| Closed treatment distal radial fracture CPT 25600 • Orthopedics | $476 | $707 | $1,098 |
| Tendon sheath incision trigger finger CPT 26055 • Orthopedics | $832 | $1,075 | $1,453 |
| Total hip replacement CPT 27130 • Orthopedics | $583 | $1,554 | $2,286 |
| Hip replacement conversion to total CPT 27132 • Orthopedics | $758 | $1,971 | $2,826 |
| Open treatment femoral fracture CPT 27236 • Orthopedics | $1,666 | $2,041 | $2,443 |
| Treatment intertrochanteric femoral fracture CPT 27244 • Orthopedics | $1,714 | $2,593 | $3,990 |
| Treatment intertrochanteric fracture with plate/screw CPT 27245 • Orthopedics | $1,712 | $2,099 | $2,510 |
| Partial knee replacement medial or lateral CPT 27446 • Orthopedics | $522 | $1,362 | $1,954 |
| Total knee replacement CPT 27447 • Orthopedics | $1,791 | $3,439 | $6,242 |
| Open treatment tibial shaft fracture CPT 27756 • Orthopedics | $780 | $1,175 | $1,938 |
| Closed treatment distal fibula fracture CPT 27786 • Orthopedics | $444 | $803 | $1,441 |
| Bunionectomy with osteotomy CPT 28296 • Orthopedics | $1,279 | $1,498 | $1,670 |
| Arthroscopy shoulder decompression CPT 29826 • Orthopedics | $242 | $364 | $552 |
| Arthroscopy shoulder rotator cuff repair CPT 29827 • Orthopedics | $1,494 | $1,821 | $2,187 |
| Arthroscopy knee with meniscectomy medial and lateral CPT 29880 • Orthopedics | $788 | $964 | $1,161 |
| Arthroscopy knee with meniscectomy CPT 29881 • Orthopedics | $760 | $929 | $1,119 |
| Arthroscopy knee with meniscus repair CPT 29882 • Orthopedics | $967 | $1,839 | $3,378 |
| Arthroscopy knee ACL repair CPT 29888 • Orthopedics | $1,366 | $1,672 | $1,993 |
| Discectomy lumbar single level CPT 63030 • Orthopedics | $1,358 | $2,659 | $4,995 |
| Laminectomy lumbar single level CPT 63047 • Orthopedics | $1,538 | $1,971 | $2,533 |
| Carpal tunnel release CPT 64721 • Orthopedics | $619 | $977 | $1,587 |
| Sacroiliac joint injection CPT 27096 • Pain Management | $232 | $300 | $399 |
| Epidural injection cervical or thoracic with imaging CPT 62321 • Pain Management | $377 | $392 | $421 |
| Epidural injection lumbar or sacral without imaging CPT 62322 • Pain Management | $203 | $245 | $275 |
| Epidural injection lumbar or sacral with imaging CPT 62323 • Pain Management | $349 | $380 | $416 |
| Spinal cord stimulator electrode implantation CPT 63650 • Pain Management | $1,468 | $2,437 | $3,168 |
| Peripheral nerve block injection CPT 64450 • Pain Management | $30 | $77 | $109 |
| Plantar common digital nerve injection CPT 64455 • Pain Management | $68 | $74 | $81 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $349 | $373 | $391 |
| Epidural injection lumbar each additional level CPT 64484 • Pain Management | $157 | $174 | $189 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $250 | $286 | $321 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $128 | $151 | $179 |
| Chemodenervation of muscle migraine CPT 64615 • Pain Management | $213 | $374 | $663 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $591 | $653 | $690 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $207 | $246 | $284 |
| Cytopathology concentration technique CPT 88108 • Pathology | $56 | $128 | $191 |
| Cytopathology cell enhancement technique CPT 88112 • Pathology | $54 | $118 | $187 |
| Cytopathology cervical/vaginal interpretation physician CPT 88141 • Pathology | $44 | $54 | $68 |
| Cytopathology cervical/vaginal manual screen CPT 88164 • Pathology | $21 | $36 | $51 |
| Cytopathology cervical/vaginal automated thin layer CPT 88175 • Pathology | $37 | $60 | $75 |
| Molecular cytogenetics DNA probe each CPT 88271 • Pathology | $29 | $45 | $60 |
| Cytogenetics molecular interpretation CPT 88291 • Pathology | $46 | $70 | $93 |
| Surgical pathology gross and micro exam level II CPT 88302 • Pathology | $34 | $74 | $97 |
| Surgical pathology gross and micro exam level III CPT 88304 • Pathology | $16 | $82 | $117 |
| Surgical pathology gross and micro exam level IV CPT 88305 • Pathology | $52 | $72 | $99 |
| Surgical pathology gross and micro exam level V CPT 88307 • Pathology | $283 | $493 | $783 |
| Surgical pathology gross and micro exam level VI CPT 88309 • Pathology | $403 | $803 | $1,169 |
| Special stain group I for microorganisms CPT 88312 • Pathology | $118 | $182 | $235 |
| Special stain group II CPT 88313 • Pathology | $95 | $143 | $192 |
| Frozen section pathology first specimen CPT 88331 • Pathology | $58 | $177 | $275 |