| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $173 | $173 | $173 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $83 | $84 | $85 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $76 | $105 | $134 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $125 | $138 | $150 |
| Group psychotherapy CPT 90853 • Mental Health | $30 | $33 | $36 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $6 | $6 | $6 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $130 | $130 | $130 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $132 | $135 | $138 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $133 | $133 | $134 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $213 | $321 | $383 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $185 | $185 | $185 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $111 | $127 | $144 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $71 | $76 | $80 |
| EMG needle each extremity complete CPT 95886 • Neurology | $55 | $55 | $55 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $40 | $65 | $90 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $48 | $80 | $112 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $132 | $133 | $134 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $130 | $153 | $175 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $228 | $256 | $285 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $60 | $69 | $75 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $111 | $119 | $128 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $13 | $71 | $155 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $166 | $184 | $216 |
| Office visit established patient minimal CPT 99211 • Office Visits | $22 | $31 | $44 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $36 | $45 | $54 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $58 | $69 | $88 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $52 | $102 | $129 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $133 | $136 | $138 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $85 | $91 | $97 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $116 | $134 | $153 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $171 | $188 | $200 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $29 | $38 | $47 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $62 | $71 | $82 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $89 | $97 | $103 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $10 | $57 | $87 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $121 | $123 | $128 |
| Consultation office low complexity CPT 99243 • Office Visits | $112 | $114 | $117 |
| Consultation office high complexity CPT 99245 • Office Visits | $21 | $145 | $269 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $565 | $565 | $565 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $55 | $55 | $55 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $937 | $937 | $937 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $241 | $241 | $241 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $949 | $998 | $1,048 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $483 | $491 | $500 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $329 | $329 | $329 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $860 | $860 | $860 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $522 | $587 | $652 |
| Intravitreal injection therapeutic agent CPT 67028 • Ophthalmology | $109 | $123 | $138 |
| Retinal detachment repair with vitrectomy CPT 67108 • Ophthalmology | $1,142 | $1,286 | $1,430 |
| Retinal photocoagulation treatment CPT 67210 • Ophthalmology | $495 | $557 | $619 |