| Lumbar spine fusion combined approach CPT 22633 • Orthopedics | $1,801 | $2,978 | $4,551 |
| Total shoulder replacement CPT 23472 • Orthopedics | $246 | $1,800 | $3,541 |
| Reverse total shoulder replacement CPT 23473 • Orthopedics | $1,700 | $2,804 | $3,682 |
| Lateral epicondylitis open treatment CPT 24357 • Orthopedics | $452 | $942 | $1,289 |
| Closed treatment distal radial fracture CPT 25600 • Orthopedics | $271 | $531 | $749 |
| Tendon sheath incision trigger finger CPT 26055 • Orthopedics | $192 | $691 | $1,666 |
| Total hip replacement CPT 27130 • Orthopedics | $1,249 | $2,233 | $3,155 |
| Hip replacement conversion to total CPT 27132 • Orthopedics | $1,451 | $2,822 | $4,151 |
| Open treatment femoral fracture CPT 27236 • Orthopedics | $994 | $1,986 | $3,057 |
| Treatment intertrochanteric femoral fracture CPT 27244 • Orthopedics | $1,075 | $1,770 | $2,793 |
| Treatment intertrochanteric fracture with plate/screw CPT 27245 • Orthopedics | $1,098 | $2,213 | $3,692 |
| Partial knee replacement medial or lateral CPT 27446 • Orthopedics | $1,011 | $2,079 | $3,316 |
| Total knee replacement CPT 27447 • Orthopedics | $229 | $1,968 | $4,411 |
| Open treatment tibial shaft fracture CPT 27756 • Orthopedics | $568 | $922 | $1,429 |
| Closed treatment distal fibula fracture CPT 27786 • Orthopedics | $49 | $328 | $710 |
| Bunionectomy with osteotomy CPT 28296 • Orthopedics | $559 | $1,114 | $1,803 |
| Arthroscopy shoulder decompression CPT 29826 • Orthopedics | $219 | $461 | $734 |
| Arthroscopy shoulder rotator cuff repair CPT 29827 • Orthopedics | $989 | $1,849 | $3,133 |
| Arthroscopy knee with meniscectomy medial and lateral CPT 29880 • Orthopedics | $348 | $746 | $1,273 |
| Arthroscopy knee with meniscectomy CPT 29881 • Orthopedics | $530 | $1,042 | $1,672 |
| Arthroscopy knee with meniscus repair CPT 29882 • Orthopedics | $654 | $1,176 | $2,047 |
| Arthroscopy knee ACL repair CPT 29888 • Orthopedics | $992 | $1,642 | $2,451 |
| Discectomy lumbar single level CPT 63030 • Orthopedics | $1,020 | $1,600 | $2,451 |
| Laminectomy lumbar single level CPT 63047 • Orthopedics | $1,156 | $1,807 | $2,662 |
| Carpal tunnel release CPT 64721 • Orthopedics | $559 | $840 | $1,070 |
| Sacroiliac joint injection CPT 27096 • Pain Management | $72 | $224 | $617 |
| Epidural injection cervical or thoracic with imaging CPT 62321 • Pain Management | $26 | $258 | $465 |
| Epidural injection lumbar or sacral without imaging CPT 62322 • Pain Management | $78 | $422 | $990 |
| Epidural injection lumbar or sacral with imaging CPT 62323 • Pain Management | $98 | $262 | $458 |
| Spinal cord stimulator electrode implantation CPT 63650 • Pain Management | $388 | $1,166 | $4,118 |
| Peripheral nerve block injection CPT 64450 • Pain Management | $56 | $124 | $202 |
| Plantar common digital nerve injection CPT 64455 • Pain Management | $34 | $71 | $118 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $146 | $343 | $534 |
| Epidural injection lumbar each additional level CPT 64484 • Pain Management | $69 | $139 | $235 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $170 | $279 | $521 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $119 | $185 | $288 |
| Chemodenervation of muscle migraine CPT 64615 • Pain Management | $124 | $213 | $359 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $178 | $548 | $994 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $56 | $244 | $536 |
| Cytopathology concentration technique CPT 88108 • Pathology | $29 | $87 | $235 |
| Cytopathology cell enhancement technique CPT 88112 • Pathology | $13 | $66 | $127 |
| Cytopathology cervical/vaginal interpretation physician CPT 88141 • Pathology | $15 | $29 | $50 |
| Cytopathology cervical/vaginal manual screen CPT 88164 • Pathology | $11 | $19 | $35 |
| Cytopathology cervical/vaginal automated thin layer CPT 88175 • Pathology | $19 | $31 | $61 |
| Molecular cytogenetics DNA probe each CPT 88271 • Pathology | $13 | $22 | $29 |
| Cytogenetics molecular interpretation CPT 88291 • Pathology | $20 | $44 | $75 |
| Surgical pathology gross and micro exam level II CPT 88302 • Pathology | $17 | $34 | $69 |
| Surgical pathology gross and micro exam level III CPT 88304 • Pathology | $5 | $46 | $110 |
| Surgical pathology gross and micro exam level IV CPT 88305 • Pathology | $29 | $55 | $89 |
| Surgical pathology gross and micro exam level V CPT 88307 • Pathology | $107 | $283 | $861 |