| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $118 | $129 | $139 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $59 | $64 | $69 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $91 | $98 | $106 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $94 | $103 | $111 |
| Group psychotherapy CPT 90853 • Mental Health | $50 | $54 | $58 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $1 | $2 | $4 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $11 | $80 | $150 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $62 | $62 | $62 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $15 | $82 | $150 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $392 | $429 | $465 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $354 | $456 | $558 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $83 | $116 | $149 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $43 | $101 | $158 |
| EMG needle each extremity complete CPT 95886 • Neurology | $26 | $77 | $128 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $37 | $79 | $120 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $30 | $91 | $151 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $181 | $181 | $181 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $73 | $156 | $238 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $178 | $281 | $385 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $6 | $47 | $89 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $55 | $92 | $129 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $40 | $81 | $122 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $140 | $175 | $209 |
| Office visit established patient minimal CPT 99211 • Office Visits | $7 | $16 | $25 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $14 | $34 | $54 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $9 | $49 | $89 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $13 | $64 | $116 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $73 | $125 | $177 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $127 | $127 | $128 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $133 | $149 | $165 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $23 | $134 | $246 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $38 | $55 | $72 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $40 | $64 | $88 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $12 | $69 | $126 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $71 | $79 | $88 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $130 | $130 | $131 |
| Consultation office low complexity CPT 99243 • Office Visits | $11 | $26 | $40 |
| Consultation office high complexity CPT 99245 • Office Visits | $26 | $138 | $251 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $299 | $513 | $726 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $5 | $29 | $53 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $771 | $936 | $1,101 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $46 | $46 | $46 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $292 | $876 | $1,460 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $471 | $572 | $672 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $141 | $141 | $141 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $105 | $105 | $105 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $76 | $76 | $76 |
| Intravitreal injection therapeutic agent CPT 67028 • Ophthalmology | $9 | $24 | $40 |
| Retinal detachment repair with vitrectomy CPT 67108 • Ophthalmology | $167 | $167 | $167 |
| Retinal photocoagulation treatment CPT 67210 • Ophthalmology | $349 | $506 | $664 |