| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $132 | $132 | $132 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $48 | $53 | $58 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $65 | $70 | $75 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $92 | $92 | $92 |
| Group psychotherapy CPT 90853 • Mental Health | $16 | $17 | $18 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $1 | $1 | $1 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $42 | $84 | $126 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $10 | $10 | $10 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $60 | $60 | $60 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $70 | $211 | $352 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $51 | $230 | $410 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $50 | $75 | $100 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $68 | $104 | $141 |
| EMG needle each extremity complete CPT 95886 • Neurology | $45 | $65 | $85 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $40 | $60 | $80 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $50 | $75 | $100 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $71 | $96 | $121 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $64 | $111 | $158 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $168 | $214 | $259 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $27 | $41 | $54 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $64 | $75 | $85 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $19 | $19 | $19 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $127 | $133 | $138 |
| Office visit established patient minimal CPT 99211 • Office Visits | $4 | $6 | $9 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $3 | $23 | $43 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $8 | $38 | $69 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $98 | $98 | $98 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $138 | $138 | $138 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $53 | $58 | $62 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $74 | $86 | $98 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $66 | $98 | $131 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $6 | $21 | $37 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $60 | $60 | $60 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $89 | $89 | $90 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $52 | $57 | $61 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $74 | $81 | $87 |
| Consultation office low complexity CPT 99243 • Office Visits | $12 | $58 | $104 |
| Consultation office high complexity CPT 99245 • Office Visits | $97 | $145 | $193 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $268 | $268 | $268 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $6 | $22 | $39 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $919 | $919 | $919 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $43 | $43 | $43 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $793 | $793 | $793 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $526 | $526 | $526 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $31 | $31 | $31 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $772 | $772 | $772 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $423 | $423 | $423 |
| Intravitreal injection therapeutic agent CPT 67028 • Ophthalmology | $72 | $72 | $72 |
| Retinal detachment repair with vitrectomy CPT 67108 • Ophthalmology | $123 | $123 | $123 |
| Retinal photocoagulation treatment CPT 67210 • Ophthalmology | $534 | $534 | $534 |