| Lumbar spine fusion combined approach CPT 22633 • Orthopedics | $2,088 | $2,088 | $2,088 |
| Total shoulder replacement CPT 23472 • Orthopedics | $1,911 | $1,944 | $2,011 |
| Reverse total shoulder replacement CPT 23473 • Orthopedics | $1,475 | $1,475 | $1,475 |
| Lateral epicondylitis open treatment CPT 24357 • Orthopedics | $456 | $456 | $456 |
| Closed treatment distal radial fracture CPT 25600 • Orthopedics | $362 | $431 | $465 |
| Tendon sheath incision trigger finger CPT 26055 • Orthopedics | $316 | $624 | $778 |
| Total hip replacement CPT 27130 • Orthopedics | $1,545 | $1,647 | $1,698 |
| Hip replacement conversion to total CPT 27132 • Orthopedics | $2,205 | $2,319 | $2,547 |
| Open treatment femoral fracture CPT 27236 • Orthopedics | $1,530 | $1,530 | $1,530 |
| Treatment intertrochanteric femoral fracture CPT 27244 • Orthopedics | $1,257 | $1,257 | $1,257 |
| Treatment intertrochanteric fracture with plate/screw CPT 27245 • Orthopedics | $1,575 | $1,608 | $1,624 |
| Partial knee replacement medial or lateral CPT 27446 • Orthopedics | $1,520 | $1,536 | $1,568 |
| Total knee replacement CPT 27447 • Orthopedics | $1,695 | $1,709 | $1,736 |
| Open treatment tibial shaft fracture CPT 27756 • Orthopedics | $850 | $850 | $850 |
| Closed treatment distal fibula fracture CPT 27786 • Orthopedics | $492 | $492 | $492 |
| Bunionectomy with osteotomy CPT 28296 • Orthopedics | $961 | $1,102 | $1,172 |
| Arthroscopy shoulder decompression CPT 29826 • Orthopedics | $225 | $488 | $1,013 |
| Arthroscopy shoulder rotator cuff repair CPT 29827 • Orthopedics | $1,221 | $1,353 | $1,419 |
| Arthroscopy knee with meniscectomy medial and lateral CPT 29880 • Orthopedics | $721 | $741 | $752 |
| Arthroscopy knee with meniscectomy CPT 29881 • Orthopedics | $668 | $706 | $724 |
| Arthroscopy knee with meniscus repair CPT 29882 • Orthopedics | $639 | $779 | $919 |
| Arthroscopy knee ACL repair CPT 29888 • Orthopedics | $898 | $1,162 | $1,294 |
| Discectomy lumbar single level CPT 63030 • Orthopedics | $949 | $1,038 | $1,204 |
| Laminectomy lumbar single level CPT 63047 • Orthopedics | $1,454 | $1,590 | $1,861 |
| Carpal tunnel release CPT 64721 • Orthopedics | $594 | $595 | $596 |
| Sacroiliac joint injection CPT 27096 • Pain Management | $127 | $127 | $127 |
| Epidural injection cervical or thoracic with imaging CPT 62321 • Pain Management | $330 | $330 | $330 |
| Epidural injection lumbar or sacral without imaging CPT 62322 • Pain Management | $262 | $262 | $262 |
| Epidural injection lumbar or sacral with imaging CPT 62323 • Pain Management | $173 | $173 | $173 |
| Spinal cord stimulator electrode implantation CPT 63650 • Pain Management | $452 | $452 | $452 |
| Peripheral nerve block injection CPT 64450 • Pain Management | $74 | $110 | $157 |
| Plantar common digital nerve injection CPT 64455 • Pain Management | $65 | $65 | $65 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $181 | $181 | $181 |
| Epidural injection lumbar each additional level CPT 64484 • Pain Management | $80 | $80 | $80 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $264 | $264 | $264 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $94 | $94 | $94 |
| Chemodenervation of muscle migraine CPT 64615 • Pain Management | $127 | $127 | $127 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $503 | $503 | $503 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $264 | $264 | $264 |
| Cytopathology concentration technique CPT 88108 • Pathology | $40 | $74 | $91 |
| Cytopathology cell enhancement technique CPT 88112 • Pathology | $25 | $69 | $90 |
| Cytopathology cervical/vaginal interpretation physician CPT 88141 • Pathology | $27 | $27 | $27 |
| Cytopathology cervical/vaginal manual screen CPT 88164 • Pathology | $18 | $18 | $18 |
| Cytopathology cervical/vaginal automated thin layer CPT 88175 • Pathology | $27 | $27 | $27 |
| Molecular cytogenetics DNA probe each CPT 88271 • Pathology | $13 | $22 | $30 |
| Cytogenetics molecular interpretation CPT 88291 • Pathology | $24 | $24 | $24 |
| Surgical pathology gross and micro exam level II CPT 88302 • Pathology | $9 | $19 | $24 |
| Surgical pathology gross and micro exam level III CPT 88304 • Pathology | $9 | $41 | $57 |
| Surgical pathology gross and micro exam level IV CPT 88305 • Pathology | $34 | $75 | $96 |
| Surgical pathology gross and micro exam level V CPT 88307 • Pathology | $188 | $316 | $380 |