| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $64 | $99 | $134 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $167 | $245 | $400 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $109 | $156 | $251 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $131 | $138 | $152 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $114 | $186 | $259 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $49 | $79 | $125 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $138 | $230 | $322 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $168 | $223 | $277 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $258 | $258 | $258 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $154 | $255 | $355 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $212 | $241 | $299 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $599 | $599 | $599 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $264 | $304 | $384 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $254 | $254 | $254 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $75 | $120 | $165 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $72 | $78 | $84 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $2 | $12 | $26 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $182 | $287 | $393 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $109 | $117 | $122 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $9 | $118 | $204 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $116 | $135 | $172 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $157 | $183 | $208 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $6 | $28 | $50 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $2 | $3 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $9 | $43 | $60 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $41 | $100 | $160 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $61 | $235 | $409 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $23 | $82 | $141 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $7 | $43 | $60 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $73 | $512 | $732 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $710 | $3,542 | $6,373 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $23 | $156 | $223 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $264 | $1,689 | $2,402 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $203 | $206 | $208 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $544 | $853 | $1,162 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $441 | $447 | $452 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $184 | $187 | $188 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $355 | $379 | $425 |
| Septoplasty CPT 30520 • ENT | $777 | $795 | $814 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $729 | $729 | $729 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $224 | $371 | $666 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $307 | $315 | $331 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $384 | $454 | $525 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $390 | $399 | $417 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $217 | $222 | $232 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $319 | $562 | $1,047 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $456 | $1,061 | $1,667 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $211 | $219 | $227 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $346 | $381 | $451 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $363 | $370 | $383 |