| Arthrocentesis aspiration major joint CPT 20610 • Orthopedics | $53 | $76 | $100 |
| Cervical spine fusion anterior approach CPT 22551 • Orthopedics | $1,809 | $2,215 | $2,932 |
| Lumbar spine fusion posterior approach CPT 22612 • Orthopedics | $381 | $1,884 | $3,101 |
| Lumbar spine fusion combined approach CPT 22633 • Orthopedics | $2,050 | $2,951 | $4,774 |
| Total shoulder replacement CPT 23472 • Orthopedics | $397 | $1,601 | $2,510 |
| Reverse total shoulder replacement CPT 23473 • Orthopedics | $443 | $1,759 | $2,788 |
| Lateral epicondylitis open treatment CPT 24357 • Orthopedics | $421 | $499 | $741 |
| Closed treatment distal radial fracture CPT 25600 • Orthopedics | $268 | $445 | $632 |
| Tendon sheath incision trigger finger CPT 26055 • Orthopedics | $302 | $525 | $858 |
| Total hip replacement CPT 27130 • Orthopedics | $371 | $1,465 | $2,232 |
| Hip replacement conversion to total CPT 27132 • Orthopedics | $401 | $1,688 | $2,897 |
| Open treatment femoral fracture CPT 27236 • Orthopedics | $326 | $1,209 | $2,082 |
| Treatment intertrochanteric femoral fracture CPT 27244 • Orthopedics | $1,135 | $1,423 | $2,142 |
| Treatment intertrochanteric fracture with plate/screw CPT 27245 • Orthopedics | $1,272 | $1,895 | $3,141 |
| Partial knee replacement medial or lateral CPT 27446 • Orthopedics | $316 | $1,373 | $2,238 |
| Total knee replacement CPT 27447 • Orthopedics | $370 | $1,509 | $2,229 |
| Open treatment tibial shaft fracture CPT 27756 • Orthopedics | $155 | $587 | $1,049 |
| Closed treatment distal fibula fracture CPT 27786 • Orthopedics | $275 | $501 | $715 |
| Bunionectomy with osteotomy CPT 28296 • Orthopedics | $140 | $760 | $1,260 |
| Arthroscopy shoulder decompression CPT 29826 • Orthopedics | $190 | $419 | $723 |
| Arthroscopy shoulder rotator cuff repair CPT 29827 • Orthopedics | $291 | $1,181 | $1,868 |
| Arthroscopy knee with meniscectomy medial and lateral CPT 29880 • Orthopedics | $597 | $757 | $997 |
| Arthroscopy knee with meniscectomy CPT 29881 • Orthopedics | $619 | $880 | $1,368 |
| Arthroscopy knee with meniscus repair CPT 29882 • Orthopedics | $667 | $952 | $1,215 |
| Arthroscopy knee ACL repair CPT 29888 • Orthopedics | $33 | $964 | $1,703 |
| Discectomy lumbar single level CPT 63030 • Orthopedics | $226 | $1,040 | $1,602 |
| Laminectomy lumbar single level CPT 63047 • Orthopedics | $294 | $1,359 | $2,160 |
| Carpal tunnel release CPT 64721 • Orthopedics | $403 | $612 | $882 |
| Sacroiliac joint injection CPT 27096 • Pain Management | $94 | $227 | $371 |
| Epidural injection cervical or thoracic with imaging CPT 62321 • Pain Management | $129 | $262 | $458 |
| Epidural injection lumbar or sacral without imaging CPT 62322 • Pain Management | $103 | $231 | $379 |
| Epidural injection lumbar or sacral with imaging CPT 62323 • Pain Management | $118 | $315 | $451 |
| Spinal cord stimulator electrode implantation CPT 63650 • Pain Management | $419 | $1,747 | $4,692 |
| Peripheral nerve block injection CPT 64450 • Pain Management | $71 | $92 | $106 |
| Plantar common digital nerve injection CPT 64455 • Pain Management | $37 | $61 | $73 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $141 | $319 | $553 |
| Epidural injection lumbar each additional level CPT 64484 • Pain Management | $88 | $175 | $276 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $125 | $250 | $402 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $87 | $142 | $204 |
| Chemodenervation of muscle migraine CPT 64615 • Pain Management | $142 | $228 | $309 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $260 | $593 | $985 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $69 | $320 | $601 |
| Unlisted nervous system procedure CPT 64999 • Pain Management | $830 | $830 | $830 |
| Cytopathology concentration technique CPT 88108 • Pathology | $19 | $61 | $91 |
| Cytopathology cell enhancement technique CPT 88112 • Pathology | $25 | $66 | $111 |
| Cytopathology cervical/vaginal interpretation physician CPT 88141 • Pathology | $11 | $32 | $44 |
| Cytopathology cervical/vaginal manual screen CPT 88164 • Pathology | $7 | $21 | $35 |
| Cytopathology cervical/vaginal automated thin layer CPT 88175 • Pathology | $18 | $39 | $52 |
| Molecular cytogenetics DNA probe each CPT 88271 • Pathology | $10 | $27 | $42 |
| Cytogenetics molecular interpretation CPT 88291 • Pathology | $13 | $34 | $60 |