| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $53 | $116 | $202 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $236 | $263 | $308 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $165 | $197 | $226 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $203 | $231 | $248 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $75 | $121 | $168 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $39 | $154 | $231 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $166 | $188 | $209 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $65 | $197 | $310 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $71 | $206 | $341 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $210 | $217 | $227 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $168 | $280 | $392 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $126 | $290 | $453 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $152 | $390 | $576 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $403 | $403 | $403 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $44 | $100 | $178 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $66 | $96 | $113 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $1 | $16 | $55 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $309 | $334 | $359 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $114 | $167 | $224 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $262 | $279 | $304 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $113 | $204 | $296 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $152 | $274 | $396 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $4 | $8 | $12 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $1 | $3 | $5 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $71 | $93 | $114 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $52 | $81 | $111 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $64 | $100 | $137 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $48 | $109 | $170 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $7 | $14 | $20 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $244 | $557 | $870 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $1,561 | $4,446 | $7,332 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $55 | $125 | $194 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $612 | $2,149 | $2,962 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $228 | $441 | $655 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $1,605 | $1,605 | $1,605 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $591 | $829 | $1,067 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $204 | $333 | $586 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $112 | $586 | $905 |
| Septoplasty CPT 30520 • ENT | $780 | $1,137 | $1,343 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $432 | $432 | $432 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $69 | $305 | $428 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $455 | $491 | $533 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $575 | $721 | $867 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $407 | $645 | $843 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $356 | $430 | $467 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $167 | $413 | $548 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $57 | $558 | $871 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $168 | $316 | $444 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $361 | $518 | $610 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $521 | $596 | $636 |