| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $74 | $74 | $74 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $102 | $102 | $102 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $106 | $106 | $106 |
| Group psychotherapy CPT 90853 • Mental Health | $29 | $29 | $29 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $4 | $4 | $4 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $58 | $58 | $58 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $125 | $125 | $125 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $125 | $125 | $125 |
| 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 | $54 | $54 | $54 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $74 | $74 | $74 |
| EMG needle each extremity complete CPT 95886 • Neurology | $44 | $44 | $44 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $33 | $33 | $33 |
| 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 | $97 | $97 | $97 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $90 | $90 | $90 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $44 | $53 | $62 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $59 | $68 | $76 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $115 | $135 | $155 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $170 | $188 | $205 |
| Office visit established patient minimal CPT 99211 • Office Visits | $21 | $21 | $21 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $33 | $33 | $33 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $47 | $54 | $61 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $89 | $89 | $90 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $168 | $168 | $168 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $76 | $76 | $76 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $121 | $121 | $121 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $161 | $161 | $161 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $45 | $45 | $45 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $73 | $73 | $73 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $110 | $110 | $110 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $75 | $75 | $75 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $106 | $106 | $106 |
| Consultation office low complexity CPT 99243 • Office Visits | $82 | $107 | $131 |
| Consultation office high complexity CPT 99245 • Office Visits | $195 | $195 | $195 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $568 | $568 | $568 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $35 | $35 | $35 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $1,079 | $1,079 | $1,079 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $223 | $223 | $223 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $996 | $996 | $996 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $461 | $461 | $461 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $215 | $215 | $215 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $680 | $680 | $680 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $496 | $496 | $496 |
| Intravitreal injection therapeutic agent CPT 67028 • Ophthalmology | $103 | $103 | $103 |
| Retinal detachment repair with vitrectomy CPT 67108 • Ophthalmology | $1,083 | $1,083 | $1,083 |
| Retinal photocoagulation treatment CPT 67210 • Ophthalmology | $454 | $454 | $454 |
| Retinal treatment extensive photocoagulation CPT 67228 • Ophthalmology | $277 | $277 | $277 |