| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $116 | $178 | $240 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $403 | $403 | $403 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $145 | $215 | $286 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $344 | $344 | $344 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $64 | $127 | $191 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $134 | $199 | $263 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $150 | $212 | $274 |
| Group psychotherapy CPT 90853 • Mental Health | $64 | $64 | $64 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $12 | $12 | $12 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $354 | $469 | $583 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $132 | $310 | $433 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $134 | $294 | $461 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $56 | $458 | $860 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $1,021 | $1,021 | $1,021 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $111 | $206 | $300 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $80 | $149 | $218 |
| EMG needle each extremity complete CPT 95886 • Neurology | $122 | $122 | $122 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $90 | $116 | $142 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $112 | $117 | $123 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $134 | $173 | $213 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $105 | $147 | $189 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $285 | $528 | $770 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $71 | $131 | $182 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $218 | $241 | $263 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $132 | $266 | $403 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $216 | $354 | $429 |
| Office visit established patient minimal CPT 99211 • Office Visits | $17 | $27 | $48 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $36 | $70 | $105 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $88 | $147 | $178 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $14 | $130 | $250 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $350 | $352 | $354 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $97 | $170 | $250 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $256 | $297 | $339 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $29 | $291 | $501 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $97 | $97 | $97 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $69 | $134 | $179 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $100 | $197 | $257 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $10 | $116 | $179 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $111 | $200 | $265 |
| Consultation office low complexity CPT 99243 • Office Visits | $9 | $157 | $238 |
| Consultation office high complexity CPT 99245 • Office Visits | $205 | $390 | $551 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $1,476 | $1,852 | $2,228 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $4 | $120 | $252 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $3,140 | $3,760 | $4,381 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $655 | $769 | $883 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $1,048 | $2,507 | $3,566 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $338 | $1,348 | $2,363 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $797 | $941 | $1,084 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $1,983 | $2,460 | $2,937 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $365 | $1,391 | $2,359 |