| Psychotherapy 60 minutes CPT 90837 • Mental Health | $130 | $130 | $130 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $149 | $149 | $149 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $181 | $181 | $181 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $87 | $87 | $87 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $125 | $128 | $131 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $136 | $136 | $136 |
| Group psychotherapy CPT 90853 • Mental Health | $46 | $46 | $46 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $6 | $6 | $6 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $122 | $122 | $122 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $110 | $120 | $130 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $128 | $128 | $128 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $351 | $351 | $351 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $417 | $417 | $417 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $105 | $106 | $108 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $147 | $147 | $147 |
| EMG needle each extremity complete CPT 95886 • Neurology | $94 | $94 | $94 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $87 | $87 | $87 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $106 | $107 | $108 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $130 | $130 | $130 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $171 | $171 | $171 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $280 | $280 | $280 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $91 | $91 | $91 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $138 | $138 | $138 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $129 | $170 | $210 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $246 | $246 | $246 |
| Office visit established patient minimal CPT 99211 • Office Visits | $19 | $19 | $19 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $54 | $54 | $54 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $95 | $95 | $95 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $138 | $149 | $160 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $185 | $185 | $185 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $71 | $71 | $71 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $112 | $112 | $112 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $129 | $139 | $150 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $43 | $43 | $43 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $68 | $68 | $68 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $103 | $103 | $103 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $69 | $69 | $69 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $98 | $99 | $99 |
| Consultation office low complexity CPT 99243 • Office Visits | $85 | $88 | $91 |
| Consultation office high complexity CPT 99245 • Office Visits | $20 | $111 | $201 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $577 | $577 | $577 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $41 | $41 | $41 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $261 | $261 | $261 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $1,163 | $1,163 | $1,163 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $535 | $535 | $536 |
| Intravitreal injection therapeutic agent CPT 67028 • Ophthalmology | $121 | $121 | $121 |
| Retinal photocoagulation treatment CPT 67210 • Ophthalmology | $548 | $548 | $548 |
| Retinal treatment extensive photocoagulation CPT 67228 • Ophthalmology | $361 | $362 | $362 |
| Strabismus surgery one horizontal muscle CPT 67311 • Ophthalmology | $484 | $484 | $484 |
| Excision chalazion single CPT 67800 • Ophthalmology | $137 | $137 | $137 |