| Partial knee replacement medial or lateral CPT 27446 • Orthopedics | $1,743 | $1,743 | $1,743 |
| Total knee replacement CPT 27447 • Orthopedics | $1,944 | $1,944 | $1,944 |
| Arthroscopy shoulder decompression CPT 29826 • Orthopedics | $258 | $258 | $258 |
| Arthroscopy shoulder rotator cuff repair CPT 29827 • Orthopedics | $1,624 | $1,624 | $1,624 |
| Arthroscopy knee with meniscectomy medial and lateral CPT 29880 • Orthopedics | $257 | $257 | $257 |
| Arthroscopy knee with meniscectomy CPT 29881 • Orthopedics | $831 | $831 | $831 |
| Arthroscopy knee with meniscus repair CPT 29882 • Orthopedics | $1,054 | $1,054 | $1,054 |
| Arthroscopy knee ACL repair CPT 29888 • Orthopedics | $883 | $883 | $883 |
| Discectomy lumbar single level CPT 63030 • Orthopedics | $806 | $806 | $806 |
| Laminectomy lumbar single level CPT 63047 • Orthopedics | $986 | $986 | $986 |
| Carpal tunnel release CPT 64721 • Orthopedics | $653 | $653 | $653 |
| Sacroiliac joint injection CPT 27096 • Pain Management | $69 | $69 | $69 |
| Epidural injection cervical or thoracic with imaging CPT 62321 • Pain Management | $87 | $87 | $87 |
| Epidural injection lumbar or sacral with imaging CPT 62323 • Pain Management | $244 | $244 | $244 |
| Spinal cord stimulator electrode implantation CPT 63650 • Pain Management | $341 | $341 | $341 |
| Peripheral nerve block injection CPT 64450 • Pain Management | $65 | $65 | $65 |
| Plantar common digital nerve injection CPT 64455 • Pain Management | $79 | $79 | $79 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $549 | $549 | $549 |
| Epidural injection lumbar each additional level CPT 64484 • Pain Management | $183 | $183 | $183 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $231 | $231 | $231 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $79 | $79 | $79 |
| Chemodenervation of muscle migraine CPT 64615 • Pain Management | $238 | $238 | $238 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $254 | $254 | $254 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $78 | $78 | $78 |
| Cytopathology concentration technique CPT 88108 • Pathology | $10 | $10 | $10 |
| Cytopathology cervical/vaginal interpretation physician CPT 88141 • Pathology | $12 | $12 | $12 |
| Cytopathology cervical/vaginal manual screen CPT 88164 • Pathology | $9 | $9 | $9 |
| Cytopathology cervical/vaginal automated thin layer CPT 88175 • Pathology | $13 | $13 | $13 |
| Cytogenetics molecular interpretation CPT 88291 • Pathology | $16 | $16 | $16 |
| Surgical pathology gross and micro exam level II CPT 88302 • Pathology | $3 | $3 | $3 |
| Surgical pathology gross and micro exam level III CPT 88304 • Pathology | $5 | $5 | $5 |
| Surgical pathology gross and micro exam level IV CPT 88305 • Pathology | $34 | $34 | $34 |
| Surgical pathology gross and micro exam level V CPT 88307 • Pathology | $38 | $38 | $38 |
| Surgical pathology gross and micro exam level VI CPT 88309 • Pathology | $66 | $66 | $66 |
| Special stain group I for microorganisms CPT 88312 • Pathology | $52 | $52 | $52 |
| Special stain group II CPT 88313 • Pathology | $39 | $39 | $39 |
| Frozen section pathology first specimen CPT 88331 • Pathology | $29 | $29 | $29 |
| Immunohistochemistry each antibody CPT 88341 • Pathology | $45 | $45 | $45 |
| Immunohistochemistry first antibody CPT 88342 • Pathology | $53 | $53 | $53 |
| Morphometric analysis tumor quantitative CPT 88360 • Pathology | $19 | $19 | $19 |
| Hot or cold packs application CPT 97010 • Physical Therapy | $5 | $5 | $5 |
| Electrical stimulation unattended CPT 97014 • Physical Therapy | $12 | $12 | $12 |
| Vasopneumatic device therapy CPT 97016 • Physical Therapy | $17 | $17 | $17 |
| Electrical stimulation attended each 15 minutes CPT 97032 • Physical Therapy | $11 | $11 | $11 |
| Ultrasound therapy each 15 minutes CPT 97035 • Physical Therapy | $10 | $10 | $10 |
| Therapeutic exercises each 15 minutes CPT 97110 • Physical Therapy | $42 | $42 | $42 |
| Neuromuscular reeducation each 15 minutes CPT 97112 • Physical Therapy | $46 | $46 | $46 |
| Gait training each 15 minutes CPT 97116 • Physical Therapy | $19 | $19 | $19 |
| Manual therapy one or more regions each 15 min CPT 97140 • Physical Therapy | $39 | $39 | $39 |
| Group therapeutic procedures CPT 97150 • Physical Therapy | $10 | $10 | $10 |