| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $124 | $124 | $124 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $52 | $52 | $53 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $78 | $85 | $91 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $76 | $82 | $91 |
| Group psychotherapy CPT 90853 • Mental Health | $48 | $48 | $49 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $1 | $3 | $4 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $7 | $71 | $135 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $45 | $74 | $103 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $18 | $67 | $117 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $57 | $231 | $350 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $66 | $197 | $328 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $48 | $72 | $96 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $28 | $83 | $138 |
| EMG needle each extremity complete CPT 95886 • Neurology | $14 | $43 | $72 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $77 | $77 | $77 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $99 | $99 | $100 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $65 | $65 | $65 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $31 | $94 | $156 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $86 | $161 | $236 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $62 | $67 | $72 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $103 | $106 | $108 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $40 | $111 | $169 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $40 | $135 | $191 |
| Office visit established patient minimal CPT 99211 • Office Visits | $17 | $19 | $21 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $11 | $32 | $48 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $61 | $68 | $77 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $40 | $86 | $129 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $61 | $114 | $142 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $43 | $95 | $146 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $116 | $131 | $146 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $86 | $144 | $185 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $17 | $41 | $64 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $65 | $66 | $68 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $45 | $70 | $94 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $31 | $48 | $66 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $14 | $55 | $97 |
| Consultation office low complexity CPT 99243 • Office Visits | $106 | $106 | $106 |
| Consultation office high complexity CPT 99245 • Office Visits | $157 | $171 | $185 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $359 | $435 | $512 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $14 | $22 | $30 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $641 | $641 | $641 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $19 | $19 | $19 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $85 | $468 | $850 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $39 | $216 | $392 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $18 | $18 | $18 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $58 | $58 | $58 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $45 | $128 | $212 |
| Intravitreal injection therapeutic agent CPT 67028 • Ophthalmology | $72 | $72 | $72 |
| Retinal detachment repair with vitrectomy CPT 67108 • Ophthalmology | $45 | $92 | $139 |
| Retinal photocoagulation treatment CPT 67210 • Ophthalmology | $402 | $402 | $403 |