| Arthrocentesis aspiration intermediate joint CPT 20605 • Orthopedics | $50 | $52 | $54 |
| Arthrocentesis aspiration major joint CPT 20610 • Orthopedics | $52 | $68 | $93 |
| Cervical spine fusion anterior approach CPT 22551 • Orthopedics | $1,931 | $3,333 | $4,735 |
| Lumbar spine fusion posterior approach CPT 22612 • Orthopedics | $1,997 | $3,218 | $4,439 |
| Lumbar spine fusion combined approach CPT 22633 • Orthopedics | $2,053 | $3,091 | $5,165 |
| Total shoulder replacement CPT 23472 • Orthopedics | $1,405 | $1,664 | $1,936 |
| Reverse total shoulder replacement CPT 23473 • Orthopedics | $4,577 | $4,577 | $4,577 |
| Lateral epicondylitis open treatment CPT 24357 • Orthopedics | $403 | $403 | $403 |
| Closed treatment distal radial fracture CPT 25600 • Orthopedics | $393 | $657 | $921 |
| Tendon sheath incision trigger finger CPT 26055 • Orthopedics | $670 | $739 | $808 |
| Total hip replacement CPT 27130 • Orthopedics | $1,311 | $1,664 | $1,841 |
| Hip replacement conversion to total CPT 27132 • Orthopedics | $2,162 | $3,446 | $4,731 |
| Open treatment femoral fracture CPT 27236 • Orthopedics | $1,503 | $2,436 | $3,369 |
| Treatment intertrochanteric femoral fracture CPT 27244 • Orthopedics | $3,468 | $3,468 | $3,468 |
| Treatment intertrochanteric fracture with plate/screw CPT 27245 • Orthopedics | $1,400 | $2,433 | $3,465 |
| Partial knee replacement medial or lateral CPT 27446 • Orthopedics | $1,442 | $2,356 | $3,269 |
| Total knee replacement CPT 27447 • Orthopedics | $1,465 | $2,423 | $3,823 |
| Open treatment tibial shaft fracture CPT 27756 • Orthopedics | $553 | $553 | $553 |
| Closed treatment distal fibula fracture CPT 27786 • Orthopedics | $381 | $628 | $875 |
| Bunionectomy with osteotomy CPT 28296 • Orthopedics | $505 | $505 | $505 |
| Arthroscopy shoulder decompression CPT 29826 • Orthopedics | $170 | $183 | $196 |
| Arthroscopy shoulder rotator cuff repair CPT 29827 • Orthopedics | $1,408 | $2,213 | $3,018 |
| Arthroscopy knee with meniscectomy medial and lateral CPT 29880 • Orthopedics | $871 | $1,224 | $1,577 |
| Arthroscopy knee with meniscectomy CPT 29881 • Orthopedics | $621 | $984 | $1,519 |
| Arthroscopy knee with meniscus repair CPT 29882 • Orthopedics | $875 | $1,412 | $1,949 |
| Arthroscopy knee ACL repair CPT 29888 • Orthopedics | $1,116 | $1,941 | $2,765 |
| Discectomy lumbar single level CPT 63030 • Orthopedics | $924 | $1,044 | $1,165 |
| Laminectomy lumbar single level CPT 63047 • Orthopedics | $1,050 | $1,198 | $1,347 |
| Carpal tunnel release CPT 64721 • Orthopedics | $528 | $865 | $1,202 |
| Sacroiliac joint injection CPT 27096 • Pain Management | $82 | $148 | $271 |
| Epidural injection cervical or thoracic with imaging CPT 62321 • Pain Management | $125 | $225 | $303 |
| Epidural injection lumbar or sacral without imaging CPT 62322 • Pain Management | $243 | $243 | $243 |
| Epidural injection lumbar or sacral with imaging CPT 62323 • Pain Management | $243 | $271 | $299 |
| Spinal cord stimulator electrode implantation CPT 63650 • Pain Management | $407 | $1,522 | $2,637 |
| Peripheral nerve block injection CPT 64450 • Pain Management | $73 | $102 | $131 |
| Plantar common digital nerve injection CPT 64455 • Pain Management | $101 | $101 | $101 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $225 | $337 | $448 |
| Epidural injection lumbar each additional level CPT 64484 • Pain Management | $61 | $175 | $290 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $204 | $343 | $482 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $60 | $84 | $105 |
| Chemodenervation of muscle migraine CPT 64615 • Pain Management | $116 | $147 | $178 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $396 | $473 | $511 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $278 | $343 | $473 |
| Cytopathology concentration technique CPT 88108 • Pathology | $14 | $14 | $14 |
| Cytopathology cell enhancement technique CPT 88112 • Pathology | $64 | $64 | $64 |
| Cytopathology cervical/vaginal interpretation physician CPT 88141 • Pathology | $15 | $15 | $15 |
| Cytopathology cervical/vaginal manual screen CPT 88164 • Pathology | $15 | $15 | $15 |
| Cytopathology cervical/vaginal automated thin layer CPT 88175 • Pathology | $16 | $16 | $16 |
| Molecular cytogenetics DNA probe each CPT 88271 • Pathology | $21 | $21 | $21 |
| Cytogenetics molecular interpretation CPT 88291 • Pathology | $33 | $33 | $33 |