| Lateral epicondylitis open treatment CPT 24357 • Orthopedics | $1,026 | $1,026 | $1,026 |
| Total hip replacement CPT 27130 • Orthopedics | $3,124 | $3,124 | $3,124 |
| Hip replacement conversion to total CPT 27132 • Orthopedics | $4,062 | $4,062 | $4,062 |
| Open treatment femoral fracture CPT 27236 • Orthopedics | $2,904 | $2,904 | $2,904 |
| Partial knee replacement medial or lateral CPT 27446 • Orthopedics | $2,808 | $2,808 | $2,808 |
| Total knee replacement CPT 27447 • Orthopedics | $3,121 | $3,121 | $3,121 |
| Open treatment tibial shaft fracture CPT 27756 • Orthopedics | $1,415 | $1,415 | $1,415 |
| Bunionectomy with osteotomy CPT 28296 • Orthopedics | $2,153 | $2,153 | $2,153 |
| Arthroscopy shoulder rotator cuff repair CPT 29827 • Orthopedics | $2,604 | $2,604 | $2,604 |
| Arthroscopy knee with meniscectomy medial and lateral CPT 29880 • Orthopedics | $1,370 | $1,370 | $1,370 |
| Arthroscopy knee with meniscectomy CPT 29881 • Orthopedics | $1,319 | $1,319 | $1,319 |
| Discectomy lumbar single level CPT 63030 • Orthopedics | $3,131 | $3,131 | $3,131 |
| Laminectomy lumbar single level CPT 63047 • Orthopedics | $3,549 | $3,549 | $3,549 |
| Carpal tunnel release CPT 64721 • Orthopedics | $433 | $433 | $433 |
| Sacroiliac joint injection CPT 27096 • Pain Management | $158 | $158 | $158 |
| Epidural injection cervical or thoracic with imaging CPT 62321 • Pain Management | $258 | $258 | $258 |
| Epidural injection lumbar or sacral with imaging CPT 62323 • Pain Management | $840 | $840 | $840 |
| Spinal cord stimulator electrode implantation CPT 63650 • Pain Management | $1,339 | $1,339 | $1,339 |
| Plantar common digital nerve injection CPT 64455 • Pain Management | $48 | $48 | $48 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $242 | $242 | $242 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $170 | $170 | $170 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $88 | $88 | $88 |
| Chemodenervation of muscle migraine CPT 64615 • Pain Management | $149 | $149 | $149 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $436 | $436 | $436 |
| Cytopathology concentration technique CPT 88108 • Pathology | $81 | $81 | $81 |
| Cytopathology cell enhancement technique CPT 88112 • Pathology | $84 | $84 | $84 |
| Cytopathology cervical/vaginal interpretation physician CPT 88141 • Pathology | $28 | $28 | $28 |
| Cytopathology cervical/vaginal manual screen CPT 88164 • Pathology | $21 | $21 | $21 |
| Cytopathology cervical/vaginal automated thin layer CPT 88175 • Pathology | $35 | $35 | $35 |
| Molecular cytogenetics DNA probe each CPT 88271 • Pathology | $28 | $28 | $28 |
| Cytogenetics molecular interpretation CPT 88291 • Pathology | $43 | $43 | $43 |
| Surgical pathology gross and micro exam level II CPT 88302 • Pathology | $40 | $40 | $40 |
| Surgical pathology gross and micro exam level III CPT 88304 • Pathology | $52 | $52 | $52 |
| Surgical pathology gross and micro exam level IV CPT 88305 • Pathology | $25 | $25 | $25 |
| Surgical pathology gross and micro exam level V CPT 88307 • Pathology | $361 | $361 | $361 |
| Surgical pathology gross and micro exam level VI CPT 88309 • Pathology | $550 | $550 | $550 |
| Special stain group I for microorganisms CPT 88312 • Pathology | $142 | $142 | $142 |
| Special stain group II CPT 88313 • Pathology | $102 | $102 | $102 |
| Frozen section pathology each additional CPT 88332 • Pathology | $69 | $69 | $69 |
| Immunohistochemistry each antibody CPT 88341 • Pathology | $112 | $112 | $112 |
| Immunohistochemistry first antibody CPT 88342 • Pathology | $128 | $128 | $128 |
| Morphometric analysis tumor quantitative CPT 88360 • Pathology | $54 | $54 | $54 |
| Microdissection manual CPT 88381 • Pathology | $263 | $263 | $263 |
| Hot or cold packs application CPT 97010 • Physical Therapy | $14 | $14 | $14 |
| Electrical stimulation unattended CPT 97014 • Physical Therapy | $30 | $30 | $30 |
| Vasopneumatic device therapy CPT 97016 • Physical Therapy | $9 | $9 | $9 |
| Electrical stimulation attended each 15 minutes CPT 97032 • Physical Therapy | $12 | $12 | $12 |
| Ultrasound therapy each 15 minutes CPT 97035 • Physical Therapy | $34 | $34 | $34 |
| Therapeutic exercises each 15 minutes CPT 97110 • Physical Therapy | $71 | $71 | $71 |
| Neuromuscular reeducation each 15 minutes CPT 97112 • Physical Therapy | $82 | $82 | $82 |