| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $117 | $117 | $117 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $154 | $154 | $154 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $161 | $161 | $161 |
| Group psychotherapy CPT 90853 • Mental Health | $45 | $45 | $45 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $8 | $8 | $8 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $249 | $249 | $249 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $233 | $233 | $233 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $178 | $178 | $178 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $91 | $91 | $91 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $715 | $715 | $715 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $193 | $193 | $193 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $273 | $273 | $273 |
| EMG needle each extremity complete CPT 95886 • Neurology | $93 | $93 | $93 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $69 | $69 | $69 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $84 | $84 | $84 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $126 | $126 | $126 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $297 | $297 | $297 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $184 | $184 | $184 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $76 | $109 | $141 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $185 | $202 | $218 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $214 | $270 | $327 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $364 | $398 | $432 |
| Office visit established patient minimal CPT 99211 • Office Visits | $14 | $29 | $44 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $56 | $83 | $109 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $106 | $141 | $177 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $156 | $204 | $252 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $299 | $326 | $352 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $132 | $208 | $285 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $208 | $296 | $384 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $276 | $421 | $566 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $79 | $94 | $109 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $126 | $164 | $203 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $189 | $241 | $292 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $131 | $167 | $203 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $184 | $242 | $300 |
| Consultation office low complexity CPT 99243 • Office Visits | $186 | $263 | $341 |
| Consultation office high complexity CPT 99245 • Office Visits | $288 | $456 | $624 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $1,056 | $1,056 | $1,056 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $58 | $58 | $58 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $1,942 | $1,942 | $1,942 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $337 | $337 | $337 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $1,820 | $1,820 | $1,820 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $853 | $853 | $853 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $393 | $393 | $393 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $1,230 | $1,230 | $1,230 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $899 | $899 | $899 |
| Intravitreal injection therapeutic agent CPT 67028 • Ophthalmology | $189 | $189 | $189 |
| Retinal detachment repair with vitrectomy CPT 67108 • Ophthalmology | $1,950 | $1,950 | $1,950 |
| Retinal photocoagulation treatment CPT 67210 • Ophthalmology | $860 | $860 | $860 |
| Retinal treatment extensive photocoagulation CPT 67228 • Ophthalmology | $497 | $497 | $497 |