| Arthrocentesis aspiration major joint CPT 20610 • Orthopedics | $47 | $47 | $47 |
| Cervical spine fusion anterior approach CPT 22551 • Orthopedics | $1,061 | $1,061 | $1,061 |
| Lumbar spine fusion posterior approach CPT 22612 • Orthopedics | $976 | $976 | $976 |
| Lumbar spine fusion combined approach CPT 22633 • Orthopedics | $1,125 | $1,125 | $1,125 |
| Total shoulder replacement CPT 23472 • Orthopedics | $875 | $875 | $875 |
| Reverse total shoulder replacement CPT 23473 • Orthopedics | $969 | $969 | $969 |
| Lateral epicondylitis open treatment CPT 24357 • Orthopedics | $263 | $263 | $263 |
| Closed treatment distal radial fracture CPT 25600 • Orthopedics | $233 | $233 | $233 |
| Tendon sheath incision trigger finger CPT 26055 • Orthopedics | $431 | $431 | $431 |
| Total hip replacement CPT 27130 • Orthopedics | $781 | $781 | $781 |
| Hip replacement conversion to total CPT 27132 • Orthopedics | $1,011 | $1,011 | $1,011 |
| Open treatment femoral fracture CPT 27236 • Orthopedics | $733 | $733 | $733 |
| Treatment intertrochanteric femoral fracture CPT 27244 • Orthopedics | $754 | $754 | $754 |
| Treatment intertrochanteric fracture with plate/screw CPT 27245 • Orthopedics | $752 | $752 | $752 |
| Partial knee replacement medial or lateral CPT 27446 • Orthopedics | $705 | $705 | $705 |
| Total knee replacement CPT 27447 • Orthopedics | $779 | $779 | $779 |
| Open treatment tibial shaft fracture CPT 27756 • Orthopedics | $381 | $381 | $381 |
| Closed treatment distal fibula fracture CPT 27786 • Orthopedics | $239 | $239 | $239 |
| Bunionectomy with osteotomy CPT 28296 • Orthopedics | $606 | $606 | $606 |
| Arthroscopy shoulder decompression CPT 29826 • Orthopedics | $99 | $99 | $99 |
| Arthroscopy shoulder rotator cuff repair CPT 29827 • Orthopedics | $658 | $658 | $658 |
| Arthroscopy knee with meniscectomy medial and lateral CPT 29880 • Orthopedics | $360 | $360 | $360 |
| Arthroscopy knee with meniscectomy CPT 29881 • Orthopedics | $349 | $349 | $349 |
| Arthroscopy knee with meniscus repair CPT 29882 • Orthopedics | $433 | $433 | $433 |
| Arthroscopy knee ACL repair CPT 29888 • Orthopedics | $600 | $600 | $600 |
| Discectomy lumbar single level CPT 63030 • Orthopedics | $598 | $598 | $598 |
| Laminectomy lumbar single level CPT 63047 • Orthopedics | $708 | $708 | $708 |
| Carpal tunnel release CPT 64721 • Orthopedics | $328 | $328 | $328 |
| Sacroiliac joint injection CPT 27096 • Pain Management | $121 | $121 | $121 |
| Epidural injection cervical or thoracic with imaging CPT 62321 • Pain Management | $190 | $190 | $190 |
| Epidural injection lumbar or sacral without imaging CPT 62322 • Pain Management | $100 | $100 | $100 |
| Epidural injection lumbar or sacral with imaging CPT 62323 • Pain Management | $61 | $61 | $61 |
| Spinal cord stimulator electrode implantation CPT 63650 • Pain Management | $1,641 | $1,641 | $1,641 |
| Peripheral nerve block injection CPT 64450 • Pain Management | $55 | $55 | $55 |
| Plantar common digital nerve injection CPT 64455 • Pain Management | $34 | $34 | $34 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $182 | $182 | $182 |
| Epidural injection lumbar each additional level CPT 64484 • Pain Management | $81 | $81 | $81 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $131 | $131 | $131 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $66 | $66 | $66 |
| Chemodenervation of muscle migraine CPT 64615 • Pain Management | $72 | $72 | $72 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $319 | $319 | $319 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $35 | $35 | $35 |
| Cytopathology concentration technique CPT 88108 • Pathology | $41 | $41 | $41 |
| Cytopathology cell enhancement technique CPT 88112 • Pathology | $23 | $23 | $23 |
| Cytopathology cervical/vaginal interpretation physician CPT 88141 • Pathology | $14 | $14 | $14 |
| Cytopathology cervical/vaginal manual screen CPT 88164 • Pathology | $11 | $11 | $11 |
| Cytopathology cervical/vaginal automated thin layer CPT 88175 • Pathology | $16 | $16 | $16 |
| Molecular cytogenetics DNA probe each CPT 88271 • Pathology | $13 | $13 | $13 |
| Cytogenetics molecular interpretation CPT 88291 • Pathology | $20 | $20 | $20 |
| Surgical pathology gross and micro exam level II CPT 88302 • Pathology | $4 | $4 | $4 |