| Psychiatric diagnostic evaluation with medical services CPT 90792 • Mental Health | $164 | $164 | $164 |
| Psychotherapy 30 minutes CPT 90832 • Mental Health | $69 | $69 | $69 |
| Psychotherapy 30 min add-on to E/M CPT 90833 • Mental Health | $65 | $67 | $70 |
| Psychotherapy 45 minutes CPT 90834 • Mental Health | $85 | $85 | $85 |
| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $82 | $82 | $82 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $105 | $108 | $112 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $113 | $113 | $113 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $157 | $157 | $157 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $76 | $76 | $76 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $98 | $98 | $98 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $102 | $102 | $102 |
| Group psychotherapy CPT 90853 • Mental Health | $24 | $24 | $24 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $4 | $4 | $5 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $348 | $348 | $348 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $126 | $126 | $126 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $178 | $178 | $178 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $103 | $103 | $103 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $94 | $94 | $94 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $97 | $97 | $97 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $178 | $178 | $178 |
| EMG needle each extremity complete CPT 95886 • Neurology | $59 | $71 | $82 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $38 | $38 | $38 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $126 | $126 | $126 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $58 | $58 | $58 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $115 | $142 | $169 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $130 | $191 | $252 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $58 | $87 | $116 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $85 | $110 | $134 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $139 | $200 | $262 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $169 | $220 | $270 |
| Office visit established patient minimal CPT 99211 • Office Visits | $29 | $29 | $29 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $42 | $44 | $46 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $75 | $94 | $113 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $115 | $120 | $125 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $178 | $191 | $205 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $163 | $163 | $163 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $94 | $159 | $224 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $131 | $230 | $329 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $45 | $56 | $67 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $67 | $94 | $121 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $102 | $138 | $174 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $123 | $123 | $123 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $101 | $139 | $177 |
| Consultation office low complexity CPT 99243 • Office Visits | $176 | $176 | $176 |
| Consultation office high complexity CPT 99245 • Office Visits | $417 | $417 | $417 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $550 | $550 | $550 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $54 | $54 | $54 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $2,281 | $2,281 | $2,281 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $651 | $651 | $651 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $1,508 | $1,508 | $1,508 |