| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $57 | $70 | $92 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $78 | $96 | $130 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $76 | $108 | $157 |
| Group psychotherapy CPT 90853 • Mental Health | $30 | $37 | $50 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $5 | $5 | $5 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $123 | $135 | $147 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $132 | $140 | $148 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $97 | $115 | $133 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $53 | $181 | $310 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $357 | $388 | $429 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $48 | $90 | $111 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $56 | $126 | $161 |
| EMG needle each extremity complete CPT 95886 • Neurology | $37 | $67 | $97 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $40 | $46 | $52 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $22 | $65 | $111 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $55 | $65 | $75 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $101 | $102 | $104 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $285 | $286 | $288 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $69 | $73 | $78 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $72 | $100 | $117 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $145 | $159 | $171 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $157 | $201 | $225 |
| Office visit established patient minimal CPT 99211 • Office Visits | $9 | $18 | $23 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $40 | $50 | $56 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $67 | $80 | $88 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $74 | $100 | $125 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $104 | $125 | $149 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $65 | $102 | $147 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $103 | $130 | $159 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $128 | $190 | $222 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $37 | $63 | $111 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $68 | $84 | $111 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $97 | $106 | $111 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $67 | $84 | $111 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $99 | $129 | $143 |
| Consultation office low complexity CPT 99243 • Office Visits | $91 | $114 | $159 |
| Consultation office high complexity CPT 99245 • Office Visits | $208 | $259 | $285 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $579 | $646 | $758 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $37 | $51 | $65 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $1,084 | $1,084 | $1,084 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $245 | $282 | $318 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $1,047 | $1,081 | $1,115 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $482 | $515 | $582 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $240 | $268 | $296 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $663 | $830 | $996 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $355 | $537 | $718 |
| Intravitreal injection therapeutic agent CPT 67028 • Ophthalmology | $109 | $114 | $119 |
| Retinal detachment repair with vitrectomy CPT 67108 • Ophthalmology | $1,141 | $1,323 | $1,506 |
| Retinal photocoagulation treatment CPT 67210 • Ophthalmology | $476 | $504 | $541 |
| Retinal treatment extensive photocoagulation CPT 67228 • Ophthalmology | $326 | $498 | $984 |