| Arthrocentesis aspiration major joint CPT 20610 • Orthopedics | $50 | $56 | $61 |
| Cervical spine fusion anterior approach CPT 22551 • Orthopedics | $265 | $1,034 | $1,804 |
| Lumbar spine fusion posterior approach CPT 22612 • Orthopedics | $1,546 | $1,546 | $1,546 |
| Lumbar spine fusion combined approach CPT 22633 • Orthopedics | $1,957 | $1,957 | $1,957 |
| Total shoulder replacement CPT 23472 • Orthopedics | $1,480 | $1,480 | $1,480 |
| Reverse total shoulder replacement CPT 23473 • Orthopedics | $1,727 | $1,727 | $1,727 |
| Lateral epicondylitis open treatment CPT 24357 • Orthopedics | $422 | $422 | $422 |
| Closed treatment distal radial fracture CPT 25600 • Orthopedics | $236 | $236 | $236 |
| Tendon sheath incision trigger finger CPT 26055 • Orthopedics | $523 | $523 | $523 |
| Total hip replacement CPT 27130 • Orthopedics | $1,420 | $1,420 | $1,420 |
| Hip replacement conversion to total CPT 27132 • Orthopedics | $1,659 | $1,659 | $1,659 |
| Open treatment femoral fracture CPT 27236 • Orthopedics | $1,163 | $1,163 | $1,163 |
| Treatment intertrochanteric femoral fracture CPT 27244 • Orthopedics | $1,196 | $1,196 | $1,196 |
| Treatment intertrochanteric fracture with plate/screw CPT 27245 • Orthopedics | $1,244 | $1,244 | $1,244 |
| Partial knee replacement medial or lateral CPT 27446 • Orthopedics | $1,098 | $1,098 | $1,098 |
| Total knee replacement CPT 27447 • Orthopedics | $1,521 | $1,521 | $1,521 |
| Open treatment tibial shaft fracture CPT 27756 • Orthopedics | $547 | $547 | $547 |
| Closed treatment distal fibula fracture CPT 27786 • Orthopedics | $285 | $285 | $285 |
| Bunionectomy with osteotomy CPT 28296 • Orthopedics | $545 | $545 | $545 |
| Arthroscopy shoulder decompression CPT 29826 • Orthopedics | $651 | $651 | $651 |
| Arthroscopy shoulder rotator cuff repair CPT 29827 • Orthopedics | $1,065 | $1,065 | $1,065 |
| Arthroscopy knee with meniscectomy medial and lateral CPT 29880 • Orthopedics | $664 | $664 | $664 |
| Arthroscopy knee with meniscectomy CPT 29881 • Orthopedics | $618 | $618 | $618 |
| Arthroscopy knee with meniscus repair CPT 29882 • Orthopedics | $670 | $670 | $670 |
| Arthroscopy knee ACL repair CPT 29888 • Orthopedics | $971 | $971 | $971 |
| Discectomy lumbar single level CPT 63030 • Orthopedics | $141 | $534 | $927 |
| Laminectomy lumbar single level CPT 63047 • Orthopedics | $1,056 | $1,056 | $1,056 |
| Carpal tunnel release CPT 64721 • Orthopedics | $397 | $397 | $397 |
| Sacroiliac joint injection CPT 27096 • Pain Management | $157 | $164 | $171 |
| Epidural injection cervical or thoracic with imaging CPT 62321 • Pain Management | $120 | $120 | $120 |
| Epidural injection lumbar or sacral without imaging CPT 62322 • Pain Management | $167 | $167 | $167 |
| Epidural injection lumbar or sacral with imaging CPT 62323 • Pain Management | $261 | $261 | $261 |
| Spinal cord stimulator electrode implantation CPT 63650 • Pain Management | $399 | $399 | $399 |
| Peripheral nerve block injection CPT 64450 • Pain Management | $71 | $71 | $71 |
| Plantar common digital nerve injection CPT 64455 • Pain Management | $51 | $51 | $51 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $232 | $247 | $262 |
| Epidural injection lumbar each additional level CPT 64484 • Pain Management | $67 | $85 | $103 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $96 | $161 | $225 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $55 | $91 | $126 |
| Chemodenervation of muscle migraine CPT 64615 • Pain Management | $151 | $151 | $151 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $471 | $471 | $471 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $198 | $198 | $198 |
| Cytopathology concentration technique CPT 88108 • Pathology | $36 | $36 | $36 |
| Cytopathology cell enhancement technique CPT 88112 • Pathology | $13 | $18 | $23 |
| Cytopathology cervical/vaginal interpretation physician CPT 88141 • Pathology | $14 | $14 | $14 |
| Cytopathology cervical/vaginal manual screen CPT 88164 • Pathology | $8 | $8 | $8 |
| Cytopathology cervical/vaginal automated thin layer CPT 88175 • Pathology | $19 | $19 | $19 |
| Molecular cytogenetics DNA probe each CPT 88271 • Pathology | $15 | $15 | $15 |
| Cytogenetics molecular interpretation CPT 88291 • Pathology | $14 | $14 | $14 |
| Surgical pathology gross and micro exam level II CPT 88302 • Pathology | $3 | $3 | $3 |