“Self Pay” Office Charge List

Office Visit TypeCPT codePremier ‘Self pay’ Charge
New patient visit level 2 99202 $ 73
New patient visit level 3 99203 $ 107
Recheck level 2 99212 $ 55
Recheck level 3 99213 $ 87
Injection (not including medication) 20610 $ 63
X-ray Foot 73630 $ 34
X-ray Ankle 73610 $ 36
X-ray Knee 73562 $ 39
X-ray Hip/Pelvis 73522 $ 33
X-ray Shoulder 73030 $ 34
X-ray Hand 73130 $ 35


We at Premier orthopedic Specialists of Tulsa are honored to have partnered with Zerocard to provide orthopedic services to their participants. We are Fastpass providers which means that Zerocard participants can contact Premier Orthopedics directly and schedule appointments and in office services without preauthorization or a copay.
Contact your Zerocard representative at www.zerocard.com for any questions.


Bundling is the process by which surgical services (Hospital charge, surgeon’s fee, anesthesia fee) are grouped together as one price for the costs of a surgical procedure. Various companies encourage this practice, which can significantly lower the overall cost of inpatient or outpatient procedures. Premier Orthopedics Specialists of Tulsa actively participates with Oklahoma Surgical Hospital in bundling with a variety of participating companies. We are always happy to discuss these options that are available to patients that have this option with their insurance plan or that chose this option if paying with cash/credit card outside of an insurance plan.

Premier Orthopedic Specialists of Tulsa
2448 E 81st St, Suite 1520
Tulsa, OK 74137
Phone: 918-900-2520
Fax: 918-900-2521
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