EVALUATION & MANAGEMENT
| 99202 | $275.00 | New patient level 2 |
| 99203 | $421.00 | New patient level 3 |
| 99204 | $867.00 | New patient level 4 |
| 99205 | $1,042.00 | New patient level 5 |
| 99211 | $109.00 | Established pt nurse visit |
| 99212 | $197.00 | Established patient level 2 |
| 99213 | $289.00 | Established patient level 3 |
| 99214 | $427.00 | Established patient level 4 |
| 99215 | $675.00 | Established patient level 5 |
| 99406 | $65.00 | Smoking cessation counseling |
SURGERY
| 62321 | $3,441.00 | Cerival/thoracic ESI w/fluoro |
| 62323 | $3,700.00 | Lumbar/caudal esi w/fluoro |
| 62369 | $756.00 | Pump refill |
| 64635 | $6,500.00 | Lumbar Nerve Ablation 1st level |
| 64636 | $2,125.00 | Lumbar Nerve Ablation 2+ level |
| 64479 | $2,650.00 | TFESI Cerv/thoracic 1st level |
| 64483 | $3,982.00 | TFESI lumbar 1st level |
| 64493 | $3,901.00 | Lumbar MBB/Facet Injection 1st level |
| 64494 | $2,466.00 | Lumbar MBB/Facet Injection 2st level |
| 20611 | $756.00 | Major jt injection w/us |
| 27096 | $2,466.00 | SI Joint Injection |
| 20552 | $434.00 | Trigger pt, 1 or 2 muscles |
| 20553 | $520.00 | Trigger pt, 3+ muscles |
LAB & PATHOLOGY
| 80307 | $200.00 | Presumptive drug testing |
RADIOLOGY
| 76942 | $1,418.00 | Ultrasound Guidance for needle placement |
| 77002 | $877.00 | Fluoroscopic Guidance for needle placement |
| 77003 | $890.00 | Fluoroscopic Guidance for spinal needle placement |
| 75809 | $889.00 | Shuntogram for investigation of indwelling shunt |
| 72295 | $2,302.00 | Radiological supervision for lumbar discography |
| 72285 | $2,323.00 | Radiological supervision for cervical discography |
MEDICINE
| 95886 | $990.00 | EMG w/NCS |
| 95907 | $701.00 | NCS 1-2 studies |
| 95908 | $895.00 | NCS 3-4 studies |
| 95909 | $1,126.00 | NCS 5-6 studies |
| 95910 | $1,565.00 | NCS 7-8 studies |
| 95911 | $1,888.00 | NCS 9-10 studies |
| 96365 | $668.00 | Medication infusion 1st hour |
| 99152 | $532.00 | Moderate Sedation Services |
| 90837 | $275.00 | Psychotherapy 60 minutes |
| 90834 | $260.00 | Psychotherapy 45 minutes |
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