| Lumbar spine fusion combined approach CPT 22633 • Orthopedics | $233 | $1,646 | $2,656 |
| Total shoulder replacement CPT 23472 • Orthopedics | $1,313 | $1,771 | $2,113 |
| Reverse total shoulder replacement CPT 23473 • Orthopedics | $1,292 | $1,821 | $2,351 |
| Lateral epicondylitis open treatment CPT 24357 • Orthopedics | $234 | $433 | $612 |
| Closed treatment distal radial fracture CPT 25600 • Orthopedics | $214 | $332 | $511 |
| Tendon sheath incision trigger finger CPT 26055 • Orthopedics | $241 | $456 | $830 |
| Total hip replacement CPT 27130 • Orthopedics | $783 | $1,304 | $1,881 |
| Hip replacement conversion to total CPT 27132 • Orthopedics | $204 | $1,366 | $2,443 |
| Open treatment femoral fracture CPT 27236 • Orthopedics | $142 | $962 | $1,749 |
| Treatment intertrochanteric femoral fracture CPT 27244 • Orthopedics | $140 | $1,005 | $1,800 |
| Treatment intertrochanteric fracture with plate/screw CPT 27245 • Orthopedics | $678 | $1,268 | $1,797 |
| Partial knee replacement medial or lateral CPT 27446 • Orthopedics | $961 | $1,218 | $1,683 |
| Total knee replacement CPT 27447 • Orthopedics | $823 | $1,348 | $1,878 |
| Open treatment tibial shaft fracture CPT 27756 • Orthopedics | $67 | $531 | $871 |
| Closed treatment distal fibula fracture CPT 27786 • Orthopedics | $140 | $308 | $470 |
| Bunionectomy with osteotomy CPT 28296 • Orthopedics | $63 | $625 | $1,253 |
| Arthroscopy shoulder decompression CPT 29826 • Orthopedics | $23 | $336 | $734 |
| Arthroscopy shoulder rotator cuff repair CPT 29827 • Orthopedics | $989 | $1,318 | $1,566 |
| Arthroscopy knee with meniscectomy medial and lateral CPT 29880 • Orthopedics | $529 | $688 | $829 |
| Arthroscopy knee with meniscectomy CPT 29881 • Orthopedics | $321 | $591 | $799 |
| Arthroscopy knee with meniscus repair CPT 29882 • Orthopedics | $588 | $769 | $1,015 |
| Arthroscopy knee ACL repair CPT 29888 • Orthopedics | $136 | $881 | $1,428 |
| Discectomy lumbar single level CPT 63030 • Orthopedics | $508 | $1,049 | $1,435 |
| Laminectomy lumbar single level CPT 63047 • Orthopedics | $129 | $1,102 | $1,734 |
| Carpal tunnel release CPT 64721 • Orthopedics | $349 | $535 | $698 |
| Sacroiliac joint injection CPT 27096 • Pain Management | $82 | $133 | $234 |
| Epidural injection cervical or thoracic with imaging CPT 62321 • Pain Management | $92 | $204 | $392 |
| Epidural injection lumbar or sacral without imaging CPT 62322 • Pain Management | $73 | $126 | $201 |
| Epidural injection lumbar or sacral with imaging CPT 62323 • Pain Management | $118 | $209 | $385 |
| Spinal cord stimulator electrode implantation CPT 63650 • Pain Management | $366 | $1,399 | $3,281 |
| Peripheral nerve block injection CPT 64450 • Pain Management | $64 | $91 | $113 |
| Plantar common digital nerve injection CPT 64455 • Pain Management | $42 | $54 | $77 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $51 | $188 | $369 |
| Epidural injection lumbar each additional level CPT 64484 • Pain Management | $37 | $100 | $166 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $98 | $156 | $269 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $37 | $78 | $138 |
| Chemodenervation of muscle migraine CPT 64615 • Pain Management | $142 | $176 | $235 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $184 | $367 | $656 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $69 | $165 | $351 |
| Unlisted nervous system procedure CPT 64999 • Pain Management | $0 | $0 | $0 |
| Cytopathology concentration technique CPT 88108 • Pathology | $16 | $42 | $80 |
| Cytopathology cell enhancement technique CPT 88112 • Pathology | $41 | $82 | $127 |
| Cytopathology cervical/vaginal interpretation physician CPT 88141 • Pathology | $13 | $21 | $29 |
| Cytopathology cervical/vaginal manual screen CPT 88164 • Pathology | $6 | $18 | $24 |
| Cytopathology cervical/vaginal automated thin layer CPT 88175 • Pathology | $15 | $32 | $47 |
| Molecular cytogenetics DNA probe each CPT 88271 • Pathology | $18 | $28 | $38 |
| Cytogenetics molecular interpretation CPT 88291 • Pathology | $14 | $27 | $40 |
| Surgical pathology gross and micro exam level II CPT 88302 • Pathology | $21 | $31 | $38 |
| Surgical pathology gross and micro exam level III CPT 88304 • Pathology | $10 | $34 | $49 |
| Surgical pathology gross and micro exam level IV CPT 88305 • Pathology | $43 | $60 | $83 |