| Arthroscopy knee with meniscus repair CPT 29882 • Orthopedics | $753 | $753 | $753 |
| Arthroscopy knee ACL repair CPT 29888 • Orthopedics | $1,093 | $1,329 | $1,566 |
| Discectomy lumbar single level CPT 63030 • Orthopedics | $1,476 | $1,486 | $1,496 |
| Laminectomy lumbar single level CPT 63047 • Orthopedics | $1,688 | $1,693 | $1,697 |
| Carpal tunnel release CPT 64721 • Orthopedics | $630 | $652 | $674 |
| Sacroiliac joint injection CPT 27096 • Pain Management | $188 | $224 | $259 |
| Epidural injection cervical or thoracic with imaging CPT 62321 • Pain Management | $393 | $406 | $419 |
| Epidural injection lumbar or sacral without imaging CPT 62322 • Pain Management | $156 | $156 | $156 |
| Epidural injection lumbar or sacral with imaging CPT 62323 • Pain Management | $179 | $284 | $390 |
| Spinal cord stimulator electrode implantation CPT 63650 • Pain Management | $661 | $661 | $661 |
| Peripheral nerve block injection CPT 64450 • Pain Management | $114 | $138 | $162 |
| Plantar common digital nerve injection CPT 64455 • Pain Management | $76 | $80 | $83 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $373 | $391 | $409 |
| Epidural injection lumbar each additional level CPT 64484 • Pain Management | $79 | $145 | $210 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $263 | $308 | $353 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $82 | $120 | $140 |
| Chemodenervation of muscle migraine CPT 64615 • Pain Management | $235 | $241 | $247 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $419 | $583 | $670 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $113 | $277 | $367 |
| Cytopathology concentration technique CPT 88108 • Pathology | $33 | $51 | $60 |
| Cytopathology cell enhancement technique CPT 88112 • Pathology | $34 | $80 | $126 |
| Cytopathology cervical/vaginal interpretation physician CPT 88141 • Pathology | $22 | $23 | $24 |
| Cytopathology cervical/vaginal manual screen CPT 88164 • Pathology | $14 | $16 | $18 |
| Cytopathology cervical/vaginal automated thin layer CPT 88175 • Pathology | $30 | $32 | $33 |
| Molecular cytogenetics DNA probe each CPT 88271 • Pathology | $5 | $17 | $24 |
| Cytogenetics molecular interpretation CPT 88291 • Pathology | $24 | $24 | $24 |
| Surgical pathology gross and micro exam level II CPT 88302 • Pathology | $15 | $23 | $32 |
| Surgical pathology gross and micro exam level III CPT 88304 • Pathology | $23 | $31 | $38 |
| Surgical pathology gross and micro exam level IV CPT 88305 • Pathology | $50 | $50 | $50 |
| Surgical pathology gross and micro exam level V CPT 88307 • Pathology | $97 | $146 | $171 |
| Surgical pathology gross and micro exam level VI CPT 88309 • Pathology | $116 | $180 | $245 |
| Special stain group I for microorganisms CPT 88312 • Pathology | $54 | $56 | $58 |
| Special stain group II CPT 88313 • Pathology | $26 | $32 | $45 |
| Frozen section pathology first specimen CPT 88331 • Pathology | $50 | $102 | $128 |
| Frozen section pathology each additional CPT 88332 • Pathology | $32 | $48 | $63 |
| Immunohistochemistry each antibody CPT 88341 • Pathology | $35 | $64 | $94 |
| Immunohistochemistry first antibody CPT 88342 • Pathology | $78 | $87 | $91 |
| Morphometric analysis tumor quantitative CPT 88360 • Pathology | $49 | $96 | $119 |
| Microdissection manual CPT 88381 • Pathology | $116 | $168 | $220 |
| Hot or cold packs application CPT 97010 • Physical Therapy | $4 | $5 | $6 |
| Electrical stimulation unattended CPT 97014 • Physical Therapy | $11 | $12 | $12 |
| Vasopneumatic device therapy CPT 97016 • Physical Therapy | $11 | $12 | $14 |
| Electrical stimulation attended each 15 minutes CPT 97032 • Physical Therapy | $13 | $14 | $15 |
| Ultrasound therapy each 15 minutes CPT 97035 • Physical Therapy | $11 | $12 | $13 |
| Therapeutic exercises each 15 minutes CPT 97110 • Physical Therapy | $26 | $27 | $27 |
| Neuromuscular reeducation each 15 minutes CPT 97112 • Physical Therapy | $27 | $29 | $32 |
| Gait training each 15 minutes CPT 97116 • Physical Therapy | $23 | $25 | $27 |
| Manual therapy one or more regions each 15 min CPT 97140 • Physical Therapy | $24 | $25 | $25 |
| Group therapeutic procedures CPT 97150 • Physical Therapy | $16 | $16 | $16 |
| Physical therapy evaluation low complexity CPT 97161 • Physical Therapy | $75 | $85 | $95 |