| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $65 | $93 | $116 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $99 | $123 | $148 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $93 | $120 | $144 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $103 | $139 | $176 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $54 | $77 | $95 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $79 | $126 | $150 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $82 | $111 | $150 |
| Group psychotherapy CPT 90853 • Mental Health | $18 | $42 | $66 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $4 | $4 | $4 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $110 | $110 | $110 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $30 | $68 | $106 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $97 | $115 | $134 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $260 | $313 | $367 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $267 | $267 | $267 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $86 | $98 | $111 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $70 | $130 | $161 |
| EMG needle each extremity complete CPT 95886 • Neurology | $36 | $36 | $36 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $18 | $28 | $39 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $22 | $55 | $87 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $114 | $128 | $134 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $151 | $163 | $175 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $89 | $187 | $285 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $40 | $58 | $71 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $77 | $86 | $96 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $102 | $143 | $164 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $116 | $151 | $188 |
| Office visit established patient minimal CPT 99211 • Office Visits | $18 | $26 | $30 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $36 | $44 | $55 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $30 | $48 | $78 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $30 | $72 | $110 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $104 | $129 | $154 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $30 | $93 | $170 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $108 | $139 | $170 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $19 | $121 | $198 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $28 | $79 | $129 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $30 | $72 | $129 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $30 | $80 | $129 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $30 | $72 | $129 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $76 | $103 | $130 |
| Consultation office low complexity CPT 99243 • Office Visits | $30 | $63 | $97 |
| Consultation office high complexity CPT 99245 • Office Visits | $138 | $196 | $255 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $441 | $441 | $441 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $33 | $33 | $33 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $845 | $987 | $1,130 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $194 | $194 | $194 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $30 | $445 | $860 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $395 | $439 | $483 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $226 | $231 | $236 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $536 | $536 | $536 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $30 | $230 | $429 |