| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $81 | $81 | $81 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $103 | $103 | $103 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $108 | $108 | $108 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $131 | $131 | $131 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $58 | $58 | $58 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $76 | $76 | $76 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $93 | $93 | $93 |
| Group psychotherapy CPT 90853 • Mental Health | $24 | $24 | $24 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $103 | $103 | $103 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $111 | $111 | $111 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $107 | $107 | $107 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $353 | $353 | $353 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $409 | $409 | $409 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $102 | $104 | $106 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $143 | $143 | $143 |
| EMG needle each extremity complete CPT 95886 • Neurology | $92 | $92 | $92 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $85 | $85 | $85 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $103 | $104 | $106 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $167 | $167 | $167 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $275 | $275 | $275 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $60 | $60 | $60 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $94 | $94 | $94 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $116 | $116 | $116 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $132 | $162 | $191 |
| Office visit established patient minimal CPT 99211 • Office Visits | $19 | $19 | $19 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $47 | $47 | $47 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $76 | $76 | $76 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $17 | $17 | $17 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $152 | $152 | $152 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $71 | $71 | $71 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $112 | $112 | $112 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $150 | $151 | $151 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $43 | $43 | $43 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $68 | $68 | $68 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $103 | $103 | $103 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $69 | $69 | $69 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $98 | $99 | $99 |
| Consultation office low complexity CPT 99243 • Office Visits | $54 | $66 | $79 |
| Consultation office high complexity CPT 99245 • Office Visits | $30 | $115 | $199 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $507 | $507 | $507 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $39 | $39 | $39 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $1,206 | $1,206 | $1,206 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $1,112 | $1,112 | $1,112 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $511 | $512 | $513 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $240 | $240 | $240 |
| Retinal photocoagulation treatment CPT 67210 • Ophthalmology | $525 | $525 | $525 |
| Retinal treatment extensive photocoagulation CPT 67228 • Ophthalmology | $346 | $346 | $346 |
| Strabismus surgery one horizontal muscle CPT 67311 • Ophthalmology | $463 | $463 | $463 |
| Blepharoptosis repair levator resection CPT 67901 • Ophthalmology | $795 | $795 | $795 |
| Lacrimal punctum closure by plug CPT 68761 • Ophthalmology | $148 | $148 | $148 |