| Lumbar spine fusion combined approach CPT 22633 • Orthopedics | $2,569 | $3,717 | $4,306 |
| Total shoulder replacement CPT 23472 • Orthopedics | $242 | $1,155 | $1,911 |
| Reverse total shoulder replacement CPT 23473 • Orthopedics | $352 | $2,118 | $3,757 |
| Lateral epicondylitis open treatment CPT 24357 • Orthopedics | $412 | $620 | $995 |
| Closed treatment distal radial fracture CPT 25600 • Orthopedics | $271 | $364 | $465 |
| Tendon sheath incision trigger finger CPT 26055 • Orthopedics | $296 | $592 | $778 |
| Total hip replacement CPT 27130 • Orthopedics | $1,249 | $1,430 | $1,698 |
| Hip replacement conversion to total CPT 27132 • Orthopedics | $1,451 | $2,090 | $2,615 |
| Open treatment femoral fracture CPT 27236 • Orthopedics | $201 | $1,321 | $2,769 |
| Treatment intertrochanteric femoral fracture CPT 27244 • Orthopedics | $1,075 | $1,624 | $1,932 |
| Treatment intertrochanteric fracture with plate/screw CPT 27245 • Orthopedics | $270 | $1,074 | $1,624 |
| Partial knee replacement medial or lateral CPT 27446 • Orthopedics | $1,011 | $2,133 | $2,705 |
| Total knee replacement CPT 27447 • Orthopedics | $1,267 | $1,435 | $1,695 |
| Open treatment tibial shaft fracture CPT 27756 • Orthopedics | $580 | $856 | $1,334 |
| Closed treatment distal fibula fracture CPT 27786 • Orthopedics | $312 | $352 | $430 |
| Bunionectomy with osteotomy CPT 28296 • Orthopedics | $113 | $615 | $1,172 |
| Arthroscopy shoulder decompression CPT 29826 • Orthopedics | $225 | $453 | $734 |
| Arthroscopy shoulder rotator cuff repair CPT 29827 • Orthopedics | $989 | $1,364 | $1,685 |
| Arthroscopy knee with meniscectomy medial and lateral CPT 29880 • Orthopedics | $562 | $673 | $752 |
| Arthroscopy knee with meniscectomy CPT 29881 • Orthopedics | $653 | $746 | $860 |
| Arthroscopy knee with meniscus repair CPT 29882 • Orthopedics | $704 | $905 | $1,092 |
| Arthroscopy knee ACL repair CPT 29888 • Orthopedics | $1,078 | $1,558 | $2,300 |
| Discectomy lumbar single level CPT 63030 • Orthopedics | $203 | $871 | $1,204 |
| Laminectomy lumbar single level CPT 63047 • Orthopedics | $1,441 | $1,549 | $1,752 |
| Carpal tunnel release CPT 64721 • Orthopedics | $559 | $617 | $697 |
| Sacroiliac joint injection CPT 27096 • Pain Management | $83 | $143 | $218 |
| Epidural injection cervical or thoracic with imaging CPT 62321 • Pain Management | $111 | $357 | $579 |
| Epidural injection lumbar or sacral without imaging CPT 62322 • Pain Management | $185 | $258 | $351 |
| Epidural injection lumbar or sacral with imaging CPT 62323 • Pain Management | $231 | $392 | $572 |
| Spinal cord stimulator electrode implantation CPT 63650 • Pain Management | $272 | $1,507 | $3,698 |
| Peripheral nerve block injection CPT 64450 • Pain Management | $44 | $65 | $96 |
| Plantar common digital nerve injection CPT 64455 • Pain Management | $45 | $55 | $67 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $73 | $182 | $326 |
| Epidural injection lumbar each additional level CPT 64484 • Pain Management | $80 | $134 | $225 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $94 | $194 | $252 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $53 | $99 | $125 |
| Chemodenervation of muscle migraine CPT 64615 • Pain Management | $193 | $202 | $213 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $200 | $478 | $649 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $61 | $240 | $390 |
| Cytopathology concentration technique CPT 88108 • Pathology | $19 | $69 | $157 |
| Cytopathology cell enhancement technique CPT 88112 • Pathology | $76 | $97 | $127 |
| Cytopathology cervical/vaginal interpretation physician CPT 88141 • Pathology | $30 | $52 | $71 |
| Cytopathology cervical/vaginal manual screen CPT 88164 • Pathology | $6 | $12 | $16 |
| Cytopathology cervical/vaginal automated thin layer CPT 88175 • Pathology | $14 | $22 | $30 |
| Molecular cytogenetics DNA probe each CPT 88271 • Pathology | $12 | $18 | $29 |
| Cytogenetics molecular interpretation CPT 88291 • Pathology | $13 | $38 | $69 |
| Surgical pathology gross and micro exam level II CPT 88302 • Pathology | $34 | $61 | $95 |
| Surgical pathology gross and micro exam level III CPT 88304 • Pathology | $44 | $72 | $116 |
| Surgical pathology gross and micro exam level IV CPT 88305 • Pathology | $55 | $143 | $277 |
| Surgical pathology gross and micro exam level V CPT 88307 • Pathology | $169 | $240 | $380 |