| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $417 | $480 | $512 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $6 | $20 | $30 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $781 | $848 | $916 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $136 | $140 | $145 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $425 | $667 | $850 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $337 | $374 | $393 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $23 | $202 | $425 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $290 | $392 | $493 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $360 | $573 | $787 |
| Intravitreal injection therapeutic agent CPT 67028 • Ophthalmology | $75 | $82 | $89 |
| Retinal detachment repair with vitrectomy CPT 67108 • Ophthalmology | $464 | $624 | $785 |
| Retinal photocoagulation treatment CPT 67210 • Ophthalmology | $193 | $309 | $402 |
| Retinal treatment extensive photocoagulation CPT 67228 • Ophthalmology | $45 | $179 | $266 |
| Strabismus surgery one horizontal muscle CPT 67311 • Ophthalmology | $233 | $333 | $465 |
| Excision chalazion single CPT 67800 • Ophthalmology | $8 | $47 | $86 |
| Blepharoptosis repair levator resection CPT 67901 • Ophthalmology | $69 | $299 | $530 |
| Lacrimal punctum closure by plug CPT 68761 • Ophthalmology | $14 | $111 | $222 |
| Eye exam new patient intermediate CPT 92002 • Ophthalmology | $43 | $55 | $66 |
| Eye exam new patient comprehensive CPT 92004 • Ophthalmology | $10 | $77 | $120 |
| Eye exam established patient intermediate CPT 92012 • Ophthalmology | $32 | $46 | $60 |
| Eye exam established patient comprehensive CPT 92014 • Ophthalmology | $9 | $55 | $84 |
| Visual field examination CPT 92083 • Ophthalmology | $25 | $45 | $67 |
| Retinal imaging OCT posterior segment CPT 92134 • Ophthalmology | $18 | $23 | $27 |
| Ophthalmic biometry IOL power calculation CPT 92136 • Ophthalmology | $12 | $32 | $45 |
| Fundus photography CPT 92250 • Ophthalmology | $11 | $22 | $35 |
| Arthrocentesis aspiration small joint CPT 20600 • Orthopedics | $3 | $20 | $36 |
| Arthrocentesis aspiration intermediate joint CPT 20605 • Orthopedics | $4 | $21 | $37 |
| Arthrocentesis aspiration major joint CPT 20610 • Orthopedics | $8 | $26 | $44 |
| Cervical spine fusion anterior approach CPT 22551 • Orthopedics | $1,132 | $1,299 | $1,617 |
| Lumbar spine fusion posterior approach CPT 22612 • Orthopedics | $737 | $1,092 | $1,473 |
| Lumbar spine fusion combined approach CPT 22633 • Orthopedics | $1,220 | $1,261 | $1,303 |
| Total shoulder replacement CPT 23472 • Orthopedics | $131 | $550 | $969 |
| Reverse total shoulder replacement CPT 23473 • Orthopedics | $730 | $904 | $1,077 |
| Lateral epicondylitis open treatment CPT 24357 • Orthopedics | $258 | $271 | $284 |
| Closed treatment distal radial fracture CPT 25600 • Orthopedics | $45 | $141 | $237 |
| Tendon sheath incision trigger finger CPT 26055 • Orthopedics | $95 | $246 | $397 |
| Total hip replacement CPT 27130 • Orthopedics | $862 | $998 | $1,219 |
| Hip replacement conversion to total CPT 27132 • Orthopedics | $301 | $975 | $1,506 |
| Open treatment femoral fracture CPT 27236 • Orthopedics | $537 | $804 | $1,073 |
| Treatment intertrochanteric femoral fracture CPT 27244 • Orthopedics | $45 | $566 | $829 |
| Treatment intertrochanteric fracture with plate/screw CPT 27245 • Orthopedics | $824 | $827 | $829 |
| Partial knee replacement medial or lateral CPT 27446 • Orthopedics | $729 | $847 | $1,040 |
| Total knee replacement CPT 27447 • Orthopedics | $609 | $896 | $1,218 |
| Open treatment tibial shaft fracture CPT 27756 • Orthopedics | $358 | $421 | $511 |
| Closed treatment distal fibula fracture CPT 27786 • Orthopedics | $191 | $195 | $200 |
| Bunionectomy with osteotomy CPT 28296 • Orthopedics | $156 | $510 | $781 |
| Arthroscopy shoulder decompression CPT 29826 • Orthopedics | $24 | $69 | $114 |
| Arthroscopy shoulder rotator cuff repair CPT 29827 • Orthopedics | $701 | $785 | $934 |
| Arthroscopy knee with meniscectomy medial and lateral CPT 29880 • Orthopedics | $100 | $327 | $499 |
| Arthroscopy knee with meniscectomy CPT 29881 • Orthopedics | $337 | $395 | $480 |