| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $50 | $82 | $115 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $87 | $136 | $184 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $80 | $112 | $144 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $126 | $151 | $176 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $65 | $80 | $95 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $61 | $86 | $112 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $76 | $113 | $150 |
| Group psychotherapy CPT 90853 • Mental Health | $21 | $40 | $58 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $4 | $4 | $4 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $148 | $148 | $148 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $132 | $140 | $149 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $110 | $110 | $110 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $226 | $226 | $226 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $303 | $303 | $303 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $37 | $74 | $111 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $59 | $127 | $161 |
| EMG needle each extremity complete CPT 95886 • Neurology | $32 | $47 | $62 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $73 | $73 | $73 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $22 | $32 | $41 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $50 | $92 | $134 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $64 | $64 | $64 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $138 | $138 | $138 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $62 | $66 | $70 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $79 | $89 | $99 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $109 | $132 | $164 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $136 | $178 | $216 |
| Office visit established patient minimal CPT 99211 • Office Visits | $17 | $24 | $30 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $21 | $39 | $57 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $53 | $80 | $108 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $58 | $103 | $125 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $75 | $125 | $176 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $82 | $126 | $170 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $111 | $140 | $170 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $163 | $186 | $198 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $32 | $80 | $129 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $46 | $88 | $129 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $66 | $97 | $129 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $59 | $94 | $129 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $86 | $108 | $130 |
| Consultation office low complexity CPT 99243 • Office Visits | $104 | $137 | $171 |
| Consultation office high complexity CPT 99245 • Office Visits | $154 | $204 | $255 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $347 | $347 | $347 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $61 | $61 | $61 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $1,003 | $1,003 | $1,003 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $301 | $301 | $301 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $1,048 | $1,048 | $1,048 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $483 | $513 | $544 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $277 | $277 | $277 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $931 | $931 | $931 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $673 | $673 | $673 |