| Psychotherapy 30 min add-on to E/M CPT 90833 • Mental Health | $115 | $115 | $115 |
| Psychotherapy 45 minutes CPT 90834 • Mental Health | $165 | $165 | $165 |
| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $129 | $129 | $129 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $213 | $213 | $213 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $193 | $193 | $193 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $206 | $206 | $206 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $103 | $103 | $103 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $156 | $156 | $156 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $164 | $164 | $164 |
| Group psychotherapy CPT 90853 • Mental Health | $38 | $38 | $38 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $7 | $7 | $7 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $234 | $234 | $234 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $192 | $192 | $192 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $176 | $176 | $176 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $631 | $631 | $631 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $89 | $89 | $89 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $100 | $100 | $100 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $255 | $255 | $255 |
| EMG needle each extremity complete CPT 95886 • Neurology | $153 | $153 | $153 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $144 | $144 | $144 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $103 | $103 | $103 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $214 | $214 | $214 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $165 | $165 | $165 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $165 | $165 | $165 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $53 | $60 | $75 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $82 | $106 | $130 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $132 | $192 | $232 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $353 | $353 | $353 |
| Office visit established patient minimal CPT 99211 • Office Visits | $37 | $37 | $37 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $43 | $64 | $91 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $65 | $86 | $104 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $106 | $160 | $221 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $228 | $228 | $228 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $97 | $133 | $171 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $171 | $189 | $207 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $274 | $274 | $274 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $78 | $78 | $78 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $97 | $117 | $130 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $187 | $187 | $187 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $128 | $128 | $128 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $181 | $181 | $181 |
| Consultation office low complexity CPT 99243 • Office Visits | $179 | $179 | $179 |
| Consultation office high complexity CPT 99245 • Office Visits | $285 | $285 | $285 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $996 | $996 | $996 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $56 | $56 | $56 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $1,865 | $1,865 | $1,865 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $324 | $324 | $324 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $1,733 | $1,733 | $1,733 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $804 | $804 | $804 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $476 | $476 | $476 |