updated March 1, 2025
Complete Care recognizes that the financial aspect of your care may be confusing. Our commitment is to be as transparent as possible, and to provide you with information to make decisions about your health care.
Complete Care encourages patients who are scheduled for services or procedures to contact a Patient Liaison who can evaluate, calculate and provide patients with their actual out-of-pocket expense. Our Patient Liaison team can be reached at Patientbilling@complete-care.com.
| CPT Code | Code Description | Billed Amount |
| X-Ray’s | ||
| 70030 | X-Ray Eye Foreign Body | $92.37 |
| 70100 | Xray of the Mandible; 1-3 views | $107.88 |
| 70110 | Xray of the mandible; 4 views | $121.98 |
| 70250 | Xray of the Skull; 1-3 vies | $106.62 |
| 70330 | Xray, temporomandibular joint, open and closed mouth;bilateral | $147.45 |
| 71045 | Xray, chest | $73.23 |
| 71046 | Xray, chest, single view | $94.44 |
| 71048 | X-ray chest, 4 or more view | $127.80 |
| 71100 | Xray, ribs, unilateral, 2 views | $102.63 |
| 71101 | Xray, ribs, unilateral, 3 views | $117.54 |
| 71110 | Xray, ribs, bilateral, 3 views | $125.22 |
| 71111 | Xray, ribs, bilateral, 4 views | $149.34 |
| 71120 | Xray, sternum, 2 views | $101.01 |
| 72040 | Xray, cervical, 2 or 3 views | $110.85 |
| 72050 | Xray, cervical, 4 views | $150.36 |
| 72052 | Xray, cervical, 6+ views | $182.91 |
| 72070 | Xray, thoracic, 2 views | $103.29 |
| 72072 | Xray, thoracic, 3 views | $114.27 |
| 72100 | Xray, lumbosacral, 2 or 3 views | $110.85 |
| 72110 | Xray, lumbosacral, 4 views | $151.41 |
| 72170 | Xray, pelvis, 1 or 2 views | $80.91 |
| 72220 | Xray, sacrum and coccyx, 2 views | $91.41 |
| 73000 | Xray, clavicle, complete | $91.35 |
| 73010 | Xray, scapula, complete | $83.04 |
| 73020 | Xray, shoulder, 1 view | $72.24 |
| 73030 | Xray, shoulder, 2 views | $96.93 |
| 73050 | Xray, acromioclavicular joints, bilateral, with or without weighted distraction | $105.27 |
| 73060 | Xray, humerus, 2 views | $89.52 |
| 73070 | Xray, elbow, 2 views | $82.23 |
| 73080 | Xray, elbow, 3 views | $94.41 |
| 73090 | Xray, forearm, 2 views | $79.77 |
| 73100 | Xray, wrist, 2 views | $94.08 |
| 73110 | Xray, wrist, 3 views | $115.11 |
| 73120 | Xray, hand, complete, 3 views | $87.69 |
| 73130 | Xray, hand, 2 views | $104.19 |
| 73140 | Xray, finger(s), 2 views | $106.68 |
| 73501 | Xray, hip, unilateral, with pelvis when performed, 1 view | $93.30 |
| 73502 | Xray, hip, unilateral, with pelvis when performed, 2-3 views | $132.75 |
| 73503 | Xray, hip, unilateral, with pelvis when performed, minimum of 4 views | $169.11 |
| 73521 | Xray, hips, bilateral, with pelvis when performed, 2 views | $115.41 |
| 73551 | Xray, femur, 1 view | $83.13 |
| 73552 | Xray, femur, 2 views | $99.66 |
| 73560 | Xray, knee; 1 or 2 views | $95.01 |
| 73562 | Xray, knee, 3 views | $113.37 |
| 73590 | Xray, tibia and fibula, 2 views | $88.62 |
| 73600 | Xray, ankle, 2 views | $89.52 |
| 73610 | Xray, ankle, complete, 3 views | $101.43 |
| 73620 | Xray, foot, 2 views | $79.50 |
| 73630 | Xray, foot, complete, 3 views | $95.04 |
| 73650 | Xray, calcaneus (heel bone), 2 views | $79.50 |
| 73660 | Xray, toe(s), 2 views | $81.15 |
