| Psychotherapy 60 minutes CPT 90837 • Mental Health | $131 | $149 | $168 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $154 | $154 | $154 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $106 | $181 | $257 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $133 | $133 | $133 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $116 | $116 | $116 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $133 | $133 | $133 |
| Group psychotherapy CPT 90853 • Mental Health | $44 | $44 | $44 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $6 | $6 | $7 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $213 | $213 | $213 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $215 | $215 | $215 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $141 | $141 | $141 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $456 | $456 | $456 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $517 | $517 | $517 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $63 | $63 | $63 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $192 | $192 | $192 |
| EMG needle each extremity complete CPT 95886 • Neurology | $120 | $120 | $120 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $130 | $130 | $130 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $161 | $161 | $161 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $83 | $83 | $83 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $146 | $146 | $146 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $260 | $260 | $260 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $71 | $76 | $86 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $90 | $98 | $105 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $117 | $153 | $191 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $190 | $206 | $238 |
| Office visit established patient minimal CPT 99211 • Office Visits | $23 | $23 | $23 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $24 | $32 | $41 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $58 | $67 | $84 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $91 | $102 | $124 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $132 | $149 | $167 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $80 | $92 | $118 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $130 | $145 | $160 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $172 | $193 | $236 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $40 | $43 | $46 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $62 | $70 | $84 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $87 | $98 | $121 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $78 | $80 | $84 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $106 | $112 | $124 |
| Consultation office low complexity CPT 99243 • Office Visits | $113 | $113 | $113 |
| Consultation office high complexity CPT 99245 • Office Visits | $223 | $223 | $223 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $839 | $839 | $839 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $73 | $73 | $73 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $1,571 | $1,571 | $1,571 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $407 | $407 | $407 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $1,617 | $1,617 | $1,617 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $843 | $843 | $843 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $348 | $348 | $348 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $1,445 | $1,445 | $1,445 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $1,042 | $1,042 | $1,042 |
| Intravitreal injection therapeutic agent CPT 67028 • Ophthalmology | $158 | $158 | $158 |