| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $132 | $136 | $145 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $46 | $74 | $96 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $78 | $126 | $150 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $77 | $118 | $150 |
| Group psychotherapy CPT 90853 • Mental Health | $30 | $58 | $77 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $1 | $2 | $4 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $12 | $21 | $30 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $11 | $11 | $11 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $27 | $27 | $27 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $73 | $73 | $73 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $215 | $297 | $379 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $61 | $61 | $61 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $80 | $121 | $161 |
| EMG needle each extremity complete CPT 95886 • Neurology | $45 | $71 | $97 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $45 | $67 | $89 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $112 | $112 | $112 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $55 | $95 | $134 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $105 | $140 | $175 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $184 | $184 | $184 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $11 | $49 | $70 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $82 | $101 | $112 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $66 | $89 | $113 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $108 | $158 | $205 |
| Office visit established patient minimal CPT 99211 • Office Visits | $4 | $14 | $30 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $5 | $40 | $57 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $56 | $77 | $88 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $48 | $97 | $125 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $30 | $88 | $132 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $30 | $88 | $170 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $20 | $90 | $131 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $30 | $131 | $198 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $39 | $99 | $130 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $10 | $69 | $129 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $100 | $111 | $129 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $75 | $100 | $129 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $102 | $111 | $129 |
| Consultation office low complexity CPT 99243 • Office Visits | $18 | $94 | $170 |
| Consultation office high complexity CPT 99245 • Office Visits | $28 | $141 | $254 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $30 | $363 | $758 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $26 | $28 | $30 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $792 | $961 | $1,130 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $148 | $197 | $245 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $30 | $67 | $105 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $362 | $362 | $362 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $227 | $261 | $296 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $30 | $269 | $747 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $104 | $230 | $355 |
| Intravitreal injection therapeutic agent CPT 67028 • Ophthalmology | $9 | $79 | $119 |
| Retinal detachment repair with vitrectomy CPT 67108 • Ophthalmology | $114 | $628 | $1,141 |
| Retinal photocoagulation treatment CPT 67210 • Ophthalmology | $30 | $215 | $515 |