| 76120 | Cineradiography/videoradiography, except where specifically included | $303.84 |
| 76499 | Ultrasonic guidance for needle placement (eg, biopsy, aspiration, injection, localization device), imaging supervision and interpretation | $500.00 |
| 76942 | Unlisted diagnostic radiographic procedure | $451.71 |
| MRI | ||
| 70551 | Mri brain w/o dye | $1,500.00 |
| 71550 | Mri chest w/o dye | $1,500.00 |
| 72141 | Mri neck spine w/o dye | $1,500.00 |
| 72146 | Mri chest spine w/o dye (thoracic) | $1,500.00 |
| 72148 | Mri lumbar spine w/o dye | $1,500.00 |
| 72195 | Mri pelvis w/o dye | $1,500.00 |
| 73218 | Mri upper extremity w/o dye | $1,500.00 |
| 73221 | Mri joint upr extrem w/o dye | $1,500.00 |
| 73718 | Mri lower extremity w/o dye | $1,500.00 |
| 73721 | Mri jnt of lwr extre w/o dye | $1,500.00 |
| 74181 | Mri abdomen w/o dye | $1,500.00 |
| 76376 | Neuro Quant | $400.00 |
| Any MRI CPT | MRI Comparison | $450.00 |
| Fee Schedule for Injury Care & Rehab Services | ||
| 96138 | Psychological or neuropsychological test | $95.37 |
| 97010 | Application of a modality to 1 or more areas; hot or cold packs | $19.11 |
| 97012 | Application of a modality to 1 or more areas; traction, mechanical | $42.09 |
| 97014 | Application of a modality to 1 or more areas; electrical stimulation (unattended) | $39.84 |
| 97110 | Therapeutic procedure, 1 or more areas, each 15 minutes; therapeutic exercises to develop strength and endurance, range of motion and flexibility | $84.30 |
| 97112 | Therapeutic procedure, 1 or more areas, each 15 minutes; neuromuscular reeducation of movement, balance, coordination, kinesthetic sense, posture, and/or proprioception for sitting and/or standing activities | $93.72 |
| 97140 | Manual therapy techniques (eg, mobilization/ manipulation, manual lymphatic drainage, manual traction), 1 or more regions, each 15 minutes | $79.65 |
| 97150 | Therapeutic procedure(s), group (2 or more individuals) | $51.45 |
| 97161 | Physical Therapy Evaluation – Low Complexity | $287.40 |
| 97164 | Re-evaluation of physical therapy established plan of care | $197.25 |
| 97530 | Therapeutic activities, direct (one-on-one) patient contact (use of dynamic activities to improve functional performance), each 15 minutes | $100.68 |
| 97535 | Self-care/home management training (eg, activities of daily living (ADL) and compensatory training, meal preparation, safety procedures, and instructions in use of assistive technology devices/adaptive equipment) direct one-on-one contact, each 15 minutes | $93.45 |
| 97760 | Orthotic(s) management and training (including assessment and fitting when not otherwise reported), upper extremity(ies), lower extremity(ies) and/or trunk, initial orthotic(s) encounter, each 15 minute | $132.96 |
| 98975 | Remote therapeutic monitoring (e.g., respiratory system status, musculoskeletal system status, therapy adherence, therapy response); initial set-up and patient education on use of equipment | $56.67 |
| 98977 | Remote therapeutic monitoring (e.g., respiratory system status, musculoskeletal system status, therapy adherence, therapy response); device(s) supply with scheduled (e.g., daily) recording(s) and/or programmed alert(s) transmission to monitor musculoskeletal system, each 30 days | $121.83 |
