| Arthrocentesis aspiration major joint CPT 20610 • Orthopedics | $47 | $47 | $47 |
| Cervical spine fusion anterior approach CPT 22551 • Orthopedics | $1,654 | $1,654 | $1,654 |
| Lumbar spine fusion posterior approach CPT 22612 • Orthopedics | $1,545 | $1,545 | $1,545 |
| Lumbar spine fusion combined approach CPT 22633 • Orthopedics | $1,772 | $1,772 | $1,772 |
| Reverse total shoulder replacement CPT 23473 • Orthopedics | $1,558 | $1,558 | $1,558 |
| Lateral epicondylitis open treatment CPT 24357 • Orthopedics | $405 | $405 | $405 |
| Tendon sheath incision trigger finger CPT 26055 • Orthopedics | $552 | $566 | $581 |
| Total hip replacement CPT 27130 • Orthopedics | $1,254 | $1,254 | $1,254 |
| Hip replacement conversion to total CPT 27132 • Orthopedics | $1,631 | $1,631 | $1,631 |
| Open treatment femoral fracture CPT 27236 • Orthopedics | $1,158 | $1,162 | $1,166 |
| Treatment intertrochanteric femoral fracture CPT 27244 • Orthopedics | $30 | $610 | $1,191 |
| Partial knee replacement medial or lateral CPT 27446 • Orthopedics | $1,114 | $1,120 | $1,127 |
| Total knee replacement CPT 27447 • Orthopedics | $1,244 | $1,248 | $1,253 |
| Open treatment tibial shaft fracture CPT 27756 • Orthopedics | $563 | $566 | $568 |
| Closed treatment distal fibula fracture CPT 27786 • Orthopedics | $308 | $308 | $308 |
| Bunionectomy with osteotomy CPT 28296 • Orthopedics | $500 | $666 | $832 |
| Arthroscopy shoulder decompression CPT 29826 • Orthopedics | $166 | $166 | $166 |
| Arthroscopy shoulder rotator cuff repair CPT 29827 • Orthopedics | $1,037 | $1,041 | $1,045 |
| Arthroscopy knee with meniscectomy medial and lateral CPT 29880 • Orthopedics | $550 | $550 | $550 |
| Arthroscopy knee with meniscectomy CPT 29881 • Orthopedics | $527 | $528 | $529 |
| Arthroscopy knee with meniscus repair CPT 29882 • Orthopedics | $670 | $670 | $670 |
| Arthroscopy knee ACL repair CPT 29888 • Orthopedics | $946 | $951 | $956 |
| Discectomy lumbar single level CPT 63030 • Orthopedics | $824 | $886 | $948 |
| Laminectomy lumbar single level CPT 63047 • Orthopedics | $1,075 | $1,075 | $1,075 |
| Carpal tunnel release CPT 64721 • Orthopedics | $397 | $415 | $433 |
| Sacroiliac joint injection CPT 27096 • Pain Management | $154 | $154 | $154 |
| Epidural injection cervical or thoracic with imaging CPT 62321 • Pain Management | $226 | $226 | $226 |
| Epidural injection lumbar or sacral with imaging CPT 62323 • Pain Management | $222 | $238 | $254 |
| Spinal cord stimulator electrode implantation CPT 63650 • Pain Management | $1,928 | $2,108 | $2,287 |
| Peripheral nerve block injection CPT 64450 • Pain Management | $65 | $65 | $65 |
| Plantar common digital nerve injection CPT 64455 • Pain Management | $44 | $46 | $48 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $242 | $242 | $242 |
| Epidural injection lumbar each additional level CPT 64484 • Pain Management | $50 | $73 | $96 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $170 | $170 | $170 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $79 | $84 | $88 |
| Chemodenervation of muscle migraine CPT 64615 • Pain Management | $137 | $143 | $149 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $380 | $408 | $436 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $204 | $222 | $240 |
| Cytopathology concentration technique CPT 88108 • Pathology | $49 | $50 | $51 |
| Cytopathology cell enhancement technique CPT 88112 • Pathology | $51 | $51 | $51 |
| Cytopathology cervical/vaginal interpretation physician CPT 88141 • Pathology | $17 | $17 | $17 |
| Cytopathology cervical/vaginal manual screen CPT 88164 • Pathology | $12 | $13 | $14 |
| Cytopathology cervical/vaginal automated thin layer CPT 88175 • Pathology | $21 | $21 | $21 |
| Surgical pathology gross and micro exam level II CPT 88302 • Pathology | $5 | $5 | $5 |
| Surgical pathology gross and micro exam level III CPT 88304 • Pathology | $31 | $31 | $31 |
| Surgical pathology gross and micro exam level IV CPT 88305 • Pathology | $29 | $29 | $29 |
| Surgical pathology gross and micro exam level V CPT 88307 • Pathology | $214 | $216 | $218 |
| Surgical pathology gross and micro exam level VI CPT 88309 • Pathology | $333 | $333 | $333 |
| Special stain group I for microorganisms CPT 88312 • Pathology | $86 | $86 | $86 |
| Special stain group II CPT 88313 • Pathology | $61 | $61 | $61 |