| Family psychotherapy with patient CPT 90847 • Mental Health | $111 | $111 | $111 |
| Group psychotherapy CPT 90853 • Mental Health | $58 | $58 | $58 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $121 | $121 | $121 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $124 | $124 | $124 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $122 | $122 | $122 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $340 | $340 | $340 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $408 | $408 | $408 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $109 | $109 | $109 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $158 | $158 | $158 |
| EMG needle each extremity complete CPT 95886 • Neurology | $93 | $93 | $93 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $87 | $87 | $87 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $110 | $110 | $111 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $174 | $174 | $174 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $281 | $281 | $281 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $74 | $74 | $74 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $106 | $106 | $106 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $162 | $162 | $162 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $209 | $209 | $209 |
| Office visit established patient minimal CPT 99211 • Office Visits | $22 | $22 | $22 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $49 | $49 | $49 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $80 | $80 | $80 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $116 | $116 | $116 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $159 | $159 | $159 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $127 | $127 | $127 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $136 | $136 | $136 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $151 | $176 | $201 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $72 | $72 | $72 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $72 | $72 | $72 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $103 | $103 | $103 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $72 | $72 | $72 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $80 | $94 | $107 |
| Consultation office low complexity CPT 99243 • Office Visits | $118 | $118 | $118 |
| Consultation office high complexity CPT 99245 • Office Visits | $222 | $222 | $223 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $482 | $482 | $482 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $37 | $37 | $37 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $192 | $192 | $192 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $1,021 | $1,021 | $1,021 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $470 | $470 | $471 |
| Intravitreal injection therapeutic agent CPT 67028 • Ophthalmology | $106 | $106 | $106 |
| Retinal detachment repair with vitrectomy CPT 67108 • Ophthalmology | $1,115 | $1,115 | $1,115 |
| Retinal photocoagulation treatment CPT 67210 • Ophthalmology | $483 | $483 | $483 |
| Retinal treatment extensive photocoagulation CPT 67228 • Ophthalmology | $213 | $266 | $319 |
| Strabismus surgery one horizontal muscle CPT 67311 • Ophthalmology | $558 | $558 | $558 |
| Blepharoptosis repair levator resection CPT 67901 • Ophthalmology | $750 | $750 | $750 |
| Eye exam new patient intermediate CPT 92002 • Ophthalmology | $79 | $79 | $79 |
| Eye exam established patient intermediate CPT 92012 • Ophthalmology | $82 | $82 | $82 |
| Visual field examination CPT 92083 • Ophthalmology | $32 | $32 | $32 |
| Retinal imaging OCT posterior segment CPT 92134 • Ophthalmology | $37 | $37 | $37 |
| Ophthalmic biometry IOL power calculation CPT 92136 • Ophthalmology | $50 | $50 | $50 |
| Arthrocentesis aspiration major joint CPT 20610 • Orthopedics | $40 | $48 | $57 |