| Cervical spine fusion anterior approach CPT 22551 • Orthopedics | $1,654 | $2,207 | $3,312 |
| Lumbar spine fusion posterior approach CPT 22612 • Orthopedics | $1,545 | $1,914 | $2,653 |
| Lumbar spine fusion combined approach CPT 22633 • Orthopedics | $1,800 | $2,407 | $3,621 |
| Total shoulder replacement CPT 23472 • Orthopedics | $1,414 | $1,796 | $2,561 |
| Reverse total shoulder replacement CPT 23473 • Orthopedics | $1,576 | $2,077 | $3,079 |
| Lateral epicondylitis open treatment CPT 24357 • Orthopedics | $412 | $546 | $813 |
| Closed treatment distal radial fracture CPT 25600 • Orthopedics | $332 | $370 | $446 |
| Tendon sheath incision trigger finger CPT 26055 • Orthopedics | $574 | $811 | $1,277 |
| Total hip replacement CPT 27130 • Orthopedics | $1,254 | $2,498 | $3,399 |
| Hip replacement conversion to total CPT 27132 • Orthopedics | $1,631 | $2,049 | $2,884 |
| Open treatment femoral fracture CPT 27236 • Orthopedics | $1,930 | $2,345 | $2,646 |
| Treatment intertrochanteric femoral fracture CPT 27244 • Orthopedics | $1,199 | $1,432 | $1,897 |
| Treatment intertrochanteric fracture with plate/screw CPT 27245 • Orthopedics | $1,198 | $1,568 | $2,308 |
| Partial knee replacement medial or lateral CPT 27446 • Orthopedics | $1,127 | $1,710 | $2,876 |
| Total knee replacement CPT 27447 • Orthopedics | $1,253 | $2,499 | $3,406 |
| Open treatment tibial shaft fracture CPT 27756 • Orthopedics | $568 | $699 | $962 |
| Closed treatment distal fibula fracture CPT 27786 • Orthopedics | $309 | $360 | $461 |
| Bunionectomy with osteotomy CPT 28296 • Orthopedics | $500 | $756 | $903 |
| Arthroscopy shoulder decompression CPT 29826 • Orthopedics | $169 | $544 | $1,085 |
| Arthroscopy shoulder rotator cuff repair CPT 29827 • Orthopedics | $1,888 | $2,155 | $2,372 |
| Arthroscopy knee with meniscectomy medial and lateral CPT 29880 • Orthopedics | $550 | $922 | $1,203 |
| Arthroscopy knee with meniscectomy CPT 29881 • Orthopedics | $529 | $665 | $936 |
| Arthroscopy knee with meniscus repair CPT 29882 • Orthopedics | $674 | $751 | $904 |
| Arthroscopy knee ACL repair CPT 29888 • Orthopedics | $956 | $1,226 | $1,766 |
| Discectomy lumbar single level CPT 63030 • Orthopedics | $948 | $1,538 | $1,992 |
| Laminectomy lumbar single level CPT 63047 • Orthopedics | $1,075 | $1,290 | $1,719 |
| Carpal tunnel release CPT 64721 • Orthopedics | $433 | $689 | $999 |
| Sacroiliac joint injection CPT 27096 • Pain Management | $158 | $211 | $316 |
| Epidural injection cervical or thoracic with imaging CPT 62321 • Pain Management | $258 | $448 | $568 |
| Epidural injection lumbar or sacral without imaging CPT 62322 • Pain Management | $137 | $174 | $247 |
| Epidural injection lumbar or sacral with imaging CPT 62323 • Pain Management | $254 | $448 | $558 |
| Spinal cord stimulator electrode implantation CPT 63650 • Pain Management | $1,174 | $1,916 | $2,287 |
| Peripheral nerve block injection CPT 64450 • Pain Management | $74 | $91 | $125 |
| Plantar common digital nerve injection CPT 64455 • Pain Management | $48 | $71 | $111 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $242 | $416 | $535 |
| Epidural injection lumbar each additional level CPT 64484 • Pain Management | $110 | $154 | $242 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $263 | $362 | $433 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $178 | $199 | $219 |
| Chemodenervation of muscle migraine CPT 64615 • Pain Management | $149 | $185 | $258 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $436 | $711 | $952 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $240 | $372 | $510 |
| Cytopathology concentration technique CPT 88108 • Pathology | $11 | $31 | $49 |
| Cytopathology cell enhancement technique CPT 88112 • Pathology | $24 | $92 | $150 |
| Cytopathology cervical/vaginal interpretation physician CPT 88141 • Pathology | $15 | $36 | $55 |
| Cytopathology cervical/vaginal manual screen CPT 88164 • Pathology | $7 | $10 | $12 |
| Cytopathology cervical/vaginal automated thin layer CPT 88175 • Pathology | $17 | $23 | $38 |
| Molecular cytogenetics DNA probe each CPT 88271 • Pathology | $14 | $17 | $24 |
| Cytogenetics molecular interpretation CPT 88291 • Pathology | $15 | $26 | $48 |
| Surgical pathology gross and micro exam level II CPT 88302 • Pathology | $3 | $36 | $73 |
| Surgical pathology gross and micro exam level III CPT 88304 • Pathology | $5 | $36 | $93 |