| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $93 | $105 | $124 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $57 | $60 | $62 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $78 | $83 | $92 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $69 | $80 | $91 |
| Group psychotherapy CPT 90853 • Mental Health | $30 | $42 | $49 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $0 | $3 | $4 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $40 | $40 | $40 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $70 | $70 | $70 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $77 | $77 | $77 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $97 | $229 | $360 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $213 | $296 | $379 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $41 | $41 | $41 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $20 | $59 | $99 |
| EMG needle each extremity complete CPT 95886 • Neurology | $40 | $40 | $40 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $44 | $44 | $44 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $55 | $55 | $55 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $52 | $85 | $117 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $67 | $67 | $67 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $99 | $99 | $99 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $21 | $43 | $66 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $8 | $50 | $112 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $30 | $116 | $163 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $20 | $153 | $224 |
| Office visit established patient minimal CPT 99211 • Office Visits | $17 | $20 | $23 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $30 | $45 | $57 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $4 | $49 | $114 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $30 | $81 | $116 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $30 | $118 | $184 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $12 | $36 | $65 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $30 | $93 | $128 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $24 | $87 | $151 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $38 | $71 | $130 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $30 | $76 | $130 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $42 | $93 | $144 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $75 | $111 | $130 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $12 | $58 | $103 |
| Consultation office low complexity CPT 99243 • Office Visits | $42 | $83 | $124 |
| Consultation office high complexity CPT 99245 • Office Visits | $175 | $175 | $175 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $381 | $570 | $758 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $14 | $14 | $14 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $613 | $613 | $613 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $129 | $248 | $368 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $40 | $40 | $40 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $281 | $281 | $281 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $88 | $192 | $296 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $111 | $429 | $747 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $61 | $284 | $508 |
| Intravitreal injection therapeutic agent CPT 67028 • Ophthalmology | $10 | $68 | $109 |
| Retinal detachment repair with vitrectomy CPT 67108 • Ophthalmology | $666 | $776 | $887 |
| Retinal photocoagulation treatment CPT 67210 • Ophthalmology | $369 | $455 | $541 |