| Closed treatment distal fibula fracture CPT 27786 • Orthopedics | $223 | $425 | $719 |
| Bunionectomy with osteotomy CPT 28296 • Orthopedics | $63 | $847 | $1,803 |
| Arthroscopy shoulder decompression CPT 29826 • Orthopedics | $23 | $293 | $734 |
| Arthroscopy shoulder rotator cuff repair CPT 29827 • Orthopedics | $42 | $1,454 | $3,133 |
| Arthroscopy knee with meniscectomy medial and lateral CPT 29880 • Orthopedics | $42 | $540 | $826 |
| Arthroscopy knee with meniscectomy CPT 29881 • Orthopedics | $42 | $699 | $1,589 |
| Arthroscopy knee with meniscus repair CPT 29882 • Orthopedics | $370 | $968 | $2,047 |
| Arthroscopy knee ACL repair CPT 29888 • Orthopedics | $119 | $1,243 | $2,451 |
| Discectomy lumbar single level CPT 63030 • Orthopedics | $807 | $1,140 | $1,416 |
| Laminectomy lumbar single level CPT 63047 • Orthopedics | $1,104 | $1,385 | $1,611 |
| Carpal tunnel release CPT 64721 • Orthopedics | $42 | $544 | $1,070 |
| Sacroiliac joint injection CPT 27096 • Pain Management | $42 | $97 | $130 |
| Epidural injection cervical or thoracic with imaging CPT 62321 • Pain Management | $92 | $188 | $306 |
| Epidural injection lumbar or sacral without imaging CPT 62322 • Pain Management | $103 | $226 | $462 |
| Epidural injection lumbar or sacral with imaging CPT 62323 • Pain Management | $84 | $211 | $355 |
| Spinal cord stimulator electrode implantation CPT 63650 • Pain Management | $366 | $1,261 | $2,416 |
| Peripheral nerve block injection CPT 64450 • Pain Management | $42 | $90 | $202 |
| Plantar common digital nerve injection CPT 64455 • Pain Management | $42 | $55 | $71 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $42 | $201 | $323 |
| Epidural injection lumbar each additional level CPT 64484 • Pain Management | $37 | $94 | $129 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $65 | $209 | $521 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $55 | $114 | $257 |
| Chemodenervation of muscle migraine CPT 64615 • Pain Management | $142 | $162 | $184 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $260 | $436 | $624 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $69 | $239 | $536 |
| Unlisted nervous system procedure CPT 64999 • Pain Management | $0 | $0 | $0 |
| Cytopathology concentration technique CPT 88108 • Pathology | $16 | $80 | $235 |
| Cytopathology cell enhancement technique CPT 88112 • Pathology | $19 | $50 | $127 |
| Cytopathology cervical/vaginal interpretation physician CPT 88141 • Pathology | $13 | $22 | $30 |
| Cytopathology cervical/vaginal manual screen CPT 88164 • Pathology | $6 | $11 | $14 |
| Cytopathology cervical/vaginal automated thin layer CPT 88175 • Pathology | $15 | $25 | $35 |
| Molecular cytogenetics DNA probe each CPT 88271 • Pathology | $15 | $18 | $20 |
| Cytogenetics molecular interpretation CPT 88291 • Pathology | $14 | $35 | $75 |
| Surgical pathology gross and micro exam level II CPT 88302 • Pathology | $7 | $23 | $34 |
| Surgical pathology gross and micro exam level III CPT 88304 • Pathology | $20 | $46 | $110 |
| Surgical pathology gross and micro exam level IV CPT 88305 • Pathology | $29 | $59 | $77 |
| Surgical pathology gross and micro exam level V CPT 88307 • Pathology | $23 | $290 | $861 |
| Surgical pathology gross and micro exam level VI CPT 88309 • Pathology | $113 | $198 | $345 |
| Special stain group I for microorganisms CPT 88312 • Pathology | $4 | $47 | $89 |
| Special stain group II CPT 88313 • Pathology | $12 | $64 | $164 |
| Frozen section pathology first specimen CPT 88331 • Pathology | $34 | $78 | $176 |
| Frozen section pathology each additional CPT 88332 • Pathology | $12 | $28 | $43 |
| Immunohistochemistry each antibody CPT 88341 • Pathology | $11 | $44 | $77 |
| Immunohistochemistry first antibody CPT 88342 • Pathology | $16 | $94 | $263 |
| Morphometric analysis tumor quantitative CPT 88360 • Pathology | $20 | $68 | $123 |
| Microdissection manual CPT 88381 • Pathology | $20 | $140 | $405 |
| Hot or cold packs application CPT 97010 • Physical Therapy | $3 | $5 | $7 |
| Electrical stimulation unattended CPT 97014 • Physical Therapy | $7 | $13 | $19 |
| Vasopneumatic device therapy CPT 97016 • Physical Therapy | $7 | $14 | $23 |
| Electrical stimulation attended each 15 minutes CPT 97032 • Physical Therapy | $9 | $15 | $23 |