| ColoRectal | 46270/46200 | Anal Fistulectomy/Fistulotomy | $4,209 |
| ColoRectal | 46260 | Hemorroidectomy | $4,209 |
| ColoRectal | 46275/45378 | Anal Fistulectomy/Fistulotomy/Colonoscopy | $7,659 |
| ColoRectal | 46922/45990 | Excision/Fulgaration Condyloma | $5,359 |
| ENT | 69436 | Bilateral Myringotomy w/tube | $2,645 |
| ENT | 69421 | Bilateral Myringotomy w/o tube | $3,220 |
| ENT | 69420/69421/69433 | Bilateral Myringotomy w/tube (In Office) | $862 |
| ENT | 69610/69620 | Tympanoplasty | $3,450 |
| ENT | 69631/69632/69633/63635/63636/69637/69641/69642/69643/69644/69645/69646 | Tympanoplasty w/Structural Repair | $7,475 |
| ENT | 69424 | Removal Myringotomy tube | $1,093 |
| ENT | 69205 | Removal Foreign Body Ear | $1,668 |
| ENT | 69436/69631 | Tympanostomy | $2,875 |
| ENT | 69501/69502/69604 | Mastoidectomy | $6,670 |
| ENT | 42950 | Pharyngoplasty | $5,175 |
| ENT | 42950/69436 | Pharyngoplasty/Bilateral Myringotomy w/tube | $6,267 |
| ENT | 42825 | Tonsilectomy | $5,589 |
| ENT | 42830 | Adenoidectomy | $3,680 |
| ENT | 42820 | Tonsilectomy/Adenoidectomy | $5,704 |
| ENT | 42140 | Uvulectomy | $3,749 |
| ENT | 30310 | Removal Foreign Body Intranasal | $2,875 |
| ENT | 31530 | Laryngoscopy w/Foreign Body Removal | $2,070 |
| ENT | 42800/42804/42806 | Biopsy Throat | $3,404 |
| ENT | 21320 | Closed Reduction Nasal Fracture | $3,105 |
| ENT | 40819 | Frenulectomy | $2,300 |
| ENT | 42410/42415/42420/42425/42440/42450 | Excision Salivary Gland | $6,854 |
| ENT | 31237 | Nasal Endoscopy (In Office) | $626 |
| ENT | 31231/92511 | Nasal Endoscopy | $1,035 |
| ENT | 31240 | Concha Bullosa Resection | $2,875 |
| ENT | 30520 | Septoplasty | $4,025 |
| ENT | 31256/31267/31287 | FESS | $5,405 |
| ENT | 30140 | Turbinate Reduction | $4,025 |
| ENT | 31295 | Balloon Sinuplasty | $7,475 |
| ENT | 31298 | Bilateral Maxillary, Sphenoid & Frontal | $8,625 |
| ENT | 30520/30140/31240/31231 | Septoplasty/Bilateral Turbinate Reduction/Direct Nasal Endoscopy | $6,325 |
| ENT | 42820/30140/31231 | Tonsilectomy/Adenoidectomy/Bilateral Turbinate Reduction/Direct Nasal Endoscopy | $7,659 |
| ENT | 31295/31298 | Balloon Sinuplasty/Bilateral Maxillary, Sphenoid, & Frontal (In Office) | $7,216 |
| ENT | 30520/31240/30140 | Septoplasty/Concha Bullosa/Inferior Turbinate Reduction | $17,940 |
| ENT | 30400/30465/30420 | Rhinoplasty/Repair of Nasal Vestibular Stenosis/Septal Repair | $17,940 |
| ENT | 30520/30140/42140 | Septoplasty/Inferior Turbinate Reduction/Uvulectomy | $7,429 |
| ENT | 95800 | Home Sleep Study | $460 |
| ENT | 21453 | Closed Reduction Mandibular Fracture w/Interdental Fixation | $20,000 |
| ENT | 60240/60260 | Thyroidectomy | $8,809 |
| General | 36568 | Mediport Placement | $3,795 |
| General | 36590 | Mediport Removal | $2,875 |
| General | 46260 | Hemorroidectomy | $4,209 |
| General | 46270 | Anal Fistulectomy/Fistulotomy | $4,025 |
| General | 11770/11771/11772 | Pilonidal Cystectomy | $4,784 |
| General | 47562 | Laparoscopic Cholecystectomy | $6,733 |
