| Reverse total shoulder replacement CPT 23473 • Orthopedics | $2,467 | $13,466 | $30,334 |
| Lateral epicondylitis open treatment CPT 24357 • Orthopedics | $636 | $6,620 | $15,806 |
| Closed treatment distal radial fracture CPT 25600 • Orthopedics | $474 | $496 | $517 |
| Tendon sheath incision trigger finger CPT 26055 • Orthopedics | $476 | $3,264 | $7,189 |
| Total hip replacement CPT 27130 • Orthopedics | $2,058 | $29,083 | $70,579 |
| Hip replacement conversion to total CPT 27132 • Orthopedics | $2,542 | $29,379 | $70,579 |
| Open treatment femoral fracture CPT 27236 • Orthopedics | $1,812 | $17,122 | $40,620 |
| Treatment intertrochanteric femoral fracture CPT 27244 • Orthopedics | $1,865 | $17,154 | $40,620 |
| Treatment intertrochanteric fracture with plate/screw CPT 27245 • Orthopedics | $1,865 | $13,099 | $30,334 |
| Partial knee replacement medial or lateral CPT 27446 • Orthopedics | $1,758 | $28,900 | $70,579 |
| Total knee replacement CPT 27447 • Orthopedics | $2,057 | $29,082 | $70,579 |
| Open treatment tibial shaft fracture CPT 27756 • Orthopedics | $869 | $6,762 | $15,806 |
| Closed treatment distal fibula fracture CPT 27786 • Orthopedics | $439 | $482 | $517 |
| Bunionectomy with osteotomy CPT 28296 • Orthopedics | $1,386 | $10,607 | $24,758 |
| Arthroscopy shoulder decompression CPT 29826 • Orthopedics | $269 | $368 | $517 |
| Arthroscopy shoulder rotator cuff repair CPT 29827 • Orthopedics | $1,602 | $16,993 | $40,620 |
| Arthroscopy knee with meniscectomy medial and lateral CPT 29880 • Orthopedics | $849 | $10,279 | $24,758 |
| Arthroscopy knee with meniscectomy CPT 29881 • Orthopedics | $817 | $10,260 | $24,758 |
| Arthroscopy knee with meniscus repair CPT 29882 • Orthopedics | $1,059 | $10,408 | $24,758 |
| Arthroscopy knee ACL repair CPT 29888 • Orthopedics | $1,492 | $16,926 | $40,620 |
| Discectomy lumbar single level CPT 63030 • Orthopedics | $1,464 | $16,909 | $40,620 |
| Laminectomy lumbar single level CPT 63047 • Orthopedics | $1,665 | $17,032 | $40,620 |
| Carpal tunnel release CPT 64721 • Orthopedics | $644 | $6,625 | $15,806 |
| Sacroiliac joint injection CPT 27096 • Pain Management | $238 | $349 | $517 |
| Epidural injection cervical or thoracic with imaging CPT 62321 • Pain Management | $370 | $2,691 | $6,252 |
| Epidural injection lumbar or sacral without imaging CPT 62322 • Pain Management | $138 | $2,587 | $6,252 |
| Epidural injection lumbar or sacral with imaging CPT 62323 • Pain Management | $363 | $2,687 | $6,252 |
| Spinal cord stimulator electrode implantation CPT 63650 • Pain Management | $648 | $16,933 | $40,620 |
| Peripheral nerve block injection CPT 64450 • Pain Management | $120 | $2,538 | $6,252 |
| Plantar common digital nerve injection CPT 64455 • Pain Management | $73 | $248 | $517 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $325 | $2,663 | $6,252 |
| Epidural injection lumbar each additional level CPT 64484 • Pain Management | $82 | $273 | $517 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $255 | $2,621 | $6,252 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $129 | $283 | $517 |
| Chemodenervation of muscle migraine CPT 64615 • Pain Management | $215 | $335 | $517 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $618 | $6,609 | $15,806 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $254 | $359 | $517 |
| Unlisted nervous system procedure CPT 64999 • Pain Management | $502 | $510 | $517 |
| Cytopathology concentration technique CPT 88108 • Pathology | $17 | $17 | $17 |
| Cytopathology cell enhancement technique CPT 88112 • Pathology | $37 | $53 | $61 |
| Cytopathology cervical/vaginal interpretation physician CPT 88141 • Pathology | $32 | $32 | $32 |
| Cytopathology cervical/vaginal manual screen CPT 88164 • Pathology | $15 | $15 | $15 |
| Cytopathology cervical/vaginal automated thin layer CPT 88175 • Pathology | $38 | $38 | $38 |
| Molecular cytogenetics DNA probe each CPT 88271 • Pathology | $30 | $51 | $62 |
| Cytogenetics molecular interpretation CPT 88291 • Pathology | $29 | $29 | $29 |
| Surgical pathology gross and micro exam level II CPT 88302 • Pathology | $17 | $25 | $29 |
| Surgical pathology gross and micro exam level III CPT 88304 • Pathology | $37 | $37 | $38 |
| Surgical pathology gross and micro exam level IV CPT 88305 • Pathology | $37 | $56 | $65 |
| Surgical pathology gross and micro exam level V CPT 88307 • Pathology | $58 | $193 | $260 |
| Surgical pathology gross and micro exam level VI CPT 88309 • Pathology | $58 | $284 | $396 |