| Psychotherapy 60 minutes CPT 90837 • Mental Health | $93 | $93 | $93 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $108 | $147 | $185 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $163 | $163 | $163 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $79 | $87 | $96 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $108 | $129 | $150 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $150 | $154 | $157 |
| Group psychotherapy CPT 90853 • Mental Health | $44 | $44 | $44 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $30 | $30 | $30 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $134 | $134 | $134 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $351 | $359 | $367 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $111 | $111 | $111 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $161 | $161 | $161 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $90 | $90 | $90 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $112 | $112 | $112 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $134 | $134 | $134 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $175 | $175 | $175 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $285 | $285 | $285 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $59 | $65 | $71 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $89 | $89 | $89 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $164 | $165 | $166 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $133 | $189 | $246 |
| Office visit established patient minimal CPT 99211 • Office Visits | $30 | $30 | $30 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $44 | $50 | $55 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $30 | $70 | $110 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $30 | $95 | $160 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $173 | $173 | $173 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $30 | $30 | $30 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $198 | $198 | $198 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $30 | $30 | $30 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $30 | $30 | $30 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $30 | $30 | $30 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $130 | $130 | $130 |
| Consultation office low complexity CPT 99243 • Office Visits | $30 | $30 | $30 |
| Consultation office high complexity CPT 99245 • Office Visits | $255 | $255 | $255 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $30 | $30 | $30 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $483 | $483 | $483 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $30 | $30 | $30 |
| Intravitreal injection therapeutic agent CPT 67028 • Ophthalmology | $30 | $30 | $30 |
| Retinal detachment repair with vitrectomy CPT 67108 • Ophthalmology | $30 | $30 | $30 |
| Retinal photocoagulation treatment CPT 67210 • Ophthalmology | $30 | $30 | $30 |
| Retinal treatment extensive photocoagulation CPT 67228 • Ophthalmology | $30 | $30 | $30 |
| Excision chalazion single CPT 67800 • Ophthalmology | $30 | $30 | $30 |
| Blepharoptosis repair levator resection CPT 67901 • Ophthalmology | $772 | $772 | $772 |
| Eye exam established patient intermediate CPT 92012 • Ophthalmology | $86 | $86 | $86 |
| Eye exam established patient comprehensive CPT 92014 • Ophthalmology | $122 | $122 | $122 |
| Retinal imaging OCT posterior segment CPT 92134 • Ophthalmology | $39 | $39 | $39 |
| Ophthalmic biometry IOL power calculation CPT 92136 • Ophthalmology | $30 | $30 | $30 |
| Fundus photography CPT 92250 • Ophthalmology | $30 | $30 | $30 |
| Arthrocentesis aspiration intermediate joint CPT 20605 • Orthopedics | $30 | $30 | $30 |
| Arthrocentesis aspiration major joint CPT 20610 • Orthopedics | $63 | $63 | $63 |