| General | 44960/44970 | Laparoscopic Appendectomy | $6,733 |
| General | 49587/49591 | Hernia Repair, Ventral/Umbilical | $5,405 |
| General | 49650 | Hernia Repair, Inguinal | $6,325 |
| General | 49650-50 | Hernia Repair, Inguinal Bilateral | $9,775 |
| General | 49652/49594 | Hernia Repair, Laparoscopic | $7,130 |
| General | 43281 | Hernia Repair, Hiatal w/mesh (Robotic) | $39,953 |
| General | 43282 | Hernia Repair, Hiatal w/o mesh (Robotic) | $38,324 |
| General | 60240 | Thyroidectomy Total | $8,809 |
| General | 21620/22903 | Xiphoidectomy/Excision of Chest Wall Mass | $5,934 |
| General | 55250 | Vasectomy | $3,346 |
| General | 19120 | Lumpectomy | $3,059 |
| General | 19303 | Mastectomy Single | $3,864 |
| General | 19303-50 | Mastectomy Bilateral | $5,589 |
| General | 21501 | Excision of Mass | $2,484 |
| Gastroenterology | 43235/43239, 45378/45380 | EGD with Colonoscopy | $2,887 |
| Gastroenterology | 43239 | EGD with Biopsy | $1,564 |
| Gastroenterology | 45378 | Diagnostic Colonoscopy procedure | $1,936 |
| Gastroenterology | 45380 | Diagnostic Colonoscopy with biopsy procedure single or multiple | $1,936 |
| Gastroenterology | 45385 | Colonoscopy procedure with lesion removal, tumor removal with snare technique | $1,936 |
| Gastroenterology | G0121 | Colon cancer screening | $1,921 |
| Gastroenterology | 45331 | Sigmoidoscopy with Biopsy | $1,821 |
| Gyn | 58120 | Dilation & Curettage | $4,370 |
| Gyn | 58558 | D&C Hysteroscopy | $5,359 |
| Gyn | 58671 | Tubal Ligation | $5,566 |
| Gyn | 58563 | Hysteroscopy w/Endometrial Ablation | $6,324 |
| Gyn | 56620 | Excision of Labia Minora (Labiaplasty) | $4,726 |
| Gyn | 58301 | Removal IUD | $690 |
| Gyn | 58750 | Tubal Reversal Open | $7,176 |
| Gyn | 58145 | Myomectomy | $6,256 |
| Gyn | 58260 | Hysterectomy Vaginal | $7,820 |
| Gyn | 58150 | Hysterectomy Abdominal | $12,995 |
| Gyn | 58570 | Hysterectomy Laparoscopic | $12,995 |
| Gyn | 57550 | Vaginal Removal of Cervical Stump | $5,988 |
| Gyn | 58661 | Laparoscopic Bilateral Salpingectomy | $6,210 |
| Gyn | 49320 | Laparoscopy Diagnostic | $5,750 |
| Gyn | 49000 | Exploratory Laparotomy | $9,959 |
| Gyn | 58925 | Ovarian Cystectomy | $5,359 |
| Orthopedic | 29848 | Carpal Tunnel Release Open vs Endo | $2,933 |
| Orthopedic | 29848 | Carpal Tunnel Release Open vs Endo | $2,525 |
| Orthopedic | 64721/64718 | Carpal Tunnel Release/Cubital Tunnel Release | $3,738 |
| Orthopedic | 26040 | Dupuytrens Contracture Release | $2,933 |
| Orthopedic | 26160 | Excision of Ganglion Cyst | $3,117 |
| Orthopedic | 28080 | Excision of Neuroma | $3,347 |
| Orthopedic | 29843 | Arthroscopy Wrist | $4,600 |
| Orthopedic | 26055 | Trigger Finger Release | $3,278 |
| Orthopedic | 26540 | CMC Arthroplasty | $4,313 |
| Orthopedic | 26410/26480 | Tendon Repair Extensor | $4,888 |
| Orthopedic | 64721/64718/14040 | Carpal Tunnel Release/Decompression Ulnar Nerve/Hypothenar Fat Flap | $5,003 |
| Orthopedic | 64721/64718 | Carpal Tunnel Release/Decompression Ulnar Nerve | $3,968 |
| Orthopedic | 26951 | Amputation Finger Index | $4,612 |
