| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $88 | $109 | $131 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $127 | $163 | $199 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $137 | $152 | $166 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $178 | $193 | $208 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $75 | $87 | $99 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $99 | $127 | $154 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $121 | $144 | $167 |
| Group psychotherapy CPT 90853 • Mental Health | $40 | $45 | $51 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $4 | $7 | $10 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $122 | $122 | $122 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $44 | $122 | $206 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $172 | $172 | $172 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $89 | $89 | $89 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $649 | $649 | $649 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $109 | $113 | $118 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $140 | $160 | $170 |
| EMG needle each extremity complete CPT 95886 • Neurology | $69 | $69 | $69 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $83 | $83 | $83 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $117 | $156 | $194 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $45 | $76 | $107 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $305 | $305 | $305 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $466 | $466 | $466 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $169 | $169 | $169 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $119 | $119 | $119 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $44 | $149 | $255 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $44 | $177 | $321 |
| Office visit established patient minimal CPT 99211 • Office Visits | $72 | $72 | $72 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $39 | $39 | $39 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $113 | $113 | $113 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $44 | $117 | $262 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $225 | $225 | $225 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $157 | $157 | $157 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $457 | $457 | $457 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $217 | $447 | $677 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $61 | $61 | $61 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $243 | $243 | $243 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $162 | $162 | $162 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $114 | $114 | $114 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $8 | $88 | $167 |
| Consultation office low complexity CPT 99243 • Office Visits | $44 | $117 | $189 |
| Consultation office high complexity CPT 99245 • Office Visits | $243 | $269 | $294 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $839 | $839 | $839 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $82 | $82 | $82 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $1,822 | $1,822 | $1,822 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $303 | $312 | $320 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $1,684 | $1,684 | $1,684 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $621 | $805 | $990 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $458 | $458 | $458 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $1,223 | $1,223 | $1,223 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $984 | $984 | $984 |