| Arthrocentesis aspiration small joint CPT 20600 • Orthopedics | $41 | $45 | $50 |
| Arthrocentesis aspiration intermediate joint CPT 20605 • Orthopedics | $63 | $83 | $103 |
| Arthrocentesis aspiration major joint CPT 20610 • Orthopedics | $58 | $66 | $73 |
| Cervical spine fusion anterior approach CPT 22551 • Orthopedics | $1,777 | $1,777 | $1,777 |
| Lumbar spine fusion posterior approach CPT 22612 • Orthopedics | $1,660 | $1,660 | $1,660 |
| Lumbar spine fusion combined approach CPT 22633 • Orthopedics | $1,935 | $2,656 | $3,376 |
| Total shoulder replacement CPT 23472 • Orthopedics | $1,414 | $1,467 | $1,520 |
| Reverse total shoulder replacement CPT 23473 • Orthopedics | $1,694 | $1,694 | $1,694 |
| Lateral epicondylitis open treatment CPT 24357 • Orthopedics | $441 | $441 | $441 |
| Closed treatment distal radial fracture CPT 25600 • Orthopedics | $352 | $352 | $352 |
| Tendon sheath incision trigger finger CPT 26055 • Orthopedics | $614 | $614 | $614 |
| Total hip replacement CPT 27130 • Orthopedics | $1,349 | $1,349 | $1,349 |
| Hip replacement conversion to total CPT 27132 • Orthopedics | $1,754 | $1,754 | $1,754 |
| Open treatment femoral fracture CPT 27236 • Orthopedics | $1,252 | $1,252 | $1,252 |
| Treatment intertrochanteric femoral fracture CPT 27244 • Orthopedics | $1,199 | $1,244 | $1,288 |
| Treatment intertrochanteric fracture with plate/screw CPT 27245 • Orthopedics | $30 | $659 | $1,287 |
| Partial knee replacement medial or lateral CPT 27446 • Orthopedics | $1,212 | $1,212 | $1,212 |
| Total knee replacement CPT 27447 • Orthopedics | $1,347 | $1,720 | $2,466 |
| Open treatment tibial shaft fracture CPT 27756 • Orthopedics | $523 | $580 | $608 |
| Closed treatment distal fibula fracture CPT 27786 • Orthopedics | $329 | $329 | $329 |
| Bunionectomy with osteotomy CPT 28296 • Orthopedics | $919 | $1,144 | $1,592 |
| Arthroscopy shoulder decompression CPT 29826 • Orthopedics | $30 | $100 | $169 |
| Arthroscopy shoulder rotator cuff repair CPT 29827 • Orthopedics | $1,123 | $1,123 | $1,123 |
| Arthroscopy knee with meniscectomy medial and lateral CPT 29880 • Orthopedics | $589 | $589 | $589 |
| Arthroscopy knee with meniscectomy CPT 29881 • Orthopedics | $621 | $742 | $984 |
| Arthroscopy knee with meniscus repair CPT 29882 • Orthopedics | $723 | $723 | $723 |
| Arthroscopy knee ACL repair CPT 29888 • Orthopedics | $946 | $986 | $1,026 |
| Discectomy lumbar single level CPT 63030 • Orthopedics | $860 | $860 | $860 |
| Laminectomy lumbar single level CPT 63047 • Orthopedics | $975 | $975 | $975 |
| Carpal tunnel release CPT 64721 • Orthopedics | $391 | $391 | $391 |
| Sacroiliac joint injection CPT 27096 • Pain Management | $146 | $157 | $169 |
| Epidural injection cervical or thoracic with imaging CPT 62321 • Pain Management | $104 | $157 | $231 |
| Epidural injection lumbar or sacral without imaging CPT 62322 • Pain Management | $124 | $162 | $201 |
| Epidural injection lumbar or sacral with imaging CPT 62323 • Pain Management | $228 | $228 | $228 |
| Spinal cord stimulator electrode implantation CPT 63650 • Pain Management | $40 | $1,036 | $2,032 |
| Peripheral nerve block injection CPT 64450 • Pain Management | $67 | $72 | $78 |
| Plantar common digital nerve injection CPT 64455 • Pain Management | $44 | $44 | $44 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $218 | $218 | $218 |
| Epidural injection lumbar each additional level CPT 64484 • Pain Management | $99 | $105 | $110 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $153 | $153 | $153 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $80 | $80 | $80 |
| Chemodenervation of muscle migraine CPT 64615 • Pain Management | $135 | $135 | $135 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $391 | $526 | $796 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $214 | $328 | $442 |
| Cytopathology concentration technique CPT 88108 • Pathology | $49 | $49 | $49 |
| Cytopathology cell enhancement technique CPT 88112 • Pathology | $46 | $46 | $46 |
| Cytopathology cervical/vaginal interpretation physician CPT 88141 • Pathology | $15 | $15 | $15 |
| Cytopathology cervical/vaginal manual screen CPT 88164 • Pathology | $11 | $11 | $11 |
| Cytopathology cervical/vaginal automated thin layer CPT 88175 • Pathology | $20 | $20 | $20 |
| Molecular cytogenetics DNA probe each CPT 88271 • Pathology | $16 | $16 | $16 |