| Arthrocentesis aspiration major joint CPT 20610 • Orthopedics | $63 | $63 | $63 |
| Cervical spine fusion anterior approach CPT 22551 • Orthopedics | $1,654 | $1,654 | $1,654 |
| Lumbar spine fusion posterior approach CPT 22612 • Orthopedics | $1,545 | $1,545 | $1,545 |
| Lumbar spine fusion combined approach CPT 22633 • Orthopedics | $1,801 | $1,801 | $1,801 |
| Total shoulder replacement CPT 23472 • Orthopedics | $1,414 | $1,414 | $1,414 |
| Closed treatment distal radial fracture CPT 25600 • Orthopedics | $317 | $317 | $317 |
| Total hip replacement CPT 27130 • Orthopedics | $1,254 | $1,254 | $1,254 |
| Hip replacement conversion to total CPT 27132 • Orthopedics | $1,631 | $1,631 | $1,631 |
| Open treatment femoral fracture CPT 27236 • Orthopedics | $1,166 | $1,166 | $1,166 |
| Partial knee replacement medial or lateral CPT 27446 • Orthopedics | $1,127 | $1,127 | $1,127 |
| Total knee replacement CPT 27447 • Orthopedics | $1,253 | $1,253 | $1,253 |
| Open treatment tibial shaft fracture CPT 27756 • Orthopedics | $568 | $568 | $568 |
| Bunionectomy with osteotomy CPT 28296 • Orthopedics | $500 | $682 | $865 |
| Arthroscopy shoulder rotator cuff repair CPT 29827 • Orthopedics | $1,045 | $1,045 | $1,045 |
| Arthroscopy knee with meniscectomy medial and lateral CPT 29880 • Orthopedics | $550 | $550 | $550 |
| Arthroscopy knee with meniscectomy CPT 29881 • Orthopedics | $529 | $529 | $530 |
| Arthroscopy knee with meniscus repair CPT 29882 • Orthopedics | $674 | $674 | $674 |
| Discectomy lumbar single level CPT 63030 • Orthopedics | $948 | $948 | $948 |
| Laminectomy lumbar single level CPT 63047 • Orthopedics | $1,075 | $1,075 | $1,075 |
| Carpal tunnel release CPT 64721 • Orthopedics | $433 | $433 | $433 |
| Sacroiliac joint injection CPT 27096 • Pain Management | $159 | $159 | $159 |
| Epidural injection cervical or thoracic with imaging CPT 62321 • Pain Management | $258 | $258 | $258 |
| Epidural injection lumbar or sacral without imaging CPT 62322 • Pain Management | $137 | $137 | $137 |
| Epidural injection lumbar or sacral with imaging CPT 62323 • Pain Management | $254 | $254 | $254 |
| Plantar common digital nerve injection CPT 64455 • Pain Management | $48 | $48 | $48 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $242 | $242 | $242 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $170 | $170 | $170 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $88 | $88 | $88 |
| Chemodenervation of muscle migraine CPT 64615 • Pain Management | $149 | $149 | $149 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $436 | $436 | $437 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $24 | $24 | $24 |
| Cytopathology concentration technique CPT 88108 • Pathology | $49 | $49 | $49 |
| Cytopathology cell enhancement technique CPT 88112 • Pathology | $51 | $51 | $51 |
| Cytopathology cervical/vaginal interpretation physician CPT 88141 • Pathology | $17 | $17 | $17 |
| Cytopathology cervical/vaginal manual screen CPT 88164 • Pathology | $12 | $12 | $12 |
| Cytopathology cervical/vaginal automated thin layer CPT 88175 • Pathology | $21 | $21 | $21 |
| Cytogenetics molecular interpretation CPT 88291 • Pathology | $25 | $25 | $25 |
| Surgical pathology gross and micro exam level II CPT 88302 • Pathology | $5 | $5 | $5 |
| Surgical pathology gross and micro exam level III CPT 88304 • Pathology | $31 | $31 | $31 |
| Surgical pathology gross and micro exam level IV CPT 88305 • Pathology | $54 | $54 | $54 |
| Surgical pathology gross and micro exam level V CPT 88307 • Pathology | $218 | $218 | $219 |
| Surgical pathology gross and micro exam level VI CPT 88309 • Pathology | $333 | $333 | $333 |
| Special stain group I for microorganisms CPT 88312 • Pathology | $86 | $86 | $86 |
| Special stain group II CPT 88313 • Pathology | $61 | $61 | $61 |
| Frozen section pathology first specimen CPT 88331 • Pathology | $48 | $48 | $48 |
| Frozen section pathology each additional CPT 88332 • Pathology | $23 | $23 | $23 |
| Immunohistochemistry each antibody CPT 88341 • Pathology | $67 | $67 | $67 |
| Immunohistochemistry first antibody CPT 88342 • Pathology | $77 | $77 | $77 |
| Morphometric analysis tumor quantitative CPT 88360 • Pathology | $92 | $92 | $92 |
| Microdissection manual CPT 88381 • Pathology | $159 | $159 | $159 |