| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $108 | $108 | $108 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $74 | $89 | $104 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $103 | $117 | $130 |
| Group psychotherapy CPT 90853 • Mental Health | $38 | $38 | $38 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $3 | $5 | $7 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $93 | $93 | $93 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $86 | $139 | $192 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $99 | $116 | $134 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $65 | $159 | $252 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $64 | $64 | $64 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $59 | $59 | $59 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $94 | $94 | $94 |
| EMG needle each extremity complete CPT 95886 • Neurology | $60 | $60 | $60 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $55 | $55 | $55 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $149 | $149 | $149 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $99 | $99 | $99 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $235 | $235 | $235 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $387 | $387 | $387 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $59 | $70 | $81 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $77 | $98 | $118 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $127 | $153 | $183 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $153 | $181 | $230 |
| Office visit established patient minimal CPT 99211 • Office Visits | $21 | $22 | $23 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $39 | $43 | $47 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $63 | $71 | $79 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $90 | $96 | $99 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $133 | $146 | $159 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $92 | $103 | $115 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $107 | $131 | $156 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $157 | $181 | $229 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $46 | $62 | $78 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $49 | $66 | $83 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $71 | $95 | $119 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $78 | $80 | $81 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $84 | $96 | $119 |
| Consultation office low complexity CPT 99243 • Office Visits | $151 | $151 | $151 |
| Consultation office high complexity CPT 99245 • Office Visits | $273 | $273 | $273 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $714 | $714 | $714 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $75 | $75 | $75 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $1,261 | $1,261 | $1,261 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $370 | $370 | $370 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $1,288 | $1,288 | $1,288 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $673 | $673 | $673 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $489 | $489 | $489 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $1,172 | $1,172 | $1,172 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $842 | $842 | $842 |
| Intravitreal injection therapeutic agent CPT 67028 • Ophthalmology | $231 | $231 | $231 |
| Retinal detachment repair with vitrectomy CPT 67108 • Ophthalmology | $1,764 | $1,764 | $1,764 |
| Retinal photocoagulation treatment CPT 67210 • Ophthalmology | $758 | $758 | $758 |
| Retinal treatment extensive photocoagulation CPT 67228 • Ophthalmology | $1,305 | $1,305 | $1,305 |