| Psychotherapy 60 minutes CPT 90837 • Mental Health | $105 | $105 | $105 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $105 | $105 | $105 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $124 | $124 | $124 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $46 | $46 | $46 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $68 | $68 | $68 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $91 | $91 | $91 |
| Group psychotherapy CPT 90853 • Mental Health | $48 | $48 | $48 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $4 | $4 | $4 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $140 | $140 | $140 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $68 | $68 | $68 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $99 | $99 | $99 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $98 | $98 | $98 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $117 | $117 | $117 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $104 | $135 | $165 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $135 | $169 | $204 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $104 | $104 | $104 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $146 | $146 | $146 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $90 | $90 | $90 |
| Consultation office low complexity CPT 99243 • Office Visits | $40 | $82 | $124 |
| Consultation office high complexity CPT 99245 • Office Visits | $206 | $206 | $206 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $374 | $374 | $374 |
| Retinal treatment extensive photocoagulation CPT 67228 • Ophthalmology | $254 | $254 | $254 |
| Blepharoptosis repair levator resection CPT 67901 • Ophthalmology | $596 | $596 | $596 |
| Eye exam new patient comprehensive CPT 92004 • Ophthalmology | $75 | $75 | $75 |
| Eye exam established patient intermediate CPT 92012 • Ophthalmology | $65 | $65 | $65 |
| Retinal imaging OCT posterior segment CPT 92134 • Ophthalmology | $31 | $31 | $31 |
| Fundus photography CPT 92250 • Ophthalmology | $16 | $16 | $16 |
| Arthrocentesis aspiration small joint CPT 20600 • Orthopedics | $42 | $42 | $42 |
| Arthrocentesis aspiration intermediate joint CPT 20605 • Orthopedics | $40 | $40 | $40 |
| Arthrocentesis aspiration major joint CPT 20610 • Orthopedics | $41 | $41 | $41 |
| Lumbar spine fusion combined approach CPT 22633 • Orthopedics | $1,685 | $1,685 | $1,685 |
| Total knee replacement CPT 27447 • Orthopedics | $1,276 | $1,276 | $1,276 |
| Open treatment tibial shaft fracture CPT 27756 • Orthopedics | $459 | $459 | $459 |
| Bunionectomy with osteotomy CPT 28296 • Orthopedics | $545 | $545 | $545 |
| Arthroscopy shoulder decompression CPT 29826 • Orthopedics | $541 | $541 | $541 |
| Arthroscopy knee with meniscectomy CPT 29881 • Orthopedics | $520 | $520 | $520 |
| Sacroiliac joint injection CPT 27096 • Pain Management | $138 | $138 | $138 |
| Epidural injection cervical or thoracic with imaging CPT 62321 • Pain Management | $97 | $97 | $97 |
| Epidural injection lumbar or sacral without imaging CPT 62322 • Pain Management | $133 | $133 | $133 |
| Peripheral nerve block injection CPT 64450 • Pain Management | $56 | $56 | $56 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $375 | $375 | $375 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $156 | $156 | $156 |
| Molecular cytogenetics DNA probe each CPT 88271 • Pathology | $13 | $13 | $13 |
| Surgical pathology gross and micro exam level IV CPT 88305 • Pathology | $63 | $63 | $63 |
| Surgical pathology gross and micro exam level V CPT 88307 • Pathology | $129 | $129 | $129 |
| Morphometric analysis tumor quantitative CPT 88360 • Pathology | $33 | $33 | $33 |
| Microdissection manual CPT 88381 • Pathology | $119 | $119 | $119 |
| Hot or cold packs application CPT 97010 • Physical Therapy | $3 | $3 | $3 |
| Electrical stimulation unattended CPT 97014 • Physical Therapy | $8 | $8 | $8 |
| Vasopneumatic device therapy CPT 97016 • Physical Therapy | $9 | $9 | $9 |