| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $132 | $141 | $150 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $81 | $88 | $96 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $112 | $120 | $128 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $113 | $131 | $150 |
| Group psychotherapy CPT 90853 • Mental Health | $58 | $58 | $58 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $2 | $2 | $2 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $25 | $27 | $30 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $114 | $123 | $132 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $11 | $72 | $133 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $56 | $183 | $310 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $86 | $257 | $429 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $111 | $111 | $111 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $81 | $121 | $161 |
| EMG needle each extremity complete CPT 95886 • Neurology | $53 | $75 | $97 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $89 | $89 | $90 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $47 | $79 | $111 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $134 | $134 | $134 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $35 | $105 | $175 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $57 | $171 | $285 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $60 | $65 | $70 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $16 | $63 | $109 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $132 | $148 | $164 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $179 | $179 | $180 |
| Office visit established patient minimal CPT 99211 • Office Visits | $17 | $23 | $30 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $43 | $50 | $57 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $65 | $77 | $88 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $96 | $110 | $125 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $88 | $110 | $132 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $97 | $134 | $170 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $66 | $98 | $131 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $149 | $173 | $198 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $38 | $83 | $129 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $129 | $129 | $130 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $50 | $89 | $129 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $10 | $70 | $129 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $15 | $72 | $129 |
| Consultation office low complexity CPT 99243 • Office Visits | $58 | $58 | $58 |
| Consultation office high complexity CPT 99245 • Office Visits | $21 | $138 | $254 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $30 | $201 | $373 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $19 | $24 | $30 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $1,130 | $1,130 | $1,131 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $138 | $138 | $138 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $30 | $539 | $1,048 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $48 | $265 | $482 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $159 | $159 | $159 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $501 | $501 | $501 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $30 | $276 | $521 |
| Intravitreal injection therapeutic agent CPT 67028 • Ophthalmology | $9 | $9 | $9 |
| Retinal detachment repair with vitrectomy CPT 67108 • Ophthalmology | $30 | $300 | $571 |
| Retinal photocoagulation treatment CPT 67210 • Ophthalmology | $30 | $201 | $372 |