| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $139 | $139 | $139 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $69 | $69 | $70 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $80 | $85 | $91 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $94 | $103 | $111 |
| Group psychotherapy CPT 90853 • Mental Health | $44 | $51 | $58 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $0 | $0 | $0 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $124 | $124 | $124 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $16 | $28 | $40 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $70 | $70 | $70 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $375 | $375 | $375 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $449 | $449 | $450 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $60 | $90 | $120 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $175 | $175 | $175 |
| EMG needle each extremity complete CPT 95886 • Neurology | $48 | $75 | $103 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $96 | $96 | $97 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $122 | $122 | $122 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $83 | $83 | $83 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $191 | $191 | $192 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $114 | $212 | $310 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $57 | $65 | $73 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $13 | $59 | $105 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $54 | $54 | $54 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $15 | $109 | $203 |
| Office visit established patient minimal CPT 99211 • Office Visits | $7 | $24 | $40 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $3 | $23 | $44 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $11 | $41 | $71 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $15 | $61 | $106 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $14 | $79 | $143 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $8 | $67 | $127 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $135 | $135 | $136 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $40 | $121 | $201 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $5 | $38 | $72 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $72 | $72 | $72 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $78 | $90 | $103 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $9 | $40 | $72 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $8 | $58 | $107 |
| Consultation office low complexity CPT 99243 • Office Visits | $43 | $91 | $139 |
| Consultation office high complexity CPT 99245 • Office Visits | $166 | $193 | $220 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $222 | $222 | $222 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $7 | $7 | $7 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $1,101 | $1,101 | $1,101 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $35 | $35 | $35 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $153 | $153 | $153 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $471 | $471 | $471 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $154 | $154 | $154 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $105 | $401 | $698 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $509 | $509 | $509 |
| Intravitreal injection therapeutic agent CPT 67028 • Ophthalmology | $21 | $21 | $21 |
| Retinal detachment repair with vitrectomy CPT 67108 • Ophthalmology | $558 | $558 | $558 |
| Retinal photocoagulation treatment CPT 67210 • Ophthalmology | $93 | $93 | $93 |