| Psychotherapy 45 minutes CPT 90834 • Mental Health | $103 | $103 | $103 |
| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $91 | $91 | $91 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $133 | $133 | $133 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $121 | $121 | $121 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $146 | $146 | $146 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $73 | $73 | $73 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $97 | $120 | $143 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $102 | $106 | $111 |
| Group psychotherapy CPT 90853 • Mental Health | $28 | $39 | $49 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $5 | $5 | $5 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $32 | $128 | $206 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $123 | $220 | $398 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $139 | $139 | $139 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $87 | $192 | $394 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $59 | $226 | $454 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $50 | $94 | $143 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $79 | $137 | $249 |
| EMG needle each extremity complete CPT 95886 • Neurology | $96 | $96 | $96 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $38 | $38 | $38 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $47 | $47 | $47 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $77 | $77 | $77 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $72 | $72 | $72 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $103 | $103 | $103 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $9 | $47 | $72 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $70 | $90 | $112 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $104 | $125 | $156 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $162 | $183 | $220 |
| Office visit established patient minimal CPT 99211 • Office Visits | $9 | $19 | $27 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $37 | $50 | $57 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $50 | $68 | $91 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $8 | $77 | $109 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $9 | $124 | $183 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $66 | $90 | $123 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $16 | $101 | $156 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $76 | $142 | $179 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $3 | $35 | $53 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $27 | $61 | $78 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $77 | $99 | $117 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $10 | $60 | $88 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $14 | $82 | $119 |
| Consultation office low complexity CPT 99243 • Office Visits | $45 | $98 | $162 |
| Consultation office high complexity CPT 99245 • Office Visits | $32 | $148 | $234 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $416 | $833 | $1,093 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $7 | $36 | $65 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $1,165 | $1,165 | $1,165 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $39 | $469 | $1,126 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $632 | $1,185 | $1,839 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $73 | $288 | $503 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $71 | $462 | $1,018 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $653 | $1,368 | $2,715 |