| Spinal cord stimulator electrode implantation CPT 63650 • Pain Management | $953 | $2,582 | $4,211 |
| Peripheral nerve block injection CPT 64450 • Pain Management | $96 | $96 | $96 |
| Plantar common digital nerve injection CPT 64455 • Pain Management | $78 | $94 | $110 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $519 | $521 | $523 |
| Epidural injection lumbar each additional level CPT 64484 • Pain Management | $230 | $230 | $230 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $383 | $389 | $395 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $197 | $199 | $201 |
| Chemodenervation of muscle migraine CPT 64615 • Pain Management | $333 | $337 | $341 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $468 | $778 | $947 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $134 | $197 | $260 |
| Cytopathology concentration technique CPT 88108 • Pathology | $133 | $145 | $157 |
| Cytopathology cell enhancement technique CPT 88112 • Pathology | $61 | $108 | $155 |
| Cytopathology cervical/vaginal interpretation physician CPT 88141 • Pathology | $56 | $63 | $71 |
| Cytopathology cervical/vaginal manual screen CPT 88164 • Pathology | $12 | $22 | $32 |
| Cytopathology cervical/vaginal automated thin layer CPT 88175 • Pathology | $19 | $38 | $57 |
| Molecular cytogenetics DNA probe each CPT 88271 • Pathology | $16 | $31 | $46 |
| Cytogenetics molecular interpretation CPT 88291 • Pathology | $27 | $50 | $73 |
| Surgical pathology gross and micro exam level II CPT 88302 • Pathology | $54 | $60 | $66 |
| Surgical pathology gross and micro exam level III CPT 88304 • Pathology | $88 | $94 | $99 |
| Surgical pathology gross and micro exam level IV CPT 88305 • Pathology | $62 | $73 | $83 |
| Surgical pathology gross and micro exam level V CPT 88307 • Pathology | $260 | $508 | $670 |
| Surgical pathology gross and micro exam level VI CPT 88309 • Pathology | $323 | $671 | $1,018 |
| Special stain group I for microorganisms CPT 88312 • Pathology | $167 | $190 | $212 |
| Special stain group II CPT 88313 • Pathology | $148 | $155 | $163 |
| Frozen section pathology first specimen CPT 88331 • Pathology | $37 | $124 | $212 |
| Frozen section pathology each additional CPT 88332 • Pathology | $110 | $114 | $117 |
| Immunohistochemistry each antibody CPT 88341 • Pathology | $194 | $196 | $199 |
| Immunohistochemistry first antibody CPT 88342 • Pathology | $148 | $189 | $231 |
| Morphometric analysis tumor quantitative CPT 88360 • Pathology | $33 | $104 | $176 |
| Microdissection manual CPT 88381 • Pathology | $183 | $257 | $330 |
| Hot or cold packs application CPT 97010 • Physical Therapy | $5 | $8 | $14 |
| Electrical stimulation unattended CPT 97014 • Physical Therapy | $9 | $20 | $31 |
| Vasopneumatic device therapy CPT 97016 • Physical Therapy | $9 | $18 | $27 |
| Electrical stimulation attended each 15 minutes CPT 97032 • Physical Therapy | $11 | $21 | $32 |
| Ultrasound therapy each 15 minutes CPT 97035 • Physical Therapy | $11 | $21 | $31 |
| Therapeutic exercises each 15 minutes CPT 97110 • Physical Therapy | $22 | $44 | $66 |
| Neuromuscular reeducation each 15 minutes CPT 97112 • Physical Therapy | $26 | $51 | $76 |
| Gait training each 15 minutes CPT 97116 • Physical Therapy | $22 | $44 | $65 |
| Manual therapy one or more regions each 15 min CPT 97140 • Physical Therapy | $21 | $41 | $61 |
| Group therapeutic procedures CPT 97150 • Physical Therapy | $13 | $26 | $39 |
| Physical therapy evaluation low complexity CPT 97161 • Physical Therapy | $78 | $131 | $184 |
| Physical therapy evaluation moderate complexity CPT 97162 • Physical Therapy | $184 | $184 | $184 |
| Physical therapy evaluation high complexity CPT 97163 • Physical Therapy | $78 | $131 | $184 |
| Physical therapy re-evaluation CPT 97164 • Physical Therapy | $55 | $91 | $127 |
| Therapeutic activities each 15 minutes CPT 97530 • Physical Therapy | $29 | $57 | $85 |
| Self-care/home management training each 15 min CPT 97535 • Physical Therapy | $25 | $49 | $74 |
| Wheelchair management training each 15 minutes CPT 97542 • Physical Therapy | $24 | $40 | $71 |
| Physical performance test each 15 minutes CPT 97750 • Physical Therapy | $26 | $51 | $75 |
| Orthotic management and training each 15 min CPT 97760 • Physical Therapy | $38 | $72 | $106 |
| Prosthetic training each 15 minutes CPT 97761 • Physical Therapy | $33 | $62 | $90 |