| Total hip replacement CPT 27130 • Orthopedics | $338 | $830 | $1,321 |
| Hip replacement conversion to total CPT 27132 • Orthopedics | $372 | $1,044 | $1,716 |
| Open treatment femoral fracture CPT 27236 • Orthopedics | $1,227 | $1,865 | $2,503 |
| Treatment intertrochanteric femoral fracture CPT 27244 • Orthopedics | $240 | $751 | $1,262 |
| Treatment intertrochanteric fracture with plate/screw CPT 27245 • Orthopedics | $1,261 | $1,285 | $1,309 |
| Partial knee replacement medial or lateral CPT 27446 • Orthopedics | $1,186 | $1,520 | $1,854 |
| Total knee replacement CPT 27447 • Orthopedics | $1,319 | $1,554 | $1,790 |
| Open treatment tibial shaft fracture CPT 27756 • Orthopedics | $514 | $555 | $595 |
| Closed treatment distal fibula fracture CPT 27786 • Orthopedics | $299 | $460 | $620 |
| Bunionectomy with osteotomy CPT 28296 • Orthopedics | $942 | $1,008 | $1,073 |
| Arthroscopy shoulder decompression CPT 29826 • Orthopedics | $177 | $266 | $355 |
| Arthroscopy shoulder rotator cuff repair CPT 29827 • Orthopedics | $288 | $694 | $1,100 |
| Arthroscopy knee with meniscectomy medial and lateral CPT 29880 • Orthopedics | $499 | $540 | $580 |
| Arthroscopy knee with meniscectomy CPT 29881 • Orthopedics | $560 | $615 | $669 |
| Arthroscopy knee with meniscus repair CPT 29882 • Orthopedics | $712 | $1,082 | $1,452 |
| Arthroscopy knee ACL repair CPT 29888 • Orthopedics | $191 | $598 | $1,006 |
| Discectomy lumbar single level CPT 63030 • Orthopedics | $998 | $1,000 | $1,001 |
| Laminectomy lumbar single level CPT 63047 • Orthopedics | $1,133 | $1,137 | $1,141 |
| Carpal tunnel release CPT 64721 • Orthopedics | $456 | $691 | $927 |
| Sacroiliac joint injection CPT 27096 • Pain Management | $72 | $121 | $171 |
| Epidural injection cervical or thoracic with imaging CPT 62321 • Pain Management | $148 | $213 | $279 |
| Epidural injection lumbar or sacral without imaging CPT 62322 • Pain Management | $149 | $156 | $164 |
| Epidural injection lumbar or sacral with imaging CPT 62323 • Pain Management | $137 | $206 | $275 |
| Spinal cord stimulator electrode implantation CPT 63650 • Pain Management | $860 | $1,598 | $2,335 |
| Peripheral nerve block injection CPT 64450 • Pain Management | $80 | $99 | $118 |
| Plantar common digital nerve injection CPT 64455 • Pain Management | $29 | $39 | $49 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $116 | $187 | $257 |
| Epidural injection lumbar each additional level CPT 64484 • Pain Management | $106 | $111 | $115 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $184 | $185 | $187 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $70 | $82 | $94 |
| Chemodenervation of muscle migraine CPT 64615 • Pain Management | $157 | $165 | $173 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $398 | $416 | $435 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $80 | $131 | $181 |
| Cytopathology concentration technique CPT 88108 • Pathology | $42 | $84 | $126 |
| Cytopathology cell enhancement technique CPT 88112 • Pathology | $26 | $35 | $44 |
| Cytopathology cervical/vaginal interpretation physician CPT 88141 • Pathology | $8 | $11 | $14 |
| Cytopathology cervical/vaginal manual screen CPT 88164 • Pathology | $10 | $18 | $26 |
| Cytopathology cervical/vaginal automated thin layer CPT 88175 • Pathology | $9 | $13 | $17 |
| Molecular cytogenetics DNA probe each CPT 88271 • Pathology | $8 | $11 | $14 |
| Cytogenetics molecular interpretation CPT 88291 • Pathology | $9 | $15 | $22 |
| Surgical pathology gross and micro exam level II CPT 88302 • Pathology | $12 | $17 | $21 |
| Surgical pathology gross and micro exam level III CPT 88304 • Pathology | $3 | $15 | $27 |
| Surgical pathology gross and micro exam level IV CPT 88305 • Pathology | $15 | $31 | $47 |
| Surgical pathology gross and micro exam level V CPT 88307 • Pathology | $139 | $166 | $192 |
| Surgical pathology gross and micro exam level VI CPT 88309 • Pathology | $39 | $166 | $293 |
| Special stain group I for microorganisms CPT 88312 • Pathology | $7 | $41 | $75 |
| Special stain group II CPT 88313 • Pathology | $15 | $34 | $54 |
| Frozen section pathology first specimen CPT 88331 • Pathology | $25 | $47 | $69 |
| Frozen section pathology each additional CPT 88332 • Pathology | $36 | $44 | $52 |
| Immunohistochemistry each antibody CPT 88341 • Pathology | $8 | $35 | $62 |