| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $508 | $597 | $686 |
| Intravitreal injection therapeutic agent CPT 67028 • Ophthalmology | $103 | $111 | $118 |
| Retinal photocoagulation treatment CPT 67210 • Ophthalmology | $541 | $578 | $615 |
| Retinal treatment extensive photocoagulation CPT 67228 • Ophthalmology | $96 | $286 | $404 |
| Strabismus surgery one horizontal muscle CPT 67311 • Ophthalmology | $710 | $710 | $710 |
| Blepharoptosis repair levator resection CPT 67901 • Ophthalmology | $1,039 | $1,039 | $1,039 |
| Lacrimal punctum closure by plug CPT 68761 • Ophthalmology | $190 | $190 | $190 |
| Eye exam new patient intermediate CPT 92002 • Ophthalmology | $61 | $61 | $61 |
| Eye exam new patient comprehensive CPT 92004 • Ophthalmology | $147 | $147 | $147 |
| Eye exam established patient intermediate CPT 92012 • Ophthalmology | $88 | $88 | $88 |
| Eye exam established patient comprehensive CPT 92014 • Ophthalmology | $124 | $124 | $124 |
| Visual field examination CPT 92083 • Ophthalmology | $60 | $61 | $62 |
| Retinal imaging OCT posterior segment CPT 92134 • Ophthalmology | $25 | $26 | $26 |
| Ophthalmic biometry IOL power calculation CPT 92136 • Ophthalmology | $44 | $62 | $79 |
| Fundus photography CPT 92250 • Ophthalmology | $36 | $39 | $42 |
| Arthrocentesis aspiration small joint CPT 20600 • Orthopedics | $42 | $42 | $42 |
| Arthrocentesis aspiration major joint CPT 20610 • Orthopedics | $61 | $65 | $68 |
| Cervical spine fusion anterior approach CPT 22551 • Orthopedics | $1,850 | $1,898 | $1,946 |
| Lumbar spine fusion posterior approach CPT 22612 • Orthopedics | $1,689 | $1,689 | $1,689 |
| Lumbar spine fusion combined approach CPT 22633 • Orthopedics | $1,884 | $1,884 | $1,884 |
| Tendon sheath incision trigger finger CPT 26055 • Orthopedics | $316 | $316 | $316 |
| Total hip replacement CPT 27130 • Orthopedics | $1,401 | $1,401 | $1,401 |
| Open treatment femoral fracture CPT 27236 • Orthopedics | $1,236 | $1,236 | $1,236 |
| Partial knee replacement medial or lateral CPT 27446 • Orthopedics | $1,197 | $1,197 | $1,197 |
| Total knee replacement CPT 27447 • Orthopedics | $1,328 | $1,364 | $1,400 |
| Open treatment tibial shaft fracture CPT 27756 • Orthopedics | $588 | $655 | $722 |
| Bunionectomy with osteotomy CPT 28296 • Orthopedics | $719 | $849 | $979 |
| Arthroscopy shoulder rotator cuff repair CPT 29827 • Orthopedics | $1,080 | $1,080 | $1,080 |
| Arthroscopy knee with meniscectomy medial and lateral CPT 29880 • Orthopedics | $579 | $579 | $579 |
| Arthroscopy knee with meniscectomy CPT 29881 • Orthopedics | $558 | $565 | $571 |
| Discectomy lumbar single level CPT 63030 • Orthopedics | $1,035 | $1,110 | $1,186 |
| Laminectomy lumbar single level CPT 63047 • Orthopedics | $1,353 | $1,353 | $1,353 |
| Carpal tunnel release CPT 64721 • Orthopedics | $505 | $520 | $535 |
| Sacroiliac joint injection CPT 27096 • Pain Management | $150 | $161 | $173 |
| Epidural injection cervical or thoracic with imaging CPT 62321 • Pain Management | $260 | $283 | $303 |
| Epidural injection lumbar or sacral with imaging CPT 62323 • Pain Management | $257 | $270 | $282 |
| Spinal cord stimulator electrode implantation CPT 63650 • Pain Management | $486 | $486 | $486 |
| Peripheral nerve block injection CPT 64450 • Pain Management | $42 | $42 | $42 |
| Plantar common digital nerve injection CPT 64455 • Pain Management | $53 | $53 | $53 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $252 | $281 | $309 |
| Epidural injection lumbar each additional level CPT 64484 • Pain Management | $42 | $73 | $103 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $198 | $234 | $269 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $77 | $88 | $99 |
| Chemodenervation of muscle migraine CPT 64615 • Pain Management | $123 | $149 | $175 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $479 | $562 | $657 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $227 | $232 | $236 |
| Cytopathology concentration technique CPT 88108 • Pathology | $45 | $45 | $45 |
| Cytopathology cell enhancement technique CPT 88112 • Pathology | $13 | $29 | $45 |
| Cytopathology cervical/vaginal interpretation physician CPT 88141 • Pathology | $20 | $20 | $20 |
| Cytopathology cervical/vaginal manual screen CPT 88164 • Pathology | $7 | $7 | $7 |