| Psychotherapy 45 minutes CPT 90834 • Mental Health | $80 | $84 | $89 |
| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $80 | $84 | $88 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $80 | $113 | $131 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $80 | $92 | $105 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $80 | $103 | $127 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $70 | $75 | $80 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $80 | $88 | $96 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $80 | $90 | $100 |
| Group psychotherapy CPT 90853 • Mental Health | $27 | $53 | $80 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $4 | $5 | $6 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $59 | $76 | $90 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $80 | $105 | $129 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $80 | $91 | $101 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $80 | $197 | $313 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $80 | $224 | $369 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $80 | $93 | $106 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $74 | $77 | $80 |
| EMG needle each extremity complete CPT 95886 • Neurology | $43 | $61 | $80 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $50 | $65 | $80 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $80 | $93 | $106 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $80 | $104 | $127 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $80 | $90 | $99 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $80 | $88 | $95 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $45 | $60 | $80 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $80 | $96 | $106 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $80 | $118 | $146 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $80 | $160 | $210 |
| Office visit established patient minimal CPT 99211 • Office Visits | $22 | $51 | $80 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $29 | $47 | $80 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $67 | $78 | $86 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $80 | $114 | $141 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $80 | $126 | $172 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $78 | $98 | $135 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $80 | $129 | $182 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $80 | $171 | $269 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $47 | $60 | $80 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $75 | $84 | $96 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $80 | $110 | $138 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $77 | $85 | $97 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $80 | $103 | $121 |
| Consultation office low complexity CPT 99243 • Office Visits | $80 | $94 | $107 |
| Consultation office high complexity CPT 99245 • Office Visits | $80 | $140 | $201 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $80 | $334 | $588 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $36 | $58 | $80 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $80 | $595 | $1,109 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $80 | $155 | $231 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $80 | $554 | $1,028 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $80 | $278 | $476 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $80 | $180 | $281 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $80 | $390 | $700 |