| Orthopedic | 26951/15240 | Amputation Finger Index/FTSG | $5,647 |
| Orthopedic | 25565 | Closed Reduction/Casting Radial/Ulnar Shaft | $2,875 |
| Orthopedic | 26650/26608 | Percutaneous Pinning Digit | $4,083 |
| Orthopedic | 25607/25608/25609 | ORIF Distal Radius | $9,430 |
| Orthopedic | 25024 | Fasciotomy Elbow | $4,543 |
| Orthopedic | 27650 | Achilles Tendon Repair | $7,705 |
| Orthopedic | 20680 | Removal Hardware Deep | $3,968 |
| Orthopedic | 23700/27570 | Manipulation Under Anesthesia | $1,898 |
| Orthopedic | 29866/29870/29871/29875/29876/29880/29881 | Arthroscopy Knee | $6,900 |
| Orthopedic | 29882/29883 | Arthroscopy Knee w/Meniscal Repair | $7,130 |
| Orthopedic | 29866 | Arthroscopy Knee Bilateral | $9,775 |
| Orthopedic | 27445 | Arthroplasty Total Knee | $20,528 |
| Orthopedic | 27445 | Arthroplasty Total Knee Bilateral | $27,600 |
| Orthopedic | 29888 | Anterior Cruciate Ligament Repair/Reconstruction w/Graft | $15,928 |
| Orthopedic | 29888 | Anterior Cruciate Ligament Repair/Reconstruction w/o Graft | $11,903 |
| Orthopedic | 22915/29916 | Arthroscopy Hip | $9,775 |
| Orthopedic | 27130 | Arthroplasty Total Hip | $21,620 |
| Orthopedic | 27130 | Arthroplasty Total Hip Bilateral | $28,865 |
| Orthopedic | 23472 | Arthroplasty Total Reverse Shoulder | $26,795 |
| Orthopedic | 23410/29827 | Arthroscopy Shoulder Rotator Cuff Repair | $11,851 |
| Orthopedic | 29806/29807 | Arthroscopy Shoulder Labrum Repair | $11,851 |
| Orthopedic | 29824 | Arthroscopy Shoulder Distal Clavicle | $9,551 |
| Pain Management | 64520 | Lumbar Sympathetic Nerve Block | $1,276 |
| Pain Management | 64530 | Celiac Plexus Nerve Block | $1,276 |
| Pain Management | 64625 | SI Joint RFA | $2,185 |
| Pain Management | 62321 | Epidural Steriod Injection (Cervical) | $1,437 |
| Pain Management | 62321, 62323 | Epidural Steriod Injection (Thoracic, Lumbar, Caudal) | $1,322 |
| Pain Management | 64490, 64493 | Medial Branch Block (Cervical/Lumbar) 1 Level | $1,621 |
| Pain Management | 64490, 64491, 64493, 64494 | Medial Branch Block (Cervical/Lumbar) 2 Level | $1,748 |
| Pain Management | 64490, 64491, 64493, 64494, 64495 | Medial Branch Block (Cervical/Lumbar) 3 Level | $1,759 |
| Pain Management | 64633 | Facet Joint RFA | $2,070 |
| Pain Management | 64633 | Facet Joint RFA Bilateral | $2,392 |
| Pain Management | G0260 | SI Joint | $1,276 |
| Pain Management | 20610 | Steroid injection knee | $598 |
| Pain Management | 64405 | Occipital nerve block for headache | $690 |
| Pain Management | 64400 | Supraorbital nerve block | $690 |
| Pain Management | 20552 | Trigger Point Injection | $690 |
| Pain Management | 22869 | Superion Indirect Decompression System | $20,240 |
| Pain Management | 63662 | SCS Explant | $5,313 |
| Pain Management | 64510 | Stellate Ganglion Nerve Block | $1,276 |
| Pain Management | 64483 | Transforaminal ESI | $1,322 |
| Pain Management | 64454 | Genicular Nerve Block | $1,495 |
| Pain Management | 64624 | Genicular RFA | $2,990 |
