| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $52 | $54 | $56 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $86 | $86 | $86 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $113 | $113 | $113 |
| EMG needle each extremity complete CPT 95886 • Neurology | $54 | $70 | $86 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $46 | $46 | $46 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $73 | $93 | $112 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $67 | $70 | $73 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $117 | $117 | $117 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $126 | $194 | $262 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $59 | $60 | $61 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $87 | $103 | $118 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $134 | $205 | $277 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $139 | $154 | $168 |
| Office visit established patient minimal CPT 99211 • Office Visits | $19 | $20 | $22 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $21 | $45 | $73 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $57 | $79 | $114 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $86 | $104 | $119 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $117 | $209 | $301 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $82 | $82 | $82 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $115 | $157 | $198 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $169 | $216 | $264 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $35 | $55 | $75 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $62 | $91 | $120 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $89 | $116 | $144 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $63 | $90 | $117 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $92 | $117 | $143 |
| Consultation office low complexity CPT 99243 • Office Visits | $116 | $116 | $116 |
| Consultation office high complexity CPT 99245 • Office Visits | $178 | $178 | $178 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $641 | $641 | $641 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $54 | $54 | $54 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $1,251 | $1,251 | $1,251 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $353 | $353 | $353 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $1,170 | $1,170 | $1,170 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $621 | $621 | $621 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $453 | $453 | $453 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $1,077 | $1,077 | $1,077 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $496 | $633 | $769 |
| Intravitreal injection therapeutic agent CPT 67028 • Ophthalmology | $109 | $166 | $224 |
| Retinal detachment repair with vitrectomy CPT 67108 • Ophthalmology | $1,610 | $1,610 | $1,610 |
| Retinal photocoagulation treatment CPT 67210 • Ophthalmology | $492 | $579 | $667 |
| Retinal treatment extensive photocoagulation CPT 67228 • Ophthalmology | $324 | $647 | $969 |
| Strabismus surgery one horizontal muscle CPT 67311 • Ophthalmology | $594 | $594 | $594 |
| Excision chalazion single CPT 67800 • Ophthalmology | $130 | $130 | $130 |
| Blepharoptosis repair levator resection CPT 67901 • Ophthalmology | $613 | $613 | $613 |
| Lacrimal punctum closure by plug CPT 68761 • Ophthalmology | $131 | $143 | $155 |
| Eye exam new patient intermediate CPT 92002 • Ophthalmology | $21 | $21 | $21 |
| Eye exam new patient comprehensive CPT 92004 • Ophthalmology | $40 | $40 | $40 |
| Eye exam established patient intermediate CPT 92012 • Ophthalmology | $17 | $17 | $17 |
| Eye exam established patient comprehensive CPT 92014 • Ophthalmology | $43 | $79 | $115 |
| Visual field examination CPT 92083 • Ophthalmology | $34 | $34 | $34 |