| Tendon sheath incision trigger finger CPT 26055 • Orthopedics | $331 | $456 | $581 |
| Total hip replacement CPT 27130 • Orthopedics | $1,254 | $1,359 | $1,464 |
| Hip replacement conversion to total CPT 27132 • Orthopedics | $1,902 | $1,902 | $1,902 |
| Open treatment femoral fracture CPT 27236 • Orthopedics | $1,358 | $1,358 | $1,358 |
| Treatment intertrochanteric femoral fracture CPT 27244 • Orthopedics | $1,397 | $1,397 | $1,397 |
| Treatment intertrochanteric fracture with plate/screw CPT 27245 • Orthopedics | $1,396 | $1,396 | $1,396 |
| Partial knee replacement medial or lateral CPT 27446 • Orthopedics | $1,307 | $1,307 | $1,307 |
| Total knee replacement CPT 27447 • Orthopedics | $1,253 | $1,358 | $1,462 |
| Open treatment tibial shaft fracture CPT 27756 • Orthopedics | $658 | $658 | $658 |
| Closed treatment distal fibula fracture CPT 27786 • Orthopedics | $329 | $329 | $329 |
| Bunionectomy with osteotomy CPT 28296 • Orthopedics | $584 | $584 | $584 |
| Arthroscopy shoulder decompression CPT 29826 • Orthopedics | $169 | $183 | $197 |
| Arthroscopy shoulder rotator cuff repair CPT 29827 • Orthopedics | $1,045 | $1,131 | $1,218 |
| Arthroscopy knee with meniscectomy medial and lateral CPT 29880 • Orthopedics | $550 | $595 | $640 |
| Arthroscopy knee with meniscectomy CPT 29881 • Orthopedics | $529 | $572 | $616 |
| Arthroscopy knee with meniscus repair CPT 29882 • Orthopedics | $786 | $786 | $786 |
| Arthroscopy knee ACL repair CPT 29888 • Orthopedics | $956 | $1,034 | $1,112 |
| Discectomy lumbar single level CPT 63030 • Orthopedics | $141 | $572 | $1,004 |
| Laminectomy lumbar single level CPT 63047 • Orthopedics | $1,220 | $1,220 | $1,220 |
| Carpal tunnel release CPT 64721 • Orthopedics | $433 | $459 | $486 |
| Sacroiliac joint injection CPT 27096 • Pain Management | $95 | $137 | $158 |
| Epidural injection cervical or thoracic with imaging CPT 62321 • Pain Management | $279 | $279 | $279 |
| Epidural injection lumbar or sacral without imaging CPT 62322 • Pain Management | $89 | $89 | $89 |
| Epidural injection lumbar or sacral with imaging CPT 62323 • Pain Management | $109 | $182 | $254 |
| Spinal cord stimulator electrode implantation CPT 63650 • Pain Management | $457 | $457 | $457 |
| Peripheral nerve block injection CPT 64450 • Pain Management | $74 | $77 | $81 |
| Plantar common digital nerve injection CPT 64455 • Pain Management | $38 | $43 | $48 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $122 | $199 | $242 |
| Epidural injection lumbar each additional level CPT 64484 • Pain Management | $57 | $90 | $110 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $99 | $165 | $225 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $88 | $104 | $126 |
| Chemodenervation of muscle migraine CPT 64615 • Pain Management | $135 | $135 | $135 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $211 | $211 | $211 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $65 | $65 | $65 |
| Cytopathology concentration technique CPT 88108 • Pathology | $30 | $30 | $30 |
| Cytopathology cell enhancement technique CPT 88112 • Pathology | $13 | $22 | $31 |
| Cytopathology cervical/vaginal interpretation physician CPT 88141 • Pathology | $11 | $11 | $11 |
| Cytopathology cervical/vaginal manual screen CPT 88164 • Pathology | $8 | $8 | $8 |
| Cytopathology cervical/vaginal automated thin layer CPT 88175 • Pathology | $12 | $12 | $12 |
| Molecular cytogenetics DNA probe each CPT 88271 • Pathology | $9 | $9 | $9 |
| Cytogenetics molecular interpretation CPT 88291 • Pathology | $15 | $15 | $15 |
| Surgical pathology gross and micro exam level II CPT 88302 • Pathology | $15 | $15 | $15 |
| Surgical pathology gross and micro exam level III CPT 88304 • Pathology | $5 | $5 | $5 |
| Surgical pathology gross and micro exam level IV CPT 88305 • Pathology | $16 | $17 | $18 |
| Surgical pathology gross and micro exam level V CPT 88307 • Pathology | $37 | $65 | $92 |
| Surgical pathology gross and micro exam level VI CPT 88309 • Pathology | $199 | $199 | $199 |
| Special stain group I for microorganisms CPT 88312 • Pathology | $12 | $25 | $38 |
| Special stain group II CPT 88313 • Pathology | $5 | $21 | $37 |
| Frozen section pathology first specimen CPT 88331 • Pathology | $29 | $29 | $29 |
| Frozen section pathology each additional CPT 88332 • Pathology | $14 | $14 | $14 |