| Retinal imaging OCT posterior segment CPT 92134 • Ophthalmology | $33 | $46 | $61 |
| Ophthalmic biometry IOL power calculation CPT 92136 • Ophthalmology | $71 | $78 | $91 |
| Fundus photography CPT 92250 • Ophthalmology | $17 | $53 | $79 |
| Arthrocentesis aspiration small joint CPT 20600 • Orthopedics | $34 | $60 | $88 |
| Arthrocentesis aspiration intermediate joint CPT 20605 • Orthopedics | $35 | $62 | $90 |
| Arthrocentesis aspiration major joint CPT 20610 • Orthopedics | $29 | $63 | $100 |
| Cervical spine fusion anterior approach CPT 22551 • Orthopedics | $1,683 | $2,226 | $2,749 |
| Lumbar spine fusion posterior approach CPT 22612 • Orthopedics | $223 | $1,662 | $2,563 |
| Lumbar spine fusion combined approach CPT 22633 • Orthopedics | $292 | $2,000 | $2,929 |
| Total shoulder replacement CPT 23472 • Orthopedics | $203 | $1,405 | $2,353 |
| Reverse total shoulder replacement CPT 23473 • Orthopedics | $226 | $1,955 | $3,160 |
| Lateral epicondylitis open treatment CPT 24357 • Orthopedics | $452 | $569 | $695 |
| Closed treatment distal radial fracture CPT 25600 • Orthopedics | $214 | $345 | $592 |
| Tendon sheath incision trigger finger CPT 26055 • Orthopedics | $189 | $513 | $975 |
| Total hip replacement CPT 27130 • Orthopedics | $1,249 | $1,739 | $2,093 |
| Hip replacement conversion to total CPT 27132 • Orthopedics | $1,056 | $1,797 | $2,716 |
| Open treatment femoral fracture CPT 27236 • Orthopedics | $168 | $1,123 | $1,952 |
| Treatment intertrochanteric femoral fracture CPT 27244 • Orthopedics | $1,075 | $1,434 | $2,008 |
| Treatment intertrochanteric fracture with plate/screw CPT 27245 • Orthopedics | $1,327 | $1,661 | $2,006 |
| Partial knee replacement medial or lateral CPT 27446 • Orthopedics | $162 | $1,086 | $1,877 |
| Total knee replacement CPT 27447 • Orthopedics | $206 | $1,360 | $2,090 |
| Open treatment tibial shaft fracture CPT 27756 • Orthopedics | $371 | $663 | $984 |
| Closed treatment distal fibula fracture CPT 27786 • Orthopedics | $189 | $343 | $541 |
| Bunionectomy with osteotomy CPT 28296 • Orthopedics | $73 | $572 | $854 |
| Arthroscopy shoulder decompression CPT 29826 • Orthopedics | $27 | $450 | $765 |
| Arthroscopy shoulder rotator cuff repair CPT 29827 • Orthopedics | $679 | $1,168 | $1,751 |
| Arthroscopy knee with meniscectomy medial and lateral CPT 29880 • Orthopedics | $572 | $748 | $935 |
| Arthroscopy knee with meniscectomy CPT 29881 • Orthopedics | $347 | $657 | $902 |
| Arthroscopy knee with meniscus repair CPT 29882 • Orthopedics | $440 | $723 | $960 |
| Arthroscopy knee ACL repair CPT 29888 • Orthopedics | $619 | $1,110 | $1,596 |
| Discectomy lumbar single level CPT 63030 • Orthopedics | $1,080 | $1,295 | $1,502 |
| Laminectomy lumbar single level CPT 63047 • Orthopedics | $707 | $1,298 | $1,807 |
| Carpal tunnel release CPT 64721 • Orthopedics | $447 | $554 | $747 |
| Sacroiliac joint injection CPT 27096 • Pain Management | $83 | $169 | $271 |
| Epidural injection cervical or thoracic with imaging CPT 62321 • Pain Management | $129 | $250 | $429 |
| Epidural injection lumbar or sacral without imaging CPT 62322 • Pain Management | $103 | $200 | $363 |
| Epidural injection lumbar or sacral with imaging CPT 62323 • Pain Management | $99 | $229 | $422 |
| Spinal cord stimulator electrode implantation CPT 63650 • Pain Management | $415 | $531 | $674 |
| Peripheral nerve block injection CPT 64450 • Pain Management | $42 | $81 | $119 |
| Plantar common digital nerve injection CPT 64455 • Pain Management | $33 | $55 | $81 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $146 | $254 | $404 |
| Epidural injection lumbar each additional level CPT 64484 • Pain Management | $51 | $96 | $154 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $100 | $176 | $293 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $50 | $70 | $90 |
| Chemodenervation of muscle migraine CPT 64615 • Pain Management | $124 | $165 | $246 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $260 | $425 | $719 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $69 | $162 | $395 |
| Unlisted nervous system procedure CPT 64999 • Pain Management | $0 | $0 | $0 |
| Cytopathology concentration technique CPT 88108 • Pathology | $20 | $59 | $98 |
| Cytopathology cell enhancement technique CPT 88112 • Pathology | $41 | $97 | $127 |