extremities | $170.40 | $142.00 | National |
| 95907 | Nerve conduction study, 1-2 studies | $86.40 | $72.00 | National |
| 95908 | Nerve conduction study, 3-4 studies | $122.40 | $102.00 | National |
| 95909 | Nerve conduction study, 5-6 studies | $158.40 | $132.00 | National |
| 95910 | Nerve conduction study, 7-8 studies | $194.40 | $162.00 | National |
| 96360 | IV infusion, hydration, initial 31+ min | $57.60 | $48.00 | National |
| 96361 | IV infusion, hydration, each additional hour | $38.40 | $32.00 | National |
| 96365 | IV infusion, therapeutic, initial up to 1 hour | $86.40 | $72.00 | National |
| 96366 | IV infusion, therapeutic, each additional hour | $38.40 | $32.00 | National |
| 96372 | Therapeutic injection, subcutaneous/intramuscular | $30.00 | $25.00 | National |
| 96374 | Therapeutic injection, IV push | $62.40 | $52.00 | National |
| 96375 | Therapeutic injection, IV push, each additional | $30.00 | $25.00 | National |
| 96401 | Chemotherapy administration, subcutaneous/IM | $74.40 | $62.00 | National |
| 96413 | Chemotherapy IV infusion, first hour | $198.00 | $165.00 | National |
| 96415 | Chemotherapy IV infusion, each additional hour | $54.00 | $45.00 | National |
| 97010 | Hot/cold pack application | $8.40 | $7.00 | National |
| 97012 | Mechanical traction therapy | $21.60 | $18.00 | National |
| 97014 | Electrical stimulation therapy, unattended | $21.60 | $18.00 | National |
| 97032 | Electrical stimulation therapy, attended | $36.00 | $30.00 | National |
| 97035 | Ultrasound therapy, each 15 minutes | $21.60 | $18.00 | National |
| 97110 | Therapeutic exercises, each 15 minutes | $42.00 | $35.00 | National |
| 97112 | Neuromuscular re-education, each 15 min | $45.60 | $38.00 | National |
| 97113 | Aquatic therapy, each 15 minutes | $45.60 | $38.00 | National |
| 97116 | Gait training therapy, each 15 minutes | $38.40 | $32.00 | National |
| 97140 | Manual therapy techniques, each 15 minutes | $39.60 | $33.00 | National |
| 97150 | Group therapeutic procedures | $21.60 | $18.00 | National |
| 97161 | PT evaluation, low complexity | $98.40 | $82.00 | National |
| 97162 | PT evaluation, moderate complexity | $110.40 | $92.00 | National |
| 97163 | PT evaluation, high complexity | $122.40 | $102.00 | National |
| 97164 | PT re-evaluation | $66.00 | $55.00 | National |
| 97165 | OT evaluation, low complexity | $98.40 | $82.00 | National |
| 97166 | OT evaluation, moderate complexity | $110.40 | $92.00 | National |
| 97167 | OT evaluation, high complexity | $122.40 | $102.00 | National |
| 97530 | Therapeutic activities, each 15 minutes | $43.20 | $36.00 | National |
| 97535 | Self-care/home management training, each 15 min | $43.20 | $36.00 | National |
| 97542 | Wheelchair management training, each 15 min | $43.20 | $36.00 | National |
| 97750 | Physical performance test, each 15 min | $38.40 | $32.00 | National |
| 97760 | Orthotic management/training, each 15 min | $45.60 | $38.00 | National |
| 98940 | Chiropractic manipulation, spinal, 1-2 regions | $36.00 | $30.00 | National |
| 98941 | Chiropractic manipulation, spinal, 3-4 regions | $45.60 | $38.00 | National |
| 98942 | Chiropractic manipulation, spinal, 5 regions | $50.40 | $42.00 | National |
| 98943 | Chiropractic manipulation, extraspinal, 1+ regions | $33.60 | $28.00 | National |
| 99195 | Phlebotomy, therapeutic | $33.60 | $28.00 | National |
| 99202 | Office/outpatient visit, new patient, 15-29 min | $91.20 | $76.00 | National |
| 99203 | Office/outpatient visit, new patient, 30-44 min | $145.20 | $121.00 | National |
| 99204 | Office/outpatient visit, new patient, 45-59 min | $210.00 | $175.00 | National |
| 99205 | Office/outpatient visit, new patient, 60-74 min | $268.80 | $224.00 | National |
| 99211 | Office/outpatient visit, established patient, minimal | $33.60 | $28.00 | National |
| 99212 | Office/outpatient visit, established patient, 10-19 min | $68.40 | $57.00 | National |
| 99213 | Office/outpatient visit, established patient, 20-29 min | $110.40 | $92.00 | National |
| 99214 | Office/outpatient visit, established patient, 30-39 min | $165.60 | $138.00 | National |
| 99215 | Office/outpatient visit, established patient, 40-54 min | $225.60 | $188.00 | National |
| 99221 | Initial hospital inpatient/observation, low severity | $174.00 | $145.00 | National |
| 99222 | Initial hospital inpatient/observation, moderate severity | $240.00 | $200.00 | National |
| 99223 | Initial hospital inpatient/observation, high severity | $338.40 | $282.00 | National |
| 99231 | Subsequent hospital inpatient/observation, stable | $94.80 | $79.00 | National |
