| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $176 | $176 | $177 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $71 | $71 | $72 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $112 | $120 | $128 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $150 | $150 | $150 |
| Group psychotherapy CPT 90853 • Mental Health | $77 | $77 | $78 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $4 | $4 | $4 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $30 | $30 | $30 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $20 | $20 | $20 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $106 | $119 | $133 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $310 | $310 | $311 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $429 | $429 | $430 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $111 | $111 | $111 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $81 | $121 | $161 |
| EMG needle each extremity complete CPT 95886 • Neurology | $49 | $73 | $97 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $52 | $71 | $89 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $22 | $67 | $111 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $55 | $55 | $56 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $35 | $105 | $175 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $57 | $171 | $285 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $53 | $62 | $70 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $12 | $61 | $109 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $139 | $139 | $139 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $108 | $161 | $215 |
| Office visit established patient minimal CPT 99211 • Office Visits | $17 | $23 | $30 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $30 | $42 | $54 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $30 | $53 | $75 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $48 | $86 | $125 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $18 | $97 | $176 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $145 | $158 | $170 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $131 | $131 | $131 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $193 | $195 | $198 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $19 | $64 | $110 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $110 | $110 | $110 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $99 | $99 | $100 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $97 | $104 | $110 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $15 | $63 | $110 |
| Consultation office low complexity CPT 99243 • Office Visits | $93 | $110 | $127 |
| Consultation office high complexity CPT 99245 • Office Visits | $213 | $234 | $254 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $30 | $226 | $421 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $30 | $33 | $35 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $792 | $792 | $792 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $119 | $119 | $119 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $30 | $277 | $524 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $482 | $482 | $483 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $34 | $34 | $34 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $30 | $30 | $30 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $30 | $276 | $522 |
| Intravitreal injection therapeutic agent CPT 67028 • Ophthalmology | $30 | $30 | $30 |
| Retinal detachment repair with vitrectomy CPT 67108 • Ophthalmology | $571 | $571 | $571 |
| Retinal photocoagulation treatment CPT 67210 • Ophthalmology | $30 | $263 | $495 |