| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $116 | $192 | $269 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $452 | $452 | $452 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $123 | $240 | $356 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $433 | $433 | $433 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $64 | $139 | $214 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $134 | $215 | $295 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $150 | $229 | $308 |
| Group psychotherapy CPT 90853 • Mental Health | $82 | $82 | $82 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $14 | $14 | $14 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $362 | $473 | $583 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $132 | $329 | $484 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $134 | $322 | $461 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $170 | $268 | $367 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $1,314 | $1,314 | $1,314 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $111 | $132 | $152 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $161 | $322 | $482 |
| EMG needle each extremity complete CPT 95886 • Neurology | $156 | $156 | $156 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $90 | $124 | $159 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $22 | $80 | $138 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $134 | $150 | $165 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $175 | $352 | $528 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $285 | $294 | $302 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $71 | $137 | $182 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $245 | $254 | $263 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $163 | $285 | $365 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $180 | $364 | $482 |
| Office visit established patient minimal CPT 99211 • Office Visits | $22 | $39 | $48 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $36 | $84 | $112 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $88 | $149 | $179 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $125 | $168 | $254 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $354 | $355 | $357 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $97 | $177 | $250 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $287 | $313 | $339 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $193 | $359 | $501 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $97 | $103 | $109 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $69 | $141 | $179 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $100 | $207 | $263 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $10 | $122 | $179 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $102 | $206 | $265 |
| Consultation office low complexity CPT 99243 • Office Visits | $117 | $236 | $341 |
| Consultation office high complexity CPT 99245 • Office Visits | $213 | $410 | $551 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $1,738 | $1,983 | $2,228 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $117 | $185 | $252 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $3,544 | $3,962 | $4,381 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $740 | $869 | $999 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $1,048 | $2,632 | $3,566 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $483 | $1,454 | $2,363 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $870 | $885 | $899 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $2,238 | $2,588 | $2,937 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $522 | $1,505 | $2,359 |