| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $130 | $154 | $200 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $125 | $143 | $161 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $38 | $58 | $67 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $88 | $113 | $126 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $104 | $104 | $104 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $118 | $118 | $118 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $86 | $86 | $86 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $148 | $185 | $250 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $139 | $139 | $139 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $143 | $143 | $143 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $162 | $182 | $202 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $149 | $169 | $188 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $216 | $242 | $261 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $167 | $167 | $167 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $57 | $78 | $99 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $71 | $87 | $111 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $3 | $8 | $15 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $98 | $103 | $108 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $92 | $123 | $185 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $115 | $129 | $137 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $64 | $98 | $138 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $133 | $160 | $186 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $5 | $5 | $5 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $4 | $6 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $34 | $68 | $96 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $12 | $46 | $83 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $79 | $93 | $102 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $12 | $99 | $253 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $11 | $23 | $47 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $107 | $142 | $177 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $525 | $4,688 | $12,067 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $17 | $125 | $322 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $448 | $2,402 | $4,484 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $198 | $200 | $203 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $630 | $630 | $630 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $300 | $364 | $429 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $166 | $167 | $169 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $148 | $514 | $1,117 |
| Septoplasty CPT 30520 • ENT | $530 | $703 | $903 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $118 | $207 | $295 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $53 | $219 | $352 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $131 | $303 | $439 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $202 | $394 | $586 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $422 | $432 | $442 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $218 | $229 | $234 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $350 | $378 | $407 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $558 | $558 | $558 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $150 | $209 | $326 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $238 | $354 | $504 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $334 | $334 | $334 |