| Hip replacement conversion to total CPT 27132 • Orthopedics | $1,662 | $1,662 | $1,662 |
| Open treatment femoral fracture CPT 27236 • Orthopedics | $1,195 | $1,195 | $1,195 |
| Treatment intertrochanteric femoral fracture CPT 27244 • Orthopedics | $1,229 | $1,229 | $1,229 |
| Partial knee replacement medial or lateral CPT 27446 • Orthopedics | $1,148 | $1,148 | $1,149 |
| Total knee replacement CPT 27447 • Orthopedics | $1,279 | $1,279 | $1,279 |
| Open treatment tibial shaft fracture CPT 27756 • Orthopedics | $602 | $602 | $602 |
| Closed treatment distal fibula fracture CPT 27786 • Orthopedics | $331 | $331 | $331 |
| Bunionectomy with osteotomy CPT 28296 • Orthopedics | $887 | $887 | $887 |
| Arthroscopy shoulder decompression CPT 29826 • Orthopedics | $168 | $168 | $168 |
| Arthroscopy shoulder rotator cuff repair CPT 29827 • Orthopedics | $1,071 | $1,071 | $1,072 |
| Arthroscopy knee with meniscectomy medial and lateral CPT 29880 • Orthopedics | $572 | $572 | $572 |
| Arthroscopy knee with meniscectomy CPT 29881 • Orthopedics | $551 | $551 | $552 |
| Arthroscopy knee with meniscus repair CPT 29882 • Orthopedics | $697 | $697 | $697 |
| Arthroscopy knee ACL repair CPT 29888 • Orthopedics | $977 | $977 | $977 |
| Discectomy lumbar single level CPT 63030 • Orthopedics | $901 | $901 | $901 |
| Laminectomy lumbar single level CPT 63047 • Orthopedics | $1,084 | $1,084 | $1,084 |
| Carpal tunnel release CPT 64721 • Orthopedics | $448 | $448 | $448 |
| Sacroiliac joint injection CPT 27096 • Pain Management | $82 | $124 | $166 |
| Epidural injection cervical or thoracic with imaging CPT 62321 • Pain Management | $104 | $181 | $258 |
| Epidural injection lumbar or sacral without imaging CPT 62322 • Pain Management | $129 | $129 | $129 |
| Epidural injection lumbar or sacral with imaging CPT 62323 • Pain Management | $253 | $253 | $253 |
| Spinal cord stimulator electrode implantation CPT 63650 • Pain Management | $2,201 | $2,201 | $2,201 |
| Peripheral nerve block injection CPT 64450 • Pain Management | $73 | $73 | $73 |
| Plantar common digital nerve injection CPT 64455 • Pain Management | $48 | $48 | $49 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $242 | $242 | $242 |
| Epidural injection lumbar each additional level CPT 64484 • Pain Management | $48 | $78 | $109 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $176 | $176 | $176 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $89 | $89 | $90 |
| Chemodenervation of muscle migraine CPT 64615 • Pain Management | $147 | $147 | $148 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $431 | $431 | $431 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $234 | $234 | $234 |
| Cytopathology concentration technique CPT 88108 • Pathology | $53 | $53 | $54 |
| Cytopathology cell enhancement technique CPT 88112 • Pathology | $51 | $51 | $51 |
| Cytopathology cervical/vaginal interpretation physician CPT 88141 • Pathology | $19 | $19 | $19 |
| Cytopathology cervical/vaginal manual screen CPT 88164 • Pathology | $13 | $13 | $14 |
| Cytopathology cervical/vaginal automated thin layer CPT 88175 • Pathology | $20 | $20 | $20 |
| Molecular cytogenetics DNA probe each CPT 88271 • Pathology | $16 | $16 | $16 |
| Cytogenetics molecular interpretation CPT 88291 • Pathology | $25 | $25 | $25 |
| Surgical pathology gross and micro exam level II CPT 88302 • Pathology | $25 | $25 | $25 |
| Surgical pathology gross and micro exam level III CPT 88304 • Pathology | $32 | $32 | $32 |
| Surgical pathology gross and micro exam level V CPT 88307 • Pathology | $220 | $220 | $220 |
| Surgical pathology gross and micro exam level VI CPT 88309 • Pathology | $328 | $328 | $328 |
| Special stain group I for microorganisms CPT 88312 • Pathology | $85 | $85 | $85 |
| Special stain group II CPT 88313 • Pathology | $9 | $36 | $63 |
| Frozen section pathology first specimen CPT 88331 • Pathology | $76 | $76 | $77 |
| Frozen section pathology each additional CPT 88332 • Pathology | $41 | $41 | $41 |
| Immunohistochemistry each antibody CPT 88341 • Pathology | $74 | $74 | $74 |
| Immunohistochemistry first antibody CPT 88342 • Pathology | $86 | $86 | $86 |
| Morphometric analysis tumor quantitative CPT 88360 • Pathology | $91 | $91 | $91 |
| Microdissection manual CPT 88381 • Pathology | $150 | $150 | $150 |