| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $118 | $135 | $152 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $52 | $55 | $58 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $80 | $95 | $110 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $83 | $105 | $126 |
| Group psychotherapy CPT 90853 • Mental Health | $59 | $62 | $66 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $4 | $4 | $5 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $22 | $22 | $22 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $77 | $97 | $116 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $117 | $117 | $117 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $68 | $203 | $338 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $93 | $93 | $93 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $60 | $89 | $119 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $151 | $155 | $158 |
| EMG needle each extremity complete CPT 95886 • Neurology | $16 | $16 | $16 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $46 | $71 | $96 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $51 | $51 | $51 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $69 | $69 | $69 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $94 | $94 | $94 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $196 | $196 | $196 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $19 | $19 | $19 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $114 | $114 | $114 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $16 | $26 | $36 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $36 | $59 | $82 |
| Office visit established patient minimal CPT 99211 • Office Visits | $22 | $22 | $22 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $3 | $3 | $3 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $69 | $69 | $69 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $84 | $100 | $116 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $68 | $68 | $68 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $8 | $8 | $8 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $10 | $10 | $10 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $183 | $200 | $216 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $29 | $29 | $29 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $110 | $110 | $110 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $8 | $8 | $8 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $5 | $5 | $5 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $38 | $38 | $38 |
| Consultation office low complexity CPT 99243 • Office Visits | $42 | $68 | $93 |
| Consultation office high complexity CPT 99245 • Office Visits | $236 | $236 | $236 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $74 | $74 | $74 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $26 | $26 | $26 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $771 | $853 | $934 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $232 | $232 | $232 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $652 | $652 | $652 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $452 | $452 | $452 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $272 | $277 | $282 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $178 | $178 | $178 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $255 | $255 | $255 |
| Intravitreal injection therapeutic agent CPT 67028 • Ophthalmology | $11 | $11 | $11 |
| Retinal detachment repair with vitrectomy CPT 67108 • Ophthalmology | $709 | $709 | $709 |
| Retinal photocoagulation treatment CPT 67210 • Ophthalmology | $62 | $62 | $62 |