| Retinal imaging OCT posterior segment CPT 92134 • Ophthalmology | $15 | $32 | $61 |
| Ophthalmic biometry IOL power calculation CPT 92136 • Ophthalmology | $32 | $69 | $136 |
| Fundus photography CPT 92250 • Ophthalmology | $11 | $49 | $75 |
| Arthrocentesis aspiration small joint CPT 20600 • Orthopedics | $43 | $52 | $61 |
| Arthrocentesis aspiration intermediate joint CPT 20605 • Orthopedics | $44 | $67 | $126 |
| Arthrocentesis aspiration major joint CPT 20610 • Orthopedics | $31 | $79 | $149 |
| Cervical spine fusion anterior approach CPT 22551 • Orthopedics | $1,809 | $2,530 | $3,947 |
| Lumbar spine fusion posterior approach CPT 22612 • Orthopedics | $1,526 | $1,973 | $3,670 |
| Lumbar spine fusion combined approach CPT 22633 • Orthopedics | $288 | $2,160 | $4,285 |
| Total shoulder replacement CPT 23472 • Orthopedics | $854 | $1,548 | $2,265 |
| Reverse total shoulder replacement CPT 23473 • Orthopedics | $1,786 | $2,158 | $2,530 |
| Lateral epicondylitis open treatment CPT 24357 • Orthopedics | $421 | $544 | $648 |
| Closed treatment distal radial fracture CPT 25600 • Orthopedics | $268 | $389 | $502 |
| Tendon sheath incision trigger finger CPT 26055 • Orthopedics | $278 | $659 | $888 |
| Total hip replacement CPT 27130 • Orthopedics | $304 | $1,315 | $1,905 |
| Hip replacement conversion to total CPT 27132 • Orthopedics | $1,646 | $2,016 | $2,609 |
| Open treatment femoral fracture CPT 27236 • Orthopedics | $1,144 | $1,553 | $1,927 |
| Treatment intertrochanteric femoral fracture CPT 27244 • Orthopedics | $254 | $1,294 | $1,917 |
| Treatment intertrochanteric fracture with plate/screw CPT 27245 • Orthopedics | $185 | $1,370 | $1,917 |
| Partial knee replacement medial or lateral CPT 27446 • Orthopedics | $1,101 | $1,364 | $1,804 |
| Total knee replacement CPT 27447 • Orthopedics | $1,428 | $1,751 | $2,110 |
| Open treatment tibial shaft fracture CPT 27756 • Orthopedics | $549 | $858 | $1,871 |
| Closed treatment distal fibula fracture CPT 27786 • Orthopedics | $280 | $347 | $484 |
| Bunionectomy with osteotomy CPT 28296 • Orthopedics | $89 | $883 | $1,405 |
| Arthroscopy shoulder decompression CPT 29826 • Orthopedics | $35 | $339 | $698 |
| Arthroscopy shoulder rotator cuff repair CPT 29827 • Orthopedics | $1,075 | $1,292 | $1,631 |
| Arthroscopy knee with meniscectomy medial and lateral CPT 29880 • Orthopedics | $337 | $682 | $873 |
| Arthroscopy knee with meniscectomy CPT 29881 • Orthopedics | $589 | $687 | $837 |
| Arthroscopy knee with meniscus repair CPT 29882 • Orthopedics | $667 | $827 | $1,091 |
| Arthroscopy knee ACL repair CPT 29888 • Orthopedics | $147 | $1,043 | $1,532 |
| Discectomy lumbar single level CPT 63030 • Orthopedics | $139 | $1,040 | $2,220 |
| Laminectomy lumbar single level CPT 63047 • Orthopedics | $1,032 | $1,354 | $2,513 |
| Carpal tunnel release CPT 64721 • Orthopedics | $403 | $600 | $1,153 |
| Sacroiliac joint injection CPT 27096 • Pain Management | $72 | $156 | $246 |
| Epidural injection cervical or thoracic with imaging CPT 62321 • Pain Management | $100 | $323 | $657 |
| Epidural injection lumbar or sacral without imaging CPT 62322 • Pain Management | $86 | $152 | $199 |
| Epidural injection lumbar or sacral with imaging CPT 62323 • Pain Management | $92 | $280 | $598 |
| Spinal cord stimulator electrode implantation CPT 63650 • Pain Management | $384 | $1,775 | $5,452 |
| Peripheral nerve block injection CPT 64450 • Pain Management | $61 | $85 | $114 |
| Plantar common digital nerve injection CPT 64455 • Pain Management | $33 | $64 | $125 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $75 | $291 | $571 |
| Epidural injection lumbar each additional level CPT 64484 • Pain Management | $55 | $146 | $310 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $89 | $243 | $449 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $51 | $98 | $226 |
| Chemodenervation of muscle migraine CPT 64615 • Pain Management | $132 | $192 | $352 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $179 | $585 | $1,087 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $64 | $175 | $313 |
| Cytopathology concentration technique CPT 88108 • Pathology | $20 | $50 | $80 |
| Cytopathology cell enhancement technique CPT 88112 • Pathology | $22 | $62 | $136 |
| Cytopathology cervical/vaginal interpretation physician CPT 88141 • Pathology | $12 | $24 | $37 |