| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $106 | $109 | $113 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $62 | $63 | $65 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $69 | $82 | $94 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $78 | $84 | $91 |
| Group psychotherapy CPT 90853 • Mental Health | $23 | $36 | $49 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $0 | $2 | $4 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $25 | $78 | $131 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $21 | $69 | $117 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $77 | $87 | $96 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $54 | $102 | $149 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $45 | $210 | $375 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $41 | $45 | $49 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $65 | $113 | $161 |
| EMG needle each extremity complete CPT 95886 • Neurology | $33 | $59 | $84 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $39 | $59 | $80 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $55 | $80 | $106 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $56 | $87 | $118 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $77 | $83 | $88 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $106 | $131 | $157 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $8 | $26 | $44 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $66 | $79 | $92 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $19 | $81 | $142 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $20 | $107 | $193 |
| Office visit established patient minimal CPT 99211 • Office Visits | $8 | $12 | $16 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $10 | $17 | $24 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $20 | $32 | $44 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $9 | $39 | $68 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $111 | $118 | $126 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $81 | $88 | $95 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $11 | $65 | $119 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $160 | $168 | $175 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $5 | $21 | $37 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $6 | $34 | $63 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $8 | $53 | $97 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $65 | $66 | $68 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $90 | $91 | $93 |
| Consultation office low complexity CPT 99243 • Office Visits | $105 | $106 | $107 |
| Consultation office high complexity CPT 99245 • Office Visits | $19 | $99 | $180 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $355 | $445 | $535 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $22 | $33 | $43 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $657 | $842 | $1,026 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $31 | $123 | $214 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $406 | $677 | $949 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $262 | $349 | $437 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $35 | $158 | $280 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $111 | $405 | $700 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $40 | $275 | $510 |
| Intravitreal injection therapeutic agent CPT 67028 • Ophthalmology | $7 | $51 | $94 |
| Retinal detachment repair with vitrectomy CPT 67108 • Ophthalmology | $133 | $625 | $1,118 |
| Retinal photocoagulation treatment CPT 67210 • Ophthalmology | $288 | $386 | $483 |