| Colonoscopy diagnostic | CPT | 45378 | 4 | $1,344.47 |
| Colonoscopy with biopsy | CPT | 45380 | 4 | $1,682.78 |
| Colonoscopy with polyp removal | CPT | 45385 | 4 | $1,756.81 |
| Knee arthroscopy with meniscectomy | CPT | 29881 | 4 | $5,881.7 |
| Shoulder arthroscopy with decompression | CPT | 29826 | 4 | $4,337.28 |
| Total hip replacement | CPT | 27130 | 4 | $1,657.99 |
| Total knee replacement | CPT | 27447 | 4 | $1,509.04 |
| Routine obstetric care including vaginal delivery | CPT | 59400 | 4 | $3,872.48 |
| Routine obstetric care with C-section | CPT | 59510 | 4 | $3,482.14 |
| Vaginal delivery only | CPT | 59409 | 4 | $1,409.51 |
| Vaginal delivery with postpartum | CPT | 59410 | 4 | $1,943.89 |
| C-section delivery only | CPT | 59514 | 4 | $1,168.31 |
| Fetal non-stress test | CPT | 59025 | 4 | $289.15 |
| Upper GI endoscopy diagnostic | CPT | 43235 | 4 | $1,048.71 |
| Upper GI endoscopy with biopsy | CPT | 43239 | 4 | $1,245.11 |
| Sigmoidoscopy diagnostic | CPT | 45330 | 4 | $929.93 |
| Sigmoidoscopy with biopsy | CPT | 45331 | 4 | $1,050.09 |
| Total shoulder arthroplasty | CPT | 23472 | 4 | $7,835.9 |
| Hip hemiarthroplasty | CPT | 27125 | 4 | $1,814.04 |
| Knee revision arthroplasty single component | CPT | 27486 | 4 | $1,925.94 |
| Knee revision arthroplasty all components | CPT | 27487 | 4 | $2,234.19 |
| Shoulder arthroscopy with rotator cuff repair | CPT | 29827 | 4 | $13,039 |
| ACL reconstruction | CPT | 29888 | 4 | $8,314.66 |
| Laparoscopic appendectomy | CPT | 44970 | 4 | $794.85 |
| Laparoscopic cholecystectomy | CPT | 47562 | 4 | $5,541.49 |
| Lap cholecystectomy with cholangiography | CPT | 47563 | 4 | $934.53 |
| Lap inguinal hernia repair | CPT | 49650 | 4 | $5,517.05 |
| Total abdominal hysterectomy | CPT | 58150 | 4 | $1,264.55 |
| Lap-assisted vaginal hysterectomy >250g | CPT | 58552 | 4 | $1,550.4 |
| Lap salpingo-oophorectomy | CPT | 58661 | 4 | $5,390.92 |
