| Total shoulder replacement CPT 23472 • Orthopedics | $1,674 | $1,674 | $1,674 |
| Reverse total shoulder replacement CPT 23473 • Orthopedics | $2,133 | $2,133 | $2,133 |
| Lateral epicondylitis open treatment CPT 24357 • Orthopedics | $473 | $473 | $473 |
| Closed treatment distal radial fracture CPT 25600 • Orthopedics | $259 | $259 | $259 |
| Tendon sheath incision trigger finger CPT 26055 • Orthopedics | $312 | $312 | $312 |
| Total hip replacement CPT 27130 • Orthopedics | $1,592 | $1,592 | $1,592 |
| Hip replacement conversion to total CPT 27132 • Orthopedics | $1,868 | $1,868 | $1,868 |
| Open treatment femoral fracture CPT 27236 • Orthopedics | $1,298 | $1,298 | $1,298 |
| Treatment intertrochanteric femoral fracture CPT 27244 • Orthopedics | $1,287 | $1,287 | $1,287 |
| Treatment intertrochanteric fracture with plate/screw CPT 27245 • Orthopedics | $1,580 | $1,580 | $1,580 |
| Partial knee replacement medial or lateral CPT 27446 • Orthopedics | $1,249 | $1,249 | $1,249 |
| Total knee replacement CPT 27447 • Orthopedics | $1,713 | $1,713 | $1,713 |
| Open treatment tibial shaft fracture CPT 27756 • Orthopedics | $622 | $622 | $622 |
| Closed treatment distal fibula fracture CPT 27786 • Orthopedics | $285 | $285 | $285 |
| Bunionectomy with osteotomy CPT 28296 • Orthopedics | $663 | $663 | $663 |
| Arthroscopy shoulder decompression CPT 29826 • Orthopedics | $747 | $747 | $747 |
| Arthroscopy shoulder rotator cuff repair CPT 29827 • Orthopedics | $1,219 | $1,219 | $1,219 |
| Arthroscopy knee with meniscectomy medial and lateral CPT 29880 • Orthopedics | $752 | $752 | $752 |
| Arthroscopy knee with meniscectomy CPT 29881 • Orthopedics | $700 | $700 | $700 |
| Arthroscopy knee with meniscus repair CPT 29882 • Orthopedics | $756 | $756 | $756 |
| Arthroscopy knee ACL repair CPT 29888 • Orthopedics | $1,101 | $1,101 | $1,101 |
| Discectomy lumbar single level CPT 63030 • Orthopedics | $1,016 | $1,016 | $1,016 |
| Laminectomy lumbar single level CPT 63047 • Orthopedics | $1,173 | $1,173 | $1,173 |
| Carpal tunnel release CPT 64721 • Orthopedics | $455 | $455 | $455 |
| Sacroiliac joint injection CPT 27096 • Pain Management | $232 | $232 | $232 |
| Epidural injection cervical or thoracic with imaging CPT 62321 • Pain Management | $142 | $142 | $142 |
| Epidural injection lumbar or sacral without imaging CPT 62322 • Pain Management | $114 | $114 | $114 |
| Epidural injection lumbar or sacral with imaging CPT 62323 • Pain Management | $130 | $130 | $130 |
| Spinal cord stimulator electrode implantation CPT 63650 • Pain Management | $474 | $474 | $474 |
| Peripheral nerve block injection CPT 64450 • Pain Management | $79 | $79 | $79 |
| Plantar common digital nerve injection CPT 64455 • Pain Management | $49 | $49 | $49 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $384 | $384 | $384 |
| Epidural injection lumbar each additional level CPT 64484 • Pain Management | $184 | $184 | $184 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $201 | $201 | $201 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $104 | $104 | $104 |
| Chemodenervation of muscle migraine CPT 64615 • Pain Management | $165 | $165 | $165 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $580 | $580 | $580 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $82 | $82 | $82 |
| Cytopathology concentration technique CPT 88108 • Pathology | $19 | $19 | $19 |
| Cytopathology cell enhancement technique CPT 88112 • Pathology | $53 | $53 | $53 |
| Cytopathology cervical/vaginal interpretation physician CPT 88141 • Pathology | $11 | $11 | $11 |
| Cytopathology cervical/vaginal manual screen CPT 88164 • Pathology | $7 | $7 | $7 |
| Cytopathology cervical/vaginal automated thin layer CPT 88175 • Pathology | $5 | $5 | $5 |
| Molecular cytogenetics DNA probe each CPT 88271 • Pathology | $14 | $14 | $14 |
| Cytogenetics molecular interpretation CPT 88291 • Pathology | $13 | $13 | $13 |
| Surgical pathology gross and micro exam level II CPT 88302 • Pathology | $22 | $22 | $22 |
| Surgical pathology gross and micro exam level III CPT 88304 • Pathology | $23 | $23 | $23 |
| 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 | $51 | $51 | $51 |
| Surgical pathology gross and micro exam level VI CPT 88309 • Pathology | $65 | $65 | $65 |