| Psychotherapy 45 minutes CPT 90834 • Mental Health | $78 | $78 | $78 |
| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $71 | $113 | $139 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $117 | $117 | $117 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $114 | $159 | $174 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $172 | $172 | $172 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $89 | $89 | $89 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $82 | $82 | $82 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $101 | $101 | $101 |
| Group psychotherapy CPT 90853 • Mental Health | $29 | $29 | $29 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $5 | $5 | $5 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $100 | $100 | $100 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $172 | $172 | $172 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $178 | $178 | $178 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $127 | $127 | $127 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $167 | $167 | $167 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $33 | $33 | $33 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $30 | $30 | $30 |
| EMG needle each extremity complete CPT 95886 • Neurology | $40 | $40 | $40 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $54 | $54 | $54 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $68 | $68 | $68 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $61 | $61 | $61 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $108 | $108 | $108 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $309 | $309 | $309 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $56 | $61 | $72 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $61 | $108 | $131 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $36 | $87 | $147 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $160 | $218 | $259 |
| Office visit established patient minimal CPT 99211 • Office Visits | $18 | $31 | $36 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $33 | $52 | $69 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $36 | $41 | $54 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $36 | $42 | $61 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $88 | $170 | $211 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $78 | $129 | $205 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $110 | $173 | $205 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $36 | $165 | $231 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $33 | $41 | $45 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $36 | $83 | $156 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $36 | $108 | $156 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $36 | $102 | $156 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $87 | $133 | $156 |
| Consultation office low complexity CPT 99243 • Office Visits | $36 | $123 | $205 |
| Consultation office high complexity CPT 99245 • Office Visits | $202 | $202 | $202 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $561 | $561 | $561 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $55 | $55 | $55 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $1,271 | $1,271 | $1,271 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $358 | $358 | $358 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $1,189 | $1,240 | $1,257 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $631 | $631 | $631 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $460 | $460 | $460 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $1,094 | $1,094 | $1,094 |