| Fundus photography CPT 92250 • Ophthalmology | $22 | $41 | $75 |
| Arthrocentesis aspiration small joint CPT 20600 • Orthopedics | $70 | $82 | $117 |
| Arthrocentesis aspiration intermediate joint CPT 20605 • Orthopedics | $38 | $73 | $123 |
| Arthrocentesis aspiration major joint CPT 20610 • Orthopedics | $49 | $88 | $146 |
| Cervical spine fusion anterior approach CPT 22551 • Orthopedics | $2,223 | $2,408 | $2,580 |
| Lumbar spine fusion posterior approach CPT 22612 • Orthopedics | $1,318 | $2,208 | $3,244 |
| Lumbar spine fusion combined approach CPT 22633 • Orthopedics | $233 | $2,291 | $3,704 |
| Total shoulder replacement CPT 23472 • Orthopedics | $196 | $1,522 | $2,020 |
| Reverse total shoulder replacement CPT 23473 • Orthopedics | $228 | $1,653 | $2,364 |
| Lateral epicondylitis open treatment CPT 24357 • Orthopedics | $412 | $526 | $587 |
| Closed treatment distal radial fracture CPT 25600 • Orthopedics | $188 | $371 | $476 |
| Tendon sheath incision trigger finger CPT 26055 • Orthopedics | $234 | $555 | $832 |
| Total hip replacement CPT 27130 • Orthopedics | $1,358 | $1,684 | $1,887 |
| Hip replacement conversion to total CPT 27132 • Orthopedics | $2,120 | $2,215 | $2,330 |
| Open treatment femoral fracture CPT 27236 • Orthopedics | $621 | $1,569 | $2,437 |
| Treatment intertrochanteric femoral fracture CPT 27244 • Orthopedics | $612 | $1,295 | $1,714 |
| Treatment intertrochanteric fracture with plate/screw CPT 27245 • Orthopedics | $658 | $1,404 | $1,712 |
| Partial knee replacement medial or lateral CPT 27446 • Orthopedics | $588 | $1,498 | $2,345 |
| Total knee replacement CPT 27447 • Orthopedics | $1,695 | $1,885 | $2,037 |
| Open treatment tibial shaft fracture CPT 27756 • Orthopedics | $90 | $603 | $809 |
| Closed treatment distal fibula fracture CPT 27786 • Orthopedics | $216 | $369 | $444 |
| Bunionectomy with osteotomy CPT 28296 • Orthopedics | $383 | $936 | $1,279 |
| Arthroscopy shoulder decompression CPT 29826 • Orthopedics | $28 | $340 | $863 |
| Arthroscopy shoulder rotator cuff repair CPT 29827 • Orthopedics | $570 | $1,222 | $1,494 |
| Arthroscopy knee with meniscectomy medial and lateral CPT 29880 • Orthopedics | $514 | $735 | $888 |
| Arthroscopy knee with meniscectomy CPT 29881 • Orthopedics | $338 | $663 | $829 |
| Arthroscopy knee with meniscus repair CPT 29882 • Orthopedics | $438 | $805 | $967 |
| Arthroscopy knee ACL repair CPT 29888 • Orthopedics | $1,287 | $1,356 | $1,475 |
| Discectomy lumbar single level CPT 63030 • Orthopedics | $110 | $975 | $1,358 |
| Laminectomy lumbar single level CPT 63047 • Orthopedics | $695 | $1,273 | $1,538 |
| Carpal tunnel release CPT 64721 • Orthopedics | $508 | $565 | $619 |
| Sacroiliac joint injection CPT 27096 • Pain Management | $96 | $213 | $397 |
| Epidural injection cervical or thoracic with imaging CPT 62321 • Pain Management | $137 | $378 | $646 |
| Epidural injection lumbar or sacral without imaging CPT 62322 • Pain Management | $110 | $228 | $379 |
| Epidural injection lumbar or sacral with imaging CPT 62323 • Pain Management | $125 | $370 | $636 |
| Spinal cord stimulator electrode implantation CPT 63650 • Pain Management | $355 | $2,783 | $5,720 |
| Peripheral nerve block injection CPT 64450 • Pain Management | $29 | $116 | $194 |
| Plantar common digital nerve injection CPT 64455 • Pain Management | $27 | $68 | $122 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $114 | $304 | $607 |
| Epidural injection lumbar each additional level CPT 64484 • Pain Management | $80 | $173 | $276 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $63 | $241 | $427 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $54 | $130 | $222 |
| Chemodenervation of muscle migraine CPT 64615 • Pain Management | $186 | $244 | $374 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $227 | $562 | $1,092 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $61 | $295 | $601 |
| Unlisted nervous system procedure CPT 64999 • Pain Management | $0 | $0 | $0 |
| Cytopathology concentration technique CPT 88108 • Pathology | $11 | $34 | $56 |
| Cytopathology cell enhancement technique CPT 88112 • Pathology | $22 | $50 | $90 |
| Cytopathology cervical/vaginal interpretation physician CPT 88141 • Pathology | $9 | $19 | $34 |
| Cytopathology cervical/vaginal manual screen CPT 88164 • Pathology | $6 | $15 | $23 |