| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $107 | $107 | $107 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $145 | $145 | $145 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $63 | $63 | $63 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $97 | $97 | $97 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $101 | $101 | $101 |
| Group psychotherapy CPT 90853 • Mental Health | $27 | $27 | $27 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $4 | $4 | $4 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $134 | $134 | $134 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $277 | $277 | $277 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $203 | $203 | $203 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $298 | $298 | $298 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $52 | $52 | $52 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $92 | $92 | $92 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $68 | $68 | $68 |
| EMG needle each extremity complete CPT 95886 • Neurology | $42 | $42 | $42 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $48 | $48 | $48 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $41 | $41 | $41 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $49 | $49 | $49 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $63 | $63 | $63 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $171 | $171 | $171 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $83 | $83 | $83 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $175 | $175 | $175 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $269 | $269 | $269 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $338 | $338 | $338 |
| Office visit established patient minimal CPT 99211 • Office Visits | $38 | $38 | $38 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $43 | $43 | $43 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $144 | $144 | $144 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $129 | $129 | $129 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $185 | $185 | $185 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $167 | $167 | $167 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $230 | $230 | $230 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $338 | $338 | $338 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $70 | $70 | $70 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $125 | $125 | $125 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $179 | $179 | $179 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $127 | $127 | $127 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $182 | $182 | $182 |
| Consultation office low complexity CPT 99243 • Office Visits | $181 | $181 | $181 |
| Consultation office high complexity CPT 99245 • Office Visits | $428 | $428 | $428 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $995 | $995 | $995 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $110 | $110 | $110 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $1,834 | $1,834 | $1,834 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $453 | $453 | $453 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $1,771 | $1,771 | $1,771 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $941 | $941 | $941 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $611 | $611 | $611 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $1,621 | $1,621 | $1,621 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $1,154 | $1,154 | $1,154 |
| Intravitreal injection therapeutic agent CPT 67028 • Ophthalmology | $259 | $259 | $259 |
| Retinal detachment repair with vitrectomy CPT 67108 • Ophthalmology | $2,421 | $2,421 | $2,421 |