| Lumbar spine fusion combined approach CPT 22633 • Orthopedics | $2,461 | $3,632 | $5,958 |
| Total shoulder replacement CPT 23472 • Orthopedics | $933 | $2,509 | $4,752 |
| Reverse total shoulder replacement CPT 23473 • Orthopedics | $1,520 | $3,065 | $5,301 |
| Lateral epicondylitis open treatment CPT 24357 • Orthopedics | $276 | $753 | $1,416 |
| Closed treatment distal radial fracture CPT 25600 • Orthopedics | $171 | $567 | $1,042 |
| Tendon sheath incision trigger finger CPT 26055 • Orthopedics | $296 | $800 | $1,755 |
| Total hip replacement CPT 27130 • Orthopedics | $205 | $2,161 | $4,421 |
| Hip replacement conversion to total CPT 27132 • Orthopedics | $1,451 | $3,178 | $5,463 |
| Open treatment femoral fracture CPT 27236 • Orthopedics | $994 | $2,253 | $3,887 |
| Treatment intertrochanteric femoral fracture CPT 27244 • Orthopedics | $165 | $1,992 | $3,997 |
| Treatment intertrochanteric fracture with plate/screw CPT 27245 • Orthopedics | $177 | $2,044 | $3,998 |
| Partial knee replacement medial or lateral CPT 27446 • Orthopedics | $181 | $1,879 | $3,778 |
| Total knee replacement CPT 27447 • Orthopedics | $215 | $2,181 | $4,419 |
| Open treatment tibial shaft fracture CPT 27756 • Orthopedics | $567 | $1,125 | $1,854 |
| Closed treatment distal fibula fracture CPT 27786 • Orthopedics | $301 | $574 | $1,013 |
| Bunionectomy with osteotomy CPT 28296 • Orthopedics | $464 | $1,221 | $2,249 |
| Arthroscopy shoulder decompression CPT 29826 • Orthopedics | $228 | $452 | $734 |
| Arthroscopy shoulder rotator cuff repair CPT 29827 • Orthopedics | $154 | $1,749 | $3,487 |
| Arthroscopy knee with meniscectomy medial and lateral CPT 29880 • Orthopedics | $704 | $1,128 | $1,822 |
| Arthroscopy knee with meniscectomy CPT 29881 • Orthopedics | $653 | $1,081 | $1,752 |
| Arthroscopy knee with meniscus repair CPT 29882 • Orthopedics | $704 | $1,335 | $2,267 |
| Arthroscopy knee ACL repair CPT 29888 • Orthopedics | $160 | $1,641 | $3,209 |
| Discectomy lumbar single level CPT 63030 • Orthopedics | $152 | $1,629 | $3,121 |
| Laminectomy lumbar single level CPT 63047 • Orthopedics | $1,441 | $2,189 | $3,551 |
| Carpal tunnel release CPT 64721 • Orthopedics | $530 | $855 | $1,376 |
| Sacroiliac joint injection CPT 27096 • Pain Management | $83 | $277 | $523 |
| Epidural injection cervical or thoracic with imaging CPT 62321 • Pain Management | $108 | $457 | $797 |
| Epidural injection lumbar or sacral without imaging CPT 62322 • Pain Management | $86 | $302 | $502 |
| Epidural injection lumbar or sacral with imaging CPT 62323 • Pain Management | $148 | $457 | $782 |
| Spinal cord stimulator electrode implantation CPT 63650 • Pain Management | $550 | $2,832 | $5,692 |
| Peripheral nerve block injection CPT 64450 • Pain Management | $63 | $120 | $189 |
| Plantar common digital nerve injection CPT 64455 • Pain Management | $50 | $77 | $118 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $95 | $313 | $626 |
| Epidural injection lumbar each additional level CPT 64484 • Pain Management | $44 | $147 | $281 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $115 | $318 | $561 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $65 | $163 | $282 |
| Chemodenervation of muscle migraine CPT 64615 • Pain Management | $178 | $286 | $456 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $216 | $660 | $1,376 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $87 | $360 | $604 |
| Unlisted nervous system procedure CPT 64999 • Pain Management | $0 | $0 | $0 |
| Cytopathology concentration technique CPT 88108 • Pathology | $16 | $45 | $72 |
| Cytopathology cell enhancement technique CPT 88112 • Pathology | $22 | $65 | $127 |
| Cytopathology cervical/vaginal interpretation physician CPT 88141 • Pathology | $13 | $33 | $64 |
| Cytopathology cervical/vaginal manual screen CPT 88164 • Pathology | $6 | $21 | $47 |
| Cytopathology cervical/vaginal automated thin layer CPT 88175 • Pathology | $15 | $39 | $68 |
| Molecular cytogenetics DNA probe each CPT 88271 • Pathology | $18 | $31 | $55 |
| Cytogenetics molecular interpretation CPT 88291 • Pathology | $14 | $42 | $87 |
| Surgical pathology gross and micro exam level II CPT 88302 • Pathology | $8 | $37 | $86 |
| Surgical pathology gross and micro exam level III CPT 88304 • Pathology | $20 | $44 | $83 |
| Surgical pathology gross and micro exam level IV CPT 88305 • Pathology | $16 | $62 | $93 |