| Colonoscopy diagnostic | CPT | 45378 | 4 | $2,124.92 |
| Colonoscopy with biopsy | CPT | 45380 | 4 | $2,564.34 |
| Colonoscopy with polyp removal | CPT | 45385 | 4 | $2,927.15 |
| Knee arthroscopy with meniscectomy | CPT | 29881 | 4 | $3,147.95 |
| Shoulder arthroscopy with decompression | CPT | 29826 | 4 | $3,214.04 |
| Total hip replacement | CPT | 27130 | 4 | $7,441.14 |
| Total knee replacement | CPT | 27447 | 4 | $6,448.03 |
| Routine obstetric care including vaginal delivery | CPT | 59400 | 4 | $3,961.31 |
| Fetal non-stress test | CPT | 59025 | 4 | $230.34 |
| Upper GI endoscopy diagnostic | CPT | 43235 | 4 | $1,865.75 |
| Upper GI endoscopy with biopsy | CPT | 43239 | 4 | $1,950.33 |
| Sigmoidoscopy diagnostic | CPT | 45330 | 4 | $651.33 |
| Sigmoidoscopy with biopsy | CPT | 45331 | 4 | $1,539.99 |
| CABG single arterial graft | CPT | 33533 | 4 | $7,615.52 |
| CABG 2 arterial grafts | CPT | 33534 | 4 | $7,744.36 |
| Total shoulder arthroplasty | CPT | 23472 | 4 | $4,950.65 |
| Hip hemiarthroplasty | CPT | 27125 | 4 | $4,351.54 |
| Knee revision arthroplasty single component | CPT | 27486 | 4 | $5,145.79 |
| Knee revision arthroplasty all components | CPT | 27487 | 4 | $5,870.88 |
| Shoulder arthroscopy with rotator cuff repair | CPT | 29827 | 4 | $3,854.01 |
| ACL reconstruction | CPT | 29888 | 4 | $5,788.26 |
| Laparoscopic appendectomy | CPT | 44970 | 4 | $1,772.19 |
| Laparoscopic cholecystectomy | CPT | 47562 | 4 | $2,074.57 |
| Lap cholecystectomy with cholangiography | CPT | 47563 | 4 | $2,041.17 |
| Lap inguinal hernia repair | CPT | 49650 | 4 | $1,519.34 |
| Total abdominal hysterectomy | CPT | 58150 | 4 | $3,528.89 |
| Vaginal hysterectomy | CPT | 58260 | 4 | $2,858.59 |
| Lap-assisted vaginal hysterectomy | CPT | 58550 | 4 | $3,257.02 |
| Lap-assisted vaginal hysterectomy >250g | CPT | 58552 | 4 | $3,020.06 |
| Lap salpingo-oophorectomy | CPT | 58661 | 4 | $2,780.98 |
