| Arthrocentesis aspiration intermediate joint CPT 20605 • Orthopedics | $62 | $62 | $62 |
| Arthrocentesis aspiration major joint CPT 20610 • Orthopedics | $75 | $75 | $75 |
| Cervical spine fusion anterior approach CPT 22551 • Orthopedics | $2,100 | $2,100 | $2,100 |
| Lumbar spine fusion posterior approach CPT 22612 • Orthopedics | $1,603 | $1,603 | $1,603 |
| Lumbar spine fusion combined approach CPT 22633 • Orthopedics | $2,250 | $2,250 | $2,250 |
| Total shoulder replacement CPT 23472 • Orthopedics | $1,569 | $1,569 | $1,569 |
| Reverse total shoulder replacement CPT 23473 • Orthopedics | $1,983 | $1,983 | $1,983 |
| Lateral epicondylitis open treatment CPT 24357 • Orthopedics | $439 | $439 | $439 |
| Closed treatment distal radial fracture CPT 25600 • Orthopedics | $308 | $308 | $308 |
| Tendon sheath incision trigger finger CPT 26055 • Orthopedics | $725 | $725 | $725 |
| Total hip replacement CPT 27130 • Orthopedics | $1,507 | $1,507 | $1,507 |
| Hip replacement conversion to total CPT 27132 • Orthopedics | $1,753 | $1,753 | $1,753 |
| Open treatment femoral fracture CPT 27236 • Orthopedics | $1,197 | $1,197 | $1,197 |
| Treatment intertrochanteric femoral fracture CPT 27244 • Orthopedics | $1,227 | $1,227 | $1,227 |
| Treatment intertrochanteric fracture with plate/screw CPT 27245 • Orthopedics | $1,537 | $1,537 | $1,537 |
| Partial knee replacement medial or lateral CPT 27446 • Orthopedics | $1,218 | $1,218 | $1,218 |
| Total knee replacement CPT 27447 • Orthopedics | $1,624 | $1,624 | $1,624 |
| Open treatment tibial shaft fracture CPT 27756 • Orthopedics | $592 | $592 | $592 |
| Closed treatment distal fibula fracture CPT 27786 • Orthopedics | $344 | $344 | $344 |
| Bunionectomy with osteotomy CPT 28296 • Orthopedics | $774 | $774 | $774 |
| Arthroscopy shoulder decompression CPT 29826 • Orthopedics | $736 | $736 | $736 |
| Arthroscopy shoulder rotator cuff repair CPT 29827 • Orthopedics | $1,187 | $1,187 | $1,187 |
| Arthroscopy knee with meniscectomy medial and lateral CPT 29880 • Orthopedics | $704 | $704 | $704 |
| Arthroscopy knee with meniscectomy CPT 29881 • Orthopedics | $652 | $652 | $652 |
| Arthroscopy knee with meniscus repair CPT 29882 • Orthopedics | $700 | $700 | $700 |
| Arthroscopy knee ACL repair CPT 29888 • Orthopedics | $1,081 | $1,081 | $1,081 |
| Discectomy lumbar single level CPT 63030 • Orthopedics | $946 | $946 | $946 |
| Laminectomy lumbar single level CPT 63047 • Orthopedics | $1,133 | $1,133 | $1,133 |
| Carpal tunnel release CPT 64721 • Orthopedics | $408 | $408 | $408 |
| Sacroiliac joint injection CPT 27096 • Pain Management | $446 | $446 | $446 |
| Epidural injection cervical or thoracic with imaging CPT 62321 • Pain Management | $290 | $290 | $290 |
| Epidural injection lumbar or sacral without imaging CPT 62322 • Pain Management | $182 | $182 | $182 |
| Epidural injection lumbar or sacral with imaging CPT 62323 • Pain Management | $285 | $285 | $285 |
| Spinal cord stimulator electrode implantation CPT 63650 • Pain Management | $1,548 | $1,548 | $1,548 |
| Peripheral nerve block injection CPT 64450 • Pain Management | $108 | $108 | $108 |
| Plantar common digital nerve injection CPT 64455 • Pain Management | $56 | $56 | $56 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $393 | $393 | $393 |
| Epidural injection lumbar each additional level CPT 64484 • Pain Management | $174 | $174 | $174 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $250 | $250 | $250 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $118 | $118 | $118 |
| Chemodenervation of muscle migraine CPT 64615 • Pain Management | $174 | $174 | $174 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $536 | $536 | $536 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $225 | $225 | $225 |
| Cytopathology concentration technique CPT 88108 • Pathology | $2 | $2 | $2 |
| Cytopathology cell enhancement technique CPT 88112 • Pathology | $65 | $65 | $65 |
| Cytopathology cervical/vaginal interpretation physician CPT 88141 • Pathology | $23 | $23 | $23 |
| Cytopathology cervical/vaginal manual screen CPT 88164 • Pathology | $11 | $11 | $11 |
| Cytopathology cervical/vaginal automated thin layer CPT 88175 • Pathology | $37 | $37 | $37 |
| Molecular cytogenetics DNA probe each CPT 88271 • Pathology | $37 | $37 | $37 |
| Cytogenetics molecular interpretation CPT 88291 • Pathology | $33 | $33 | $33 |