| Lateral epicondylitis open treatment CPT 24357 • Orthopedics | $412 | $613 | $813 |
| Closed treatment distal radial fracture CPT 25600 • Orthopedics | $30 | $238 | $446 |
| Tendon sheath incision trigger finger CPT 26055 • Orthopedics | $574 | $1,172 | $1,770 |
| Total hip replacement CPT 27130 • Orthopedics | $3,399 | $3,669 | $3,939 |
| Hip replacement conversion to total CPT 27132 • Orthopedics | $30 | $1,457 | $2,884 |
| Open treatment femoral fracture CPT 27236 • Orthopedics | $30 | $980 | $1,930 |
| Treatment intertrochanteric femoral fracture CPT 27244 • Orthopedics | $30 | $963 | $1,897 |
| Treatment intertrochanteric fracture with plate/screw CPT 27245 • Orthopedics | $1,198 | $1,753 | $2,308 |
| Partial knee replacement medial or lateral CPT 27446 • Orthopedics | $30 | $1,453 | $2,876 |
| Total knee replacement CPT 27447 • Orthopedics | $3,406 | $3,670 | $3,934 |
| Open treatment tibial shaft fracture CPT 27756 • Orthopedics | $30 | $496 | $962 |
| Closed treatment distal fibula fracture CPT 27786 • Orthopedics | $30 | $245 | $461 |
| Bunionectomy with osteotomy CPT 28296 • Orthopedics | $903 | $1,789 | $2,676 |
| Arthroscopy shoulder decompression CPT 29826 • Orthopedics | $523 | $804 | $1,085 |
| Arthroscopy shoulder rotator cuff repair CPT 29827 • Orthopedics | $1,888 | $2,588 | $3,288 |
| Arthroscopy knee with meniscectomy medial and lateral CPT 29880 • Orthopedics | $30 | $521 | $1,012 |
| Arthroscopy knee with meniscectomy CPT 29881 • Orthopedics | $936 | $1,309 | $1,682 |
| Arthroscopy knee with meniscus repair CPT 29882 • Orthopedics | $904 | $1,519 | $2,133 |
| Arthroscopy knee ACL repair CPT 29888 • Orthopedics | $1,766 | $2,382 | $2,999 |
| Discectomy lumbar single level CPT 63030 • Orthopedics | $30 | $853 | $1,675 |
| Laminectomy lumbar single level CPT 63047 • Orthopedics | $30 | $875 | $1,719 |
| Carpal tunnel release CPT 64721 • Orthopedics | $635 | $1,010 | $1,384 |
| Sacroiliac joint injection CPT 27096 • Pain Management | $316 | $408 | $500 |
| Epidural injection cervical or thoracic with imaging CPT 62321 • Pain Management | $520 | $653 | $787 |
| Epidural injection lumbar or sacral without imaging CPT 62322 • Pain Management | $137 | $192 | $247 |
| Epidural injection lumbar or sacral with imaging CPT 62323 • Pain Management | $533 | $653 | $773 |
| Spinal cord stimulator electrode implantation CPT 63650 • Pain Management | $30 | $602 | $1,174 |
| Peripheral nerve block injection CPT 64450 • Pain Management | $125 | $176 | $226 |
| Plantar common digital nerve injection CPT 64455 • Pain Management | $48 | $51 | $54 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $470 | $606 | $741 |
| Epidural injection lumbar each additional level CPT 64484 • Pain Management | $242 | $288 | $334 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $263 | $402 | $540 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $178 | $227 | $277 |
| Chemodenervation of muscle migraine CPT 64615 • Pain Management | $258 | $358 | $457 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $745 | $1,032 | $1,319 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $366 | $536 | $706 |
| Cytopathology concentration technique CPT 88108 • Pathology | $11 | $25 | $33 |
| Cytopathology cell enhancement technique CPT 88112 • Pathology | $24 | $114 | $207 |
| Cytopathology cervical/vaginal interpretation physician CPT 88141 • Pathology | $15 | $44 | $77 |
| Cytopathology cervical/vaginal manual screen CPT 88164 • Pathology | $7 | $10 | $12 |
| Cytopathology cervical/vaginal automated thin layer CPT 88175 • Pathology | $17 | $25 | $38 |
| Molecular cytogenetics DNA probe each CPT 88271 • Pathology | $14 | $18 | $24 |
| Cytogenetics molecular interpretation CPT 88291 • Pathology | $15 | $29 | $48 |
| Surgical pathology gross and micro exam level II CPT 88302 • Pathology | $3 | $40 | $101 |
| Surgical pathology gross and micro exam level III CPT 88304 • Pathology | $5 | $56 | $129 |
| Surgical pathology gross and micro exam level IV CPT 88305 • Pathology | $18 | $93 | $221 |
| Surgical pathology gross and micro exam level V CPT 88307 • Pathology | $100 | $375 | $871 |
| Surgical pathology gross and micro exam level VI CPT 88309 • Pathology | $211 | $586 | $1,305 |
| Special stain group I for microorganisms CPT 88312 • Pathology | $33 | $140 | $339 |
| Special stain group II CPT 88313 • Pathology | $6 | $90 | $247 |