| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $143 | $165 | $176 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $63 | $84 | $95 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $96 | $124 | $150 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $100 | $133 | $150 |
| Group psychotherapy CPT 90853 • Mental Health | $27 | $57 | $77 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $4 | $4 | $4 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $123 | $127 | $136 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $30 | $80 | $131 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $101 | $122 | $133 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $54 | $225 | $310 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $54 | $304 | $429 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $106 | $110 | $111 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $74 | $119 | $161 |
| EMG needle each extremity complete CPT 95886 • Neurology | $43 | $49 | $52 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $50 | $51 | $52 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $62 | $99 | $112 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $78 | $103 | $127 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $66 | $91 | $104 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $271 | $280 | $285 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $45 | $46 | $47 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $106 | $108 | $109 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $123 | $148 | $162 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $30 | $127 | $179 |
| Office visit established patient minimal CPT 99211 • Office Visits | $8 | $17 | $22 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $34 | $35 | $35 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $63 | $64 | $65 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $30 | $96 | $125 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $172 | $175 | $176 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $78 | $139 | $170 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $124 | $129 | $131 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $30 | $148 | $198 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $47 | $102 | $129 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $75 | $111 | $129 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $99 | $104 | $113 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $77 | $112 | $129 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $101 | $110 | $130 |
| Consultation office low complexity CPT 99243 • Office Visits | $30 | $77 | $116 |
| Consultation office high complexity CPT 99245 • Office Visits | $172 | $204 | $217 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $588 | $597 | $601 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $36 | $37 | $37 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $1,109 | $1,123 | $1,130 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $231 | $234 | $237 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $1,028 | $1,041 | $1,047 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $476 | $481 | $483 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $281 | $284 | $288 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $30 | $482 | $715 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $511 | $518 | $521 |
| Intravitreal injection therapeutic agent CPT 67028 • Ophthalmology | $88 | $94 | $106 |
| Retinal detachment repair with vitrectomy CPT 67108 • Ophthalmology | $1,115 | $1,128 | $1,141 |
| Retinal photocoagulation treatment CPT 67210 • Ophthalmology | $484 | $491 | $495 |