| Psychotherapy 60 minutes CPT 90837 • Mental Health | $187 | $187 | $187 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $127 | $127 | $127 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $195 | $195 | $195 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $74 | $74 | $74 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $109 | $109 | $109 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $112 | $112 | $112 |
| Group psychotherapy CPT 90853 • Mental Health | $33 | $33 | $33 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $5 | $5 | $5 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $189 | $189 | $189 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $152 | $152 | $152 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $152 | $152 | $152 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $491 | $491 | $491 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $79 | $79 | $79 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $129 | $129 | $129 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $232 | $232 | $232 |
| EMG needle each extremity complete CPT 95886 • Neurology | $55 | $55 | $55 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $103 | $103 | $103 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $73 | $73 | $73 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $110 | $110 | $110 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $111 | $111 | $111 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $410 | $410 | $410 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $64 | $72 | $81 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $98 | $109 | $120 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $148 | $161 | $175 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $32 | $132 | $232 |
| Office visit established patient minimal CPT 99211 • Office Visits | $26 | $29 | $32 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $29 | $45 | $61 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $79 | $80 | $80 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $102 | $112 | $121 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $151 | $153 | $156 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $109 | $145 | $181 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $147 | $164 | $181 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $210 | $213 | $216 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $44 | $91 | $137 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $77 | $107 | $137 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $111 | $124 | $137 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $82 | $110 | $137 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $114 | $126 | $137 |
| Consultation office low complexity CPT 99243 • Office Visits | $27 | $83 | $139 |
| Consultation office high complexity CPT 99245 • Office Visits | $207 | $238 | $270 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $692 | $692 | $692 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $62 | $62 | $62 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $1,328 | $1,328 | $1,328 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $233 | $233 | $233 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $1,474 | $1,474 | $1,474 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $678 | $678 | $678 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $337 | $337 | $337 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $1,010 | $1,010 | $1,010 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $613 | $613 | $613 |
| Intravitreal injection therapeutic agent CPT 67028 • Ophthalmology | $114 | $114 | $114 |