| 98980 | Remote therapeutic monitoring treatment management services, physician/other qualified healthcare professional time in a calendar month requiring at least one interactive communication with the patient/caregiver during the calendar month; first 20 minutes | $147.03 |
| 98981 | Remote therapeutic monitoring treatment management services, physician/other qualified healthcare professional time in a calendar month requiring at least one interactive communication with the patient/caregiver during the calendar month; each additional 20 minutes (list separately in addition to code for primary procedure) | $115.98 |
| G0283 | Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care | $36.21 |
| Adjustments | ||
| 98940 | Chiropractic manipulative treatment (CMT); spinal, 1-2 regions | $78.00 |
| 98941 | Chiropractic manipulative treatment (CMT); spinal, 3-4 regions | $113.19 |
| 98942 | Chiropractic manipulative treatment (CMT); spinal, 5 regions | $146.58 |
| 98943 | Chiropractic manipulative treatment (CMT); extraspinal, 1 or more regions | $32.00 |
| Consults | ||
| 99202 | Office New Patient ~ 15-29 Min | $206.01 |
| 99203 | Office New Patient ~ 30-44 Min | $324.90 |
| 99204 | Office New Patient ~ 45-59 Min | $813.45 |
| 99211 | Office Established Patient | $65.40 |
| 99212 | Office Established Patient ~ 10-19 Min | $161.70 |
| 99213 | Office Established Patient ~ 20-29 Min | $263.52 |
| 99214 | Office Established Patient ~ 30-39 Min (Re-Exam) | $619.75 |
| 99446 | Telemed (Phone/Internet) ~ 5-10 Min | $51.93 |
| 99448 | Telemed (Phone/Internet) ~ 21-30 Min | $155.25 |
| Mental Health | ||
| 90785 | Psytx complex interactive | $42.57 |
| 90791 | Psychiatric diagnostic eva; w/o medical services | $498.15 |
| 90792 | Psychiatric diagnostic eva; w/ medical services | $562.38 |
| 90832 | Individual psychotherapy, 30 mins | $235.44 |
| 90833 | Individual psychotherapy, 30 mins w/ eval and managament services (E/M) | $217.86 |
| 90834 | Individual psychotherapy, 45 mins | $310.53 |
| 90836 | Individual psychotherapy, 45 mins with E/M | $277.08 |
| 90837 | Individual psychotherapy, 60 mins | $460.32 |
| 90838 | Individual psychotherapy, 60 mins with E/M | $369.24 |
| 90839 | Psychotherapy for crisis, first 60 mins | $443.76 |
| 90840 | Psychotherapy for crisis, each additional 30 mins | $217.86 |
| 90845 | Psychoanalysis | $296.49 |
| 90846 | Family Psychotherapy w/o client present, 50 mins | $296.58 |
| 90847 | Family Psychotherapy w/ client present, 50 mins | $318.48 |
| 90853 | Group psychotherapy (other than multi-family group) | $89.34 |
| Neuro Testing | ||
| 95924 | NCV | $417.45 |
| 95923 | NCV | $329.79 |
| 95913 | NCV | $804.78 |
| 95912 | NCV | $687.36 |
| 95911 | NCV | $588.45 |
| 95910 | NCV | $489.15 |
| 95909 | NCV | $373.92 |
| 95908 | NCV | $310.86 |
| 95907 | NCV | $250.11 |
| 95905 | NCV | $90.72 |
| 95886 | EMG | $261.96 |
| 95885 | EMG | $165.84 |
| 95875 | EMG | $337.35 |
| 95870 | EMG | $222.60 |
| 95864 | EMG | $621.87 |
| 95863 | EMG | $587.82 |
| 95861 | EMG | $433.98 |
| 95860 | EMG | $310.08 |
| 95851 | EMG | $68.04 |
| 92540 | VNG | $296.70 |
