| Obstetric ultrasound detailed fetal anatomy CPT 76811 • Maternity | $154 | $154 | $154 |
| Obstetric ultrasound limited CPT 76815 • Maternity | $72 | $72 | $72 |
| Ultrasound transvaginal obstetric CPT 76817 • Maternity | $82 | $82 | $82 |
| Interactive complexity add-on CPT 90785 • Mental Health | $6 | $11 | $16 |
| Psychiatric diagnostic evaluation CPT 90791 • Mental Health | $148 | $171 | $184 |
| Psychiatric diagnostic evaluation with medical services CPT 90792 • Mental Health | $171 | $192 | $206 |
| Psychotherapy 30 minutes CPT 90832 • Mental Health | $60 | $80 | $93 |
| Psychotherapy 30 min add-on to E/M CPT 90833 • Mental Health | $80 | $91 | $102 |
| Psychotherapy 45 minutes CPT 90834 • Mental Health | $79 | $106 | $130 |
| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $93 | $113 | $132 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $154 | $156 | $157 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $104 | $114 | $129 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $148 | $166 | $184 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $74 | $82 | $88 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $93 | $113 | $134 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $96 | $128 | $150 |
| Group psychotherapy CPT 90853 • Mental Health | $40 | $44 | $48 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $132 | $132 | $132 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $134 | $134 | $134 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $367 | $367 | $367 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $111 | $111 | $111 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $161 | $161 | $161 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $90 | $90 | $90 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $112 | $112 | $112 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $134 | $134 | $134 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $175 | $175 | $175 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $285 | $285 | $285 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $65 | $68 | $71 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $101 | $101 | $101 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $54 | $122 | $163 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $232 | $251 | $270 |
| Office visit established patient minimal CPT 99211 • Office Visits | $22 | $23 | $25 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $36 | $43 | $51 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $88 | $93 | $97 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $125 | $133 | $140 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $161 | $174 | $188 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $66 | $82 | $97 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $103 | $103 | $103 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $137 | $175 | $212 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $44 | $44 | $44 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $69 | $70 | $71 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $100 | $103 | $106 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $10 | $41 | $72 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $103 | $116 | $130 |
| Consultation office low complexity CPT 99243 • Office Visits | $117 | $118 | $120 |
| Consultation office high complexity CPT 99245 • Office Visits | $223 | $248 | $273 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $1,048 | $1,048 | $1,048 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $483 | $483 | $483 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $522 | $522 | $522 |
| Intravitreal injection therapeutic agent CPT 67028 • Ophthalmology | $109 | $109 | $109 |