| Psychiatric diagnostic evaluation with medical services CPT 90792 • Mental Health | $164 | $164 | $164 |
| Psychotherapy 30 minutes CPT 90832 • Mental Health | $59 | $59 | $59 |
| Psychotherapy 30 min add-on to E/M CPT 90833 • Mental Health | $71 | $71 | $71 |
| Psychotherapy 45 minutes CPT 90834 • Mental Health | $85 | $85 | $85 |
| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $80 | $80 | $80 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $151 | $151 | $151 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $107 | $107 | $107 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $128 | $128 | $128 |
| 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 | $6 | $6 | $6 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $140 | $140 | $140 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $264 | $264 | $264 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $178 | $178 | $178 |
| 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 | $97 | $97 | $97 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $146 | $146 | $146 |
| EMG needle each extremity complete CPT 95886 • Neurology | $44 | $44 | $44 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $48 | $48 | $48 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $126 | $126 | $126 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $49 | $49 | $49 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $115 | $115 | $115 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $130 | $130 | $130 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $114 | $114 | $114 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $168 | $168 | $168 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $204 | $204 | $204 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $274 | $274 | $274 |
| Office visit established patient minimal CPT 99211 • Office Visits | $29 | $29 | $29 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $41 | $41 | $41 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $111 | $111 | $111 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $123 | $123 | $123 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $226 | $226 | $226 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $154 | $154 | $154 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $220 | $220 | $220 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $324 | $324 | $324 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $67 | $67 | $67 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $111 | $111 | $111 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $166 | $166 | $166 |
| 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 | $168 | $168 | $168 |
| Consultation office low complexity CPT 99243 • Office Visits | $225 | $225 | $225 |
| Consultation office high complexity CPT 99245 • Office Visits | $379 | $379 | $379 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $1,039 | $1,039 | $1,039 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $98 | $98 | $98 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $1,657 | $1,657 | $1,657 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $466 | $466 | $466 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $1,508 | $1,508 | $1,508 |