| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $63 | $88 | $116 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $127 | $133 | $138 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $108 | $118 | $135 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $123 | $143 | $163 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $64 | $85 | $96 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $127 | $147 | $164 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $75 | $113 | $150 |
| Group psychotherapy CPT 90853 • Mental Health | $28 | $35 | $41 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $4 | $5 | $5 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $164 | $165 | $167 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $30 | $88 | $131 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $119 | $129 | $135 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $252 | $322 | $367 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $50 | $160 | $271 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $90 | $97 | $104 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $149 | $162 | $176 |
| EMG needle each extremity complete CPT 95886 • Neurology | $79 | $88 | $97 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $60 | $85 | $104 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $38 | $99 | $130 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $69 | $102 | $134 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $59 | $146 | $203 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $135 | $251 | $333 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $27 | $58 | $77 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $83 | $96 | $109 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $30 | $109 | $164 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $169 | $174 | $179 |
| Office visit established patient minimal CPT 99211 • Office Visits | $8 | $18 | $30 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $38 | $45 | $55 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $30 | $51 | $70 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $30 | $70 | $98 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $98 | $105 | $111 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $30 | $71 | $104 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $73 | $90 | $107 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $158 | $187 | $206 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $32 | $36 | $40 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $30 | $58 | $86 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $30 | $63 | $83 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $30 | $54 | $74 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $85 | $114 | $130 |
| Consultation office low complexity CPT 99243 • Office Visits | $30 | $100 | $147 |
| Consultation office high complexity CPT 99245 • Office Visits | $203 | $253 | $301 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $501 | $565 | $629 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $39 | $52 | $65 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $905 | $905 | $905 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $212 | $264 | $317 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $30 | $683 | $1,091 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $427 | $497 | $582 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $219 | $254 | $288 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $30 | $465 | $900 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $30 | $206 | $558 |