| Psychotherapy 60 minutes CPT 90837 • Mental Health | $133 | $159 | $185 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $118 | $132 | $145 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $144 | $147 | $150 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $71 | $77 | $82 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $97 | $114 | $130 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $102 | $130 | $158 |
| Group psychotherapy CPT 90853 • Mental Health | $27 | $47 | $67 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $4 | $4 | $4 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $137 | $137 | $137 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $131 | $131 | $131 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $104 | $104 | $104 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $367 | $367 | $367 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $54 | $54 | $54 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $106 | $106 | $106 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $74 | $74 | $74 |
| EMG needle each extremity complete CPT 95886 • Neurology | $91 | $91 | $91 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $35 | $35 | $35 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $43 | $43 | $43 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $75 | $75 | $75 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $66 | $66 | $66 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $272 | $272 | $272 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $69 | $70 | $71 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $107 | $108 | $109 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $161 | $162 | $163 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $180 | $196 | $212 |
| Office visit established patient minimal CPT 99211 • Office Visits | $8 | $15 | $22 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $34 | $44 | $55 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $87 | $88 | $88 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $94 | $109 | $125 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $139 | $158 | $176 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $80 | $89 | $97 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $126 | $129 | $131 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $167 | $180 | $193 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $38 | $43 | $48 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $69 | $73 | $76 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $100 | $107 | $114 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $70 | $74 | $78 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $102 | $106 | $110 |
| Consultation office low complexity CPT 99243 • Office Visits | $85 | $101 | $117 |
| Consultation office high complexity CPT 99245 • Office Visits | $203 | $208 | $213 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $592 | $592 | $592 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $34 | $34 | $34 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $1,120 | $1,120 | $1,120 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $195 | $195 | $195 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $1,036 | $1,036 | $1,036 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $479 | $479 | $479 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $224 | $224 | $224 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $706 | $706 | $706 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $515 | $515 | $515 |
| Intravitreal injection therapeutic agent CPT 67028 • Ophthalmology | $107 | $107 | $107 |