| Arthrocentesis aspiration major joint CPT 20610 • Orthopedics | $40 | $80 | $100 |
| Cervical spine fusion anterior approach CPT 22551 • Orthopedics | $238 | $1,640 | $2,749 |
| Lumbar spine fusion posterior approach CPT 22612 • Orthopedics | $1,821 | $2,187 | $2,563 |
| Lumbar spine fusion combined approach CPT 22633 • Orthopedics | $240 | $1,987 | $2,929 |
| Total shoulder replacement CPT 23472 • Orthopedics | $1,313 | $1,713 | $2,353 |
| Reverse total shoulder replacement CPT 23473 • Orthopedics | $1,520 | $2,279 | $3,160 |
| Lateral epicondylitis open treatment CPT 24357 • Orthopedics | $268 | $477 | $695 |
| Closed treatment distal radial fracture CPT 25600 • Orthopedics | $271 | $383 | $592 |
| Tendon sheath incision trigger finger CPT 26055 • Orthopedics | $174 | $509 | $975 |
| Total hip replacement CPT 27130 • Orthopedics | $895 | $1,479 | $2,093 |
| Hip replacement conversion to total CPT 27132 • Orthopedics | $266 | $1,600 | $2,716 |
| Open treatment femoral fracture CPT 27236 • Orthopedics | $186 | $1,127 | $1,952 |
| Treatment intertrochanteric femoral fracture CPT 27244 • Orthopedics | $1,075 | $1,411 | $2,008 |
| Treatment intertrochanteric fracture with plate/screw CPT 27245 • Orthopedics | $197 | $1,247 | $2,006 |
| Partial knee replacement medial or lateral CPT 27446 • Orthopedics | $1,011 | $1,320 | $1,877 |
| Total knee replacement CPT 27447 • Orthopedics | $1,344 | $1,681 | $2,090 |
| Open treatment tibial shaft fracture CPT 27756 • Orthopedics | $77 | $590 | $984 |
| Closed treatment distal fibula fracture CPT 27786 • Orthopedics | $314 | $391 | $541 |
| Bunionectomy with osteotomy CPT 28296 • Orthopedics | $451 | $667 | $854 |
| Arthroscopy shoulder decompression CPT 29826 • Orthopedics | $26 | $450 | $765 |
| Arthroscopy shoulder rotator cuff repair CPT 29827 • Orthopedics | $989 | $1,398 | $1,751 |
| Arthroscopy knee with meniscectomy medial and lateral CPT 29880 • Orthopedics | $604 | $756 | $935 |
| Arthroscopy knee with meniscectomy CPT 29881 • Orthopedics | $653 | $789 | $902 |
| Arthroscopy knee with meniscus repair CPT 29882 • Orthopedics | $671 | $781 | $960 |
| Arthroscopy knee ACL repair CPT 29888 • Orthopedics | $156 | $994 | $1,596 |
| Discectomy lumbar single level CPT 63030 • Orthopedics | $580 | $1,092 | $1,502 |
| Laminectomy lumbar single level CPT 63047 • Orthopedics | $169 | $1,163 | $1,807 |
| Carpal tunnel release CPT 64721 • Orthopedics | $464 | $592 | $747 |
| Sacroiliac joint injection CPT 27096 • Pain Management | $83 | $161 | $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 | $203 | $363 |
| Epidural injection lumbar or sacral with imaging CPT 62323 • Pain Management | $98 | $229 | $422 |
| Spinal cord stimulator electrode implantation CPT 63650 • Pain Management | $486 | $584 | $674 |
| Peripheral nerve block injection CPT 64450 • Pain Management | $49 | $83 | $119 |
| Plantar common digital nerve injection CPT 64455 • Pain Management | $32 | $54 | $81 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $92 | $235 | $404 |
| Epidural injection lumbar each additional level CPT 64484 • Pain Management | $27 | $90 | $154 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $100 | $170 | $293 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $42 | $68 | $90 |
| Chemodenervation of muscle migraine CPT 64615 • Pain Management | $119 | $164 | $246 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $260 | $434 | $719 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $58 | $154 | $395 |
| Unlisted nervous system procedure CPT 64999 • Pain Management | $0 | $0 | $0 |
| Cytopathology concentration technique CPT 88108 • Pathology | $7 | $56 | $98 |
| Cytopathology cell enhancement technique CPT 88112 • Pathology | $19 | $91 | $127 |
| Cytopathology cervical/vaginal interpretation physician CPT 88141 • Pathology | $13 | $30 | $41 |
| Cytopathology cervical/vaginal manual screen CPT 88164 • Pathology | $6 | $19 | $30 |
| Cytopathology cervical/vaginal automated thin layer CPT 88175 • Pathology | $15 | $32 | $44 |
| Molecular cytogenetics DNA probe each CPT 88271 • Pathology | $26 | $35 | $43 |
| Cytogenetics molecular interpretation CPT 88291 • Pathology | $14 | $35 | $56 |