| Total shoulder replacement CPT 23472 • Orthopedics | $1,414 | $1,414 | $1,414 |
| Reverse total shoulder replacement CPT 23473 • Orthopedics | $1,576 | $1,576 | $1,576 |
| Lateral epicondylitis open treatment CPT 24357 • Orthopedics | $412 | $412 | $412 |
| Closed treatment distal radial fracture CPT 25600 • Orthopedics | $317 | $317 | $317 |
| Tendon sheath incision trigger finger CPT 26055 • Orthopedics | $87 | $87 | $87 |
| Total hip replacement CPT 27130 • Orthopedics | $1,341 | $1,341 | $1,341 |
| Hip replacement conversion to total CPT 27132 • Orthopedics | $1,743 | $1,743 | $1,743 |
| Open treatment femoral fracture CPT 27236 • Orthopedics | $1,166 | $1,205 | $1,244 |
| Treatment intertrochanteric femoral fracture CPT 27244 • Orthopedics | $1,200 | $1,200 | $1,200 |
| Partial knee replacement medial or lateral CPT 27446 • Orthopedics | $1,128 | $1,162 | $1,197 |
| Total knee replacement CPT 27447 • Orthopedics | $1,253 | $1,297 | $1,340 |
| Open treatment tibial shaft fracture CPT 27756 • Orthopedics | $603 | $610 | $617 |
| Closed treatment distal fibula fracture CPT 27786 • Orthopedics | $309 | $309 | $309 |
| Bunionectomy with osteotomy CPT 28296 • Orthopedics | $865 | $880 | $896 |
| Arthroscopy shoulder decompression CPT 29826 • Orthopedics | $169 | $169 | $169 |
| Arthroscopy shoulder rotator cuff repair CPT 29827 • Orthopedics | $1,046 | $1,081 | $1,116 |
| Arthroscopy knee with meniscectomy medial and lateral CPT 29880 • Orthopedics | $586 | $586 | $586 |
| Arthroscopy knee with meniscectomy CPT 29881 • Orthopedics | $530 | $547 | $564 |
| Arthroscopy knee with meniscus repair CPT 29882 • Orthopedics | $674 | $674 | $674 |
| Arthroscopy knee ACL repair CPT 29888 • Orthopedics | $956 | $956 | $956 |
| Discectomy lumbar single level CPT 63030 • Orthopedics | $865 | $907 | $949 |
| Laminectomy lumbar single level CPT 63047 • Orthopedics | $1,051 | $1,051 | $1,051 |
| Carpal tunnel release CPT 64721 • Orthopedics | $418 | $426 | $433 |
| Sacroiliac joint injection CPT 27096 • Pain Management | $80 | $119 | $159 |
| Epidural injection cervical or thoracic with imaging CPT 62321 • Pain Management | $104 | $181 | $258 |
| Epidural injection lumbar or sacral with imaging CPT 62323 • Pain Management | $236 | $245 | $255 |
| Spinal cord stimulator electrode implantation CPT 63650 • Pain Management | $405 | $1,346 | $2,288 |
| Peripheral nerve block injection CPT 64450 • Pain Management | $74 | $74 | $74 |
| Plantar common digital nerve injection CPT 64455 • Pain Management | $47 | $48 | $49 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $225 | $225 | $225 |
| Epidural injection lumbar each additional level CPT 64484 • Pain Management | $110 | $110 | $110 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $162 | $162 | $162 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $84 | $86 | $89 |
| Chemodenervation of muscle migraine CPT 64615 • Pain Management | $144 | $147 | $150 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $28 | $216 | $405 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $6 | $123 | $240 |
| Cytopathology concentration technique CPT 88108 • Pathology | $49 | $49 | $49 |
| Cytopathology cell enhancement technique CPT 88112 • Pathology | $61 | $61 | $61 |
| Cytopathology cervical/vaginal interpretation physician CPT 88141 • Pathology | $21 | $21 | $21 |
| Cytopathology cervical/vaginal manual screen CPT 88164 • Pathology | $13 | $15 | $17 |
| Cytopathology cervical/vaginal automated thin layer CPT 88175 • Pathology | $21 | $24 | $26 |
| Cytogenetics molecular interpretation CPT 88291 • Pathology | $25 | $25 | $25 |
| Surgical pathology gross and micro exam level II CPT 88302 • Pathology | $29 | $29 | $29 |
| 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 | $250 | $256 | $262 |
| Surgical pathology gross and micro exam level VI CPT 88309 • Pathology | $397 | $397 | $397 |
| Special stain group I for microorganisms CPT 88312 • Pathology | $86 | $86 | $86 |
| Special stain group II CPT 88313 • Pathology | $61 | $61 | $62 |
| Frozen section pathology first specimen CPT 88331 • Pathology | $79 | $79 | $79 |
| Frozen section pathology each additional CPT 88332 • Pathology | $50 | $50 | $50 |