| Pain Management | | Trial Spinal Cord Stimulator | $15,415 |
| Pain Management | | Trial Spinal Cord Stimulator DRG | $16,198 |
| Pain Management | | Perm Spinal Cord Stimulator | $49,800 |
| Pain Management | | Perm Spinal Cord Stimulator DRG | $39,716 |
| Pain Management | 38222 | Sacral Bone Marrow Biopsy | $2,599 |
| Pain Management | 0232T | PRP Injection | $518 |
| Podiatry | 28292 | Bunionectomy | $5,750 |
| Podiatry | 64774, 64784 | Excision of neuroma | $4,197 |
| Podiatry | 28118 | Haglunds | $3,795 |
| Podiatry | 28285 | Hammertoe (1) | $4,370 |
| Podiatry | 28285 | Hammertoe (2) | $2,472 |
| Podiatry | 28285 | Hammertoe (3) | $2,472 |
| Podiatry | 28008 | Instep/ Fasciotomy | $4,255 |
| Podiatry | 28113 | Osteotomy | $4,255 |
| Podiatry | 0232T | PRP Injection (platelet-rich plasma inj) | $2,242 |
| Podiatry | 28820 | Toe amp | $4,439 |
| Podiatry | 27687 | Gastrocnemius Resection | $4,255 |
| Podiatry | 28304 | Cotton Osteotomy | $6,670 |
| Podiatry | 29897 | Ankle Arthroscopy | $4,255 |
| Podiatry | 29893 | Endoscopic Plantar Fascia Release | $4,600 |
| Podiatry | 28060 | Plantar Fasciotomy | $4,600 |
| Podiatry | 28119 | Heel Spur Excision | $4,255 |
| Podiatry | 28297, 28299 | Lapidus Bunionectomy | $14,260 |
| Podiatry | 17110 | Destruction Periungual wart/Laser | $1,955 |
| Podiatry | 27687-50/28465-50 | Bilateral Gastrocnemius Resection/ORIF Navicular | $15,410 |
| Podiatry | 28299 | First Metatarsal Prox Phalanx Osteotomy w/Screw Fixation | $9,775 |
| Podiatry | 28289 | Cheilectomy | $4,600 |
| Podiatry | 28750 | 1st Metatarsophalangeal Joint Fusion | $10,350 |
| Spine | 22551 | ACDF 1 level | $28,520 |
| Spine | 22552 | ACDF 2 level | $33,695 |
| Spine | 22552 | ACDF 3 level | $39,445 |
| Spine | 63030 | Microdisectomy 1 Level | $19,895 |
| Spine | 63047 | Laminectomy Lumbar Level 1 | $19,895 |
| Spine | 22612 | Lumbar Fusion 1 level | $34,845 |
| Spine | 22612, 22614 | Lumbar Fusion 2 level | $40,595 |
| Urology | 54161 | Circumcision | $3,450 |
| Urology | 52356 | Cystourethroscopy | $5,807 |
| Urology | 52010 | Cystoscopy | $3,507 |
| Urology | 52000 | Cystoscopy (In Office) | $402 |
| Urology | 52356 | Cystoscopy w/Lithotripsy | $5,807 |
| Urology | 52351 | CystoUrethroscopy w/Ureteroscopy | $4,658 |
| Urology | 50590 | Extracorporeal Shockwave (ESWL) | $5,191 |
| Urology | 54530 | Orchiectomy | $4,600 |
| Urology | 55250 | Vasectomy | $3,346 |
| Urology | 55250 | Vasectomy (In Office) Anusionwu | $1,012 |
| Urology | 55250 | Vasectomy (In Office) Johnston | $1,058 |
| Urology | 55530 | Excision of Varicocele | $4,381 |
| Urology | 55110 | Scrotal Exploration | $4,439 |
| Urology | 52601 | Transurethral Resection of Prostate (TURP) | $6,993 |
| Urology | 57288 | Midurethral Bladder Sling | $6,555 |
| Urology | 52441 | Urolift | $9,315 |
| Urology | 53854 | Rezum | $8,620 |
| Urology | 64590 | Interstim Trial | $8,050 |
| Urology | 64590 | Interstim Placement | $38,525 |
| Urology | 64595 | Interstim Revision or Removal | $9,200 |
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