| Total hip replacement CPT 27130 • Orthopedics | $2,077 | $2,077 | $2,077 |
| Hip replacement conversion to total CPT 27132 • Orthopedics | $2,428 | $2,428 | $2,428 |
| Open treatment femoral fracture CPT 27236 • Orthopedics | $1,709 | $1,709 | $1,709 |
| Treatment intertrochanteric femoral fracture CPT 27244 • Orthopedics | $1,759 | $1,759 | $1,759 |
| Treatment intertrochanteric fracture with plate/screw CPT 27245 • Orthopedics | $1,785 | $1,785 | $1,785 |
| Partial knee replacement medial or lateral CPT 27446 • Orthopedics | $1,593 | $1,593 | $1,593 |
| Total knee replacement CPT 27447 • Orthopedics | $2,221 | $2,221 | $2,221 |
| Open treatment tibial shaft fracture CPT 27756 • Orthopedics | $804 | $804 | $804 |
| Closed treatment distal fibula fracture CPT 27786 • Orthopedics | $382 | $382 | $382 |
| Bunionectomy with osteotomy CPT 28296 • Orthopedics | $780 | $780 | $780 |
| Arthroscopy shoulder decompression CPT 29826 • Orthopedics | $948 | $948 | $948 |
| Arthroscopy shoulder rotator cuff repair CPT 29827 • Orthopedics | $1,546 | $1,546 | $1,546 |
| Arthroscopy knee with meniscectomy medial and lateral CPT 29880 • Orthopedics | $976 | $976 | $976 |
| Arthroscopy knee with meniscectomy CPT 29881 • Orthopedics | $911 | $911 | $911 |
| Arthroscopy knee with meniscus repair CPT 29882 • Orthopedics | $985 | $985 | $985 |
| Arthroscopy knee ACL repair CPT 29888 • Orthopedics | $1,416 | $1,416 | $1,416 |
| Discectomy lumbar single level CPT 63030 • Orthopedics | $1,352 | $1,352 | $1,352 |
| Laminectomy lumbar single level CPT 63047 • Orthopedics | $1,546 | $1,546 | $1,546 |
| Carpal tunnel release CPT 64721 • Orthopedics | $588 | $588 | $588 |
| Sacroiliac joint injection CPT 27096 • Pain Management | $253 | $253 | $253 |
| Epidural injection cervical or thoracic with imaging CPT 62321 • Pain Management | $381 | $381 | $381 |
| Epidural injection lumbar or sacral without imaging CPT 62322 • Pain Management | $139 | $139 | $139 |
| Epidural injection lumbar or sacral with imaging CPT 62323 • Pain Management | $374 | $374 | $374 |
| Spinal cord stimulator electrode implantation CPT 63650 • Pain Management | $606 | $606 | $606 |
| Peripheral nerve block injection CPT 64450 • Pain Management | $147 | $147 | $147 |
| Plantar common digital nerve injection CPT 64455 • Pain Management | $58 | $58 | $58 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $379 | $379 | $379 |
| Epidural injection lumbar each additional level CPT 64484 • Pain Management | $194 | $194 | $194 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $245 | $245 | $245 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $81 | $81 | $81 |
| Chemodenervation of muscle migraine CPT 64615 • Pain Management | $201 | $201 | $201 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $373 | $373 | $373 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $100 | $100 | $100 |
| Cytopathology concentration technique CPT 88108 • Pathology | $20 | $20 | $20 |
| Cytopathology cell enhancement technique CPT 88112 • Pathology | $28 | $28 | $28 |
| Cytopathology cervical/vaginal interpretation physician CPT 88141 • Pathology | $13 | $13 | $13 |
| Cytopathology cervical/vaginal manual screen CPT 88164 • Pathology | $7 | $7 | $7 |
| Cytopathology cervical/vaginal automated thin layer CPT 88175 • Pathology | $18 | $18 | $18 |
| Molecular cytogenetics DNA probe each CPT 88271 • Pathology | $15 | $15 | $15 |
| Cytogenetics molecular interpretation CPT 88291 • Pathology | $14 | $14 | $14 |
| Surgical pathology gross and micro exam level II CPT 88302 • Pathology | $19 | $19 | $19 |
| Surgical pathology gross and micro exam level III CPT 88304 • Pathology | $28 | $28 | $28 |
| Surgical pathology gross and micro exam level IV CPT 88305 • Pathology | $30 | $30 | $30 |
| Surgical pathology gross and micro exam level V CPT 88307 • Pathology | $98 | $98 | $98 |
| Surgical pathology gross and micro exam level VI CPT 88309 • Pathology | $83 | $83 | $83 |
| Special stain group I for microorganisms CPT 88312 • Pathology | $33 | $33 | $33 |
| Special stain group II CPT 88313 • Pathology | $6 | $6 | $6 |
| Frozen section pathology first specimen CPT 88331 • Pathology | $29 | $29 | $29 |
| Frozen section pathology each additional CPT 88332 • Pathology | $5 | $5 | $5 |
| Immunohistochemistry each antibody CPT 88341 • Pathology | $11 | $11 | $11 |