| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $118 | $125 | $133 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $109 | $155 | $201 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $136 | $155 | $174 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $177 | $193 | $210 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $75 | $88 | $100 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $113 | $138 | $162 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $118 | $146 | $174 |
| Group psychotherapy CPT 90853 • Mental Health | $53 | $53 | $53 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $9 | $9 | $9 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $39 | $153 | $267 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $23 | $148 | $273 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $201 | $201 | $201 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $573 | $573 | $573 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $92 | $250 | $407 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $120 | $157 | $195 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $86 | $102 | $134 |
| EMG needle each extremity complete CPT 95886 • Neurology | $80 | $80 | $80 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $161 | $161 | $161 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $60 | $129 | $198 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $132 | $137 | $143 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $313 | $313 | $313 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $173 | $173 | $173 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $83 | $83 | $83 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $39 | $81 | $123 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $105 | $161 | $273 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $21 | $188 | $329 |
| Office visit established patient minimal CPT 99211 • Office Visits | $32 | $35 | $39 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $39 | $56 | $72 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $39 | $79 | $120 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $39 | $85 | $177 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $39 | $135 | $230 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $39 | $100 | $162 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $39 | $133 | $226 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $39 | $134 | $323 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $39 | $52 | $65 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $39 | $79 | $119 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $39 | $105 | $170 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $39 | $79 | $119 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $83 | $129 | $175 |
| Consultation office low complexity CPT 99243 • Office Visits | $60 | $132 | $204 |
| Consultation office high complexity CPT 99245 • Office Visits | $18 | $124 | $315 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $39 | $544 | $1,049 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $39 | $74 | $110 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $1,928 | $1,928 | $1,928 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $437 | $437 | $437 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $39 | $797 | $1,555 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $687 | $863 | $1,039 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $411 | $468 | $525 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $1,274 | $1,274 | $1,274 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $1,025 | $1,025 | $1,025 |