| Spinal cord stimulator electrode implantation CPT 63650 • Pain Management | $2,006 | $2,006 | $2,006 |
| Peripheral nerve block injection CPT 64450 • Pain Management | $145 | $145 | $145 |
| Plantar common digital nerve injection CPT 64455 • Pain Management | $49 | $61 | $73 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $143 | $190 | $238 |
| Epidural injection lumbar each additional level CPT 64484 • Pain Management | $93 | $161 | $229 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $105 | $146 | $187 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $40 | $67 | $92 |
| Chemodenervation of muscle migraine CPT 64615 • Pain Management | $147 | $173 | $200 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $365 | $421 | $449 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $188 | $249 | $310 |
| Cytopathology concentration technique CPT 88108 • Pathology | $5 | $43 | $81 |
| Cytopathology cell enhancement technique CPT 88112 • Pathology | $84 | $105 | $125 |
| Cytopathology cervical/vaginal interpretation physician CPT 88141 • Pathology | $23 | $26 | $28 |
| Cytopathology cervical/vaginal manual screen CPT 88164 • Pathology | $11 | $16 | $21 |
| Cytopathology cervical/vaginal automated thin layer CPT 88175 • Pathology | $35 | $36 | $37 |
| Molecular cytogenetics DNA probe each CPT 88271 • Pathology | $10 | $25 | $37 |
| Cytogenetics molecular interpretation CPT 88291 • Pathology | $33 | $38 | $43 |
| Surgical pathology gross and micro exam level II CPT 88302 • Pathology | $17 | $28 | $40 |
| Surgical pathology gross and micro exam level III CPT 88304 • Pathology | $26 | $39 | $52 |
| Surgical pathology gross and micro exam level IV CPT 88305 • Pathology | $42 | $43 | $45 |
| Surgical pathology gross and micro exam level V CPT 88307 • Pathology | $95 | $233 | $361 |
| Surgical pathology gross and micro exam level VI CPT 88309 • Pathology | $127 | $338 | $550 |
| Special stain group I for microorganisms CPT 88312 • Pathology | $22 | $82 | $142 |
| Special stain group II CPT 88313 • Pathology | $14 | $58 | $102 |
| Frozen section pathology first specimen CPT 88331 • Pathology | $70 | $100 | $131 |
| Frozen section pathology each additional CPT 88332 • Pathology | $35 | $52 | $69 |
| Immunohistochemistry each antibody CPT 88341 • Pathology | $72 | $92 | $112 |
| Immunohistochemistry first antibody CPT 88342 • Pathology | $45 | $86 | $128 |
| Morphometric analysis tumor quantitative CPT 88360 • Pathology | $111 | $132 | $153 |
| Microdissection manual CPT 88381 • Pathology | $213 | $238 | $263 |
| Hot or cold packs application CPT 97010 • Physical Therapy | $5 | $8 | $14 |
| Electrical stimulation unattended CPT 97014 • Physical Therapy | $21 | $25 | $30 |
| Vasopneumatic device therapy CPT 97016 • Physical Therapy | $21 | $25 | $28 |
| Electrical stimulation attended each 15 minutes CPT 97032 • Physical Therapy | $24 | $29 | $35 |
| Ultrasound therapy each 15 minutes CPT 97035 • Physical Therapy | $18 | $26 | $34 |
| Therapeutic exercises each 15 minutes CPT 97110 • Physical Therapy | $41 | $56 | $71 |
| Neuromuscular reeducation each 15 minutes CPT 97112 • Physical Therapy | $42 | $62 | $82 |
| Gait training each 15 minutes CPT 97116 • Physical Therapy | $36 | $53 | $71 |
| Manual therapy one or more regions each 15 min CPT 97140 • Physical Therapy | $39 | $52 | $65 |
| Group therapeutic procedures CPT 97150 • Physical Therapy | $27 | $35 | $42 |
| Physical therapy evaluation low complexity CPT 97161 • Physical Therapy | $123 | $182 | $241 |
| Physical therapy evaluation moderate complexity CPT 97162 • Physical Therapy | $123 | $182 | $241 |
| Physical therapy evaluation high complexity CPT 97163 • Physical Therapy | $123 | $182 | $241 |
| Physical therapy re-evaluation CPT 97164 • Physical Therapy | $42 | $63 | $84 |
| Therapeutic activities each 15 minutes CPT 97530 • Physical Therapy | $42 | $65 | $89 |
| Self-care/home management training each 15 min CPT 97535 • Physical Therapy | $45 | $62 | $79 |
| Wheelchair management training each 15 minutes CPT 97542 • Physical Therapy | $23 | $47 | $76 |
| Physical performance test each 15 minutes CPT 97750 • Physical Therapy | $24 | $33 | $42 |
| Orthotic management and training each 15 min CPT 97760 • Physical Therapy | $28 | $36 | $44 |
| Prosthetic training each 15 minutes CPT 97761 • Physical Therapy | $24 | $30 | $35 |