| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $177 | $196 | $215 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $114 | $121 | $129 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $166 | $187 | $209 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $121 | $147 | $173 |
| Group psychotherapy CPT 90853 • Mental Health | $45 | $49 | $52 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $8 | $9 | $11 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $246 | $246 | $246 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $100 | $152 | $237 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $237 | $237 | $237 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $504 | $504 | $504 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $712 | $712 | $712 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $87 | $88 | $88 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $128 | $131 | $137 |
| EMG needle each extremity complete CPT 95886 • Neurology | $76 | $76 | $76 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $90 | $90 | $90 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $88 | $144 | $200 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $134 | $134 | $134 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $316 | $316 | $316 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $314 | $314 | $314 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $133 | $133 | $133 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $188 | $188 | $188 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $176 | $266 | $333 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $189 | $258 | $363 |
| Office visit established patient minimal CPT 99211 • Office Visits | $40 | $40 | $40 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $79 | $79 | $79 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $131 | $139 | $148 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $117 | $141 | $190 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $255 | $255 | $255 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $179 | $179 | $179 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $241 | $241 | $241 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $217 | $286 | $354 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $69 | $69 | $69 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $127 | $127 | $127 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $182 | $182 | $182 |
| 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 | $116 | $152 | $187 |
| Consultation office low complexity CPT 99243 • Office Visits | $121 | $162 | $195 |
| Consultation office high complexity CPT 99245 • Office Visits | $242 | $290 | $338 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $1,082 | $1,082 | $1,082 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $65 | $65 | $65 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $2,075 | $2,075 | $2,075 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $434 | $462 | $491 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $1,919 | $1,919 | $1,919 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $507 | $695 | $883 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $414 | $509 | $604 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $744 | $1,030 | $1,315 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $543 | $751 | $958 |
| Intravitreal injection therapeutic agent CPT 67028 • Ophthalmology | $177 | $177 | $177 |
| Retinal detachment repair with vitrectomy CPT 67108 • Ophthalmology | $2,101 | $2,101 | $2,101 |
| Retinal photocoagulation treatment CPT 67210 • Ophthalmology | $909 | $909 | $909 |