| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $178 | $178 | $179 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $67 | $71 | $76 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $87 | $102 | $116 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $91 | $106 | $121 |
| Group psychotherapy CPT 90853 • Mental Health | $51 | $51 | $52 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $0 | $2 | $4 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $25 | $25 | $25 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $111 | $120 | $130 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $96 | $96 | $96 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $343 | $343 | $343 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $413 | $413 | $413 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $50 | $50 | $50 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $34 | $102 | $170 |
| EMG needle each extremity complete CPT 95886 • Neurology | $21 | $21 | $21 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $52 | $52 | $52 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $51 | $51 | $51 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $62 | $62 | $62 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $183 | $183 | $183 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $297 | $297 | $297 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $6 | $6 | $6 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $66 | $66 | $66 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $133 | $133 | $133 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $18 | $31 | $44 |
| Office visit established patient minimal CPT 99211 • Office Visits | $22 | $22 | $22 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $7 | $7 | $7 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $8 | $8 | $8 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $44 | $61 | $79 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $134 | $134 | $134 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $79 | $79 | $79 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $107 | $107 | $107 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $44 | $44 | $44 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $92 | $92 | $92 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $78 | $78 | $78 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $95 | $95 | $95 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $95 | $95 | $95 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $116 | $116 | $116 |
| Consultation office low complexity CPT 99243 • Office Visits | $122 | $122 | $122 |
| Consultation office high complexity CPT 99245 • Office Visits | $182 | $182 | $182 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $249 | $249 | $249 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $36 | $36 | $36 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $1,072 | $1,072 | $1,072 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $46 | $46 | $46 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $935 | $935 | $935 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $62 | $62 | $62 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $37 | $163 | $288 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $680 | $680 | $680 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $99 | $99 | $99 |
| Intravitreal injection therapeutic agent CPT 67028 • Ophthalmology | $111 | $111 | $111 |
| Retinal detachment repair with vitrectomy CPT 67108 • Ophthalmology | $44 | $382 | $721 |
| Retinal photocoagulation treatment CPT 67210 • Ophthalmology | $44 | $44 | $44 |