| Ophthalmic biometry IOL power calculation CPT 92136 • Ophthalmology | $40 | $77 | $109 |
| Fundus photography CPT 92250 • Ophthalmology | $36 | $53 | $64 |
| Arthrocentesis aspiration small joint CPT 20600 • Orthopedics | $34 | $65 | $107 |
| Arthrocentesis aspiration intermediate joint CPT 20605 • Orthopedics | $35 | $66 | $131 |
| Arthrocentesis aspiration major joint CPT 20610 • Orthopedics | $40 | $95 | $166 |
| Cervical spine fusion anterior approach CPT 22551 • Orthopedics | $245 | $1,851 | $3,487 |
| Lumbar spine fusion posterior approach CPT 22612 • Orthopedics | $977 | $2,374 | $3,244 |
| Lumbar spine fusion combined approach CPT 22633 • Orthopedics | $240 | $1,975 | $3,704 |
| Total shoulder replacement CPT 23472 • Orthopedics | $1,180 | $1,826 | $2,956 |
| Reverse total shoulder replacement CPT 23473 • Orthopedics | $335 | $1,905 | $3,558 |
| Lateral epicondylitis open treatment CPT 24357 • Orthopedics | $410 | $675 | $1,181 |
| Closed treatment distal radial fracture CPT 25600 • Orthopedics | $245 | $462 | $691 |
| Tendon sheath incision trigger finger CPT 26055 • Orthopedics | $290 | $546 | $1,170 |
| Total hip replacement CPT 27130 • Orthopedics | $234 | $1,816 | $3,155 |
| Hip replacement conversion to total CPT 27132 • Orthopedics | $302 | $1,172 | $1,763 |
| Open treatment femoral fracture CPT 27236 • Orthopedics | $994 | $1,921 | $3,057 |
| Treatment intertrochanteric femoral fracture CPT 27244 • Orthopedics | $1,075 | $1,249 | $1,530 |
| Treatment intertrochanteric fracture with plate/screw CPT 27245 • Orthopedics | $1,327 | $2,342 | $3,692 |
| Partial knee replacement medial or lateral CPT 27446 • Orthopedics | $181 | $1,659 | $3,100 |
| Total knee replacement CPT 27447 • Orthopedics | $209 | $2,076 | $4,128 |
| Open treatment tibial shaft fracture CPT 27756 • Orthopedics | $88 | $509 | $810 |
| Closed treatment distal fibula fracture CPT 27786 • Orthopedics | $160 | $344 | $642 |
| Bunionectomy with osteotomy CPT 28296 • Orthopedics | $63 | $773 | $1,756 |
| Arthroscopy shoulder decompression CPT 29826 • Orthopedics | $189 | $489 | $734 |
| Arthroscopy shoulder rotator cuff repair CPT 29827 • Orthopedics | $989 | $1,542 | $2,186 |
| Arthroscopy knee with meniscectomy medial and lateral CPT 29880 • Orthopedics | $653 | $895 | $1,149 |
| Arthroscopy knee with meniscectomy CPT 29881 • Orthopedics | $366 | $949 | $1,672 |
| Arthroscopy knee with meniscus repair CPT 29882 • Orthopedics | $563 | $833 | $1,410 |
| Arthroscopy knee ACL repair CPT 29888 • Orthopedics | $796 | $1,215 | $1,995 |
| Discectomy lumbar single level CPT 63030 • Orthopedics | $133 | $1,367 | $2,451 |
| Laminectomy lumbar single level CPT 63047 • Orthopedics | $174 | $1,486 | $2,290 |
| Carpal tunnel release CPT 64721 • Orthopedics | $259 | $621 | $852 |
| Sacroiliac joint injection CPT 27096 • Pain Management | $69 | $273 | $617 |
| Epidural injection cervical or thoracic with imaging CPT 62321 • Pain Management | $106 | $216 | $467 |
| Epidural injection lumbar or sacral without imaging CPT 62322 • Pain Management | $78 | $104 | $129 |
| Epidural injection lumbar or sacral with imaging CPT 62323 • Pain Management | $98 | $206 | $459 |
| Spinal cord stimulator electrode implantation CPT 63650 • Pain Management | $271 | $412 | $495 |
| Peripheral nerve block injection CPT 64450 • Pain Management | $56 | $86 | $135 |
| Plantar common digital nerve injection CPT 64455 • Pain Management | $34 | $54 | $91 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $60 | $224 | $438 |
| Epidural injection lumbar each additional level CPT 64484 • Pain Management | $44 | $69 | $97 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $77 | $170 | $315 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $42 | $138 | $288 |
| Chemodenervation of muscle migraine CPT 64615 • Pain Management | $124 | $181 | $281 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $178 | $360 | $786 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $56 | $97 | $184 |
| Unlisted nervous system procedure CPT 64999 • Pain Management | $0 | $0 | $0 |
| Cytopathology concentration technique CPT 88108 • Pathology | $10 | $49 | $75 |
| Cytopathology cell enhancement technique CPT 88112 • Pathology | $40 | $71 | $106 |
| Cytopathology cervical/vaginal interpretation physician CPT 88141 • Pathology | $13 | $28 | $50 |