| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $145 | $152 | $159 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $70 | $76 | $83 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $78 | $81 | $84 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $81 | $91 | $100 |
| Group psychotherapy CPT 90853 • Mental Health | $21 | $24 | $28 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $4 | $4 | $5 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $58 | $58 | $58 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $147 | $147 | $147 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $109 | $109 | $109 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $104 | $104 | $104 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $82 | $230 | $379 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $32 | $32 | $32 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $24 | $24 | $24 |
| EMG needle each extremity complete CPT 95886 • Neurology | $46 | $46 | $46 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $50 | $50 | $50 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $47 | $47 | $47 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $132 | $132 | $132 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $101 | $101 | $101 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $108 | $108 | $108 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $41 | $56 | $72 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $63 | $75 | $88 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $30 | $97 | $169 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $124 | $165 | $205 |
| Office visit established patient minimal CPT 99211 • Office Visits | $8 | $15 | $21 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $21 | $39 | $56 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $31 | $54 | $76 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $30 | $77 | $129 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $104 | $112 | $121 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $59 | $65 | $71 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $98 | $100 | $103 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $137 | $137 | $137 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $30 | $38 | $47 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $49 | $58 | $68 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $69 | $86 | $103 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $62 | $67 | $72 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $84 | $95 | $106 |
| Consultation office low complexity CPT 99243 • Office Visits | $81 | $81 | $81 |
| Consultation office high complexity CPT 99245 • Office Visits | $160 | $160 | $160 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $498 | $628 | $758 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $55 | $55 | $55 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $901 | $901 | $901 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $271 | $319 | $368 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $812 | $812 | $812 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $435 | $435 | $435 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $278 | $287 | $296 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $663 | $724 | $784 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $355 | $473 | $590 |
| Intravitreal injection therapeutic agent CPT 67028 • Ophthalmology | $119 | $147 | $174 |
| Retinal detachment repair with vitrectomy CPT 67108 • Ophthalmology | $1,185 | $1,185 | $1,185 |
| Retinal photocoagulation treatment CPT 67210 • Ophthalmology | $515 | $516 | $517 |