| Arthrocentesis aspiration intermediate joint CPT 20605 • Orthopedics | $35 | $65 | $112 |
| Arthrocentesis aspiration major joint CPT 20610 • Orthopedics | $40 | $79 | $96 |
| Cervical spine fusion anterior approach CPT 22551 • Orthopedics | $1,072 | $2,273 | $3,553 |
| Lumbar spine fusion posterior approach CPT 22612 • Orthopedics | $256 | $2,005 | $3,320 |
| Lumbar spine fusion combined approach CPT 22633 • Orthopedics | $1,716 | $2,606 | $3,868 |
| Total shoulder replacement CPT 23472 • Orthopedics | $230 | $1,698 | $3,041 |
| Reverse total shoulder replacement CPT 23473 • Orthopedics | $1,520 | $2,290 | $3,394 |
| Lateral epicondylitis open treatment CPT 24357 • Orthopedics | $276 | $561 | $879 |
| Closed treatment distal radial fracture CPT 25600 • Orthopedics | $198 | $415 | $704 |
| Tendon sheath incision trigger finger CPT 26055 • Orthopedics | $296 | $536 | $825 |
| Total hip replacement CPT 27130 • Orthopedics | $895 | $1,725 | $2,700 |
| Hip replacement conversion to total CPT 27132 • Orthopedics | $274 | $1,944 | $3,509 |
| Open treatment femoral fracture CPT 27236 • Orthopedics | $994 | $1,626 | $2,504 |
| Treatment intertrochanteric femoral fracture CPT 27244 • Orthopedics | $188 | $1,427 | $2,578 |
| Treatment intertrochanteric fracture with plate/screw CPT 27245 • Orthopedics | $1,327 | $1,917 | $2,575 |
| Partial knee replacement medial or lateral CPT 27446 • Orthopedics | $176 | $1,342 | $2,424 |
| Total knee replacement CPT 27447 • Orthopedics | $940 | $1,759 | $2,697 |
| Open treatment tibial shaft fracture CPT 27756 • Orthopedics | $79 | $601 | $1,211 |
| Closed treatment distal fibula fracture CPT 27786 • Orthopedics | $216 | $401 | $604 |
| Bunionectomy with osteotomy CPT 28296 • Orthopedics | $559 | $1,130 | $1,899 |
| Arthroscopy shoulder decompression CPT 29826 • Orthopedics | $27 | $349 | $734 |
| Arthroscopy shoulder rotator cuff repair CPT 29827 • Orthopedics | $989 | $1,475 | $2,245 |
| Arthroscopy knee with meniscectomy medial and lateral CPT 29880 • Orthopedics | $420 | $788 | $1,180 |
| Arthroscopy knee with meniscectomy CPT 29881 • Orthopedics | $366 | $743 | $1,138 |
| Arthroscopy knee with meniscus repair CPT 29882 • Orthopedics | $704 | $1,055 | $1,451 |
| Arthroscopy knee ACL repair CPT 29888 • Orthopedics | $1,078 | $1,520 | $2,053 |
| Discectomy lumbar single level CPT 63030 • Orthopedics | $1,204 | $1,590 | $2,311 |
| Laminectomy lumbar single level CPT 63047 • Orthopedics | $169 | $1,474 | $2,619 |
| Carpal tunnel release CPT 64721 • Orthopedics | $559 | $741 | $1,048 |
| Sacroiliac joint injection CPT 27096 • Pain Management | $83 | $180 | $238 |
| Epidural injection cervical or thoracic with imaging CPT 62321 • Pain Management | $135 | $326 | $636 |
| Epidural injection lumbar or sacral without imaging CPT 62322 • Pain Management | $108 | $236 | $363 |
| Epidural injection lumbar or sacral with imaging CPT 62323 • Pain Management | $98 | $205 | $363 |
| Spinal cord stimulator electrode implantation CPT 63650 • Pain Management | $271 | $940 | $1,946 |
| Peripheral nerve block injection CPT 64450 • Pain Management | $33 | $101 | $184 |
| Plantar common digital nerve injection CPT 64455 • Pain Management | $40 | $69 | $116 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $138 | $299 | $587 |
| Epidural injection lumbar each additional level CPT 64484 • Pain Management | $64 | $148 | $305 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $74 | $214 | $421 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $60 | $94 | $129 |
| Chemodenervation of muscle migraine CPT 64615 • Pain Management | $119 | $194 | $291 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $275 | $554 | $997 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $74 | $242 | $412 |
| Unlisted nervous system procedure CPT 64999 • Pain Management | $0 | $0 | $0 |
| Cytopathology concentration technique CPT 88108 • Pathology | $8 | $36 | $60 |
| Cytopathology cell enhancement technique CPT 88112 • Pathology | $41 | $77 | $127 |
| Cytopathology cervical/vaginal interpretation physician CPT 88141 • Pathology | $13 | $23 | $33 |
| Cytopathology cervical/vaginal manual screen CPT 88164 • Pathology | $9 | $15 | $22 |
| Cytopathology cervical/vaginal automated thin layer CPT 88175 • Pathology | $15 | $26 | $39 |
| Molecular cytogenetics DNA probe each CPT 88271 • Pathology | $13 | $22 | $31 |