| Psychotherapy 60 minutes CPT 90837 • Mental Health | $126 | $126 | $126 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $100 | $100 | $100 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $4 | $4 | $4 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $69 | $96 | $123 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $246 | $246 | $246 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $179 | $179 | $179 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $335 | $426 | $518 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $390 | $493 | $596 |
| EMG needle each extremity complete CPT 95886 • Neurology | $53 | $68 | $83 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $126 | $126 | $126 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $98 | $98 | $98 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $130 | $130 | $130 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $231 | $231 | $231 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $89 | $93 | $97 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $100 | $125 | $149 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $202 | $213 | $224 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $296 | $301 | $306 |
| Office visit established patient minimal CPT 99211 • Office Visits | $20 | $26 | $31 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $62 | $69 | $76 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $108 | $115 | $122 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $115 | $144 | $172 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $219 | $231 | $243 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $99 | $99 | $99 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $178 | $178 | $178 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $210 | $210 | $210 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $63 | $63 | $63 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $98 | $98 | $98 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $151 | $151 | $151 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $103 | $103 | $103 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $146 | $146 | $146 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $605 | $717 | $829 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $1,564 | $1,564 | $1,564 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $715 | $715 | $715 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $720 | $720 | $720 |
| Strabismus surgery one horizontal muscle CPT 67311 • Ophthalmology | $604 | $604 | $604 |
| Arthrocentesis aspiration small joint CPT 20600 • Orthopedics | $45 | $58 | $72 |
| Arthrocentesis aspiration intermediate joint CPT 20605 • Orthopedics | $49 | $61 | $73 |
| Arthrocentesis aspiration major joint CPT 20610 • Orthopedics | $59 | $73 | $86 |
| Cervical spine fusion anterior approach CPT 22551 • Orthopedics | $1,944 | $2,083 | $2,223 |
| Total shoulder replacement CPT 23472 • Orthopedics | $1,728 | $1,820 | $1,911 |
| Reverse total shoulder replacement CPT 23473 • Orthopedics | $1,745 | $1,745 | $1,745 |
| Closed treatment distal radial fracture CPT 25600 • Orthopedics | $465 | $465 | $465 |
| Tendon sheath incision trigger finger CPT 26055 • Orthopedics | $296 | $537 | $778 |
| Total hip replacement CPT 27130 • Orthopedics | $1,376 | $1,537 | $1,698 |
| Hip replacement conversion to total CPT 27132 • Orthopedics | $2,205 | $2,205 | $2,205 |
| Treatment intertrochanteric fracture with plate/screw CPT 27245 • Orthopedics | $1,468 | $1,546 | $1,624 |
| Partial knee replacement medial or lateral CPT 27446 • Orthopedics | $1,520 | $1,520 | $1,520 |
| Total knee replacement CPT 27447 • Orthopedics | $1,373 | $1,534 | $1,695 |
| Bunionectomy with osteotomy CPT 28296 • Orthopedics | $257 | $714 | $1,172 |
| Arthroscopy shoulder decompression CPT 29826 • Orthopedics | $20 | $122 | $225 |