| Open treatment tibial shaft fracture CPT 27756 • Orthopedics | $611 | $649 | $687 |
| Bunionectomy with osteotomy CPT 28296 • Orthopedics | $937 | $996 | $1,055 |
| Arthroscopy shoulder rotator cuff repair CPT 29827 • Orthopedics | $1,260 | $1,260 | $1,260 |
| Arthroscopy knee with meniscectomy medial and lateral CPT 29880 • Orthopedics | $664 | $664 | $664 |
| Arthroscopy knee with meniscectomy CPT 29881 • Orthopedics | $571 | $606 | $640 |
| Arthroscopy knee ACL repair CPT 29888 • Orthopedics | $1,015 | $1,015 | $1,015 |
| Discectomy lumbar single level CPT 63030 • Orthopedics | $1,102 | $1,102 | $1,102 |
| Laminectomy lumbar single level CPT 63047 • Orthopedics | $1,248 | $1,248 | $1,248 |
| Carpal tunnel release CPT 64721 • Orthopedics | $507 | $507 | $507 |
| Sacroiliac joint injection CPT 27096 • Pain Management | $173 | $173 | $173 |
| Epidural injection cervical or thoracic with imaging CPT 62321 • Pain Management | $12 | $12 | $12 |
| Epidural injection lumbar or sacral with imaging CPT 62323 • Pain Management | $301 | $301 | $301 |
| Spinal cord stimulator electrode implantation CPT 63650 • Pain Management | $473 | $473 | $473 |
| Plantar common digital nerve injection CPT 64455 • Pain Management | $57 | $57 | $57 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $287 | $287 | $287 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $201 | $201 | $201 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $104 | $104 | $104 |
| Chemodenervation of muscle migraine CPT 64615 • Pain Management | $174 | $174 | $174 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $468 | $492 | $516 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $260 | $260 | $260 |
| Cytopathology concentration technique CPT 88108 • Pathology | $49 | $49 | $49 |
| Cytopathology cell enhancement technique CPT 88112 • Pathology | $50 | $50 | $50 |
| Cytopathology cervical/vaginal interpretation physician CPT 88141 • Pathology | $17 | $17 | $17 |
| Cytopathology cervical/vaginal manual screen CPT 88164 • Pathology | $12 | $12 | $12 |
| Cytopathology cervical/vaginal automated thin layer CPT 88175 • Pathology | $20 | $20 | $20 |
| Surgical pathology gross and micro exam level II CPT 88302 • Pathology | $24 | $24 | $24 |
| Surgical pathology gross and micro exam level III CPT 88304 • Pathology | $31 | $31 | $31 |
| Surgical pathology gross and micro exam level V CPT 88307 • Pathology | $218 | $239 | $260 |
| Surgical pathology gross and micro exam level VI CPT 88309 • Pathology | $331 | $331 | $331 |
| Special stain group I for microorganisms CPT 88312 • Pathology | $85 | $85 | $85 |
| Special stain group II CPT 88313 • Pathology | $61 | $61 | $61 |
| Frozen section pathology each additional CPT 88332 • Pathology | $41 | $41 | $41 |
| Immunohistochemistry each antibody CPT 88341 • Pathology | $67 | $67 | $67 |
| Immunohistochemistry first antibody CPT 88342 • Pathology | $77 | $77 | $77 |
| Morphometric analysis tumor quantitative CPT 88360 • Pathology | $60 | $60 | $60 |
| Microdissection manual CPT 88381 • Pathology | $159 | $159 | $159 |
| Hot or cold packs application CPT 97010 • Physical Therapy | $3 | $4 | $5 |
| Electrical stimulation unattended CPT 97014 • Physical Therapy | $7 | $7 | $7 |
| Vasopneumatic device therapy CPT 97016 • Physical Therapy | $9 | $9 | $9 |
| Electrical stimulation attended each 15 minutes CPT 97032 • Physical Therapy | $11 | $11 | $11 |
| Ultrasound therapy each 15 minutes CPT 97035 • Physical Therapy | $8 | $8 | $8 |
| Therapeutic exercises each 15 minutes CPT 97110 • Physical Therapy | $15 | $15 | $15 |
| Neuromuscular reeducation each 15 minutes CPT 97112 • Physical Therapy | $16 | $16 | $16 |
| Gait training each 15 minutes CPT 97116 • Physical Therapy | $22 | $22 | $22 |
| Manual therapy one or more regions each 15 min CPT 97140 • Physical Therapy | $21 | $21 | $21 |
| Group therapeutic procedures CPT 97150 • Physical Therapy | $10 | $10 | $10 |
| Physical therapy evaluation low complexity CPT 97161 • Physical Therapy | $41 | $41 | $41 |
| Physical therapy evaluation moderate complexity CPT 97162 • Physical Therapy | $59 | $63 | $66 |
| Physical therapy evaluation high complexity CPT 97163 • Physical Therapy | $59 | $59 | $59 |
| Physical therapy re-evaluation CPT 97164 • Physical Therapy | $55 | $55 | $55 |