| Epidural injection lumbar or sacral with imaging CPT 62323 • Pain Management | $112 | $522 | $955 |
| Spinal cord stimulator electrode implantation CPT 63650 • Pain Management | $595 | $2,178 | $5,908 |
| Peripheral nerve block injection CPT 64450 • Pain Management | $53 | $265 | $955 |
| Plantar common digital nerve injection CPT 64455 • Pain Management | $26 | $416 | $955 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $160 | $619 | $955 |
| Epidural injection lumbar each additional level CPT 64484 • Pain Management | $70 | $325 | $955 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $234 | $606 | $955 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $121 | $552 | $985 |
| Chemodenervation of muscle migraine CPT 64615 • Pain Management | $56 | $451 | $955 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $250 | $876 | $1,376 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $68 | $513 | $955 |
| Unlisted nervous system procedure CPT 64999 • Pain Management | $79 | $553 | $955 |
| Cytopathology concentration technique CPT 88108 • Pathology | $47 | $49 | $52 |
| Cytopathology cell enhancement technique CPT 88112 • Pathology | $28 | $42 | $49 |
| Cytopathology cervical/vaginal interpretation physician CPT 88141 • Pathology | $16 | $17 | $19 |
| Cytopathology cervical/vaginal manual screen CPT 88164 • Pathology | $13 | $13 | $14 |
| Cytopathology cervical/vaginal automated thin layer CPT 88175 • Pathology | $21 | $34 | $58 |
| Molecular cytogenetics DNA probe each CPT 88271 • Pathology | $17 | $18 | $20 |
| Cytogenetics molecular interpretation CPT 88291 • Pathology | $20 | $24 | $26 |
| Surgical pathology gross and micro exam level II CPT 88302 • Pathology | $23 | $25 | $28 |
| Surgical pathology gross and micro exam level III CPT 88304 • Pathology | $7 | $22 | $30 |
| Surgical pathology gross and micro exam level IV CPT 88305 • Pathology | $17 | $46 | $97 |
| Surgical pathology gross and micro exam level V CPT 88307 • Pathology | $51 | $158 | $211 |
| Surgical pathology gross and micro exam level VI CPT 88309 • Pathology | $90 | $245 | $322 |
| Special stain group I for microorganisms CPT 88312 • Pathology | $16 | $60 | $82 |
| Special stain group II CPT 88313 • Pathology | $12 | $43 | $59 |
| Frozen section pathology first specimen CPT 88331 • Pathology | $29 | $56 | $77 |
| Frozen section pathology each additional CPT 88332 • Pathology | $12 | $31 | $41 |
| Immunohistochemistry each antibody CPT 88341 • Pathology | $54 | $64 | $71 |
| Immunohistochemistry first antibody CPT 88342 • Pathology | $30 | $60 | $75 |
| Morphometric analysis tumor quantitative CPT 88360 • Pathology | $70 | $88 | $106 |
| Microdissection manual CPT 88381 • Pathology | $73 | $126 | $153 |
| Hot or cold packs application CPT 97010 • Physical Therapy | $5 | $8 | $13 |
| Electrical stimulation unattended CPT 97014 • Physical Therapy | $11 | $23 | $35 |
| Vasopneumatic device therapy CPT 97016 • Physical Therapy | $11 | $16 | $31 |
| Electrical stimulation attended each 15 minutes CPT 97032 • Physical Therapy | $13 | $19 | $36 |
| Ultrasound therapy each 15 minutes CPT 97035 • Physical Therapy | $13 | $20 | $29 |
| Therapeutic exercises each 15 minutes CPT 97110 • Physical Therapy | $27 | $30 | $37 |
| Neuromuscular reeducation each 15 minutes CPT 97112 • Physical Therapy | $31 | $46 | $74 |
| Gait training each 15 minutes CPT 97116 • Physical Therapy | $27 | $42 | $63 |
| Manual therapy one or more regions each 15 min CPT 97140 • Physical Therapy | $25 | $31 | $39 |
| Group therapeutic procedures CPT 97150 • Physical Therapy | $16 | $17 | $18 |
| Physical therapy evaluation low complexity CPT 97161 • Physical Therapy | $83 | $97 | $117 |
| Physical therapy evaluation moderate complexity CPT 97162 • Physical Therapy | $83 | $97 | $115 |
| Physical therapy evaluation high complexity CPT 97163 • Physical Therapy | $93 | $121 | $180 |
| Physical therapy re-evaluation CPT 97164 • Physical Therapy | $56 | $66 | $79 |
| Therapeutic activities each 15 minutes CPT 97530 • Physical Therapy | $34 | $40 | $54 |
| Self-care/home management training each 15 min CPT 97535 • Physical Therapy | $30 | $35 | $47 |
| Wheelchair management training each 15 minutes CPT 97542 • Physical Therapy | $29 | $47 | $68 |
| Physical performance test each 15 minutes CPT 97750 • Physical Therapy | $30 | $45 | $74 |