| Lumbar spine fusion combined approach CPT 22633 • Orthopedics | $288 | $1,815 | $3,107 |
| Total shoulder replacement CPT 23472 • Orthopedics | $1,313 | $1,833 | $2,453 |
| Reverse total shoulder replacement CPT 23473 • Orthopedics | $1,821 | $2,483 | $2,891 |
| Lateral epicondylitis open treatment CPT 24357 • Orthopedics | $452 | $554 | $702 |
| Closed treatment distal radial fracture CPT 25600 • Orthopedics | $271 | $441 | $547 |
| Tendon sheath incision trigger finger CPT 26055 • Orthopedics | $296 | $531 | $939 |
| Total hip replacement CPT 27130 • Orthopedics | $1,249 | $1,949 | $2,313 |
| Hip replacement conversion to total CPT 27132 • Orthopedics | $1,451 | $2,251 | $2,826 |
| Open treatment femoral fracture CPT 27236 • Orthopedics | $747 | $1,252 | $2,015 |
| Treatment intertrochanteric femoral fracture CPT 27244 • Orthopedics | $1,075 | $1,788 | $2,215 |
| Treatment intertrochanteric fracture with plate/screw CPT 27245 • Orthopedics | $1,327 | $1,871 | $2,212 |
| Partial knee replacement medial or lateral CPT 27446 • Orthopedics | $193 | $1,053 | $1,954 |
| Total knee replacement CPT 27447 • Orthopedics | $178 | $1,269 | $2,284 |
| Open treatment tibial shaft fracture CPT 27756 • Orthopedics | $99 | $575 | $970 |
| Closed treatment distal fibula fracture CPT 27786 • Orthopedics | $186 | $341 | $523 |
| Bunionectomy with osteotomy CPT 28296 • Orthopedics | $87 | $730 | $1,544 |
| Arthroscopy shoulder decompression CPT 29826 • Orthopedics | $204 | $412 | $734 |
| Arthroscopy shoulder rotator cuff repair CPT 29827 • Orthopedics | $989 | $1,353 | $1,782 |
| Arthroscopy knee with meniscectomy medial and lateral CPT 29880 • Orthopedics | $564 | $737 | $943 |
| Arthroscopy knee with meniscectomy CPT 29881 • Orthopedics | $342 | $635 | $909 |
| Arthroscopy knee with meniscus repair CPT 29882 • Orthopedics | $434 | $770 | $1,173 |
| Arthroscopy knee ACL repair CPT 29888 • Orthopedics | $969 | $1,235 | $1,657 |
| Discectomy lumbar single level CPT 63030 • Orthopedics | $1,204 | $1,499 | $1,668 |
| Laminectomy lumbar single level CPT 63047 • Orthopedics | $697 | $1,327 | $1,842 |
| Carpal tunnel release CPT 64721 • Orthopedics | $277 | $521 | $725 |
| Sacroiliac joint injection CPT 27096 • Pain Management | $81 | $144 | $268 |
| Epidural injection cervical or thoracic with imaging CPT 62321 • Pain Management | $128 | $226 | $421 |
| Epidural injection lumbar or sacral without imaging CPT 62322 • Pain Management | $103 | $159 | $256 |
| Epidural injection lumbar or sacral with imaging CPT 62323 • Pain Management | $118 | $227 | $416 |
| Spinal cord stimulator electrode implantation CPT 63650 • Pain Management | $496 | $1,240 | $2,674 |
| Peripheral nerve block injection CPT 64450 • Pain Management | $50 | $74 | $96 |
| Plantar common digital nerve injection CPT 64455 • Pain Management | $33 | $52 | $81 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $146 | $241 | $378 |
| Epidural injection lumbar each additional level CPT 64484 • Pain Management | $76 | $112 | $164 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $89 | $159 | $288 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $58 | $93 | $147 |
| Chemodenervation of muscle migraine CPT 64615 • Pain Management | $142 | $190 | $245 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $230 | $393 | $690 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $69 | $146 | $284 |
| Cytopathology concentration technique CPT 88108 • Pathology | $28 | $37 | $53 |
| Cytopathology cell enhancement technique CPT 88112 • Pathology | $41 | $74 | $127 |
| Cytopathology cervical/vaginal interpretation physician CPT 88141 • Pathology | $12 | $26 | $39 |
| Cytopathology cervical/vaginal manual screen CPT 88164 • Pathology | $6 | $11 | $14 |
| Cytopathology cervical/vaginal automated thin layer CPT 88175 • Pathology | $15 | $25 | $36 |
| Molecular cytogenetics DNA probe each CPT 88271 • Pathology | $12 | $21 | $29 |
| Cytogenetics molecular interpretation CPT 88291 • Pathology | $14 | $21 | $29 |
| Surgical pathology gross and micro exam level II CPT 88302 • Pathology | $7 | $21 | $34 |
| Surgical pathology gross and micro exam level III CPT 88304 • Pathology | $28 | $35 | $44 |
| Surgical pathology gross and micro exam level IV CPT 88305 • Pathology | $36 | $44 | $55 |
| Surgical pathology gross and micro exam level V CPT 88307 • Pathology | $169 | $190 | $219 |