| Psychiatric diagnostic evaluation with medical services CPT 90792 • Mental Health | $164 | $164 | $164 |
| Psychotherapy 30 minutes CPT 90832 • Mental Health | $69 | $69 | $69 |
| Psychotherapy 30 min add-on to E/M CPT 90833 • Mental Health | $65 | $65 | $65 |
| Psychotherapy 45 minutes CPT 90834 • Mental Health | $85 | $85 | $85 |
| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $82 | $82 | $82 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $105 | $105 | $105 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $113 | $113 | $113 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $157 | $157 | $157 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $62 | $62 | $62 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $126 | $126 | $126 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $94 | $94 | $94 |
| Group psychotherapy CPT 90853 • Mental Health | $31 | $31 | $31 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $5 | $5 | $5 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $226 | $226 | $226 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $221 | $221 | $221 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $178 | $178 | $178 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $103 | $103 | $103 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $94 | $94 | $94 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $97 | $97 | $97 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $41 | $41 | $41 |
| EMG needle each extremity complete CPT 95886 • Neurology | $59 | $59 | $59 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $38 | $38 | $38 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $126 | $126 | $126 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $58 | $58 | $58 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $103 | $103 | $103 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $130 | $130 | $130 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $53 | $62 | $71 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $30 | $53 | $76 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $30 | $95 | $159 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $183 | $229 | $274 |
| Office visit established patient minimal CPT 99211 • Office Visits | $29 | $29 | $29 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $25 | $28 | $30 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $30 | $49 | $69 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $30 | $67 | $103 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $30 | $85 | $140 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $154 | $154 | $154 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $136 | $136 | $136 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $300 | $300 | $300 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $67 | $67 | $67 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $74 | $74 | $74 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $106 | $106 | $106 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $115 | $115 | $115 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $108 | $108 | $108 |
| Consultation office low complexity CPT 99243 • Office Visits | $198 | $198 | $198 |
| Consultation office high complexity CPT 99245 • Office Visits | $379 | $379 | $379 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $663 | $663 | $663 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $67 | $67 | $67 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $1,145 | $1,145 | $1,145 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $283 | $283 | $283 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $1,508 | $1,508 | $1,508 |