| Psychotherapy 60 minutes CPT 90837 • Mental Health | $188 | $188 | $188 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $133 | $133 | $133 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $160 | $160 | $160 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $89 | $89 | $89 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $122 | $122 | $122 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $128 | $128 | $128 |
| Group psychotherapy CPT 90853 • Mental Health | $30 | $30 | $30 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $6 | $6 | $6 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $79 | $79 | $79 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $149 | $149 | $149 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $172 | $172 | $172 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $401 | $401 | $401 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $71 | $71 | $71 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $77 | $77 | $77 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $201 | $201 | $201 |
| EMG needle each extremity complete CPT 95886 • Neurology | $122 | $122 | $122 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $66 | $66 | $66 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $57 | $57 | $57 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $99 | $99 | $99 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $220 | $220 | $220 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $359 | $359 | $359 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $55 | $92 | $110 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $128 | $150 | $171 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $132 | $150 | $163 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $162 | $235 | $336 |
| Office visit established patient minimal CPT 99211 • Office Visits | $26 | $30 | $35 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $41 | $71 | $86 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $76 | $117 | $138 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $147 | $179 | $195 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $206 | $240 | $274 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $96 | $96 | $96 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $150 | $150 | $150 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $168 | $212 | $267 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $57 | $57 | $57 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $91 | $112 | $122 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $138 | $138 | $138 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $93 | $93 | $93 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $132 | $132 | $132 |
| Consultation office low complexity CPT 99243 • Office Visits | $131 | $131 | $131 |
| Consultation office high complexity CPT 99245 • Office Visits | $244 | $244 | $244 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $787 | $787 | $787 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $46 | $46 | $46 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $1,484 | $1,484 | $1,484 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $310 | $310 | $310 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $1,374 | $1,374 | $1,374 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $635 | $635 | $635 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $377 | $377 | $377 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $937 | $937 | $937 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $684 | $684 | $684 |
| Intravitreal injection therapeutic agent CPT 67028 • Ophthalmology | $143 | $143 | $143 |