Practice Fee Schedule
Manage your practice's billable services and procedures
About Fee Schedule: This is your practice's master list of billable codes. Providers select from this list for their preferred billing codes. Codes can be tagged for specific clinical uses (in-house procedures, drug administration, injections).
Fee Schedule (34 codes)
| Type | Code | Description | Amount | Usage Type | Actions |
|---|---|---|---|---|---|
CPT | 82075 | Breath test for alcohol (Breath analyzer) | $15.00 Units: 1 | In-House Procedure | |
CPT | 99201 | Office/outpatient visit new patient, level 1 | $45.00 Units: 1 | Standard | |
CPT | 99214 | Office/outpatient visit established patient, level 4 | $125.00 Units: 1 | Standard | |
CPT | 99213 | Office/outpatient visit established patient, level 3 | $85.00 Units: 1 | Standard | |
CPT | 99407 | Smoking and tobacco use cessation counseling visit, intensive (>10 min) | $45.00 Units: 1 | In-House Procedure | |
CPT | 81025 | Pregnancy test, by visual color comparison methods (Instant pregnancy test) | $20.00 Units: 1 | In-House Procedure | |
HCPCS | J0696 | Injection, ceftriaxone sodium, per 250 mg Drug | $20.00 | Standard | |
HCPCS | J2001 | Injection, lidocaine HCl for intravenous infusion, 10 mg Drug | $5.00 | Standard | |
HCPCS | J3490 | Unclassified drugs Drug | $0.00 | Standard | |
HCPCS | A4206 | Syringe with needle, sterile, 1 cc or less Supply | $1.50 | Standard | |
HCPCS | A4215 | Needle, sterile, any size Supply | $0.50 | Standard | |
HCPCS | 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections); 1 vaccine Procedure | $25.00 | Standard | |
HCPCS | 90658 | Influenza virus vaccine, trivalent, split virus Drug | $30.00 | Administered Drug | |
HCPCS | 90670 | Pneumococcal conjugate vaccine, 13 valent Drug | $180.00 | Standard | |
HCPCS | 90732 | Pneumococcal polysaccharide vaccine, 23-valent Drug | $95.00 | Administered Drug | |
HCPCS | 90715 | Tetanus, diphtheria toxoids and acellular pertussis vaccine (Tdap) Drug | $50.00 | Injection Admin | |
CPT | CASH01 | No-show fee Custom | $50.00 Units: 1 | Standard | |
CPT | CASH02 | Medical record copy fee Custom | $25.00 Units: 1 | Standard | |
CPT | CASH03 | Form completion fee Custom | $35.00 Units: 1 | Standard | |
CPT | 99213 | Office or other outpatient visit, established patient, level 3 | $120.00 Units: 1 | Standard | |
CPT | 99214 | Office or other outpatient visit, established patient, level 4 | $175.00 Units: 1 | Standard | |
CPT | 99203 | Office or other outpatient visit, new patient, level 3 | $150.00 Units: 1 | Standard | |
CPT | 99204 | Office or other outpatient visit, new patient, level 4 | $210.00 Units: 1 | Standard | |
CPT | 90471 | Immunization administration, first injection | $25.00 Units: 1 | Injection Admin | |
CPT | 90472 | Immunization administration, each additional injection | $15.00 Units: 1 | Standard | |
CPT | 36415 | Routine venipuncture for collection of specimen | $10.00 Units: 1 | In-House Procedure | |
CPT | 85025 | Complete blood count (CBC) with automated differential | $15.00 Units: 1 | Standard | |
CPT | 80053 | Comprehensive metabolic panel | $25.00 Units: 1 | Standard | |
CPT | 81002 | Urinalysis, non-automated, without microscopy | $8.00 Units: 1 | In-House Procedure | |
CPT | 80307 | Drug test presumptive, any number of drug classes | $45.00 Units: 1 | In-House Procedure | |
CPT | 93000 | Electrocardiogram, routine ECG with interpretation | $35.00 Units: 1 | In-House Procedure | |
CPT | 96372 | Therapeutic, prophylactic, or diagnostic injection | $30.00 Units: 1 | Standard | |
HCPCS | J1885 | Injection, ketorolac tromethamine, per 15 mg Drug | $12.00 | Administered Drug | |
HCPCS | J3301 | Injection, triamcinolone acetonide, per 10 mg Drug | $15.00 | Standard |