| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $118 | $120 | $122 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $46 | $68 | $89 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $78 | $84 | $90 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $101 | $120 | $139 |
| Group psychotherapy CPT 90853 • Mental Health | $22 | $34 | $46 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $0 | $3 | $5 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $23 | $23 | $23 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $17 | $17 | $17 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $25 | $25 | $25 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $53 | $53 | $53 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $379 | $404 | $430 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $44 | $44 | $44 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $85 | $85 | $85 |
| EMG needle each extremity complete CPT 95886 • Neurology | $98 | $98 | $98 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $52 | $52 | $52 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $112 | $112 | $112 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $134 | $134 | $134 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $38 | $38 | $38 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $45 | $45 | $45 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $72 | $81 | $91 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $46 | $79 | $112 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $133 | $151 | $169 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $150 | $178 | $205 |
| Office visit established patient minimal CPT 99211 • Office Visits | $10 | $14 | $18 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $38 | $44 | $50 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $13 | $52 | $91 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $30 | $56 | $82 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $121 | $149 | $176 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $10 | $37 | $65 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $53 | $111 | $169 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $151 | $160 | $168 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $39 | $59 | $78 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $35 | $68 | $102 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $30 | $67 | $103 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $75 | $102 | $130 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $10 | $56 | $103 |
| Consultation office low complexity CPT 99243 • Office Visits | $30 | $30 | $30 |
| Consultation office high complexity CPT 99245 • Office Visits | $255 | $255 | $255 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $373 | $565 | $758 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $4 | $4 | $4 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $1,159 | $1,159 | $1,159 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $34 | $201 | $368 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $33 | $33 | $33 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $628 | $628 | $628 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $220 | $258 | $296 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $30 | $389 | $747 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $104 | $306 | $508 |
| Intravitreal injection therapeutic agent CPT 67028 • Ophthalmology | $30 | $75 | $119 |
| Retinal detachment repair with vitrectomy CPT 67108 • Ophthalmology | $322 | $322 | $322 |
| Retinal photocoagulation treatment CPT 67210 • Ophthalmology | $248 | $382 | $515 |