| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $79 | $98 | $117 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $118 | $131 | $143 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $58 | $61 | $63 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $90 | $92 | $94 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $86 | $93 | $101 |
| Group psychotherapy CPT 90853 • Mental Health | $23 | $50 | $78 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $0 | $0 | $0 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $35 | $40 | $45 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $117 | $117 | $117 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $73 | $98 | $123 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $183 | $273 | $362 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $204 | $311 | $417 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $105 | $107 | $109 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $67 | $113 | $158 |
| EMG needle each extremity complete CPT 95886 • Neurology | $19 | $54 | $90 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $35 | $60 | $85 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $22 | $64 | $105 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $27 | $27 | $27 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $105 | $135 | $165 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $53 | $162 | $270 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $53 | $78 | $104 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $43 | $43 | $44 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $172 | $188 | $205 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $17 | $76 | $135 |
| Office visit established patient minimal CPT 99211 • Office Visits | $19 | $32 | $44 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $38 | $41 | $44 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $30 | $37 | $44 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $8 | $62 | $116 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $44 | $79 | $113 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $45 | $49 | $54 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $45 | $86 | $128 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $45 | $103 | $162 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $45 | $78 | $110 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $45 | $59 | $72 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $8 | $27 | $45 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $45 | $57 | $70 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $85 | $86 | $88 |
| Consultation office low complexity CPT 99243 • Office Visits | $76 | $101 | $127 |
| Consultation office high complexity CPT 99245 • Office Visits | $45 | $68 | $92 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $45 | $130 | $215 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $7 | $26 | $45 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $1,212 | $1,212 | $1,212 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $31 | $31 | $31 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $45 | $580 | $1,114 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $500 | $507 | $513 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $45 | $106 | $168 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $105 | $401 | $698 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $556 | $556 | $556 |
| Intravitreal injection therapeutic agent CPT 67028 • Ophthalmology | $69 | $78 | $87 |
| Retinal detachment repair with vitrectomy CPT 67108 • Ophthalmology | $228 | $228 | $228 |