| 99232 | Subsequent hospital inpatient/observation, responding | $134.40 | $112.00 | National |
| 99233 | Subsequent hospital inpatient/observation, unstable | $192.00 | $160.00 | National |
| 99238 | Hospital discharge day management, 30 min or less | $118.80 | $99.00 | National |
| 99239 | Hospital discharge day management, more than 30 min | $172.80 | $144.00 | National |
| 99241 | Office consultation, straightforward | $74.40 | $62.00 | National |
| 99242 | Office consultation, low complexity | $129.60 | $108.00 | National |
| 99243 | Office consultation, moderate complexity | $174.00 | $145.00 | National |
| 99244 | Office consultation, moderate-high complexity | $256.80 | $214.00 | National |
| 99245 | Office consultation, high complexity | $338.40 | $282.00 | National |
| 99281 | Emergency department visit, self-limited/minor | $26.40 | $22.00 | National |
| 99282 | Emergency department visit, low-moderate severity | $56.40 | $47.00 | National |
| 99283 | Emergency department visit, moderate severity | $98.40 | $82.00 | National |
| 99284 | Emergency department visit, high severity | $177.60 | $148.00 | National |
| 99285 | Emergency department visit, life-threatening | $261.60 | $218.00 | National |
| 99291 | Critical care, first 30-74 minutes | $379.20 | $316.00 | National |
| 99292 | Critical care, each additional 30 minutes | $171.60 | $143.00 | National |
| 99304 | Initial nursing facility care, low complexity | $144.00 | $120.00 | National |
| 99305 | Initial nursing facility care, moderate complexity | $199.20 | $166.00 | National |
| 99306 | Initial nursing facility care, high complexity | $266.40 | $222.00 | National |
| 99307 | Subsequent nursing facility care, stable | $57.60 | $48.00 | National |
| 99308 | Subsequent nursing facility care, responding | $87.60 | $73.00 | National |
| 99309 | Subsequent nursing facility care, significant complication | $121.20 | $101.00 | National |
| 99310 | Subsequent nursing facility care, unstable | $172.80 | $144.00 | National |
| 99354 | Prolonged service, outpatient, first hour | $148.80 | $124.00 | National |
| 99355 | Prolonged service, outpatient, each additional 30 min | $74.40 | $62.00 | National |
| 99356 | Prolonged service, inpatient, first hour | $148.80 | $124.00 | National |
| 99357 | Prolonged service, inpatient, each additional 30 min | $74.40 | $62.00 | National |
| 99381 | Preventive visit, new patient, infant (< 1 year) | $144.00 | $120.00 | National |
| 99382 | Preventive visit, new patient, early childhood (1-4) | $153.60 | $128.00 | National |
| 99383 | Preventive visit, new patient, late childhood (5-11) | $153.60 | $128.00 | National |
| 99384 | Preventive visit, new patient, adolescent (12-17) | $177.60 | $148.00 | National |
| 99385 | Preventive visit, new patient, adult (18-39) | $195.60 | $163.00 | National |
| 99386 | Preventive visit, new patient, adult (40-64) | $217.20 | $181.00 | National |
| 99387 | Preventive visit, new patient, adult (65+) | $234.00 | $195.00 | National |
| 99391 | Preventive visit, established patient, infant (< 1 year) | $124.80 | $104.00 | National |
| 99392 | Preventive visit, established patient, early childhood (1-4) | $134.40 | $112.00 | National |
| 99393 | Preventive visit, established patient, late childhood (5-11) | $134.40 | $112.00 | National |
| 99394 | Preventive visit, established patient, adolescent (12-17) | $153.60 | $128.00 | National |
| 99395 | Preventive visit, established patient, adult (18-39) | $175.20 | $146.00 | National |
| 99396 | Preventive visit, established patient, adult (40-64) | $192.00 | $160.00 | National |
| 99397 | Preventive visit, established patient, adult (65+) | $204.00 | $170.00 | National |
| 99421 | Online digital E/M, 5-10 min, established patient | $19.20 | $16.00 | National |
| 99422 | Online digital E/M, 11-20 min, established patient | $39.60 | $33.00 | National |
| 99423 | Online digital E/M, 21+ min, established patient | $66.00 | $55.00 | National |
| 99439 | Chronic care management, each additional 20 min/month | $56.40 | $47.00 | National |
| 99457 | Remote physiologic monitoring, first 20 min/month | $61.20 | $51.00 | National |
| 99458 | Remote physiologic monitoring, each additional 20 min | $50.40 | $42.00 | National |
| 99490 | Chronic care management, first 20 min/month | $74.40 | $62.00 | National |
| 99491 | Chronic care management, complex, first 30 min/month | $104.40 | $87.00 | National |
| 99495 | Transitional care management, moderate complexity | $236.40 | $197.00 | National |
| 99496 | Transitional care management, high complexity | $321.60 | $268.00 | National |