| Partial knee replacement medial or lateral CPT 27446 • Orthopedics | $1,310 | $1,310 | $1,311 |
| Total knee replacement CPT 27447 • Orthopedics | $1,465 | $1,465 | $1,465 |
| Open treatment tibial shaft fracture CPT 27756 • Orthopedics | $648 | $655 | $663 |
| Closed treatment distal fibula fracture CPT 27786 • Orthopedics | $363 | $363 | $364 |
| Bunionectomy with osteotomy CPT 28296 • Orthopedics | $999 | $999 | $1,000 |
| Arthroscopy shoulder decompression CPT 29826 • Orthopedics | $196 | $196 | $196 |
| Arthroscopy shoulder rotator cuff repair CPT 29827 • Orthopedics | $1,223 | $1,223 | $1,223 |
| Arthroscopy knee with meniscectomy medial and lateral CPT 29880 • Orthopedics | $644 | $644 | $644 |
| Arthroscopy knee with meniscectomy CPT 29881 • Orthopedics | $606 | $613 | $620 |
| Arthroscopy knee with meniscus repair CPT 29882 • Orthopedics | $791 | $791 | $791 |
| Arthroscopy knee ACL repair CPT 29888 • Orthopedics | $1,116 | $1,116 | $1,116 |
| Discectomy lumbar single level CPT 63030 • Orthopedics | $1,063 | $1,063 | $1,064 |
| Laminectomy lumbar single level CPT 63047 • Orthopedics | $1,289 | $1,289 | $1,289 |
| Carpal tunnel release CPT 64721 • Orthopedics | $521 | $521 | $522 |
| Sacroiliac joint injection CPT 27096 • Pain Management | $184 | $184 | $184 |
| Epidural injection cervical or thoracic with imaging CPT 62321 • Pain Management | $303 | $303 | $303 |
| Epidural injection lumbar or sacral with imaging CPT 62323 • Pain Management | $298 | $298 | $299 |
| Spinal cord stimulator electrode implantation CPT 63650 • Pain Management | $2,637 | $2,637 | $2,637 |
| Peripheral nerve block injection CPT 64450 • Pain Management | $87 | $87 | $87 |
| Plantar common digital nerve injection CPT 64455 • Pain Management | $58 | $58 | $59 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $284 | $284 | $284 |
| Epidural injection lumbar each additional level CPT 64484 • Pain Management | $130 | $130 | $130 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $204 | $204 | $204 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $105 | $105 | $105 |
| Chemodenervation of muscle migraine CPT 64615 • Pain Management | $178 | $178 | $178 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $431 | $471 | $511 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $236 | $236 | $236 |
| Cytopathology concentration technique CPT 88108 • Pathology | $48 | $48 | $48 |
| Cytopathology cell enhancement technique CPT 88112 • Pathology | $49 | $49 | $49 |
| Cytopathology cervical/vaginal interpretation physician CPT 88141 • Pathology | $16 | $16 | $16 |
| Cytopathology cervical/vaginal manual screen CPT 88164 • Pathology | $13 | $13 | $14 |
| Cytopathology cervical/vaginal automated thin layer CPT 88175 • Pathology | $4 | $12 | $20 |
| Surgical pathology gross and micro exam level II CPT 88302 • Pathology | $23 | $23 | $23 |
| Surgical pathology gross and micro exam level III CPT 88304 • Pathology | $30 | $30 | $30 |
| Surgical pathology gross and micro exam level V CPT 88307 • Pathology | $210 | $268 | $327 |
| Surgical pathology gross and micro exam level VI CPT 88309 • Pathology | $319 | $319 | $319 |
| Special stain group I for microorganisms CPT 88312 • Pathology | $81 | $81 | $81 |
| Special stain group II CPT 88313 • Pathology | $59 | $59 | $59 |
| Frozen section pathology first specimen CPT 88331 • Pathology | $75 | $75 | $75 |
| Frozen section pathology each additional CPT 88332 • Pathology | $40 | $40 | $40 |
| Immunohistochemistry each antibody CPT 88341 • Pathology | $63 | $63 | $63 |
| Immunohistochemistry first antibody CPT 88342 • Pathology | $73 | $73 | $73 |
| Morphometric analysis tumor quantitative CPT 88360 • Pathology | $31 | $59 | $86 |
| Microdissection manual CPT 88381 • Pathology | $145 | $145 | $145 |
| Hot or cold packs application CPT 97010 • Physical Therapy | $4 | $4 | $5 |
| Electrical stimulation unattended CPT 97014 • Physical Therapy | $8 | $8 | $9 |
| Vasopneumatic device therapy CPT 97016 • Physical Therapy | $8 | $8 | $8 |
| Electrical stimulation attended each 15 minutes CPT 97032 • Physical Therapy | $10 | $10 | $10 |
| Ultrasound therapy each 15 minutes CPT 97035 • Physical Therapy | $10 | $10 | $10 |
| Therapeutic exercises each 15 minutes CPT 97110 • Physical Therapy | $20 | $20 | $20 |