| Arthroscopy knee with meniscus repair CPT 29882 • Orthopedics | $953 | $953 | $953 |
| Arthroscopy knee ACL repair CPT 29888 • Orthopedics | $1,146 | $1,247 | $1,349 |
| Discectomy lumbar single level CPT 63030 • Orthopedics | $1,338 | $1,350 | $1,363 |
| Laminectomy lumbar single level CPT 63047 • Orthopedics | $1,517 | $1,534 | $1,552 |
| Carpal tunnel release CPT 64721 • Orthopedics | $601 | $605 | $609 |
| Sacroiliac joint injection CPT 27096 • Pain Management | $48 | $162 | $269 |
| Epidural injection cervical or thoracic with imaging CPT 62321 • Pain Management | $126 | $254 | $361 |
| Epidural injection lumbar or sacral without imaging CPT 62322 • Pain Management | $128 | $154 | $179 |
| Epidural injection lumbar or sacral with imaging CPT 62323 • Pain Management | $85 | $272 | $376 |
| Spinal cord stimulator electrode implantation CPT 63650 • Pain Management | $604 | $1,693 | $2,633 |
| Peripheral nerve block injection CPT 64450 • Pain Management | $48 | $88 | $128 |
| Plantar common digital nerve injection CPT 64455 • Pain Management | $44 | $61 | $71 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $135 | $242 | $359 |
| Epidural injection lumbar each additional level CPT 64484 • Pain Management | $48 | $139 | $213 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $238 | $250 | $261 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $127 | $134 | $144 |
| Chemodenervation of muscle migraine CPT 64615 • Pain Management | $184 | $197 | $209 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $569 | $634 | $666 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $212 | $258 | $282 |
| Cytopathology concentration technique CPT 88108 • Pathology | $41 | $52 | $62 |
| Cytopathology cell enhancement technique CPT 88112 • Pathology | $29 | $48 | $84 |
| Cytopathology cervical/vaginal interpretation physician CPT 88141 • Pathology | $11 | $20 | $27 |
| Cytopathology cervical/vaginal manual screen CPT 88164 • Pathology | $12 | $13 | $15 |
| Cytopathology cervical/vaginal automated thin layer CPT 88175 • Pathology | $13 | $27 | $37 |
| Molecular cytogenetics DNA probe each CPT 88271 • Pathology | $21 | $23 | $24 |
| Cytogenetics molecular interpretation CPT 88291 • Pathology | $35 | $35 | $35 |
| Surgical pathology gross and micro exam level II CPT 88302 • Pathology | $7 | $25 | $44 |
| Surgical pathology gross and micro exam level III CPT 88304 • Pathology | $19 | $40 | $52 |
| Surgical pathology gross and micro exam level IV CPT 88305 • Pathology | $33 | $53 | $86 |
| Surgical pathology gross and micro exam level V CPT 88307 • Pathology | $88 | $155 | $189 |
| Surgical pathology gross and micro exam level VI CPT 88309 • Pathology | $277 | $281 | $285 |
| Special stain group I for microorganisms CPT 88312 • Pathology | $28 | $52 | $89 |
| Special stain group II CPT 88313 • Pathology | $13 | $37 | $65 |
| Frozen section pathology first specimen CPT 88331 • Pathology | $103 | $103 | $103 |
| Frozen section pathology each additional CPT 88332 • Pathology | $9 | $21 | $33 |
| Immunohistochemistry each antibody CPT 88341 • Pathology | $44 | $56 | $67 |
| Immunohistochemistry first antibody CPT 88342 • Pathology | $35 | $54 | $86 |
| Morphometric analysis tumor quantitative CPT 88360 • Pathology | $54 | $59 | $64 |
| Microdissection manual CPT 88381 • Pathology | $26 | $90 | $154 |
| Hot or cold packs application CPT 97010 • Physical Therapy | $4 | $5 | $6 |
| Electrical stimulation unattended CPT 97014 • Physical Therapy | $12 | $14 | $15 |
| Vasopneumatic device therapy CPT 97016 • Physical Therapy | $8 | $11 | $13 |
| Electrical stimulation attended each 15 minutes CPT 97032 • Physical Therapy | $18 | $19 | $21 |
| Ultrasound therapy each 15 minutes CPT 97035 • Physical Therapy | $9 | $12 | $16 |
| Therapeutic exercises each 15 minutes CPT 97110 • Physical Therapy | $22 | $27 | $36 |
| Neuromuscular reeducation each 15 minutes CPT 97112 • Physical Therapy | $23 | $28 | $37 |
| Gait training each 15 minutes CPT 97116 • Physical Therapy | $20 | $24 | $32 |
| Manual therapy one or more regions each 15 min CPT 97140 • Physical Therapy | $19 | $23 | $29 |
| Group therapeutic procedures CPT 97150 • Physical Therapy | $14 | $17 | $23 |
| Physical therapy evaluation low complexity CPT 97161 • Physical Therapy | $63 | $76 | $89 |