| Arthrocentesis aspiration small joint CPT 20600 • Orthopedics | $22 | $52 | $67 |
| Arthrocentesis aspiration intermediate joint CPT 20605 • Orthopedics | $45 | $58 | $69 |
| Arthrocentesis aspiration major joint CPT 20610 • Orthopedics | $79 | $107 | $160 |
| Cervical spine fusion anterior approach CPT 22551 • Orthopedics | $207 | $9,716 | $21,253 |
| Lumbar spine fusion posterior approach CPT 22612 • Orthopedics | $314 | $16,604 | $32,895 |
| Lumbar spine fusion combined approach CPT 22633 • Orthopedics | $210 | $5,784 | $16,543 |
| Total shoulder replacement CPT 23472 • Orthopedics | $870 | $1,472 | $2,074 |
| Reverse total shoulder replacement CPT 23473 • Orthopedics | $870 | $870 | $870 |
| Lateral epicondylitis open treatment CPT 24357 • Orthopedics | $3,701 | $3,701 | $3,701 |
| Closed treatment distal radial fracture CPT 25600 • Orthopedics | $132 | $375 | $690 |
| Tendon sheath incision trigger finger CPT 26055 • Orthopedics | $225 | $670 | $1,506 |
| Total hip replacement CPT 27130 • Orthopedics | $1,537 | $11,841 | $22,144 |
| Hip replacement conversion to total CPT 27132 • Orthopedics | $600 | $8,235 | $15,869 |
| Open treatment femoral fracture CPT 27236 • Orthopedics | $450 | $794 | $1,137 |
| Treatment intertrochanteric femoral fracture CPT 27244 • Orthopedics | $522 | $778 | $1,034 |
| Treatment intertrochanteric fracture with plate/screw CPT 27245 • Orthopedics | $522 | $1,001 | $1,480 |
| Partial knee replacement medial or lateral CPT 27446 • Orthopedics | $300 | $2,614 | $6,574 |
| Total knee replacement CPT 27447 • Orthopedics | $1,594 | $10,339 | $21,690 |
| Open treatment tibial shaft fracture CPT 27756 • Orthopedics | $11,387 | $11,387 | $11,387 |
| Closed treatment distal fibula fracture CPT 27786 • Orthopedics | $302 | $317 | $331 |
| Bunionectomy with osteotomy CPT 28296 • Orthopedics | $3,701 | $3,701 | $3,701 |
| Arthroscopy shoulder decompression CPT 29826 • Orthopedics | $165 | $798 | $2,594 |
| Arthroscopy shoulder rotator cuff repair CPT 29827 • Orthopedics | $375 | $2,226 | $4,972 |
| Arthroscopy knee with meniscectomy medial and lateral CPT 29880 • Orthopedics | $708 | $2,204 | $3,701 |
| Arthroscopy knee with meniscectomy CPT 29881 • Orthopedics | $683 | $2,192 | $3,701 |
| Arthroscopy knee with meniscus repair CPT 29882 • Orthopedics | $439 | $2,249 | $3,701 |
| Arthroscopy knee ACL repair CPT 29888 • Orthopedics | $1,215 | $6,600 | $10,846 |
| Discectomy lumbar single level CPT 63030 • Orthopedics | $1,143 | $4,686 | $8,228 |
| Laminectomy lumbar single level CPT 63047 • Orthopedics | $1,061 | $4,644 | $8,228 |
| Carpal tunnel release CPT 64721 • Orthopedics | $280 | $1,367 | $2,168 |
| Sacroiliac joint injection CPT 27096 • Pain Management | $80 | $1,589 | $5,919 |
| Epidural injection cervical or thoracic with imaging CPT 62321 • Pain Management | $152 | $486 | $871 |
| Epidural injection lumbar or sacral without imaging CPT 62322 • Pain Management | $88 | $179 | $277 |
| Epidural injection lumbar or sacral with imaging CPT 62323 • Pain Management | $119 | $436 | $871 |
| Spinal cord stimulator electrode implantation CPT 63650 • Pain Management | $341 | $6,128 | $11,915 |
| Peripheral nerve block injection CPT 64450 • Pain Management | $79 | $100 | $121 |
| Plantar common digital nerve injection CPT 64455 • Pain Management | $32 | $54 | $66 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $119 | $436 | $1,120 |
| Epidural injection lumbar each additional level CPT 64484 • Pain Management | $54 | $130 | $340 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $109 | $482 | $1,120 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $56 | $76 | $113 |
| Chemodenervation of muscle migraine CPT 64615 • Pain Management | $131 | $183 | $235 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $300 | $593 | $1,121 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $73 | $216 | $296 |
| Unlisted nervous system procedure CPT 64999 • Pain Management | $396 | $396 | $396 |
| Cytopathology concentration technique CPT 88108 • Pathology | $12 | $17 | $20 |
| Cytopathology cell enhancement technique CPT 88112 • Pathology | $34 | $48 | $62 |
| Cytopathology cervical/vaginal interpretation physician CPT 88141 • Pathology | $13 | $24 | $39 |
| Cytopathology cervical/vaginal manual screen CPT 88164 • Pathology | $7 | $11 | $16 |
| Cytopathology cervical/vaginal automated thin layer CPT 88175 • Pathology | $18 | $27 | $38 |