| Fundus photography CPT 92250 • Ophthalmology | $17 | $40 | $77 |
| Arthrocentesis aspiration small joint CPT 20600 • Orthopedics | $55 | $65 | $79 |
| Arthrocentesis aspiration intermediate joint CPT 20605 • Orthopedics | $40 | $49 | $57 |
| Arthrocentesis aspiration major joint CPT 20610 • Orthopedics | $54 | $76 | $109 |
| Cervical spine fusion anterior approach CPT 22551 • Orthopedics | $1,337 | $1,779 | $2,348 |
| Lumbar spine fusion posterior approach CPT 22612 • Orthopedics | $1,245 | $1,689 | $2,189 |
| Lumbar spine fusion combined approach CPT 22633 • Orthopedics | $1,935 | $2,162 | $2,555 |
| Total shoulder replacement CPT 23472 • Orthopedics | $1,520 | $1,923 | $2,245 |
| Reverse total shoulder replacement CPT 23473 • Orthopedics | $1,268 | $1,774 | $2,236 |
| Lateral epicondylitis open treatment CPT 24357 • Orthopedics | $324 | $464 | $567 |
| Closed treatment distal radial fracture CPT 25600 • Orthopedics | $306 | $393 | $493 |
| Tendon sheath incision trigger finger CPT 26055 • Orthopedics | $46 | $353 | $614 |
| Total hip replacement CPT 27130 • Orthopedics | $1,254 | $1,487 | $1,871 |
| Hip replacement conversion to total CPT 27132 • Orthopedics | $1,311 | $1,832 | $2,312 |
| Open treatment femoral fracture CPT 27236 • Orthopedics | $935 | $1,271 | $1,644 |
| Treatment intertrochanteric femoral fracture CPT 27244 • Orthopedics | $1,349 | $1,463 | $1,692 |
| Treatment intertrochanteric fracture with plate/screw CPT 27245 • Orthopedics | $46 | $996 | $1,691 |
| Partial knee replacement medial or lateral CPT 27446 • Orthopedics | $1,123 | $1,304 | $1,597 |
| Total knee replacement CPT 27447 • Orthopedics | $1,347 | $1,523 | $1,869 |
| Open treatment tibial shaft fracture CPT 27756 • Orthopedics | $623 | $677 | $783 |
| Closed treatment distal fibula fracture CPT 27786 • Orthopedics | $244 | $323 | $386 |
| Bunionectomy with osteotomy CPT 28296 • Orthopedics | $847 | $976 | $1,219 |
| Arthroscopy shoulder decompression CPT 29826 • Orthopedics | $137 | $198 | $243 |
| Arthroscopy shoulder rotator cuff repair CPT 29827 • Orthopedics | $837 | $1,138 | $1,471 |
| Arthroscopy knee with meniscectomy medial and lateral CPT 29880 • Orthopedics | $589 | $704 | $870 |
| Arthroscopy knee with meniscectomy CPT 29881 • Orthopedics | $309 | $521 | $738 |
| Arthroscopy knee with meniscus repair CPT 29882 • Orthopedics | $46 | $621 | $1,072 |
| Arthroscopy knee ACL repair CPT 29888 • Orthopedics | $1,026 | $1,203 | $1,518 |
| Discectomy lumbar single level CPT 63030 • Orthopedics | $860 | $1,066 | $1,382 |
| Laminectomy lumbar single level CPT 63047 • Orthopedics | $975 | $1,223 | $1,568 |
| Carpal tunnel release CPT 64721 • Orthopedics | $210 | $444 | $642 |
| Sacroiliac joint injection CPT 27096 • Pain Management | $81 | $117 | $169 |
| Epidural injection cervical or thoracic with imaging CPT 62321 • Pain Management | $104 | $214 | $341 |
| Epidural injection lumbar or sacral without imaging CPT 62322 • Pain Management | $74 | $128 | $224 |
| Epidural injection lumbar or sacral with imaging CPT 62323 • Pain Management | $197 | $247 | $337 |
| Spinal cord stimulator electrode implantation CPT 63650 • Pain Management | $370 | $1,111 | $2,032 |
| Peripheral nerve block injection CPT 64450 • Pain Management | $33 | $63 | $102 |
| Plantar common digital nerve injection CPT 64455 • Pain Management | $44 | $53 | $73 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $108 | $223 | $312 |
| Epidural injection lumbar each additional level CPT 64484 • Pain Management | $49 | $93 | $138 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $153 | $225 | $327 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $68 | $91 | $152 |
| Chemodenervation of muscle migraine CPT 64615 • Pain Management | $117 | $148 | $204 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $307 | $377 | $477 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $47 | $230 | $407 |
| Cytopathology concentration technique CPT 88108 • Pathology | $11 | $30 | $39 |
| Cytopathology cell enhancement technique CPT 88112 • Pathology | $18 | $43 | $76 |
| Cytopathology cervical/vaginal interpretation physician CPT 88141 • Pathology | $12 | $17 | $25 |
| Cytopathology cervical/vaginal manual screen CPT 88164 • Pathology | $7 | $8 | $9 |
| Cytopathology cervical/vaginal automated thin layer CPT 88175 • Pathology | $13 | $21 | $27 |