| Cervical spine fusion anterior approach CPT 22551 • Orthopedics | $1,793 | $1,838 | $1,891 |
| Lumbar spine fusion posterior approach CPT 22612 • Orthopedics | $1,510 | $1,702 | $2,040 |
| Lumbar spine fusion combined approach CPT 22633 • Orthopedics | $1,932 | $2,560 | $4,276 |
| Total shoulder replacement CPT 23472 • Orthopedics | $242 | $1,126 | $1,503 |
| Reverse total shoulder replacement CPT 23473 • Orthopedics | $352 | $1,384 | $1,821 |
| Lateral epicondylitis open treatment CPT 24357 • Orthopedics | $418 | $575 | $995 |
| Closed treatment distal radial fracture CPT 25600 • Orthopedics | $262 | $305 | $354 |
| Tendon sheath incision trigger finger CPT 26055 • Orthopedics | $296 | $521 | $702 |
| Total hip replacement CPT 27130 • Orthopedics | $1,249 | $1,336 | $1,401 |
| Hip replacement conversion to total CPT 27132 • Orthopedics | $1,451 | $1,893 | $2,615 |
| Open treatment femoral fracture CPT 27236 • Orthopedics | $201 | $890 | $1,236 |
| Treatment intertrochanteric femoral fracture CPT 27244 • Orthopedics | $1,075 | $1,348 | $1,932 |
| Treatment intertrochanteric fracture with plate/screw CPT 27245 • Orthopedics | $270 | $1,026 | $1,327 |
| Partial knee replacement medial or lateral CPT 27446 • Orthopedics | $1,011 | $1,498 | $2,705 |
| Total knee replacement CPT 27447 • Orthopedics | $1,267 | $1,340 | $1,400 |
| Open treatment tibial shaft fracture CPT 27756 • Orthopedics | $542 | $778 | $1,334 |
| Closed treatment distal fibula fracture CPT 27786 • Orthopedics | $282 | $307 | $321 |
| Bunionectomy with osteotomy CPT 28296 • Orthopedics | $113 | $532 | $737 |
| Arthroscopy shoulder decompression CPT 29826 • Orthopedics | $178 | $373 | $734 |
| Arthroscopy shoulder rotator cuff repair CPT 29827 • Orthopedics | $989 | $1,201 | $1,685 |
| Arthroscopy knee with meniscectomy medial and lateral CPT 29880 • Orthopedics | $562 | $611 | $704 |
| Arthroscopy knee with meniscectomy CPT 29881 • Orthopedics | $558 | $662 | $860 |
| Arthroscopy knee with meniscus repair CPT 29882 • Orthopedics | $657 | $794 | $1,092 |
| Arthroscopy knee ACL repair CPT 29888 • Orthopedics | $949 | $1,336 | $2,300 |
| Discectomy lumbar single level CPT 63030 • Orthopedics | $203 | $874 | $1,204 |
| Laminectomy lumbar single level CPT 63047 • Orthopedics | $1,033 | $1,395 | $1,752 |
| Carpal tunnel release CPT 64721 • Orthopedics | $391 | $538 | $697 |
| Sacroiliac joint injection CPT 27096 • Pain Management | $83 | $135 | $169 |
| Epidural injection cervical or thoracic with imaging CPT 62321 • Pain Management | $111 | $193 | $287 |
| Epidural injection lumbar or sacral without imaging CPT 62322 • Pain Management | $103 | $148 | $185 |
| Epidural injection lumbar or sacral with imaging CPT 62323 • Pain Management | $118 | $218 | $282 |
| Spinal cord stimulator electrode implantation CPT 63650 • Pain Management | $272 | $852 | $1,537 |
| Peripheral nerve block injection CPT 64450 • Pain Management | $44 | $77 | $96 |
| Plantar common digital nerve injection CPT 64455 • Pain Management | $43 | $50 | $53 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $73 | $177 | $252 |
| Epidural injection lumbar each additional level CPT 64484 • Pain Management | $80 | $103 | $140 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $94 | $140 | $198 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $53 | $74 | $99 |
| Chemodenervation of muscle migraine CPT 64615 • Pain Management | $128 | $159 | $193 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $200 | $347 | $479 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $61 | $153 | $294 |
| Cytopathology concentration technique CPT 88108 • Pathology | $19 | $29 | $45 |
| Cytopathology cell enhancement technique CPT 88112 • Pathology | $39 | $72 | $127 |
| Cytopathology cervical/vaginal interpretation physician CPT 88141 • Pathology | $20 | $31 | $54 |
| Cytopathology cervical/vaginal manual screen CPT 88164 • Pathology | $6 | $10 | $15 |
| Cytopathology cervical/vaginal automated thin layer CPT 88175 • Pathology | $14 | $40 | $100 |
| Molecular cytogenetics DNA probe each CPT 88271 • Pathology | $12 | $36 | $100 |
| Cytogenetics molecular interpretation CPT 88291 • Pathology | $13 | $24 | $34 |
| Surgical pathology gross and micro exam level II CPT 88302 • Pathology | $7 | $39 | $95 |
| Surgical pathology gross and micro exam level III CPT 88304 • Pathology | $29 | $57 | $116 |