| Arthrocentesis aspiration major joint CPT 20610 • Orthopedics | $40 | $109 | $206 |
| Cervical spine fusion anterior approach CPT 22551 • Orthopedics | $1,779 | $3,028 | $5,393 |
| Lumbar spine fusion posterior approach CPT 22612 • Orthopedics | $1,654 | $2,949 | $5,035 |
| Lumbar spine fusion combined approach CPT 22633 • Orthopedics | $1,908 | $3,339 | $5,736 |
| Total shoulder replacement CPT 23472 • Orthopedics | $1,313 | $2,523 | $4,618 |
| Reverse total shoulder replacement CPT 23473 • Orthopedics | $1,665 | $2,966 | $5,142 |
| Lateral epicondylitis open treatment CPT 24357 • Orthopedics | $412 | $730 | $1,354 |
| Closed treatment distal radial fracture CPT 25600 • Orthopedics | $271 | $576 | $1,058 |
| Tendon sheath incision trigger finger CPT 26055 • Orthopedics | $296 | $914 | $1,891 |
| Total hip replacement CPT 27130 • Orthopedics | $1,249 | $2,324 | $4,102 |
| Hip replacement conversion to total CPT 27132 • Orthopedics | $1,451 | $2,912 | $5,329 |
| Open treatment femoral fracture CPT 27236 • Orthopedics | $994 | $2,122 | $3,813 |
| Treatment intertrochanteric femoral fracture CPT 27244 • Orthopedics | $1,075 | $2,193 | $3,922 |
| Treatment intertrochanteric fracture with plate/screw CPT 27245 • Orthopedics | $1,280 | $2,194 | $3,919 |
| Partial knee replacement medial or lateral CPT 27446 • Orthopedics | $1,011 | $2,021 | $3,667 |
| Total knee replacement CPT 27447 • Orthopedics | $1,266 | $2,386 | $4,098 |
| Open treatment tibial shaft fracture CPT 27756 • Orthopedics | $598 | $1,063 | $1,861 |
| Closed treatment distal fibula fracture CPT 27786 • Orthopedics | $300 | $561 | $1,024 |
| Bunionectomy with osteotomy CPT 28296 • Orthopedics | $535 | $1,413 | $2,814 |
| Arthroscopy shoulder decompression CPT 29826 • Orthopedics | $175 | $417 | $734 |
| Arthroscopy shoulder rotator cuff repair CPT 29827 • Orthopedics | $989 | $1,872 | $3,424 |
| Arthroscopy knee with meniscectomy medial and lateral CPT 29880 • Orthopedics | $567 | $1,026 | $1,808 |
| Arthroscopy knee with meniscectomy CPT 29881 • Orthopedics | $547 | $983 | $1,741 |
| Arthroscopy knee with meniscus repair CPT 29882 • Orthopedics | $691 | $1,228 | $2,215 |
| Arthroscopy knee ACL repair CPT 29888 • Orthopedics | $967 | $1,747 | $3,125 |
| Discectomy lumbar single level CPT 63030 • Orthopedics | $959 | $1,703 | $2,904 |
| Laminectomy lumbar single level CPT 63047 • Orthopedics | $1,090 | $2,014 | $3,517 |
| Carpal tunnel release CPT 64721 • Orthopedics | $447 | $803 | $1,404 |
| Sacroiliac joint injection CPT 27096 • Pain Management | $77 | $293 | $520 |
| Epidural injection cervical or thoracic with imaging CPT 62321 • Pain Management | $106 | $363 | $646 |
| Epidural injection lumbar or sacral without imaging CPT 62322 • Pain Management | $78 | $241 | $443 |
| Epidural injection lumbar or sacral with imaging CPT 62323 • Pain Management | $98 | $284 | $636 |
| Spinal cord stimulator electrode implantation CPT 63650 • Pain Management | $413 | $1,813 | $5,720 |
| Peripheral nerve block injection CPT 64450 • Pain Management | $41 | $151 | $239 |
| Plantar common digital nerve injection CPT 64455 • Pain Management | $34 | $78 | $122 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $110 | $298 | $607 |
| Epidural injection lumbar each additional level CPT 64484 • Pain Management | $50 | $215 | $356 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $90 | $226 | $427 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $50 | $166 | $289 |
| Chemodenervation of muscle migraine CPT 64615 • Pain Management | $124 | $284 | $487 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $178 | $621 | $1,092 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $56 | $337 | $767 |
| Cytopathology concentration technique CPT 88108 • Pathology | $19 | $50 | $107 |
| Cytopathology cell enhancement technique CPT 88112 • Pathology | $61 | $88 | $127 |
| Cytopathology cervical/vaginal interpretation physician CPT 88141 • Pathology | $17 | $28 | $57 |
| Cytopathology cervical/vaginal manual screen CPT 88164 • Pathology | $12 | $22 | $45 |
| Cytopathology cervical/vaginal automated thin layer CPT 88175 • Pathology | $19 | $38 | $69 |
| Molecular cytogenetics DNA probe each CPT 88271 • Pathology | $15 | $29 | $55 |
| Cytogenetics molecular interpretation CPT 88291 • Pathology | $18 | $38 | $81 |
| Surgical pathology gross and micro exam level II CPT 88302 • Pathology | $13 | $45 | $80 |