CPT/HCPCS	SHORT DESCRIPTION	PROC STAT	CARRIER LOCALITY	NON FACILITY PRICE	FACILITY PRICE	CONV FACTOR	OPPS NON FACILITY PAYMENT AMOUNT	OPPS FACILITY PAYMENT AMOUNT
99201	Office/ Outpatient Visit new patient	A	1230201	$47.15	$27.37	34.023
99202	Office/ Outpatient Visit new patient	A	1230201	$79.78	$51.79	34.023
99203	Office/ Outpatient Visit new patient	A	1230201	$115.83	$79.62	34.023
99204	Office/ Outpatient Visit new patient	A	1230201	$175.71	$135.77	34.023
99205	Office/ Outpatient Visit new patient	A	1230201	$217.02	$174.10	34.023
99211	Office/Outpatient Visit Established Patient	A	1230201	$22.00	$9.31	34.023
99212	Office/Outpatient Visit Established Patient	A	1230201	$47.15	$25.88	34.023
99213	Office/Outpatient Visit Established Patient	A	1230201	$77.82	$52.44	34.023
99214	Office/Outpatient Visit Established Patient	A	1230201	$113.99	$80.78	34.023
99215	Office/Outpatient Visit Established Patient	A	1230201	$152.25	$113.81	34.023