| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $94 | $94 | $94 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $143 | $143 | $143 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $91 | $91 | $91 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $96 | $96 | $96 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $76 | $76 | $76 |
| Group psychotherapy CPT 90853 • Mental Health | $21 | $21 | $21 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $4 | $4 | $4 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $387 | $387 | $387 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $52 | $52 | $52 |
| EMG needle each extremity complete CPT 95886 • Neurology | $86 | $86 | $86 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $112 | $112 | $112 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $73 | $73 | $73 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $262 | $262 | $262 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $57 | $57 | $57 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $83 | $83 | $83 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $124 | $124 | $124 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $180 | $180 | $180 |
| Office visit established patient minimal CPT 99211 • Office Visits | $18 | $18 | $18 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $41 | $41 | $41 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $72 | $72 | $72 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $103 | $103 | $103 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $134 | $134 | $134 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $198 | $198 | $198 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $130 | $130 | $130 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $75 | $75 | $75 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $65 | $65 | $65 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $88 | $88 | $88 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $67 | $67 | $67 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $143 | $143 | $143 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $415 | $415 | $415 |
| Intravitreal injection therapeutic agent CPT 67028 • Ophthalmology | $109 | $109 | $109 |
| Retinal photocoagulation treatment CPT 67210 • Ophthalmology | $492 | $492 | $492 |
| Retinal treatment extensive photocoagulation CPT 67228 • Ophthalmology | $324 | $324 | $324 |
| Strabismus surgery one horizontal muscle CPT 67311 • Ophthalmology | $586 | $586 | $586 |
| Lacrimal punctum closure by plug CPT 68761 • Ophthalmology | $131 | $131 | $131 |
| Eye exam new patient comprehensive CPT 92004 • Ophthalmology | $127 | $127 | $127 |
| Eye exam established patient intermediate CPT 92012 • Ophthalmology | $80 | $80 | $80 |
| Eye exam established patient comprehensive CPT 92014 • Ophthalmology | $113 | $113 | $113 |
| Visual field examination CPT 92083 • Ophthalmology | $55 | $55 | $55 |
| Retinal imaging OCT posterior segment CPT 92134 • Ophthalmology | $10 | $10 | $10 |
| Ophthalmic biometry IOL power calculation CPT 92136 • Ophthalmology | $40 | $40 | $40 |
| Fundus photography CPT 92250 • Ophthalmology | $31 | $31 | $31 |
| Arthrocentesis aspiration major joint CPT 20610 • Orthopedics | $84 | $84 | $84 |
| Arthroscopy shoulder rotator cuff repair CPT 29827 • Orthopedics | $934 | $934 | $934 |
| Carpal tunnel release CPT 64721 • Orthopedics | $535 | $535 | $535 |
| Sacroiliac joint injection CPT 27096 • Pain Management | $127 | $127 | $127 |
| Epidural injection cervical or thoracic with imaging CPT 62321 • Pain Management | $260 | $260 | $260 |
| Epidural injection lumbar or sacral with imaging CPT 62323 • Pain Management | $257 | $257 | $257 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $250 | $250 | $250 |
| Epidural injection lumbar each additional level CPT 64484 • Pain Management | $111 | $111 | $111 |