| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $92 | $120 | $147 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $141 | $179 | $217 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $110 | $178 | $245 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $132 | $140 | $148 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $55 | $59 | $64 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $65 | $84 | $103 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $92 | $100 | $107 |
| Group psychotherapy CPT 90853 • Mental Health | $21 | $23 | $25 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $5 | $5 | $5 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $143 | $205 | $267 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $120 | $121 | $121 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $111 | $124 | $138 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $240 | $276 | $313 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $60 | $161 | $262 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $69 | $90 | $101 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $141 | $152 | $176 |
| EMG needle each extremity complete CPT 95886 • Neurology | $99 | $154 | $209 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $98 | $144 | $191 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $69 | $136 | $238 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $83 | $83 | $83 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $111 | $243 | $374 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $195 | $401 | $607 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $52 | $60 | $69 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $40 | $75 | $109 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $40 | $100 | $132 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $40 | $126 | $211 |
| Office visit established patient minimal CPT 99211 • Office Visits | $23 | $32 | $40 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $40 | $43 | $46 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $40 | $58 | $76 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $40 | $63 | $110 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $40 | $94 | $148 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $104 | $155 | $207 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $140 | $209 | $278 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $132 | $249 | $408 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $40 | $60 | $80 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $74 | $110 | $147 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $106 | $158 | $211 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $74 | $111 | $148 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $87 | $137 | $216 |
| Consultation office low complexity CPT 99243 • Office Visits | $88 | $106 | $126 |
| Consultation office high complexity CPT 99245 • Office Visits | $193 | $206 | $230 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $561 | $561 | $561 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $39 | $43 | $47 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $1,207 | $1,207 | $1,207 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $252 | $252 | $252 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $1,117 | $1,117 | $1,117 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $514 | $520 | $526 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $241 | $241 | $241 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $765 | $765 | $765 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $558 | $558 | $558 |