| Psychotherapy 30 min add-on to E/M CPT 90833 • Mental Health | $72 | $92 | $102 |
| Psychotherapy 45 minutes CPT 90834 • Mental Health | $71 | $104 | $130 |
| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $84 | $99 | $116 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $119 | $128 | $138 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $94 | $120 | $144 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $114 | $145 | $176 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $50 | $73 | $85 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $84 | $110 | $134 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $116 | $139 | $150 |
| Group psychotherapy CPT 90853 • Mental Health | $40 | $50 | $59 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $108 | $108 | $108 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $132 | $132 | $132 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $117 | $125 | $134 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $359 | $363 | $367 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $421 | $421 | $421 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $108 | $108 | $109 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $157 | $159 | $161 |
| EMG needle each extremity complete CPT 95886 • Neurology | $97 | $97 | $97 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $38 | $63 | $89 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $109 | $109 | $109 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $54 | $94 | $134 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $175 | $175 | $175 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $179 | $232 | $285 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $59 | $68 | $74 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $107 | $110 | $112 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $122 | $140 | $163 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $178 | $179 | $180 |
| Office visit established patient minimal CPT 99211 • Office Visits | $19 | $21 | $23 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $36 | $48 | $54 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $86 | $88 | $88 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $110 | $119 | $125 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $171 | $173 | $176 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $59 | $103 | $152 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $93 | $122 | $152 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $165 | $186 | $212 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $47 | $81 | $115 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $69 | $87 | $115 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $96 | $104 | $115 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $10 | $67 | $115 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $109 | $116 | $130 |
| Consultation office low complexity CPT 99243 • Office Visits | $92 | $114 | $133 |
| Consultation office high complexity CPT 99245 • Office Visits | $21 | $165 | $272 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $534 | $534 | $534 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $37 | $37 | $37 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $1,130 | $1,130 | $1,130 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $1,046 | $1,047 | $1,048 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $481 | $482 | $483 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $521 | $521 | $522 |
| Intravitreal injection therapeutic agent CPT 67028 • Ophthalmology | $88 | $99 | $109 |
| Retinal detachment repair with vitrectomy CPT 67108 • Ophthalmology | $1,142 | $1,142 | $1,142 |