| Psychotherapy 45 minutes CPT 90834 • Mental Health | $81 | $123 | $164 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $101 | $121 | $142 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $165 | $165 | $165 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $104 | $104 | $104 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $110 | $110 | $110 |
| Group psychotherapy CPT 90853 • Mental Health | $25 | $25 | $25 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $4 | $5 | $6 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $70 | $70 | $70 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $181 | $181 | $181 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $264 | $264 | $264 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $80 | $80 | $80 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $80 | $80 | $80 |
| EMG needle each extremity complete CPT 95886 • Neurology | $129 | $129 | $129 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $164 | $164 | $164 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $112 | $112 | $112 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $147 | $147 | $147 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $412 | $412 | $412 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $64 | $83 | $102 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $93 | $98 | $104 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $179 | $201 | $223 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $185 | $231 | $277 |
| Office visit established patient minimal CPT 99211 • Office Visits | $19 | $25 | $31 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $35 | $43 | $50 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $60 | $68 | $76 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $126 | $136 | $147 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $177 | $187 | $198 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $139 | $139 | $139 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $189 | $189 | $189 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $278 | $278 | $278 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $54 | $54 | $54 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $97 | $97 | $97 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $117 | $148 | $179 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $125 | $125 | $125 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $113 | $119 | $125 |
| Consultation office low complexity CPT 99243 • Office Visits | $131 | $131 | $131 |
| Consultation office high complexity CPT 99245 • Office Visits | $308 | $308 | $308 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $729 | $729 | $729 |
| Visual field examination CPT 92083 • Ophthalmology | $85 | $85 | $85 |
| Ophthalmic biometry IOL power calculation CPT 92136 • Ophthalmology | $84 | $84 | $84 |
| Arthrocentesis aspiration small joint CPT 20600 • Orthopedics | $67 | $67 | $67 |
| Arthrocentesis aspiration intermediate joint CPT 20605 • Orthopedics | $89 | $89 | $89 |
| Arthrocentesis aspiration major joint CPT 20610 • Orthopedics | $158 | $158 | $158 |
| Cervical spine fusion anterior approach CPT 22551 • Orthopedics | $2,283 | $2,283 | $2,283 |
| Lumbar spine fusion combined approach CPT 22633 • Orthopedics | $344 | $344 | $344 |
| Closed treatment distal radial fracture CPT 25600 • Orthopedics | $449 | $449 | $449 |
| Tendon sheath incision trigger finger CPT 26055 • Orthopedics | $387 | $387 | $387 |
| Total hip replacement CPT 27130 • Orthopedics | $2,383 | $2,383 | $2,383 |
| Total knee replacement CPT 27447 • Orthopedics | $1,831 | $1,831 | $1,831 |
| Closed treatment distal fibula fracture CPT 27786 • Orthopedics | $426 | $426 | $426 |
| Arthroscopy shoulder decompression CPT 29826 • Orthopedics | $237 | $237 | $237 |