| 92541 | VNG | $158.37 |
| 92542 | VNG | $161.82 |
| 92544 | VNG | $129.39 |
| 92545 | VNG | $118.59 |
| 92547 | VNG | $28.29 |
| 92546 | VNG | $364.44 |
| 92548 | Balance | $295.98 |
| 92537 | Caloric (4) | $111.24 |
| 92538 | Caloric (4) | $62.97 |
| 20553 | TPI (3 or more) | $173.55 |
| 20610 | Joint Injection | $200.64 |
| Durable Medical Equipment (DME) | ||
| A4467 | Knee Sleeve | $24.02 |
| A4565 | Sling | $31.53 |
| A9270 | Walker Boot | $133.73 |
| E0100 | Cane of any material | $88.35 |
| E0105 | 4 pronged cane | $205.89 |
| E0114 | Crutches | $174.57 |
| E0143 | Walker | $177.87 |
| E0720 | TENS – newest device as of 06/03/2024 | $518.31 |
| E0730 | TENS | $2,223.33 |
| E0855 | Posture pump | $2,965.29 |
| L0120 | Cervical Soft Collar | $198.57 |
| L0170 | Cervical collar (Molded) | $4,978.47 |
| L0172 | Cervical immobilizer collar | $1,009.35 |
| L0180 | Cervical collar (Multiple post) | $2,466.09 |
| L0456 | T. Back Brace | $7,059.45 |
| L0621 | Sacroiliac orthosis brace | $433.89 |
| L0623 | Sacroiliac Orthosis (SO) | $777.81 |
| L0625 | Soft LSO | $242.73 |
| L0627 | Lumbar Orthosis, sagittal control with rigid anterior and posterior panels | $2,917.77 |
| L0642 | Medium LSO (Used to be L0627) | $1,811.25 |
| L0648 | Rigid LSO (Used to be L0631) | $4,523.43 |
| L0650 | LSO | $5,233.89 |
| L1810 | Lateral stabilizer knee brace | $859.29 |
| L1820 | Knee brace | $855.87 |
| L1832 | Shortrunner knee brace | $5,350.95 |
| L1833 | Telescoping hinged knee brace | $3,155.43 |
| L1851 | OA knee brace (Used to be K0901) | $4,164.87 |
| L1902 | Ankle brace with or without joints | $542.19 |
| L1971 | AFO | $3,326.97 |
| L2397 | Cobra knee brace | $773.67 |
| L3670 | Shoulder Orthosis | $925.29 |
| L3675 | Shoulder stabilizer with vest component | $1,133.61 |
| L3760 | Hinged Elbow Brace | $2,870.25 |
| L3807 | Wrist brace w/ thumb | $1,615.29 |
| L3906 | Wrist Brace without joints | $2,725.05 |
| L3908 | Wrist brace | $386.97 |
| L3915 | Wrist and hand brace | $3,433.89 |
| L3923 | Splint | $561.87 |
| L4360 | Cam Fracture Walking Boot | $1,941.93 |
| L4387 | Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated, off-the-shelf | $1,125.27 |
| J3490 | Lidocaine Patches | $354.75 |
| Fee Schedule for Spine & Orthopedic Services | ||
| 96138 | Brain Check | $63.58 |
| 62321 | Cervical ESI | $1,456.80 |
| 62323 | Lumbar ESI | $1,430.34 |
| 64479 | Cervical ESI (transform) | $1,878.42 |
| 64483 | Lumbar ESI (transform) | $1,880.16 |
| 20550 | Tendon Injection | $338.22 |
| 20551 | Inj Tendon Origin/Insert | $332.52 |
| 20553 | TPI (3 or more) | $347.10 |
| 20552 | TPI (1-2 muscles) | $301.26 |
| 20600 | Joint Injection | $519.00 |
| 20605 | Joint Injection W/O ultrasound | $538.70 |
| 20606 | Joint Injection WITH Ultrasound | $862.50 |
| 20610 | Joint Injection | $668.80 |
| 20611 | Drain/inj joint/bursa w/us | $954.70 |
| 27096 | SI Joint injection | $1,891.80 |
| 10140 | Drainage of a hematoma | $1,614.10 |
| 0232T | PRP Injection in office | $4,637.58 |
| 64405 | 3rd occipital nerve block | $982.00 |
| 64445 | nerve block Njx aa&/strd sciatic nerve | $1,477.20 |
| 64450 | Peripheral Nerve Blocks | $937.10 |
| 64490 | C MBB/Facet 1 level | $1,815.70 |
