| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $124 | $135 | $146 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $53 | $61 | $70 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $77 | $89 | $102 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $80 | $93 | $106 |
| Group psychotherapy CPT 90853 • Mental Health | $56 | $61 | $66 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $5 | $5 | $5 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $7 | $86 | $164 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $117 | $127 | $136 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $87 | $120 | $153 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $191 | $287 | $382 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $227 | $341 | $454 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $125 | $125 | $126 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $90 | $135 | $180 |
| EMG needle each extremity complete CPT 95886 • Neurology | $48 | $75 | $101 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $50 | $75 | $100 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $64 | $95 | $127 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $67 | $72 | $76 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $87 | $144 | $200 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $318 | $318 | $318 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $78 | $78 | $78 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $33 | $71 | $110 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $21 | $21 | $21 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $27 | $27 | $27 |
| Office visit established patient minimal CPT 99211 • Office Visits | $1 | $12 | $23 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $3 | $25 | $46 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $7 | $41 | $76 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $95 | $103 | $112 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $149 | $149 | $150 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $44 | $84 | $124 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $18 | $79 | $140 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $18 | $112 | $207 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $83 | $83 | $83 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $6 | $45 | $83 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $14 | $60 | $106 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $6 | $45 | $83 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $47 | $78 | $110 |
| Consultation office low complexity CPT 99243 • Office Visits | $44 | $69 | $95 |
| Consultation office high complexity CPT 99245 • Office Visits | $196 | $213 | $230 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $66 | $279 | $492 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $11 | $41 | $70 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $1,269 | $1,269 | $1,269 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $38 | $38 | $38 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $1,679 | $1,679 | $1,680 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $773 | $773 | $774 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $462 | $462 | $462 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $172 | $172 | $172 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $839 | $839 | $839 |
| Intravitreal injection therapeutic agent CPT 67028 • Ophthalmology | $23 | $88 | $154 |
| Retinal detachment repair with vitrectomy CPT 67108 • Ophthalmology | $1,836 | $1,836 | $1,836 |
| Retinal photocoagulation treatment CPT 67210 • Ophthalmology | $115 | $455 | $795 |