| Total hip replacement CPT 27130 • Orthopedics | $4,421 | $4,421 | $4,421 |
| Hip replacement conversion to total CPT 27132 • Orthopedics | $5,463 | $5,463 | $5,463 |
| Open treatment femoral fracture CPT 27236 • Orthopedics | $3,887 | $3,887 | $3,887 |
| Treatment intertrochanteric femoral fracture CPT 27244 • Orthopedics | $3,997 | $3,997 | $3,997 |
| Treatment intertrochanteric fracture with plate/screw CPT 27245 • Orthopedics | $3,998 | $3,998 | $3,998 |
| Partial knee replacement medial or lateral CPT 27446 • Orthopedics | $3,778 | $3,778 | $3,778 |
| Total knee replacement CPT 27447 • Orthopedics | $4,419 | $4,419 | $4,419 |
| Open treatment tibial shaft fracture CPT 27756 • Orthopedics | $1,854 | $1,854 | $1,854 |
| Closed treatment distal fibula fracture CPT 27786 • Orthopedics | $1,013 | $1,013 | $1,013 |
| Bunionectomy with osteotomy CPT 28296 • Orthopedics | $2,329 | $2,329 | $2,329 |
| Arthroscopy shoulder decompression CPT 29826 • Orthopedics | $577 | $577 | $577 |
| Arthroscopy shoulder rotator cuff repair CPT 29827 • Orthopedics | $3,487 | $3,487 | $3,487 |
| Arthroscopy knee with meniscectomy medial and lateral CPT 29880 • Orthopedics | $1,822 | $1,822 | $1,822 |
| Arthroscopy knee with meniscectomy CPT 29881 • Orthopedics | $1,752 | $1,752 | $1,752 |
| Arthroscopy knee with meniscus repair CPT 29882 • Orthopedics | $2,267 | $2,267 | $2,267 |
| Arthroscopy knee ACL repair CPT 29888 • Orthopedics | $3,209 | $3,209 | $3,209 |
| Discectomy lumbar single level CPT 63030 • Orthopedics | $3,121 | $3,121 | $3,121 |
| Laminectomy lumbar single level CPT 63047 • Orthopedics | $3,551 | $3,551 | $3,551 |
| Carpal tunnel release CPT 64721 • Orthopedics | $1,376 | $1,376 | $1,376 |
| Sacroiliac joint injection CPT 27096 • Pain Management | $280 | $280 | $280 |
| Epidural injection cervical or thoracic with imaging CPT 62321 • Pain Management | $797 | $797 | $797 |
| Epidural injection lumbar or sacral without imaging CPT 62322 • Pain Management | $502 | $502 | $502 |
| Epidural injection lumbar or sacral with imaging CPT 62323 • Pain Management | $332 | $332 | $332 |
| Spinal cord stimulator electrode implantation CPT 63650 • Pain Management | $1,375 | $1,375 | $1,375 |
| Peripheral nerve block injection CPT 64450 • Pain Management | $257 | $257 | $257 |
| Plantar common digital nerve injection CPT 64455 • Pain Management | $157 | $157 | $157 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $375 | $375 | $375 |
| Epidural injection lumbar each additional level CPT 64484 • Pain Management | $285 | $285 | $285 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $561 | $561 | $561 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $174 | $174 | $174 |
| Chemodenervation of muscle migraine CPT 64615 • Pain Management | $456 | $456 | $456 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $1,376 | $1,376 | $1,376 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $569 | $569 | $569 |
| Cytopathology concentration technique CPT 88108 • Pathology | $22 | $22 | $22 |
| Cytopathology cell enhancement technique CPT 88112 • Pathology | $32 | $32 | $32 |
| Cytopathology cervical/vaginal interpretation physician CPT 88141 • Pathology | $30 | $30 | $30 |
| Cytopathology cervical/vaginal manual screen CPT 88164 • Pathology | $14 | $14 | $14 |
| Cytopathology cervical/vaginal automated thin layer CPT 88175 • Pathology | $35 | $35 | $35 |
| Molecular cytogenetics DNA probe each CPT 88271 • Pathology | $20 | $20 | $20 |
| Cytogenetics molecular interpretation CPT 88291 • Pathology | $30 | $30 | $30 |
| Surgical pathology gross and micro exam level II CPT 88302 • Pathology | $28 | $28 | $28 |
| Surgical pathology gross and micro exam level III CPT 88304 • Pathology | $41 | $41 | $41 |
| Surgical pathology gross and micro exam level IV CPT 88305 • Pathology | $67 | $67 | $67 |
| Surgical pathology gross and micro exam level V CPT 88307 • Pathology | $272 | $272 | $272 |
| Surgical pathology gross and micro exam level VI CPT 88309 • Pathology | $414 | $414 | $414 |
| Special stain group I for microorganisms CPT 88312 • Pathology | $62 | $62 | $62 |
| Special stain group II CPT 88313 • Pathology | $50 | $50 | $50 |
| Frozen section pathology first specimen CPT 88331 • Pathology | $61 | $61 | $61 |
| Frozen section pathology each additional CPT 88332 • Pathology | $30 | $30 | $30 |
| Immunohistochemistry each antibody CPT 88341 • Pathology | $21 | $57 | $71 |