| 64491 | C MBB/Facet 2 level | $935.60 |
| 64492 | C MBB/Facet 3 level & additional | $930.80 |
| 64493 | L MBB/Facet 1 level | $1,674.40 |
| 64494 | L MBB/Facet 2 level | $863.50 |
| 64495 | L MBB/Facet 3 level & additional | $851.00 |
| 64447 | Njx aa&/strd femoral nerve | $1,106.30 |
| 64633 | C/T RFN 1 level | $4,034.90 |
| 64634 | C/T RFN 2 level & additonal | $2,316.00 |
| 64635 | L/S RFN 1 level | $4,066.60 |
| 64636 | L/S RFN 2 level & additional | $2,171.40 |
| 64625 | SI RFN (1 level only) | $4,366.70 |
| 64999 | unlisted (price can vary) | |
| J7322 | Hymovis Injection 1 | $4,560.48 |
| J7322 | Hymovis Injection 2 | $9,120.96 |
| J0171 | Adrenaline | $14.80 |
| J1010 | 40 Depo | $66.90 |
| J1040 | 80 Depo | $129.60 |
| J2001 | Lidocane | $32.00 |
| J3490 | Lidocane Patches | $55.00 |
| S0020 | Bupivacaine | $7.30 |
| c9290 | Bupivicane liposome | $166.25 |
| Q9966 | Omnupaque | $102.20 |
| J1100 | Dexamethasone | $20.88 |
| J3301 | Kenalog | $100.00 |
| 99441 | Phone code 5-10 min | $282.12 |
| 99442 | Phone code 11-20 min | $357.12 |
| 99443 | Phone code 21 -30 min | $507.04 |
| 99446 | Phone code (Change place of service) | $69.24 |
| 99447 | Phone code (Change place of service) | $139.68 |
| 99448 | Phone code (Change place of service) | $207.00 |
| 90785 | Psytx complex interactive | $28.37 |
| 90791 | Psychiatric diagnostic eval w/o medical services | $332.09 |
| 90792 | Psychiatric diagnostic eval w/ medical services | $374.91 |
| 90832 | Individual psychotherapy, 30 mins | $156.95 |
| 90833 | Individual psychotherapy, 30 mins w/ eval and management service (E/M) | $145.23 |
| 90834 | Individual psychotherapy, 45 mins | $207.01 |
| 90836 | Individual psychotherapy, 45 mins with E/M | $184.71 |
| 90837 | Individual psychotherapy, 60 mins | $306.87 |
| 90838 | Individual psychotherapy, 60 mins with E/M | $246.15 |
| 90839 | Psychotherapy for crisis, first 60 mins | $295.83 |
| 90840 | Psychotherapy for crisis, each additional 30 mins | $145.23 |
| 90845 | Psychoanalysis | $197.65 |
| 90846 | Family psychotherapy w/o client present, 50 mins | $197.71 |
| 90847 | Family psychotherapy w/ client present, 50 mins | $212.31 |
| 90853 | Group psychotherapy (other than multi family group) | $59.55 |
| 95924 | NCV | $834.90 |
| 95923 | NCV | $659.58 |
| 95913 | NCV | $1,609.56 |
| 95912 | NCV | $1,374.72 |
| 95911 | NCV | $1,176.90 |
| 95910 | NCV | $978.30 |
| 95909 | NCV | $747.84 |
| 95908 | NCV | $621.72 |
| 95907 | NCV | $500.22 |
| 95905 | NCV | $181.44 |
| 95886 | EMG | $523.92 |
| 95885 | EMG | $331.68 |
| 95875 | EMG | $674.70 |
| 95870 | EMG | $445.20 |
| 95864 | EMG | $1,243.74 |
| 95863 | EMG | $1,175.64 |
| 95861 | EMG | $867.96 |
| 95860 | EMG | $620.16 |
| 95851 | EMG | $136.08 |
| 92540 | VNG | $593.40 |
| 92541 | VNG | $316.74 |
| 92542 | VNG | $323.64 |
| 92544 | VNG | $258.78 |
| 92545 | VNG | $237.18 |
| 92547 | VNG | $56.58 |
| 92546 | VNG | $728.88 |
| 92548 | Balance | $591.96 |
| 92537 | Caloric (4) | $222.48 |
| 92538 | Caloric (2) | $125.94 |
| 95816 | EEG awake & drowsy | $2,140.62 |
| 95819 | EEG awake/asleep | $2,490.12 |
| 95812 | EEG 41-60 min | $1,921.74 |
| 95813 | EEG extended over 60 min | $2,453.76 |